Respiratory System

Overview: two lungs + series of airways that connect lungs to external environment Respiration includes 4 major events 1. Breathing: movement of air in and out of the lungs 2. External Respiration: exchange of O2 in inspired air for CO2 in the blood 3. Transport of Gases: conveyance of O2 and CO2 to and from the cells 4. Internal Respiration: exchange of CO2 for O2 in the vicinity of the cells Functionally 1. Conducting portion y nose, pharynx, larynx, trachea, bronchi, bronchioles up to and including the terminal bronchioles 2. Resipratory Portion- gas exchange y respiratory bronchioles, alveolar ducts, alveolar sacs Structurally A. Upper Resp. System: nose, pharynx, associated structures Most of air HERE (5-6 L) B. Lower Resp. System: larynx, trachea, bronchi, lungs 150mL of air here Airway flow is inversely proportional to resistance MEDIUM SIZE BRONCHI are the sites of HIGHEST resistance *K-N-O-W y smaller airways have parallel arrangements y total resistance becomes sum inverse of resistances Mechanics of Breathing Inflow and outflow of air due to: 1. Rib cage 2. DIAPHRAGM muscle (most important) 3. Intercostal muscles 4. Elastic connective tissue of the lung *KNOW air behaves as fluid, moving from high to low pressure Conducting Portion Nose terminal bronchioles y Airways kept open by rigid or semi rigid walls supported by: bone, cartilage, smooth muscle y NO GAS EXCHANGE occurs in this portion y Airways purpose is to warm, moisten, filter air y Pseudostratified ciliated columnar epithelium y THICK basement membrane before lamina propria y 5 cell types, all in contact with basement membrane y ENDODERM derived (mostly) *KNOW 1. Goblet Cells y mucus traps particulate matter, moistens air y Cl- secretion *KNOW 2. Ciliated Columnar Cells y effective stroke towards oropharynx y form mucociliary escalator 3. Basal Cells y stem cells 4. Brush Cells y in every airway, function unknown, microvilli 5. DNES cells/APUD cells y small granule cells, release serotonin? Maybe reflex?

A. Nasal Cavity 1. External Nares- nostrils, thin skin 2. Vestibule: thin skin with hairs to filter dust particles 3. Nasal Cavity Proper y divided by nasal septum y lined by respiratory epithelium y seromucus glands in lamina propria help moisten air y communicates with pharynx via internal nares/choanae y vascular lamina propria; blood flows posterior to anterior y Air flows anterior to posterior: countercurrent heat exchange Swell bodies: erectile tissue containing a large venous plexus in lamina propria over conchae y swell every hour; decrease airflow in that side y swollen side given time to rehydrate Conchae cause turbulence in air y Facilitates contact with mucus covering resp. epithelium 4. Olfactory Mucosa y pseudostratified epithelium with three cell types (i) Olfactory receptors: 5+ million y first-order, bipolar neurons y Single axon projects from each olfactory receptor Schwann cells surround but axon is UNMYELINATED Collect into fasicles in lamina propria Fasicles pass through cribiform plate y olfactory knob with long, nonmotile cilia Cilia act as odor receptors Coupled to G-proteins (ii) Supporting Cells: columnar epithelial cells y Nuclei in upper 1/3 of epithelium y Physical support, nourishment, electrical insulation (iii) Basal Cells: on basal lamina y Nuclei located in lower 1/3 of epithelium y STEM CELLS for all three cell types B. Paranasal Sinuses y Mucoperiosteum-lined spaces, communicate w nasal cavity y Lined by respiratory epithelium y Lamina propria have seromucous glands C. Nasopharynx y Begins at choana, becomes oropharynx at soft palate y Lined by respiratory epithelium y Lamina propria has seromucous glands, LYMPHOID tissue Pharyngeal tonsil y connected to middle ear by Eustachian Tube D. Larynx Supported by: y Hyaline cartilage (thyroid, cricoid, arytenoids) y Elastic cartilage (epiglottis, corniculate, tips of arytenoids) Lumen has 2 sets of folds: 1. False vocal chords (superior) y loose CT with seromucous glands, lymphoid cells, fat cells y covered by stratified squamous nonkeratinized cells 2. True vocal chords (inferior) y skeletal muscle (vocalis) and vocal ligament (elastic fibers) y covered by stratified squamous nonkeratinized epithelium y no glands in lamina propria y ADduction creates sound- phonation

