What are the two portions of the

respiratory system?

Conductance zone = nasal cavities,

nasopharynx, larynx, trachea, bronchi,
bronchioles, terminal bronchioles
Respiratory zone = respiratory
bronchioles, alveolar ducts, alveoli

What are the two components of

the left and right nasal cavities?

Describe the skin in the vestibule.

1. External, dilated vestibule

2. Internal nasal cavity

Epithelium loses its keratinized

nature and undergoes a transition
to pseudostratified columnar
epithelium; sweat glands,
sebaceous glands, and vibrissae
(hairs) are present

What separates the two nasal

cavities?

An osseous nasal septum

What extend from the lateral wall of

each nasal cavity?

3 bony, shelflike projections called

conchae, or turbinates

What types of epithelium cover the

conchae?

What are the important roles of the

lamina propria of the nasal cavity?

What are the general type and

arrangement of cells in respiratory
epithelium?

Middle and inferior conchae:

respiratory epithelium
Superior conchae and roof of nasal
cavity: olfactory epithelium
Conditioning inhaled air:
1. Vasculature that has loops of capillaries carrying
blood flowing opposite to inhaled air and that warms the
air
2. Seromucous glands release water to humidify the air
3. Goblet cells produce mucus that traps particulate and
gaseous impurities
4. Plasma cells secrete IgA that is present in the nasal
mucosa

Ciliated pseudostratified columnar

epithelium
Unusually thick basement
membrane
1. Ciliated columnar cells

What are the 5 major cell types of

respiratory epithelium?

2. Goblet cells: basal nuclei and apical domains filled with granules of
mucin glycoproteins
3. Brush cells: apical microvilli; chemosensory receptors with afferent nerve
endings on their basal surface
4. Small granule cells (Kulchitsky cells): part of the diffuse neuroendocrine
system
5. Basal cells: mitotically active stem cells and progenitor cells

What are the 3 major cell types in

olfactory epithelium?

1. Olfactory neurons
2. Supporting cells
3. Basal cells

Describe olfactory neurons.

Bipolar
Nuclei form an irregular row near the middle of the thick
olfactory epithelium
Apical pole = dendrite end; about a dozen basal bodies
with long, nonmotile, chemoreceptor-rich cilia
Basal pole = axons unite in lamina propria as small
nerves that pass to the brain through foramina in the
cribriform plate of the ethmoid bone and form the
olfactory nerve (cranial nerve I)

Describe the supporting cells of the

olfactory epithelium.

Columnar
Broad, cylindrical apexes and narrower
bases
Microvilli
Junctional complexes bind them to
olfactory cells
Abundant ion channels

Describe basal cells in the olfactory

epithelium.

Spherical or conical cells near the

basal lamina
Stem cells: replace olfactory
neurons every 2-3 months and
support cells less frequently

What are olfactory glands?

What is loss or reduction of the

ability to smell called?

Large serous glands (olfactory

glands of Bowman) that produce a
constant fluid surrounding the
olfactory cilia and facilitating access
of new odoriferous substances

Loss of sense of smell: anosmia

Reduced sense of smell: hyposmia

Is loss of the sense of smell usually

temporary or permanent?

Loss of the sense of smell due to toxic

fumes or physical injury to the olfactory
mucosa is usually temporary because
of the regenerative activity of the
epithelial stem cells.

Bilateral cavities in the frontal, maxillary, ethmoid, and sphenoid

bones of the skull

What are the paranasal sinuses?

Lined with thinner respiratory epithelium with fewer goblet cells;

lamina propria contains only a few small glands and is continuous
with underlying periosteum
Communicate with nasal cavities via small openings; mucus
produced in the sinuses is moved into the nasal cavities by ciliated
cells

What is the nasopharynx?

Nasal cavities open posteriorly into this space, which

is continuous caudally with the oropharynx, the
posterior part of the oral cavity leading to the larynx
Lined with respiratory epithelium
Mucosa contains the medial pharyngeal tonsil and
the bilateral openings of the auditory tubes
connected to each middle ear cavity

Hyaline cartilage: located in the thyroid, cricoid, and

inferior arytenoid cartilages

Describe the cartilage that

reinforces the walls of the larynx.

Elastic cartilage: located in the epiglottis, cuneiform,

corniculate, and superior arytenoid cartilages
Connected by ligaments
Movements of these cartilages by skeletal muscles
participate in sound production during phonation

Flattened structure projecting from the upper rim of the larynx

Describe the epiglottis.

Prevents swallowed food or fluid from entering the larynx

Upper (lingual) surface has stratified squamous epithelium that
transitions to respiratory epithelium on the laryngeal surface
Mixed serous and mucous glands in the lamina propria

What are the two pairs of folds that

project into the lumen of the larynx?

Describe vestibular folds.

Vestibular folds
Vocal folds (cords)

Upper pair of folds in the larynx

Immovable
Partly covered with typical
respiratory epithelium overlying
numerous seromucous glands and
occasional lymphoid nodules
Lower pair of folds in the larynx covered in stratified
squamous epithelium

Describe the vocal folds.

