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RESPIRATORY SYSTEM By: Drugz INTRODUCTION  To carry out their metabolic processes, human cells o Utilize Oxygen (O2

) o Produce Carbon Dioxide (CO2 )  Two types of respiration: o Internal respiration  Exchange of gases between blood and the cells  Occurs in all tissues of the body o External respiration  Exchange of gases between blood and air  Occurs only in the lungs RESPIRATORY SYSTEM Function: External respiration Component Organs (from most external to the most internal):  Nose  Pharynx  Larynx  Trachea  Bronchi  Lungs (paired) Functionally, system is divided into:  Respiratory portion o Alveoli  Conducting portion o Nose to subdivisions of bronchial tree NOSE Description:  Hollow organ  Has two nasal cavities (fossae)  Fossae are separated by a nasal septum (cartilaginous wall)  Boundaries: o Anterior Anterior Naris; Nostril (orifice) o Posterior Posterior Naris (orifice)  Continuous with the pharynx o Medial wall Nasal Septum o Lateral wall (3) Nasal Turbinates or Conchae (Superior, Middle, and Inferior)  Linings: o Externally Skin o Internally Mucous membrane (mucosa)  *Except at the vestibule (partly lined by skin)  Mucosa moist lining  Consists of: y Epithelium y Lamina propria (loose connective tissue layer) y Third layer: Fibrous connective tissues or smooth muscle fibers (muscularis mucosae) o Separates mucosa from the underlying tissue

Framework:  Bone  Cartilage Anterior and posterior boundaries:  Nostrils or anterior nares  Posterior nares Parts:  External nose o Skin:  External cover  Continues into vestibule  Appendages y Sweat glands (numerous) y Sebaceous gland (numerous) y Hair (coarse and stiff in vestibule; gross filters for inhaled air)  Nasal Cavities (fossae) o Two (2) hollow structures o Parts:  Medial wall nasal septum  Roof  Floor  Lateral Wall y Contains nasal turbinates (superior, middle, inferior) o Mucous Membrane (mucosa)  Lines nasal cavity except at vestibule  Also lines digestive, genitourinary, and most of respiratory tract  Parts: y Epithelium it is usually **respiratory epithelium (ciliated pseudostratified columnar with goblet cells) except at the junction of vestibule and rest of nasal cavity (non-ciliated cuboidal or columnar) and the roof of the nose and some adjacent areas (olfactory epithelium) o Respiratory Epithelium (in most of nose)  Also lines most of the conducting portion of respiratory system  Six types of cells (in EM; all rest on the basal lamina) y Ciliated columnar cell o Most abundant o Up to 300 cilia on its free surface o Moves secretions and particulate materials y Goblet cell o Secretes mucus y Brush cell o A columnar cell o Has microvilli (instead of cilia)

Sensory cell associated with afferent nerve ending y Serous cell o A columnar, non-ciliated cell o With dense apical granules o Serous secreting (less viscous than that of Goblet cells) y Basal cell o It is a short and rounded stem cell y Granule cell o Looks like basal cell (a.k.a. Kulchitsky cell) o Has numerous electron dense secretory granules in cytoplasm o Neuroendocrine cell similar to those in GIT o Helps regulate function of secretory and muscle cells o Nonciliated cuboidal or columnar (at junction of vestibule and rest of nasal cavity) o Olfactory Epithelium (Roof of nose and some adjacent areas)  A.K.A. Organ of Olfaction  Location: y Roof of nasal cavity y Superior turbinate y Superior portions of septum  Pseudostratified columnar epithelium y Tall, about 60 micrometers in thickness y Grossly, yellowish-brown (vs. pink for rest of nasal mucosa) y Contains receptors for sense of smell y No goblet cells y Basal lamina is indistinct  Lamina Propria y Contains MALT y Richly supplied with blood and lymphatic vessels y Loose lymphoid tissue y Glands of Bowman (olfactory glands) o Branched tubuloalveolar glands o Secretes serous fluid that moistens the epithelial surface and serves as a solvent for odiferous substances  Cells: y Sustentacular (supporting) cells o Tall, slender cells; broad at apex; narrow at base o

