Respiratory System

The respiratory system can be divided into:

I. Conducting portions: are specialized to carry air to and from the sites of
gas exchange.
They include: nasal cavity, nasopharynx, larynx, trachea, bronchi, bronchioles
and terminal bronchioles.
II. Respiratory or functioning portions:
are specialized for gas (O2 & CO2) exchange between the blood in capillaries
and air in alveoli of the lungs.
They include: respiratory bronchioles, alveolar ducts, alveolar sacs and alveoli.
Nasal cavities:
➢ They are 2 cavities separated by nasal septum.
➢ The wall of the cavity (from outside inwards) is formed of: skin,
striated muscle,
hyaline cartilage and spongy bone and mucous membrane.
➢ The mucous membrane is formed of epithelium and underling
corium. It differs according to region.
➢ In the vestibule of the nose: keratinized stratified squamous
epithelium then non-keratinized.
➢ In respiratory area (nasal cavity proper): pseudostratified columnar ciliated with goblet cells
(respiratory epithelium).
➢ In olfactory area (organ of smell): is pseudostratified columnar ciliated without goblet cells
and without distinct basal lamina(neuroepithelium). It extending over part of roof of nasal
cavity and small portions of upper ⅓ of nasal septum and superior nasal concha.
It differentiated into:
Olfactory cells:
➢ Are slender fusiform bipolar nerve cells arranged perpendicular to surface.
➢ They have modified cylindrical dendritic process ending on surface as bulblike swelling
(olfactory vesicle or knob) which giving rise to olfactory cilia (10-24 of variable length and
embedded within thick mucus layer).
➢ The cytoplasm contains typical well-developed basal bodies with cilia shafts, neurofilaments,
neurotubules, numerous mitochondria and SER.
➢ Nuclei are rounded in lower half.
➢ Its function is to sense odoriferous substances

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Supporting (sustentacular) cells :
➢ Are slender tall columnar on basal lamina with numerous long slender microvilli at free
surface.
➢ Connected to adjacent olfactory cell by many junctional complexes except gap junctions.
➢ The cytoplasm contains apical well-developed terminal web, small supranuclear Golgi,
numerous mitochondria, some rER, abundant SER, lysosomes, tonofilaments, lipid droplets and
lipofuscin granules .
➢ Nuclei are oval, pale and in upper half of cells.
Basal cells:
➢ Small conical or round on basal lamina with some basal branching processes but without
reaching the free surface.
➢ Cytoplasm rarely contains poorly-developed organoids.
➢ Nuclei are dark, rounded and frequently invaginated.
➢ Capable of division and differentiation into supporting
cells and olfactory cells.
Brush cells:
➢ Few with thick short apical microvilli.
➢ Probably receive ordinary sensation in olfactory mucosa.
Respiratory cells: Single ciliated, may be observed.
Nasopharynx
➢ The nasal cavities open posteriorly into the nasopharynx.
➢ It is wall is lined by respiratory epithelium and has a corium of C.T. rich in elastic fibers,
mucous glands and lymphatic tissue (pharyngeal tonsils) and supported by bone and skeletal
muscles.
Larynx
It lies between the base of the oropharynx and the trachea. The wall is formed of:
Mucosa:
Epithelium: is of 3 types :respiratory epithelium, non-keratinized stratified squamous
epithelium(on anterior surface, tips of epiglottis, and vocal cords) and neuroepithelium (in taste
buds on anterior surface of epiglottis).
Corium: loose C.T. rich in elastic fibers and contains lymph nodules and glands.
Cartilages: several laryngeal cartilages. The laryngeal cartilages may be hyaline as thyroid,
cricoid and arytenoids cartilages or elastic as cuneiform, corniculate and epiglottic cartilage.
Muscle: striated arranged into extrinsic for deglutition and intrinsic for speech.
Adventitia: loose C.T.

