Respiratory System

Dr. Ameet Kumar Jha, Ph.D.,(Med)

Associate Professor, Anatomical Sciences
School of Medicine, Saint Matthews University

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 Organization of the respiratory system
 Two parts - histologically and functionally
 Conducting portion
 conditions air and bring it into the lungs
 ends at terminal bronchioles
 NO GAS EXCHANGE occurs here
 Respiratory portion
 gas exchange occurs here
 respiratory bronchioles, alveolar ducts, alveolar sacs,
and alveoli

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 Upper respiratory system
Respiratory functions
• Filters, warms, and humidifies incoming air
• Protects delicate lower respiratory tract
• Reabsorbs heat and water in outgoing air

Non-respiratory functions
• Speech and Olfaction
• Endocrine
• Immune responses

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 Lower respiratory tract
• Conducts air to and from gas exchange surfaces

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 Respiratory epithelium
• Pseudostratified ciliated columnar epithelium
• Sits on a very thick basement membrane (BM)
• The lamina propria is well-vascularized (BVs)

Pseudostratified ciliated epithelium

BM

BVs

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 Cells in respiratory epithelium
• Ciliated columnar cells - the majority
• Goblet cells - secrete mucin glycoproteins (hydrated to mucous)
• Brush cells - rare and sparsely scattered columnar cells - microvilli.
• chemosensory receptors
• Small granule cells (of Kulchitsky) – rare, possess numerous dense core
granules
• part of the diffuse neuroendocrine system (DNES)
• origin of bronchial carcinoid tumors
• Basal cells – rest on basement membrane, do not extend to the luminal
surface
• stem cells that give rise to the other cell types

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Changes in respiratory epithelium
Nose

Vocal cords

Trachea and bronchi

Bronchioles

Alveoli

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 Nasal cavities
• Left and right nasal cavity each has two components:
• internal nasal cavities (or fossae)
• external vestibule – most anterior and dilated portion
• Skin in nose up to the vestibule has coarse vibrissae (hairs) that filter out particulate material
from the inspired air
• Epithelium transitions to respiratory epithelium before entering the nasal fossae

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 Nasal cavities
• Vestibule – stratified squamous epithelium
• Middle and inferior conchae - respiratory epithelium
• Superior conchae - specialized olfactory epithelium
• Lamina propria of the conchae contain large venous plexuses known as
swell bodies
• every 20–30 minutes, the swell bodies on one side become temporarily engorged
with blood, resulting in distension of the conchal mucosa and a concomitant
decrease in the flow of air
• during this time, most of the air is directed through the other nasal fossa, allowing
the engorged respiratory mucosa to recover from dehydration

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 Olfactory epithelium
• Roof of the nasal cavity and on the
superior nasal conchae
• Tall pseudostratified columnar
epithelium
• consists of
• olfactory receptor (bipolar neurons)
cells
• supporting (sustentacular) cells
• basal cells (stem cells)
• brush cells – similar to respiratory epi.

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 Olfactory epithelial cells

• Bipolar neurons
• bulbous apical end - olfactory
vesicle
• olfactory cilia – olfactory hairs
• very long, nonmotile cilia
• receptors for odor

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 Olfactory epithelial cells

• Supporting (sustentacular) cells

• nuclei are more apically located
• have many microvilli
• Basal cells
• rest on the basal lamina
• regenerate all three cell types of
the olfactory epithelium

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 Olfaction epithelium
• Serous glands (glands of Bowman) in lamina propria
• produce serous fluid
• containing odorant-binding protein (OBP) - binds odor molecules
• flushes the epithelial surface, preparing the receptors to receive
new odorous stimuli

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 Olfaction neuron
• dendritic end is the apical (luminal) pole of the cell
• apex has a knoblike swelling with dozen basal bodies
• long nonmotile cilia (olfactory hair) extend from the basal bodies
• cilia membrane contain the chemoreceptors that respond to
odoriferous substances

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 Olfaction epithelium

Olfactory epithelium-pseudostratified

Ducts of glands of Bowman

Glands of Bowman

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 Paranasal sinuses
• Bilateral cavities in the frontal, maxillary, ethmoid, and sphenoid bones of
the skull
• Lined by a thinner respiratory epithelium with fewer goblet cells
• Communicate with the nasal cavities
Medical application
• Sinusitis is an inflammation of the sinuses that may persist for long
periods of time, mainly because of obstruction of drainage orifices
• Chronic sinusitis and bronchitis are components of immotile cilia
syndrome, which is characterized by defective ciliary action