Free (apical surface) contains long, slender microvilli (bathed with mucus) o Nucleus ovoid; off-center o Cytoplasm contains:  Numerous Smooth Endoplasmic Reticulum  Small Golgi Complex  Lipofuschin granules (pigment granules) responsible for the yellowish brown color of the olfactory area y Olfactory Cells o Spindle shaped o Bipolar Neurons (lies between sustentacular cells)  Nuclei situated between those of sustentacular and basal cells  Dendrite  Terminate in olfactory vesicle (small, bulb-like expansion) on the surface of epithelium  Olfactory cilia (6-10 radiate from olfactory vesicle; non-motile but long; actual receptors)  Axons (olfactory nerve fiber)  Unmyelinated  0.2 mm in diameters  Form many small bundles (fila olfoctoria; olfactory nerves) that enters cranial cavity through perforations in cribriform plate (of the ethmoid bone) to terminate in the olfactory bulb. y Basal Cells o Small, rounded or conical o Deeply-staining o Found between the bases of the sustentacular cells and olfactory cells o They have branching cytoplasmic processes o Nuclei dark and ovoid o Stem cells for the other two (olfactory cells and sustentacular cells) y Lamina Propria o Connective tissue with  Mucus glands and Serous glands (secretions keeps the nasal cavity moist)  Mast cells o

 MALT o Contains rich venous plexuses (at the area of the nasal turbinates)  Venous plexuses serves to warm the air that passes through the nose o Blends with periosteum or perichondrium o **Paranasal Sinuses  Cavities in bones of skull that arose as invaginations of nasal mucosa  Makes the face less heavy by reducing its bony mass  Serve as resonating chambers for speech  Frontal, Maxillary, Ethmoidal, and Sphenoidal  Walls lined by mucous membrane y Epithelium o Respiratory epithelium  Is thinner and has fewer goblet cells compared to that of the nasal cavity o Direction of ciliary movement of cells is towards nasal cavity y Lamina propria o Very few glands o Merges with periosteum of underlying bones PHARYNX  Funnel-shaped; fibromuscular tube  Extends from the base of the skull to the level of the hyoid bone  Common to digestive and respiratory systems  Continuous with esophagus  Subdivisions (from above downwards, the pharynx is behind): o Nasopharynx (Nasal cavity) o Oropharynx (Oral cavity) o Laryngopharynx (larynx)  Histological layers o Mucosa  Epithelium y Nasopharynx o It is filled with respiratory epithelium (ciliated psudostratified columnar with goblet cells) except for areas subjected to friction (stratified squamous nonkeratinized epithelium) and roof (stratified columnar ciliated epithelium) y Oropharynx and Laryngopharynx o Both have stratified squamous nonkeratinized epithelium  Lamina Propria y Relatively dense connective tissue with some elastic fibers y Rich in MALT o Pharyngeal tonsils (posterior wall of the nasopharynx)

Palatine tonsil (lateral wall of the oropharynx) o Tubal tonsil (around the opening of the Eustachian tubes in the nasopharynx) y Glands o Pure Mucous in areas lined by stratified squamous epithelium o Mixed In areas lined by respiratory epithelium o Submucosa  Consists of loose connective tissue  Present only in: y Lateral wall of nasopharynx y Terminal portion of laryngopharynx  Separated from lamina propria by thick, dense elastic layer (not muscularis mucosa, as in rest of GIT)  Blends with the connective tissue that envelops the muscle bundles of the underlying muscularis externa o Muscularis externa  Consists of muscle fibers  2 layers of skeletal muscle: y Inner longitudinal y Outer circular or oblique layer o Adventitia  Connective tissue that envelops muscularis externa externally  Blends with surrounding structures o LARYNX (Voice Box)  Also serves an important role in phonation  Connects the pharynx to the trachea  Framework is formed by cartilage o Three unpaired cartilages thyroid, cricoids, and epiglottic o Three paired cartilages corniculate, cuneiform, and arytenoids o **HYALINE Cartilage Thyroid, cricoids, and arytenoids (except for tips, which are ELASTIC) o **ELASTIC Cartilage Epiglottic, corniculate, cuneiform, and tip of arytenoids o Held together by ligaments and membranes o Serve as attachment for two groups of skeletal muscles (Extrinsic muscles and Intrinsic muscles)  Extrinsic Muscles o Connect larynx to surrounding structures o During deglutition, their contraction raises the larynx  Intrinsic Muscles o Originate and insert within the larynx o Serves to open and close the rima of glottis o Also serves to regulate tension of vocal cords  Mucosa lines internal surfaces of larynx o Epithelium  Non Keratinized Stratified Squamous