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Epiglottis
Flap or spoon like organ, cover for the larynx.
Vocal cords
False vocal cords: are the upper pair of folds. They are covered with respiratory epithelium.
True vocal cords: are the lower pair of folds. They are covered with stratified squamous
Trachea
The wall of the trachea consists of 4 definable layers:
Mucosa:
Epithelial lining: is pseudo-stratified columnar ciliated with goblet cells (respiratory epithelium).
Basement membrane: is thick distinctive layer which is characteristic to the tracheal
epithelium.
Lamina propria: is loose C.T. layer rich in lymphocytes, plasma
cells, mast cells, eosinophils,
fibroblasts, elastic fibers, blood vessels, lymphatics and
seromucous glands.
Elastic membrane: marks the boundary between the lamina
propria and submucosa. In H&E
preparation, however the boundary is not obvious.
Submucosa: C.T. with blood vessels, lymphatic, nerves and
mixed tubuloaveolar gland.
Cartilage and Muscle:
The hyaline cartilage of trachea is arranged into the characteristic 16-20 C-shaped cartilage
rings that open posteriorly, where the esophagus is located. Fibroelastic fibers and smooth
muscle fibers (trachealis muscle) are found potsteriorly.
Adventitia:
Thin C.T. layer which surrounding the trachea. It contains the largest blood vessels and nerves
that supply the tracheal wall, as well as the larger lymphatics that drain the wall.
Bronchi
The trachea divides into 2 extra pulmonary bronchi (primary).
Primary bronchi penetrate the hilum of each lung, forming
secondary bronchi.
Extra pulmonary bronchi (primary): Their structure is similar to
that of trachea.
Intra pulmonary bronchi (secondary):
Mucosa: as the trachea but the height of the epithelial cells and
the thickness of the lamina propria decreases as the bronchi
become reduced in size.

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Muscularis: is a continuous layer of circular of smooth muscle fibers in the larger bronchi. It is
more attenuated and loosely organized in smaller bronchi.
Submucosa: remains as a relatively loose C.T. Glands are present as well as adipose
tissue in the larger bronchi.
Cartilage layer: consists of discontinuous cartilage plates that become reduced in size as the
bronchial diameter diminishes.
Adventitia: is moderately dense C.T. that is continuous with that of adjacent structures
as pulmonary artery.
Bronchioles
The main features of the bronchioles are the absence of cartilage, goblet cells, glands and
lymphatic nodules. Goblet cells are lost before the cilia in the
bronchial tree to prevent the individuals from drawing in their own
mucus. It is formed of:
Mucosa: The large bronchioles are lined with pseudostratified
columnar ciliated with no
goblet cells. As they branch further, the lining epithelium changed
gradually into simple
columnar ciliated, simple cuboidal ciliated and simple cuboidal non-
ciliated (Clara cells) in
smaller bronchioles. Lamina propria has no glands and no lymphatic nodules.
Muscle: circular smooth muscle fibers are well developed. They act as sphincter to regulate the
amount of air entering to the respiratory portion.
Adventitia: thin layer of loose C.T.
Terminal bronchioles
They are the smallest and terminal part of the conducting portion; the lining epithelium is
partially ciliated cuboidal cells with no goblet cells but with Clara cells.
Clara cells:
LM: Non-ciliated cells that have rounded or dome-shaped apical
surface projection.
E/M :They have the characteristics of
protein- secreting cells: well-developed basal rER, lateral or
supranuclear Golgi complex, numerous cisternae of sER in apical
cytoplasm, secretory granules that stain for protein.
Function: Clara cells are the secondary source of surfactant, that
prevent luminal
adhesion particularly during expiration.
They secret glycosaminoglycans that protect the bronchiolar lining.

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Respiratory bronchioles
Respiratory bronchioles constitute a transitional zone in the respiratory system
concerning with both air conduction and gas exchange between air and blood. They
have a narrow diameter and are lined by a cuboidal epithelium. The epithelium of
initial segments contains both ciliated cells and Clara cells. Distally, the Clara cells
predominate. Scattered alveoli extend from the lumen of the respiratory bronchioles.