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 Nasopharynx

• posterior to the nasal cavities

• first part of the pharynx
• continues caudally with the oropharynx
• Lined by respiratory epithelium
• contains
• medial pharyngeal tonsil and
• bilateral openings of the auditory tubes

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 The larynx
• connects the pharynx to the trachea
• wall is supported by
• hyaline cartilage (thyroid, cricoid, and lower
part of arytenoids)
• elastic cartilages (epiglottis, corniculate, and
tips of arytenoids)

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 The larynx – vocal cords
• Vocal cords (true vocal cord) consist of
• skeletal muscle (the vocalis muscle)
• the vocal ligament (formed by a band of
elastic fibers)
• covering of stratified squamous
nonkeratinized epithelium
• Variations in the opening between the
vocal cords affect pitch of sounds
• Vestibular folds (false vocal cords) lie
superior to the vocal cords
• covered by stratified squamous
nonkeratinized epithelium
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 The larynx – vocal cords
FVC

FVC – false vocal cord

TVC – true vocal cord

FVC
TVC

TVC

TVC-transition

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 The trachea
• Is 12-14 cm long
• respiratory mucosa
• seromucous gland in lamina propria
• submucosa are 16–20 C-shaped rings of hyaline
cartilage in submucosa
• C-shaped cartilage bridged posteriorly by a
• bundle of smooth muscle (trachealis muscle)
• fibroelastic tissue attached to the perichondrium

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 Trachealis muscle
• relaxes during swallowing
• to facilitate the passage of food by allowing the
esophagus to bulge into the lumen of the trachea
• contracts during the cough reflex
• to narrow the tracheal lumen and provide for
increased velocity of the expelled air

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 Tracheal wall

Pseudostratified epithelium

Seromucous glands

Cartilage

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 Mucociliary escalator

• Describes the flow of mucus and trapped debris

• Sticky mucus produced by mucous (goblet) cell
and mucous glands
• Traps debris/particles
• Moved by beating cilia toward pharynx
• Swallowed (to be destroyed by acids in stomach)
or coughed out

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 The bronchial tree
• trachea divides into two primary (main)
bronchi
• primary bronchi gives rise to secondary
(lobar) bronchi
• three in the right lung
• two in the left lung
• each supplies a pulmonary lobe
• Lobar bronchi divide to form tertiary
(segmental) bronchi
• color-coding of the major branches of the
bronchial tree

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 Bronchopulmonary segment
• Each tertiary or segmental bronchi together with the smaller branches
it supplies, constitutes a bronchopulmonary segment—each with its own
connective tissue capsule and blood supply
• The existence of such lung segments facilitates the specific surgical
resection of diseased lung tissue without affecting nearby healthy tissue

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 Bronchi, bronchiole and pulmonary lobule
 The tertiary bronchi give rise to bronchioles
 Each bronchiole enters a pulmonary lobule
 then branches into 5-7 terminal bronchioles
 Each lobule is delineated by a thin connective tissue septum, best seen in the
fetus

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 Bronchial structure
• Wall of the larger bronchi is similar to tracheal mucosa except for the
organization of cartilage and smooth muscle
• Extrapulmonary primary bronchi - most cartilage rings completely
encircle the lumen
• Intra-pulmonary bronchi - isolated plates of hyaline cartilage occur
• Bronchial lamina propria has crisscrossing bundles of smooth muscle
• become more prominent in the smaller bronchial branches
• Contraction of this muscle layer is responsible for the folded appearance
of the bronchial mucosa observed in histologic section

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Tertiary or segmental bronchus
 respiratory epithelium (E)
 smooth muscle (SM)
 hyaline cartilage (C)
 seromucous glands (G) in the
submucosa

 arteries and veins (V)

 lung tissue (LT)

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 Bronchioles
• Intralobular airways with diameters of 5 mm or less
• No cartilage or glands in mucosa
• Larger bronchioles - ciliated pseudostratified columnar
• Smaller terminal bronchioles - ciliated simple columnar or cuboidal epithelium
• goblet cells disappear
• numerous columnar cells (exocrine bronchiolar cells Club or Clara cells)
• Mitotically active cells, secrete surfactant and have various important defense roles
• Scattered neuroendocrine cells produce serotonin and other peptides (local smooth muscle control)
• Neuroepithelial bodies, occur in some bronchioles
• innervated by autonomic and sensory fibers and to function as chemosensory receptors in
monitoring air O2 levels.