Over anterior surface and upper half of posterior surface of epiglottis, aryepiglottic folds, and vocal cords  Respiratory Epithelium y Rest of larynx y Direction of the ciliary movement upwards, towards the pharynx o Lamina propria  Thick with elastic fibers  MALT has some lymph nodules  Has large tubuloalveolar glands mainly mucus-secreting  In epiglottis, glands similar to salivary glands  Blends with muscle layer or endochondrium of cartilage o **Laryngeal mucosa blends with the endochondrium of the cartilages, the connective tissue that envelops laryngeal muscles, and the ligaments and membranes that bind the cartilages together y TRACHEA  Description o Permanently patent tube o Extends from the cricoids cartilage o Communicates with the larynx to the level of the sternal angle o Bifurcates to form two (left and right) main bronchi  Histologic Layers o Mucosa  Epithelium y Respiratory epithelium o Very thick basal lamina o Abundant goblet cells  Lamina propria y Loose connective tissue y Contains MALT y In deep layer elastic fibers form a band that separates the lamina propria from submucosa o Submucosa (Tracheal)  Loose connective tissue  Bronchial Submucosal Glands y Tubuloalveolar glands y Mixed glands o Cartilage and Muscle layer  Most characteristic features  16-20 C-shaped hyaline cartilages (keeps the lumen of the organ permanently open; they are opened posteriorly and stacked vertically)  Trachealis muscle (thick layer of smooth muscle fibers) and fibroelastic ligament y Bridge the open end  Trachealis muscle can decrease the luminal diameter of the trachea by contracting o Adventitia

Loose connective tissue that blends with surrounding structures

BRONCHI  Main bronchi o Morphologically similar to trachea, except:  Smaller caliber  Thinner respiratory epithelium  Fewer submucosal glands  Discontinuous smooth muscle layer (instead of elastic tissue) separates mucosa from submucosa  Cartilages (instead of C-shaped) are in form of discontinuous rings around the lumen o As in the Trachea  The gaps between the cartilages in the main bronchi are bridged by smooth muscle fibers o Rest of bronchial tree  *discussed with lungs o Right main bronchi supply the right lung o Left main bronchi supply the left lung

LUNGS  Description: o Pair of conical organs o Occupies the greater part of the thoracic cavity o Heart and other structures in the mediastinum separates the lungs from each other o Parts:  Apex rises to the neck  Base rests on the diaphragm o Borders:  Anterior  Inferior  Posterior o Surfaces:  Costal surface related to the ribs and the costal cartilages  Mediastinal surface presents hilus (triangular depression where the structures that comprise the root of the lung enter and leave the organ) o Structures that comprise each root of the lung:  Main bronchus  Pulmonary artery  Pulmonary veins  Bronchial arteries  Bronchial veins  Lymphatic vessels  Nerves o Lobes of the heart (divided by fissures)  Right lung three lobes  Left lung two lobes  Pleura o Double layer of fibrous tissue that envelop lung o 2 parts (which are continuous with each other at the root of the lungs):  Parietal pleura


