Ingegneria delle tecnologie
per la salute
Fondamenti di
anatomia e istologia
Apparato respiratorio
Schema generale approccio all’anatomia:
•Nome
•Tipo di organo: (cavo/parenchimatoso. Pari/dispari)
•Derivazione embriologica (endo-meso-ecto-dermico)
•Forma e dimensioni
•Posizione nel corpo
•Rapporti anatomici
•Vascolarizzazione
•Innervazione
•funzione
+ istologia
lezione
data
argomento
1
28-set introduzione del corso. introduzione all’anatomia: terminologia. Organizzazione generale: cellule tessuti organi apparati sistemi
2
29-set cenni di biologia
3
05-ott cenni di embriologia
4
06-ott apparato cardiocircolatorio: cuore + istologia miocardio/vasi, endotelio
5
12-ott apparato cardiocircolatorio: circolazione polmonare, vasi principali, linfatici, milza
6
13-ott apparato respiratorio+laringe e fonazione
7
19-ott SNC: cranio e morfologia encefalo. Istologia tessuto nervoso
8
20-ott SNC: tronco cerebrale e midollo spinale, le vie
9
26-ott SNC: sistema nervoso autonomo. Nervi cranici
10
27-ott SNC: occhio ed orecchio
11
02-nov locomotore: istologia. Classificazione ossa ed articolazioni.
12
03-nov locomotore: arto superiore, arto inferiore
13
09-nov locomotore: parete addominale, pavimento pelvico
14
10-nov digerente: istologia. Morfologia tubo digerente
15
16-nov digerente: morfologia tubo digerente
16
17-nov digerente: fegato e pancreas.
17
23-nov tegumentario: cute e mammella (lezione JOLLY)
18
24-nov endocrino
19
30-nov urinario
20
01-dic genitale maschile
21
07-dic genitale femminile
22
08-dic sala op/jolly
23
14-dic sala op/jolly
24
15-dic sala op/jolly
Lezione 6. Apparato respiratorio.
https://lectureug5.files.wordpress.com/2014/02/difiores
-atlas-of-histology-with-functional-correlations-11thed.pdf
https://www.openstaxcollege.org/files/textbook_version/hi_res_pdf/13/col114961.7_20150715-OP.pdf
https://human.biodigital.com/index.html
RESPIRATORY SYSTEM
After studying this chapter, you will be able to:
• List the structures of the respiratory system
• List the major functions of the respiratory system
• every human cell needs to run oxidative cellular respiration (=
oxidative phosphorylation, process where energy is produced in the
form of ATP) where oxygen is a reactant and carbon dioxide is a
waste product
• it is actually the accumulation of carbon dioxide that primarily
drives the need to breathe
• carbon dioxide is exhaled and oxygen is inhaled through the RS,
which includes:
1. muscles to move air into and out of the lungs,
2. passageways through which air moves, and
3. microscopic gas exchange surfaces covered by capillaries.
RESPIRATORY SYSTEM
Major RS function: to provide oxygen to body
tissues for cellular respiration, remove the waste
product carbon dioxide, and help to maintain acidbase balance.
RS also used for non-vital functions: sensing odors,
speech production, and for straining, such as
during childbirth or coughing
Functionally, RS
divided in:
conducting zone =
organs and structures
not directly involved
in gas exchange
respiratory zone =
where gas exchange
occurs
RESPIRATORY
SYSTEM
Conducting Zone
major functions:
 to provide a route for incoming
and outgoing air,
 remove debris and pathogens
from the incoming air,
 warm and humidify the
incoming air.
other functions:
 epithelium of the nasal
passages is essential to sensing
odors,
 bronchial epithelium that lines
the lungs can metabolize some
airborne carcinogens.
Nose
(+ its Adjacent Structures)
major entrance and exit for the RS through the nose, divided into 2 sections:
1. external nose = surface and skeletal structures  outward appearance + numerous
functions










root = region located between the eyebrows
bridge = part that connects the root to the dorsum
dorsum nasi = length of the nose
apex = tip of the nose
alae (singular = ala) = cartilaginous structure on
either side of the apex forming the nostrils
naris (plural = nares), or nostril opening = the
“holes”
philtrum = concave surface that connects the apex
of the nose to the upper lip
nasal bone = one of a pair lying under the root and
bridge, articulating superiorly with frontal bone and
laterally with maxillary bones.
septal cartilage = flexible hyaline cartilage
connected to the nasal bone, forming the dorsum
nasi.
alar cartilage = apex of the nose surrounding naris.