Alveolar ducts
They are the distal extensions of the respiratory bronchioles. They are lined with simple
cuboidal non-ciliated epithelium. Many alveoli, lined with simple squamous cells, open in these
ducts. The atrium is the distal termination of alveolar duct. Atria open into alveolar duct, alveoli
and alveolar sacs.
Alveolar sacs
Alveolar sacs are spaces surrounded by clusters of alveoli. The surrounded alveoli open into
these spaces. Alveolar sacs usually occur at the termination of an alveolar duct but may occur
anywhere along its length.
Alveoli
The alveolus is the fundamental structural and functional unit of respiratory tissue. An alveolus
may open into an alveolar sac, an alveolar duct or a respiratory bronchiole. They connected
together by alveolar pores. The alveoli are lined by pneumocyte type I and pneumocyte type II
and separated by interalveolar septa.

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 Pneumocyte type I
L/M: They are very thin and line most of the alveolar wall.
- They are flattened simple squamous epithelium, with flat
nuclei.
E/M: The nuclei are rounded and bulge to the lumen.
- The cytoplasm contains Golgi apparatus near the
nucleus, few mitochondria and few ER.
-Tight junctions (zonula occludens) and desmosomes
(macula adherens) are found between neighboring cells.
They prevent leakage of tissues fluid into alveolar lumen.
-These cells rest on a clear basal lamina that fuses with
the basal lamina of adjacent endothelium of blood
capillary.
Function :It is specialized to serve as a very thin gas permeable component of the
blood air barrier.
Pneumocyte type II
L/M: The cells are cuboidal with central rounded
nuclei .
- They cover about 3% of the alveolar surface.
E/M:They are attached to type I cells by tight
junctions and desmosomes.
-The cytoplasm contains the characteristic large
electron dense multi-lamellar granules rich in
phospholipid ,glycosaminoglycans and proteins.
- It also contains well developed Golgi apparatus and many mitochondria.
Function: It secrets pulmonary surfactant, that forms a thin film over the entire alveolar
surface. It serves as stem cell for both types.
Inter-alveolar septa:
Connective tissue between alveoli contains blood
capillaries supported by elastic
fibers, reticular fibers; macrophages and fibroblasts and
squamous epithelium lining the alveoli. Fibroblasts are of
special type called septal cells which are ordinary
fibroblasts with long
branched processes and gap junctions between these processes. Bundles of
actin filaments are present in their cytoplasm. They produce collagen III, elastin, and
proteoglycans of the extracellular matrix at the alveolar septa.

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N.B:
➢ Surfactant reduces the surface tension in the alveoli preventing them from collapse
during expiration. It also has some bactericidal effect, so it prevents bacterial
invasion and clean the alveolar surface.
➢ Elastic and reticular fibers forming a complex network encircling the openings at
atria, alveolar sacs, and alveoli.
➢ Elastic fibers enable alveoli to expand with inspiration and contract passively during
expiration.
➢ Reticular fibers support and prevent over distension and damage to the delicate
capillaries and alveolar septa.
➢ Alveolar pores (pores of Kohn): Equalize pressure, Promote collaterals when
obstruction occurs and migration of alveolar macrophages.
➢ Alveolar macrophages may be either dust cells that phagocytose dust particles or
heart failure cells that phagocytose erythrocytes in heart failure.
Blood air barrier
It is the barrier through which gas exchange
will take place between the lumen of the
alveoli and blood in capillaries. It is formed of:
➢ Film of pulmonary surfactant on alveolar
surface.
➢ Cytoplasm of type I alveolar cell.
➢ Fused basal laminae of type I cell and
capillary endothelium.
➢ The cytoplasm of capillary endothelium (not
fenestrated).

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