y Outer layer y Adheres to thoracic wall  Visceral pleura y Inner layer y Adheres to substance of lung o Pleural Cavity  Between two layers of pleura  In life, contains small amount of serous fluid o Histological structure  Connective tissue y abundant in collagenous and elastic fibers y Fibroblasts and Macrophages relative paucity of cellular elements  Surface of both layers related to pleural cavity is lined by mesothelium Two (2) conical organs: RIGHT and LEFT Occupy most of thoracic cavity LOBES o Right lung 3  Upper  Middle  Lower o Left lung 2  Upper  Lower Bronchial Tree o More than twenty (20) generations of braches that each main bronchus gives off o Bronchi (Main Bronchi extrapulmonary bronchi; Secondary, Tertiary, Other Generations of Bronchi intrapulmonary bronchi)  Main bronchi y Divides and give off secondary bronchi  Secondary bronchi (lobar branch) y Supplies a lung lobe; One per lung lobe o Right main bronchus 3 o Left main bronchus 2 y Divides further into tertiary bronchi  Tertiary bronchi (segmental bronchi) y From secondary bronchi o Right lung 10 bronchopulmonary segments o Left lung 8 bronchopulmonary segments y *Tertiary bronchus and area of lung it supplies Bronchopulmonary segment y Gives off other generations of smaller bronchi  Other generations y Latest generation is smaller than the previous generation  ***Extrapulmonary Bronchi and Intrapulmonary Bronchi (Differences): y Bigger intrapulmonary bronchi similar to extrapulmonary bronchi, except that in intrapulmonary bronchi:

Mucuous membrane thrown into folds (consequence of the contraction of the smooth muscle layer) o Epithelium is lower y Smaller bronchi o Cartilage rings are in the form of irregular plates that form incomplete rings or isolated plates in really small ones o Circular band of smooth muscle fibers that separates the lamina propria from the submucosa is more prominent o Goblet cells considerably fewer o Lesser cartilage o Progressively lower epithelium y In terms of LOCATION o Extrapulmonary bronchi main bronchi before they enter the lung o Intrapulmonary bronchi all the bronchi that are within the lung o Bronchioles  Supplies a lung lobule (30 to 60 per bronchopulmonary segment)  Gives off terminal bronchioles  Incomplete fibrous septa separates the lung lobules  Arise after several generations of branches of bronchi  Smaller caliber than bronchi (less than 1 mm in diameter)  Wall has NO: y Cartilage y Submucosal gland y Lymphoid nodule  Epithelium y Ciliated, but progressively diminishes in height thus transforms from pseudostratified to simple columnar to simple cuboidalal distally y In larger bronchioles, cells the same as in respiratory epithelium, except: o No serous cells o Few goblet cells y In smaller bronchioles: o No goblet cells o Presence of CLARA CELLS o ***CLARA CELLS  Cuboidal, nonciliated cells  Rounded apices contain microvilli  Contains dense secretory cytoplasmic granules y Protect bronchiolar lining y Form a non-sticky layer that helps keep bronchioles patent  Humans present only in the bronchioles  Lower animals present even among the bronchi o

Lamina propria of a bronchiole y Contains MALT y Separated from the submucosa by a smooth muscle layer  Submucosa y Merges with the lung parenchyma  Ramifies repeatedly  Final branches (lobular bronchioles) supplies lung lobule  Enters lung lobules at apex in the company of the interlobular branches (branches that supply the lung lobule)  Counterpart of intralobular ducts of glands  Lung Lobules y 30-60 per bronchopulmonary segment y Separated by incomplete fibrous septa y Vary greatly in size and shape o Peripheral lobules pyramidal o Centrally located lobules irregular in shape o Terminal Bronchioles  5-7 per lobular bronchiole  Epithelium is simple cuboidal y With patches of cells containing cilia y Brush cells, granule cells, basal cells and numerous CLARA CELLS y No goblet and serous cells y Largely nonciliated (but some ciliated cells still persist)  Lamina propria and submucosa also present and are separated from each other by smooth muscle fibers  Gives rise to Respiratory Bronchioles o Respiratory Bronchioles  2 or more or terminal bronchiole  Short (1-4 mm), branching tubes with diameters of less than 0.5 mm  Lining epithelium y Initially simple cuboidal then becomes simple squamous peripherally y Numerous CLARA CELLS  Few smooth muscle cells still present under epithelium  Not sites of actual gas exchange between capillaries and inhaled air  Gives off any or all three terminal segments of bronchiol tree y Alveolar ducts branch further to give off alveolar sacs and alveoli y Alveolar sacs clusters of alveoli y Alveoli o Alveolar ducts  2-11 or respiratory bronchiole  Cone-shaped, thin-walled tubes  Give off numerous y Alveoli y Alveolar sacs clusters of alveoli