Nose
(+ its Adjacent Structures)
Nose
(+ its Adjacent Structures)
2. Nasal cavity = separated into left and right sections by the nasal septum
nasal septum = anteriorly by a portion of the septal cartilage and posteriorly by the
perpendicular plate of the ethmoid and the vomer
lateral walls = 3 bony projections, called the superior, middle, and inferior nasal conchae
(turbinate), inferior conchae are separate bones, whereas the superior and middle conchae
are portions of ethmoid.
floor = palate (hard palate at the anterior region composed of bone + soft palate at the
posterior portion consists of muscle tissue
Nose
(+ its Adjacent Structures)
Vomeronasal organ (Jacobson’s)
Nose
(+ its Adjacent Structures)
paranasal sinuses = air-containing spaces lined with a mucosa in the bones that form the walls
of the nasal cavity, serving to warm and humidify incoming air, producing mucus and
lightening the weight of the skull, named for its associated bone: frontal sinus, maxillary sinus,
sphenoidal sinus, and ethmoidal sinus
Nose
(+ its Adjacent Structures)
 Nares + ant. portion of nasal cavities lined
with mucous membranes, containing
sebaceous glands and hair follicles,
preventing the passage of large debris, such
as dirt, through the nasal cavity
 olfactory epithelium detecting odors deeper
in the nasal cavity
 conchae, meatuses, and paranasal sinuses
lined by respiratory epithelium composed of
pseudostratified
ciliated
columnar
epithelium + goblet cells  cilia of the
respiratory epithelium help remove the
mucus and debris with a constant beating
motion, sweeping materials towards the
throat to be swallowed
 serous and mucus-producing cells also
secrete the lysozyme enzyme and proteins
called defensins, with antibacterial properties
and immune cells that patrol the connective
tissue deep to the respiratory epithelium
provide additional protection
histology
Nose
(+ its Adjacent Structures)
histology
Nose
(+ its Adjacent Structures)
histology
Nose
(+ its Adjacent Structures)
histology
Pharynx
= tube formed by skeletal muscle and lined by mucous membrane that is continuous
with that of the nasal cavities, divided into 3 major regions:
Nasopharynx = flanked by the conchae, shows at the
top the pharyngeal tonsil (= adenoid, aggregate of
lymphoid reticular tissue), down the uvula (= small
bulbous, teardrop-shaped structure located at the apex
of the soft palate) and an opening of auditory
(Eustachian) tubes
Oropharynx = passageway for both air and food,
bordered superiorly by the nasopharynx and anteriorly
by the oral cavity (fauces)  nasopharynx becomes
oropharynx, epithelium changes from pseudostratified
ciliated columnar to stratified squamous epithelium,
contains 2 distinct sets of tonsils, the palatine and
lingual tonsils.
Laryngopharynx = inferior to the oropharynx and
posterior to the larynx, anteriorly opens into the larynx,
whereas posteriorly, it enters the esophagus, stratified
squamous epithelium continues
Pharynx
Pharynx
Larynx
= cartilaginous structure inferior to
the
laryngopharynx
connecting
pharynx to the trachea, regulating the
volume of air that enters and leaves
the lungs and producing speech, made
of several pieces of cartilage, 3 large
cartilage pieces: a) thyroid cartilage
(anterior), largest piece of cartilage
that makes up the larynx, consists of
the laryngeal prominence, or “Adam’s
apple,” which tends to be more
prominent in males, b) epiglottis
(superior),
c)
cricoid
cartilage
(inferior), thick cartilage forms a ring,
with a wide posterior region and a
thinner anterior region
3 smaller paired cartilages: a)
arytenoids,
b)
corniculates
c)
cuneiforms—attach to the epiglottis
and the vocal cords and muscle
thathelp move the vocal cords
Larynx
Larynx
Larynx
Larynx
Epiglottis = very flexible piece of
elastic cartilage attached to the
thyroid cartilage that covers the
opening of the trachea resting on
the glottis.
Glottis = composed of: a)
vestibular folds or false vocal cord
= a pair of folded sections of
mucous membrane, b) true vocal
cords = white, membranous folds
attached by muscle to the thyroid
and arytenoid cartilages of the
Inner edges of the true vocal cords are free,
larynx on their outer edges, and allowing oscillation to produce sound.
the space between these folds
The act of swallowing causes the pharynx and
larynx to lift upward, allowing the pharynx to
expand and the epiglottis of the larynx to swing
downward, closing the opening to the trachea.
These movements produce a larger area for
food to pass through, while preventing food
and beverages from entering the trachea.