Vocal ligament = dense regular bundle of elastic

connective tissue that supports the free edge of each
vocal cord
Vocalis muscle = deep to the mucosa of each vocal fold
are these large bundles of striated fibers

What happens during phonation?

Vocalis muscles draw the paired vocal folds

together (adduction), narrowing the
intervening luminal space, the rima glottidis
Air expelled from the lungs causes the
adducted vocal folds to vibrate and produce
sound

Describe the cartilage in the

trachea.

C-shaped rings of hyaline cartilage

Open ends of the cartilage rings are on
the posterior surface, against the
esophagus, and are bridged by a bundle
of smooth muscle (trachealis muscle)
and a sheet of fibroblastic tissue
attached to the perichondrium

What is the epithelium of the

trachea like?

What is the entire trachea

surrounded by?

What does the trachealis muscle do

during swallowing? Coughing?

Typical respiratory epithelium with a

lamina propria that contains
numerous seromucous glands
producing watery mucus

Adventitia

Relaxes during swallowing to allow the

esophagus to bulge into the lumen of the trachea
Strongly contracts during the cough reflex to
narrow the tracheal lumen and provide for
increased velocity of expelled air and better
loosening of material in the air passage

How many secondary bronchi does

each lung have?

Right lung = 3
Left lung = 2
Each secondary bronchi supplies a
pulmonary lobe

What do the tertiary bronchi

supply?

Each tertiary bronchi, together with

its smaller branches, constitutes a
bronchopulmonary segment with
its own connective tissue capsule
and blood supply

What do bronchioles supply?

Describe pulmonary lobules

Describe cartilage in the bronchi.

Each bronchiole enters a pulmonary

lobe and branches into 5-7 terminal
bronchioles

Pulmonary lobules are pyramidshaped, with their apex aimed at the

hilum
Each is delineated by a thin layer of
connective tissue which is
frequently incomplete
Primary bronchi: most rings completely
encircle the lumen
As bronchi diameter decreases,
cartilage rings are gradually replaced
with isolated plates of hyaline cartilage.

Describe the lamina propria and

submucosa of bronchi.

Contains crisscrossing bundles of spirally arranged

smooth muscle and elastic fibers, which become more
prominent in the smaller branches
Small mucous and serous glands open into the bronchial
lumen
Mucous-associated lymphoid tissue and lymphocytes
become more abundant as bronchi become smaller

What kind of epithelium do bronchi

have?

Respiratory (pseudostratified
columnar) epithelium

What is the diameter of

bronchioles?

1 mm or less

What type of epithelium do

bronchioles have?

Larger bronchioles have

pseudostratified columnar epithelium,
but this decreases in height and
complexity to become ciliated simple
columnar or ciliated simple cuboidal
epithelium with Clara cells

Describe the support structures of

bronchioles

No cartilage
Dense connective tissue and elastic
fibers are associated with
prominent circular layer of smooth
muscle
No mucosal glands

Describe the epithelium and

support structures of terminal
bronchioles.

Ciliated simple cuboidal epithelium

with Clara cells
Thin, incomplete circular layer of
smooth muscle; elastic fibers but no
cartilage
Also the mucociliary escalator

What is the mucociliary apparatus?

Begins in the ciliated epithelial lining of terminal

bronchioles
Important in clearing cell debris and mucus by
moving it upward along the bronchial tree and
trachea

Which cells are most numerous in

the cuboidal epithelium of terminal
bronchioles?

Clara cells

Describe the appearance of Clara

cells.

Non-ciliated, domed apical ends

with secretory granules

1. Secretion of surfactant lipoproteins and mucins in the fluid layer on the epithelial
surface; surfacant reduces surface tension and helps prevent collapse of bronchioles

What are some of the functions of

Clara cells?

2. Detoxification of inhaled xenobiotic compounds by P450 enzyme system in the SER

3. Secretion of antimicrobial peptides and cytokines for local immune defense;
production of the secretory component for the transfer of IgA into the bronchiolar
lumen
4. In a stem cell subpopulation, injury-induced mitosis for replacement of other
bronchiolar cell types

Besides Clara cells, what other cell

types are present in the terminal
bronchiole epithelium?

Describe the epithelium and

structural support of respiratory
bronchioles.

Small mucous cells

Ciliated cuboidal cells
Chemosensory brush cells
DNES small granule cells (cells of the
diffuse neuroendocrine system)
Ciliated simple cuboidal epithelium with
Clara cells
Simple squamous cells at the alveolar
openings and extending into the alveoli
Some (few) smooth muscle fibers and
elastic connective tissue

Collapse or closure of a lung or part of a lung

What is atelectasis?

Obstruction of air supply in bronchi due to excess mucus or

aspirated material can lead to collapse of pulmonary lobules as
circulating blood absorbs gases from affected alveoli
Condition is normally reversible when blockage is relieved but, if
persistent, can cause fibrosis and loss of respiratory function

Describe the epithelium and

structural support of alveolar ducts.