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 Large bronchiole
• respiratory epithelium (E)
• prominent smooth muscle
• (arrows)
• supported only by fibrous
connective tissue (C)

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 Small bronchiole
• simple low columnar epithelium (E)
• several layers of smooth muscle cells (arrows) comprise a high
proportion of the wall

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 Epithelial transition

Simple cuboidal epithelium

Simple columnar epithelium

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 Respiratory bronchioles
• terminal bronchiole subdivides into two or more
respiratory bronchioles
• mucosal is interrupted by the openings to
alveoli where gas exchange occurs
• portions lined with ciliated cuboidal epithelial
cells and Clara (club) cells
• smooth muscle and elastic connective tissue
support the epithelium

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• The micrograph shows the
branching nature of the
bronchioles in two
dimensions

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 Alveolar ducts, atrium, alveolar sacs and alveoli

• Branch of respiratory bronchioles

• completely lined by openings of
alveoli
• lined with squamous alveolar cells-
type I alveolar cells/pneumocytes
• elastic and collagen fibers provide
support for duct and its alveoli
• open into atria of two or more
alveolar sacs

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 Alveoli
• saclike evaginations of the respiratory bronchioles, alveolar ducts, and
alveolar sacs
• O2 and CO2 are exchanged between air in alveoli and blood in capillaries
• interalveolar septum - wall between two neighboring alveoli

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 Interalveolar septum
• wall between two neighboring alveoli
• has richest capillary network
• pores occur in the interalveolar septum
• pores connect neighboring alveoli opening to
different bronchioles
• pores equalize air pressure in the alveoli and
promote collateral circulation of air when a
bronchiole is obstructed

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 Blood-air-barrier
• Alveolar capillaries are closely apposed to the alveolar lumen (in
the interalveolar septum)
• Blood-air barrier consists of
• cytoplasmic extensions of type I alveolar cells
• dual basal lamina, synthesized by type I alveolar cells and
endothelial cells
• cytoplasmic extensions of continuous endothelial cells
• Gas exchange occurs by passive diffusion

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 Type I alveolar cells
• aka type I pneumocytes or squamous alveolar cells
• cover 97% of the alveolar surface (type II cells cover the remainder)
• very thin cells
• organelles are grouped around the nucleus
• much of the cytoplasm is virtually free of organelles
• this reduces the thickness of the blood-air-barrier
• form desmosomes and occluding junctions that prevent the leakage of
tissue fluid into the alveolar air space

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 Type II alveolar cells
• aka type II pneumocytes
• forms desmosomes and occluding junctions with type I cells
• divide by mitosis to replace their own population and the type I
population
• characteristic vesicular or foamy cytoplasm in histologic sections
• vesicles are caused by the presence of lamellar bodies
• contain concentric or parallel lamellae limited by a unit membrane
• Lamellar bodies contain phospholipids, glycosaminoglycans, and proteins,
(surfactant)
• surfactant reduces surface tension on the alveoli

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 Ultrastructure of type II alveolar cells
• Arrows indicate lamellar bodies which store newly
synthesized pulmonary surfactant after processing of its
components in rough ER (RER) and the Golgi apparatus (G)
• Smaller multivesicular bodies with intralumenal vesicles are
also often present.
• Short microvilli are present and the type II cell is attached
via junctional complexes (JC) with the adjacent, very thin
type I epithelial cell
• The ECM contains prominent reticular fibers (RF)

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 Alveolar macrophages
• aka called dust cells, are found in alveoli and in the interalveolar septum
• phagocytose erythrocytes lost from damaged capillaries and air-borne
particulate matter that has entered alveoli
• active macrophages in lung are often slightly darker due to their content
of dust and carbon from air and complexed iron (hemosiderin) from
erythrocytes
• Filled macrophages have various fates:
• most migrate into bronchioles and move up the mucociliary escalator
• exit the lungs in the lymphatic drainage
• remain in the interalveolar septa connective tissue for years

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 Pleura
• serous membrane that covers outer surface of lung and internal wall of
the thoracic cavity
• simple squamous mesothelial cells
• part attached to lung tissue is called the visceral pleura
• part lining the thoracic walls is the parietal pleura
• two layers are continuous at the hilum of the lung
• between the parietal and visceral layers is the pleural cavity
• mesothelial cells normally produce a thin film of serous fluid

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 Pleura
Diagram illustrates the parietal pleura lining
the inner surface of the thoracic
cavity and the visceral pleura covering the
outer surface of the lung. Between these
layers is the narrow space of the pleural
cavity.

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