Wall y Only knobs because of numerous alveoli branching off y Lined by simple squamous epithelium y With connective tissue and occasional smooth muscle fibers o Alveolar sacs  Clusters of alveoli o Alveoli  Thin-walled polyhedral sacs  REMEMBER Site of gas exchange between blood and air  Around 300 million on both lungs  Arise as individual units or as a cluster (alveolar sac) from either respiratory bronchioles or alveolar ducts  Open on one side to allow entry of air  Interalveolar septum y Common wall shared by adjacent alveoli y Alveoli packed so closely that each one does not have a separate wall y Contains Alveolar pores o Little round holes in interalveolar septum (2-13 micrometer diameter) o Allow direct communication between adjacent alveoli o Route for migration of macrophages o Covered by and are storage sites of surfactant y Has three components Connective tissue, epithelium, and capillaries y Connective tissue o thin supporting framework of the structure (0.2 micrometers in most places) o Contains collagen, elastic and reticular fibers, and several types of cells (mast cells, plasma cells, lymphocytes, and interstitial fibroblasts  Interstitial fibroblasts contain more actin filaments than ordinary fibroblasts; they are possibly contractile y Simple squamous epithelium on luminal surfaces y Capillaries o embedded in connective tissue o lined by endothelial cells y Epithelium has 2 types of cells: o Type I-alveolar cell  A,K.A. Pulmonary epithelial cell; small alveolar cell; pneumonocyte type I cell  Less in number  Stretched thinly  0.2 micron thick except in area of nucleus  Covers 95% of alveolar surface

y o o o o

y o o o o o o o

Form tight junctions with other type I and type II-alveolar cells  Rest on basal lamina, supported by small amount of connective tissue (except in areas of the epithelium that are associated with capillaries)  In areas associated with capillaries, basal lamina is in direct contact with basal lamina of capillary cells; sometimes 2 basal laminae fuse Type II-alveolar cell  A.K.A. Great alveolar cell or pneumonocyte type II cell  More in number  Much larger  But account only for 5% of epithelial cover  Occurs in between type I cells  Occur singly or in clusters  Bulges into the alveolar lumen or occupies niches in alveolar wall  Cuboidal or round cells  Prominent nucleolus  Free surface contains short microvilli  Lamellar bodies in cytoplasm y Membrane bound inclusions y Secretory granules for pulmonary surfactant o Reduces alveolar surface tension o Prevents collapse of alveoli at end of expiration Other cells in connective tissue of septum Mast cells Plasma cells Lymphocytes Interstitial fibroblasts  More actin filaments than ordinary fibroblasts  Possibly contractile Pulmonary alveolar macrophages Most numerous cells in alveoli Not part of interalveolar septum Float freely in alveoli First line of defense of lungs Avid scavengers DUST CELLS pulmonary alveolar macrophages with dust particles Arise from monocytes

BLOOD-AIR BARRIER o Ultra-thin wall o Separates blood in a pulmonary capillary from air in alveolus o Composed of:  Pulmonary epithelial cell  Basal lamina of the alveolar epithelium  Basal lamina of the capillary endothelium  Capillary endothelial cell  BLOOD VESSELS (no communication between arteries except in terminal branches) o Pulmonary artery  Branches y Brings blood to lungs for oxygenation y Accompany bronchial tree up to respiratory bronchiole y Then form rich capillary network in the interalveolar septa  Venules (tributaries of the pulmonary veins) in interlobular connective tissue collect oxygenated blood  From apex of lung lobule, veins accompany arteries o Bronchial artery  Arise, directly or indirectly from aorta  Supply with oxygenated blood walls of bronchial tree down to level of respiratory bronchioles, pleura, and connective tissue of lungs  Most of blood from bronchial arteries drain pulmonary veins  Some is drained by bronchial veins which drain into AZYGOS system  Branching pattern within lobule same as pulmonary artery  But branches of bronchial artery have smaller caliber and thicker walls than those of the pulmonary artery in relation to lumen  At the apex of the lobule the vein that drain the lobule, the branches of the pulmonary and bronchial arteries that supply the lobule, and the bronchiole come together and accompany each other as far as the hilus of the lung o Lymphatic vessels  Travel in the interlobular septa  Continuous with the bigger lymphatic vessels beneath the pleura (Based on Dr. Eduardo Gonzales book)