Describe the lamina propria of

alveolar sacs

Describe the interalveolar septa

Simple cuboidal epithelium between alveoli

Extremely attenuated squamous cells in alveoli
Thin lamina propria; a strand of smooth muscle
cells surrounds each alveolar oening and a
matrix of elastic and collagen fibers supports the
duct and its alveoli

Extremely thin, consisting of a network

of elastic and reticular fibers that
encircles the alveolar openings and
closely surrounds each alveolus
Capillaries are prominent; another
network of capillaries surround each
alveolus
Contain: scattered fibroblasts, elastic and reticular fibers,
macrophages and leuckocytes, richest capillary networks in the
body
Elastic fibers: enable alveoli to expand with inspiration and
contract passively with expiration
Reticular fibers: prevent both collapse and excessive distension of
alveoli

What are the 3 components of the

blood-air barrier?

1. 2-3 highly attenuated, thin cells

lining the alveolus
2. Fused basal lamina of these cells
and the capillary endothelial cells
3. Thin endothelial cells of the
capillary

What do alveolar pores do?

Alveolar pores (of Kohn) penetrate the

interalveolar septa and connect neighboring
alveoli that open to different bronchioles
These pores equalize air pressure in theses
alveoli and permit collateral circulation of air
when a bronchiole is constricted

What enzyme liberates CO2 from its

bicarbonate form?

Describe type I alveolar cells (type I

pneumocytes)

Describe type II alveolar cells (type II

pneumocytes)

What do lamellar bodies contain?

Carbonic anhydrase

Extremely attenuated
Organelles grouped around nucleus, reducing thickness
of of cytoplasm at blood-air barrier to as little as 25 nm
Cover about 95% of the alveolar surface
Tight junctions prevent leakage of fluid into the alveolar
air space
Pinocytotic vesicles in attenuated cytoplasm may be
involved in surfactant turnover or removal of small
particulate contaminants

Cuboidal cells that bulge into the air space

Interspersed among type I cells and bound to
them via desmosomes and tight junctions
Round nucleus with 1+ nucleoli; pale cytoplasm
with many vesicles (lamellar bodies)
Divide to replace themselves and provide
progenitor cells for the type I population

Phospholipids, lipids, and proteins that are

continuously synthesized and release at the
apical surface of type II pneumocytes
Secreted material spreads over the inner
alveolar surface as a film of complexed
lipoproteins and water that acts as pulmonary
surfactant

What does pulmonary surfactant

do?

Lowers surface tension at airepithelium interface, helping to prevent

alveolar collapse at exhalation and
allowing alveoli to be inflated with less
inspiratory force, easing the work of
breathing

What are important components of

the surfactant layer?

Dipalmitoylphosphatidylcholine
(DPPC) = phospholipid
Cholesterol
Surfactant proteins A, B, C, and D

What do the surfactant proteins do?

What is infant respiratory distress

syndrome?

SP-A and SP-D = important for

innate protection within the lungs
SP-B and SP-C = required for
maturation of DPPC and its proper
orientation in the surfactant film
inside the alveolus
Leading cause of death in premature babies
Due to incomplete differentiation of type II
alveolar cells and a resulting deficit of surfactant
and difficulty expanding the alveoli in breathing
Treatment = endotracheal tube to provide
continuous positive airway pressure (CPAP) and
exogenous surfactant

Describe dust cells (alveolar

macrophages)

Slightly darker in color due to their content of

dust and carbon from air and complexed iron
from phagocytized erythrocytes
Potential fates = (1) swept up by the mucociliary
apparatus, (2) exit via the lympatic drainage, or
(3) remain in connective tissue for years

What are heart failure cells?

What is emphysema?

Describe the histological structure

of the pleural membranes.

Describe the pleural cavity

In congestive heart failure, lungs become

congested with blood and erythrocytes pass into
the alveoli, where they are phagocytized by
alveolar macrophages. These macrophages are
called heart failure cells when present in the lung
and sputum; they are identified by a positive
reaction for iron pigment (hemosiderin)

Chronic lung disease most commonly caused

by smoking
Involves dilation and permanent enlargement
of the bronchioles leading to pulmonary acini
and accompanying loss of cells in the alveoli
and airways, causing irreversible loss of
respiratory function

Simple squamous mesothelial cells

on a thin connective tissue layer
containing collagen and elastic
fibers, blood vessels, and
lymphatics
Entirely lined with mesothelial cells
that produce a thin film of serous
fluid that acts as a lubricant,
facilitating smooth sliding of one
surface over another during
respiratory movements
Squamous cell carcinoma: common among smokers; arises most
often from epithelial cells of segmental bronchi

What are the different types of lung

cancer?

Adenocarcinoma: most common in nonsmokers; usually arises

from epithelial cells more peripherally, in bronchioles and alveoli
Small cell carcinoma: less common but highly malignant; develops
after neoplastic transformation of small granule Kulchitsky cells in
bronchial respiratory epithelium

Transformation of the pseudostratified columnar epithelium into

a non-keratinized stratified squamous epithelium

What is squamous cell metaplasia?

Caused by environmental stress, notably cigarette smoke

Benign event that is reversible if the stress is removed
Not considered pre-cancerous, but can progress to pre-cancerous
dysplasia if the stress continues