y Below chords, lining becomes respiratory epithelium E. Trachea y Begins at cricoid cartilage of larynx, ends when it bifurcates into primary bronchi y Walls supported by C-rings of hyaline cartilage Open ends face posteriorly Keep trachea from collapsing with inhalation y Trachealis (smooth) muscle extends between open ends contraction decreases diameter of trachea = faster airflow, expel lodged object y Dense fiborelastic CT between adjacent C-rings allow elongation of trachea during inhalation 1. Mucosa: respiratory epithelium y thick underlying basement membrane y thin lamina propria with longitudinal elastic fibers 2. Submucosa: dense, irregular fibroelastic CT y contains numerous seromucous glands 3. Adventitia: fibroelastic CT containing C-rings of hyaline cart y forms outer layer of trachea, anchors it to adjacent structures Bronchial Tree Begins at bifurcation of trachea, left and right primary bronchi Composed of airways located inside and outside the lungs Trends (*K-N-O-W) y Decreasing diameter of lumen, increase total surface area y Decreasing amount of cartilage, increase in smooth muscle relative to diameter of airway lumen y Increase in amount of elastic fibers relative to diameter y Decreases in height & number of cilia on lining epithelium y Decrease in number of glands F. Bronchi 1. Primary/Main bronchi (2) y Mixed glands, O-rings of cartilage y Accompanying pulmonary arteries, veins, lymph vessels Together pierce hilus of lung y right trifurcates (more vertical), left bifurcates 2. Secondary/Lobar bronchi y intrapulmonary bronchi y supply LOBE of lung; 2 on left, 3 on right 3. Tertiary/Segmental bronchi y subdivisions of secondary bronchi y each goes to bronchopulmonary segment Intrapulmonary Bronchi y C rings replaced by irregular plates of hyaline cartilage Completely surround the lumen y 2 smooth muscle layers spiraling in opposite directions y increasing number of elastic fibers y mixed seromucous glands G. Conducting Bronchioles y Short, branched tubes, each supplying pulmonary lobule y lack cartilage and glands, smooth musc keeps airways open EPITHELIUM CHANGE: to simple columnar ciliated w goblet Sympathetic: Epinephrine acts on B2 adrenergic receptors y Relaxation and increase diameter of airways Parasympathetic: Vagus N., muscarinic (ACh) receptors y Constriction and decrease diameter of airways

H. Terminal Bronchioles y Last portion of conducting airways y Supply air to lung acini y Simple cuboidal ciliated epithelium, NO GOBLET CELLS Not secreting mucus anymore, still elevating mucus (cilia) CLARA CELLS- columnar with dome shaped apices y Secretory cell of terminal bronchioles: surfactant-like product that prevent collapse during exhalation, proteolytic enzymes to

Histamine, Leukotrienes, PGs: bronchiolar constriction Respiratory Portion A. Respiratory Bronchioles y Supply an acinus y Simple cuboidal epithelium with Clara Cells, some cilia y Number of ciliated cells decrease, Clara cells increase y One side of wall interrupted by alveoli y Opposite wall has branch of pulmonary artery B. Alveolar Ducts y Linear passageway continuous with respiratory bronchiole y Lined by highly attenuated simple squamous epithelium (type 1 pneumocytes) & types II pneumocytes y Alveoli on both sides, increasing in number y Separated by interalveolar septum Smooth muscle adjacent to alveolar openings C. Alveolar Sacs y Expanded outpouchings of numerous alveoli located at distal end of alveolar ducts y NO SMOOTH MUSCLE D. Alveoli y Thin walled, pouch-like evaginations of resp. bronchioles, alveolar duct, and alveolar sacs (respiratory portion) y Allows exchange of O2 and CO2 y Separated by interalveolar septa Contain PORES, permit equalization of pressure also spread infection y rimmed by elastic fibers, supported by reticular fibers 1. Type 1 Pneumocytes: FLAT, simple squamous y 95% of alveolar surface y THIN cytoplasm gas exchange y TIGHT JUNCTIONS, cannot divide 2. Type II pneumocytes: cuboidal, microvilli y 5% of alveolar surface y TIGHT JUNCTIONS, can divide and regenerate both I&II y Membrane bound lamellar bodies produce & secrete surfactant Surfactant: y 2 phospholipids- dipalmitoyl phosphatidylchoine (DPPC) y released by exocytosis into lumen of alveolus y spreads to form monomolecular film over alveolar surface lower aqueous phase superficial lipid phase *REDUCES SURFACE TENSION of alveolar surface y expansion during inspiration, prevent collapse w expiration 3. Alveolar Macrophages: aka dust cells y monocytes between type 1 pneumocytes, enter lumen y phagocytose particulate matter, surfactant y released when debris in lumen, migrate up y last ditch attempt to get rid of foreign material y produce elastase (not released in healthy lung) y heart failure cells full of RBCs in CHF

break down mucus, protease inhibitor, lysozymes y Also act as STEM CELLS

E. Interalveolar Septum Partition lined on both sides by thin alveolar epithelium 1. Thick Regions: CONTINOUS CAPILLARIES (leaky) K-N-O-W y interstitial space btw unfused basal laminas y elastic and reticular fibers, macrophages, MAST CELLS 2. Thin Regions y blood-air barrier site of gas exchange Four layers: *KNOW a. Endothelium of continuous capillaries with septum b. Fused basal lamina of type 1 pn. And endothelial cells c. Type 1 pneumocytes d. Surfactant

F. Lung Lobules y Contain single primary bronchi that branches y Separated by connective tissue septum y Veins and lymphatics run in septa

G. Vascular Supply 1. Pulmonary Artery: carries deoxygenated blood to lungs y enters lobules, path parallels the bronchioles branching 2. Pulmonary Veins: carries oxygenated blood back to left heart y run in intersegmental CT, separate from arteries y after leaving lobule, run with pulmonary artery 3. Bronchiole arteries and veins: nourish nonrespiratory parts y branch with bronchiole tree y anastomose with pulmonary vessels near capillary beds

H. Pulmonary Nerve Supply ANS fibers to smooth muscles of bronchi and bronchioles Parasympathetic: contraction Sympathetic: relaxation *Asthma- constriction of smooth muscle, inability to expire air y B2 agonists (sym mimic) alleviate