RESPIRATORY
SYSTEM
Anatomy
• Upper respiratory tract
– Nasal cavity
– Paranasal sinuses
– Nasopharynx
• Lower respiratory tract
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Larynx
Trachea
Bronchial tree
Respiratory part
Airways wall
• Epithelium of the respiratory tract
• Lamina propria
• Submucosa
Epithelium of the RT
• pseudostratified columnar with the cilia
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columnar ciliated cells
goblet (mucous) cells
brush cells (microvilli)
Kultchitski cells (DNES)
secretory cells (granulated)
basal cells
• stratified sqamous epithelium
Nasus et cavitas nasi
• function
• cavitas nasi mucosa :
- vestibulum  lumen nasi
• regio respiratoria et olfactoria
Sinus paranasales
sinus maxillaris (15 cm3)
sinus frontalis (8 cm3)
sinus sphenoidalis (6 cm3)
cellulae etmoidales (ant. et post.)
• the development
• epithelium
• function
Nasopharynx
= cranial part of the pharynx
• epithelium of the respiratory tract
• mouth of the tubae auditivae
in a level of the meatus nasi inferior
• tonsilla pharyngea
- Waldeyer´s circle
Larynx
• cartilage
• epiglottis
– lingual surface
– laryngeal surface
• vocal cords
– true
– false
Larynx - cartilages:
• cartilago thyroidea
• cartilago cricoidea
• cartilago epiglottica
• cartilago arytenoidea
• cartilago corniculata, cuneiformis et triticea
Cavitas laryngis
• Aditus
• Vestibulum
- plica vestibularis - lig.vestibularia
- rima vestibuli, ventriculus
• Glottis
- plica vocalis, rima glottidis
• Cavitas infraglottica
• lamina propria
• submucosa laryngis
D1 - epiglottis (HE)
D2 - larynx (HE)
Trachea
• pars cervicalis + thoracica
• bifurcatio tracheae (Th4)
• epithelium of the respiratory tract
• submucosa - glandulae tracheales
• cartilagines tracheales
• ligamenta anularia
• paries membranaceus (tracheal muscles, ligaments)
D3 - trachea (HE)
Bronchial tree
• Primary bronchi (bronchus pricipalis dx. et sin.)
• Secondary bronchi (bb. lobares  bb. segmentales)
• Terminal bronchioles
• Respiratory bronchioles
• Alveolar corridors (ductus  sacculi)
• Alveoli
Bronchi
• cartilage - here and there
• smooth muscles - spiral
• epithelium - pseudostratified, ciliated
• lamina propria
- seromucinous glands, elastic fibres
• lymphocytes, lymphatic follicles
D4
Intrapulmonary bronchus (HE)
Bronchioles
• epithelium
- gradually simple cuboidal
- Clara cells
• elastic fibres, smooth muscles
• no cartilage, no glands
neither lymphatic follicles
The lung
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Respiratory bronchi
Alveolar corridors
Alveoli
Pleura
Respiratory
bronchioles
• simple, cuboidal,
ciliated epithelium
• into alveoli
- squamous
epithelium
• bronchioles gradually
transform into
the alveolar corridors
Alveoli
• 200 μm large,
many-sided, thin wall
• alveolar epithelium
• alveolar septum
Alveolar epithelium
• Membranous pneumocytes (type I)
• 97%; desmosomes, zonulae occludentes
• squamous, thin - 25 nm
• organelles around the nucleus,
pinocytal pouches
• Granular pneumocytes (type II)
• ovoid shape, microvilli
• lamellar bodies (1,5 μm) - surfactant
• proliferation and differentiation (lining renewal)
Alveolar septum
• fibroblasts
(collagen type I, III)
• endothelial capillary cells
• pericytes
• dust cells, lymphocytes
• alveolar cells
• reticular and elastic fibres
• inter-alveolar pores (10μm)
D5
The lungs (HE)
Alveolar-capillary barrier
0,1- 0,5μm
• alveolar cells (type I) cytoplasm
• basal membranes
• endothelial (capillary) cells
• respiratory surface = 140 m2
Surfactant
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reduces tension on the surface of alveoli
resists the collapse of the alveoli in expirium
water hypophase & lipid epiphase
absorption & renovation in granular pneumocytes
passage in respiratory tract within
the bronchoalveolar fluid
Defence mechanism
• Nose airways - mucous, vibrissae
• Respiratory ciliated epithelium
• Alveolar macrophages
• T a B lymphocytes
Pleura
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serose membrane - mezothelium
parietal and visceral sheet
cupula pleurae
recessus pleurales (costodiaphragmaticus,
costo-, phrenico- a vertebromediastinalis)
• pleural cavity - liquosus pleurae
Respiratory system
- the development
The development of the RT
• begins in week 4
• day 24-26 - laryngotracheal groove
=> laryngnotracheal diverticulum
=> lung bud  bronchial buds...
• tracheo-oesophageal septum =>
ventral (laryngotracheal tube)
dorsal (oropharynx, eosophagus)
- parts of the foregut
• tracheoesophageal fistula
The development of the larynx
• epithelium - pseudostratified, columnar, ciliated
• origin of the cartilages and muscles
• aditus laryngis
- adhesion (month 1), recanalisation
• ventriculus laryngis
• eminentia hypobranchialis - epiglottis
The development of the trachea
• endodermal lining
=> epithelium and glands
• splanchnic mesoderm
=> cartilages, connective tissue and muscles
of the trachea
The development of the bronchi
and the lungs
• lung bud => bronchial buds
• week 5 - primary bronchi => lobar bronchi
• week 7 - segmental bronchi
+ mesenchym => bronchopulmonal segment
• the end of the week 24 - „level 17“; respiratory
bronchiole
• the origin of the visceral, parietal pleura
The maturation of the lungs
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pseudoglandular phase (week 5-17)
canalicular phase (week16-25)
terminal pouches phase (week 24 ad partus)
alveolar phase (late fetal period, childhood)
• adequate space of the chest
• fetal breathing movements
• adequate volume of the amnion fluid
Adaptive changes to the
autonomic breathing
• sufficient amount of the surfactant
• conversion of the function of the lungs
(secretory fce - respiratory fce)
• parallel lungs and body circulation
• fluid removal of the lungs:
in a course of the delivery
lungs capillaries and vessels, lymphatic vessels
D6
Fetal lungs (HE)