Larynx
Larynx
Larynx
Larynx
histology
Continuous with laryngopharynx,
larynx’ superior portion is lined
by stratified squamous
epithelium, transitioning into
pseudostratified ciliated
columnar epithelium that
contains goblet cells. Similar to
the nasal cavity and
nasopharynx, this specialized
epithelium produces mucus to
trap debris and pathogens as
they enter the trachea: cilia beat
mucus upward towards
laryngopharynx, where it can be
swallowed down esophagus.
Larynx
histology
Trachea
= extending from larynx to lungs, formed by 16 to 20 stacked, C-shaped pieces of hyaline
cartilage that are connected by dense connective tissue (providing structural support and
preventing the trachea from collapsing) + fibroelastic membrane (formed by trachealis muscle
and elastic connective tissue together) a flexible membrane that closes the posterior surface of
the trachea, connecting the C-shaped cartilages, allowing the trachea to stretch and expand
slightly during inhalation and exhalation.
lined with pseudostratified ciliated columnar epithelium
Trachea
histology
Trachea
Bronchial Tree
 Trachea branches into the right and left primary bronchi (still lined by
pseudostratified ciliated columnar epithelium containing mucus-producing
goblet cells, with rings of cartilage, similar to those of the trachea, supporting
their structure and preventing their collapse: enter the lungs at the hilum, a
concave region where blood vessels, lymphatic vessels, and nerves also enter
lungs) at the carina (= raised structure containing specialized nervous tissue
inducing violent coughing if foreign body is present).
 Bronchi continue to branch into bronchial tree (or respiratory tree = collective
term used for multiple-branched bronchi) providing passageway for air to
move into and out of each lung and trapping debris and pathogens.
 Bronchiole (about 1 mm in ) branches from the tertiary bronchi and further
branch until terminal bronchioles (more than 1000 in each lung) leading to the
structures of gas exchange and their muscular walls do not contain cartilage
like those of the bronchi. This muscular wall can change the size of the tubing
to increase or decrease airflow through the tube.
Bronchial Tree
Bronchial Tree
histology
Bronchial Tree
histology
Bronchial Tree
histology
Bronchial Tree
histology
Respiratory Zone
= includes structures that are directly involved in gas exchange, beginning where the terminal
bronchioles join a respiratory bronchiole (smallest type of bronchiole), which then leads to
an alveolar duct, opening into a cluster of alveoli.
Respiratory Zone
histology
Respiratory Zone
histology
Alveoli
alveolar duct = tube of smooth muscle and connective tissue, which opens into
a cluster of alveoli.
alveolar sac = cluster of many individual alveoli
alveolus = one of the many small, grape-like sacs connected to the alveolar
ducts responsible for gas exchange, approximately 200 µm  with elastic walls
that allow the alveolus to stretch during air intake, which greatly increases the
surface area available for gas exchange and connected to their neighbors by
alveolar pores, which help maintain equal air pressure throughout the alveoli
and lung
Alveoli
histology
 alveolar wall = 3 cell types:
1. type I alveolar cell = squamous epithelial cell of the alveoli, which constitute up to 97 % of the
alveolar surface area, 25 nm thick, highly permeable to gases, attached to a thin elastic basement
membrane
2. type II alveolar cell = (club cells, Clara cells) interspersed among the type I cells and secretes
pulmonary surfactant, a substance composed of phospholipids and proteins reducing surface
tension of alveoli
3. alveolar macrophage = phagocytic cell of the immune system roaming around the alveolar wall
 respiratory membrane =
that removes debris and pathogens
extremely
thin
epithelium
borders
endothelial membrane
of capillaries, 0.5 mm
thick, allowing gases to
cross by simple diffusion,
allowing oxygen to be
picked up by the blood
for transport and CO to
be released into the air
of the alveoli.
Club cells…
Club cells were previously called Clara cells, as they were first
described by Max Clara (1899–1966), in 1937. Clara was an active
member of the Nazi Party and used tissue taken from executed
victims of the Third Reich for his research—including the work
that led to his discovery of Clara cells.[1] In May 2012, the
editorial boards of most of the major respiratory journals
(including the journals of the American Thoracic Society, the
European Respiratory Society and the American College of Chest
Physicians) concluded that the continued use of Clara's eponym
would be equivalent to honoring him; they therefore introduced
a name-change policy, which went into effect beginning January
1, 2013.[2] The term "Clara" is to be used parenthetically after
"club cell" for a 2-year period, at which point when "Clara cell"
and "Clara cell secretory protein" will be conclusively replaced
with "club cell" and "club cell secretory protein", respectively.[3]
1.
2.
3.
Winkelmann, Andreas; Noack, Thorsten (2010). "The Clara cell - a "Third Reich eponym"?". European Respiratory
Journal 36 (4): 722–7.
Irwin, RS; Augustyn N; French CT; Rice J; Tedeschi V; Welch SJ (2013). "Spread the word about the journal in 2013:
from citation manipulation to invalidation of patient-reported outcomes measures to renaming the Clara cell to new
journal features". Chest 143: 1–5.
Akram, KM; Lomas NJ; Spiteri MA; Forsyth NR (2013). "Club cells inhibit alveolar epithelial wound repair via TRAILdependent apoptosis". Eur Respir J 41: 683–694.
Alveoli
histology
Alveoli
histology
Lungs
= houses structures of both the conducting
and respiratory zones, their main function
to perform the exchange of respiratory
gases across a very large epithelial surface
area—about 70 square meters—that is
highly permeable to gases.
of connective tissue)
Gross Anatomy
= pyramid-shaped, paired organs connected to the trachea by the right and left bronchi
and enclosed by the pleurae, which are attached to the mediastinum; on the inferior
surface, the lungs are bordered by the diaphragm (= flat, dome-shaped muscle located at
the base of the lungs and thoracic cavity); right lung is shorter and wider than left, and left
lung occupies a smaller volume than right; cardiac notch = indentation on the surface of
the left lung allowing space for the heart; apex of the lung is superior region, whereas base
is opposite region near the diaphragm, costal surface of the lung borders the ribs and
mediastinal surface faces the midline; composed of smaller units = lobes (right lung 3
lobes: superior, middle, and inferior; left lung 2 lobes: superior and inferior), separated by
fissures. Bronchopulmonary segment = division of a lobe, each receiving air from its own
tertiary bronchus and supplied with blood by its own artery. Pulmonary lobule =
subdivision formed by bronchi branching into bronchioles, separated by interlobular
septum (=wall, composed connective tissue)
Lungs
Lungs
Lungs
Lungs
Blood Supply
Being major function of the lungs performing blood supply containing deoxygenated blood,
traveling to the lungs where red blood cells pick up oxygen to be transported to tissues
throughout the body, pulmonary artery arises from the pulmonary trunk carrying
deoxygenated arterial blood to the alveoli and branching multiple times as it follows the
bronchi, becoming progressively smaller in diameter; one arteriole accompanied by venule
supply drain one pulmonary lobule, becoming pulmonary capillary network, as they near the
alveoli, consisting of tiny vessels with very thin walls that lack smooth muscle fibers, creating
the respiratory membrane: once blood is oxygenated, it drains from the alveoli by way of
multiple pulmonary veins, which exit the lungs through the hilum.
Nervous Innervation
Dilation and constriction of the airway are achieved through nervous control by the
parasympathetic ( bronchoconstriction) and sympathetic (bronchodilation) nervous
systems: reflexes such as coughing, and the ability of the lungs to regulate oxygen and carbon
dioxide levels, also result from this autonomic nervous system control. Sensory nerve fibers
arise from the vagus nerve, and from the second to fifth thoracic ganglia. The pulmonary
plexus is a region on the lung root formed by the entrance of the nerves at the hilum. The
nerves then follow the bronchi in the lungs and branch to innervate muscle fibers, glands, and
blood vessels.
Pleura
Each lung is enclosed within
a cavity that is surrounded by
the pleura (plural = pleurae)
= serous membranes
surrounding lungs, separated
by the mediastinum. pleurae
consist of 2 layers: 1. visceral
pleura = layer that is
superficial to the lungs, and
extends into and lines the
lung fissures; 2. parietal
pleura = outer layer
connected to the thoracic
wall, the mediastinum, and
the diaphragm; visceral and
parietal pleurae connect to
each other at the hilum;
pleural cavity = space
between visceral and parietal
layers.
Pleura
Diaphragm
= dome-shaped curved
upwards structure
of muscle and fibrous tissue
separating thorax from
abdomen, with peripheral
attachments to abdominal
and chest walls, from which
muscle fibres converge in
a central tendon (crest of
the dome); emerges from
many surrounding
structures:ant xifoid and
along costal margin, lat ribs
6-12, post vertebra at T12 (+
2 appendages, the right and
left crus, descend and
insert at L1 & L2) with 2
lumbocostal arches,
medial and lateral, on either
side.
Diaphragm
primarily innervated by phrenic
nerves formed from cervical
nerves C3, C4 and C5, while the
central portion of the diaphragm
sends sensory afferents via the
phrenic nerve, the peripheral
portions of the diaphragm send
sensory afferents via the
intercostal
(T5-T11)
and
subcostal nerves(T12).
hiccup
Mediastinum
Mediastinum
luca.ansaloni@unibg.it
lansaloni@hpg23.it