Respiratory System

Structurally the respiratory system divided into:

 Upper respiratory tract (nose to larynx)
and
 Lower respiratory tract ( trachea
onwards) .
Functionally classified as:
 Conducting portion transports air.
- includes the nose, nasal cavity, pharynx, larynx,
trachea, and progressively smaller airways, from the
primary bronchi to the terminal bronchioles
 Respiratory portion carries out gas exchange.
- composed of small airways called respiratory
bronchioles and alveolar ducts as well as air sacs called
alveoli.
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Nose: The external nose consist of bone and cartilage
covered with skin and lined with mucus membrane.
 It has two openings called external nares or nostrils.
 The internal nose connect to the throat through two
openings called the internal nares.
Contains:
Respiratory area  inferior 2/3 of cavities &
Olfactory area  superior 1/3 of cavities.
 A vertical partition, the nasal septum, divides the
nasal cavity in to right and left sides.
 The septum consists of perpendicular plate of the
ethmoid bone, maxillae, vomer and septal
cartilages.
Anterior part of nasal septum is an area rich in
blood supply (Kiesselbach anastamosis) where
all five arteries supplying the septum
anastomose.
This area is site of profuse bleeding (epistaxis).
The major arteries of the septum:
1. anterior ethmoidal (ophthalmic)
2. posterior ethmoidal (opththalmic)
3. sphenopalatine (maxillary)
4. greater palatine (maxillary)
5. branch of superior labial (facial)
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Paranasal Sinuses: The paranasal sinuses(-para-beside)
are cavities within certain cranial and facial bones near the
nasal cavity.
• The paranasal sinuses are lined with mucous membranes.
• Secretions produced by the mucous membrane of the
paranasal sinuses drain into the lateral wall of the nasal
cavity.
• Paranasal sinuses are rudimentary or absent at birth and
increase in size during two critical periods of facial
enlargement—during the eruption of the teeth and at
the onset of puberty.
• Skull bones containing the paranasal sinuses are the
frontal, sphenoid, ethmoid bones, and the maxillae.
• The paranasal sinuses allow the skull to increase in size
without a corresponding change in the mass (weight) of
the bone.
• In addition, the paranasal sinuses serve as resonating
(echo) chambers within the skull that intensify and
prolong sounds, thereby enhancing the quality of the
voice.
Sinusitis is an inflammation of the mucous membrane of
one or more paranasal sinuses.
• It may be caused by a microbial infection (virus,
bacterium, or fungus) and allergic reactions,.
• If the inflammation or an obstruction blocks the
drainage of mucus into the nasal cavity, fluid pressure
builds up in the paranasal sinuses, and a sinus headache
may develop.
Pharynx: the pharynx or throat, is a funnel shaped tube
that starts at the internal nares and extends the
pathway down the neck.
 Pharynx is pathway for air and food
 The upper part of the pharynx, called the nasopharynx,
connects with the two internal nares and has two
openings that lead in to auditory (eustachian) tubes.
 The posterior wall contains the pharyngeal tonsils.
 The middle portion of the pharynx, the oropharynx,
opens in to the mouth and nasopharynx.
 Two pairs of tonsils, the palatine tonsils and lingual
tonsils are found in oropharynx.
 The lowest portion of the pharynx, laryngopharynx,
connects with both the esophagus (food tube) and the
larynx (voice box).
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 Larynx
Voice box is a short, somewhat cylindrical airway ends in
the trachea.
Conducts air into the lower respiratory tract.
Produces sounds.
Supported by a framework of nine pieces of cartilage
(three individual pieces and three cartilage pairs) that
are held in place by ligaments and muscles.
Nine C-rings of cartilage form the framework of the
larynx
Thyroid cartilage – (1) Adam’s apple, hyaline, anterior
attachment of vocal folds, testosterone increases size
after puberty
Cricoid cartilage – (1) ring-shaped, hyaline
Arytenoid cartilages – (2) hyaline, posterior attachment
of vocal folds.
Cuneiform cartilages - (2) hyaline
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Corniculate cartilages - (2) hyaline
Epiglottis – (1) elastic cartilage
 Epiglottis prevents food and drink from entering
airway when swallowing
Lined by pseudostratified ciliated columnar epithelium
Trachea: A flexible tube also called windpipe.
 Extends through the mediastinum and lies anterior to
the esophagus and inferior to the larynx.
 Anterior and lateral walls of the trachea supported by 15
to 20 C-shaped tracheal cartilages.
 Cartilage rings reinforce and provide rigidity to the
tracheal wall to ensure that the trachea remains open at
all times
 Posterior part of tube lined by trachealis muscle. Lined
by ciliated pseudostratified columnar epithelium.
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 Bronchi
 At the level of the sternal angle, the trachea bifurcates
into two smaller tubes, called the right and left primary
bronchi.
 Each primary bronchus projects laterally toward each
lung.
 The left and right primary bronchi progressively branch
into narrower tubes as they diverge throughout the lungs
before terminating in terminal bronchioles.
 Incomplete rings of hyaline cartilage support the
walls of the primary bronchi to ensure that they remain
open.
 Right primary bronchus is shorter, wider, and more
vertically oriented than the left primary bronchus.
 Foreign particles are more likely to lodge in the right
primary bronchus.
 The primary bronchi enter the hilus of each lung
together with the pulmonary vessels, lymphatic
vessels, and nerves.
 Each primary bronchus branches into several secondary
bronchi (or lobar bronchi).
 The left lung has two secondary bronchi. The right lung
has three secondary bronchi
 They further divide into tertiary bronchi.
 Each tertiary bronchus is called a segmental bronchus
because it supplies a part of the lung called a
bronchopulmonary segment.
 Secondary bronchi tertiary bronchi
bronchioles terminal bronchioles
 With successive branching amount of cartilage decreases
and amount of smooth muscle increases.
 During exertion and when sympathetic division active
 bronchodilation
 Parasympathetic stimulation cause release of mediators
of allergic reactions like histamine 
bronchoconstriction
 Epithelium gradually changes from ciliated
pseudostratified columnar epithelium to simple
cuboidal epithelium in terminal bronchioles
 The Lungs
• The lungs occupy all of the thoracic cavity
except the mediastinum
• Each cone shaped lung is suspended in its own
pleural cavity and connected to the mediastinum
External anatomy
 Spongy in texture and pink in color in young
but mottled black by carbon particles in adults
 Has
 An apex
 A base

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Apex
• Lie above anterior end of first rib
• Projects into the root of neck through the thoracic inlet
extending 1 inch above the medial 1/3 of clavicle
The base (diaphragmatic surface)
Rests on diaphragm which separates the right lung
from right lobe of liver and left lung from fundus of
stomach
It is found at the level of
• the 6th costal cartilage in the mid-clavicular line
• the 8th costal cartilage in the mid-axillary line
• rib 10 dorsally

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 The right lung

The right lung has 2 fissures and 3 lobes

Horizontal fissure
Divide the superior from the middle lobe
Oblique fissure
Between middle and inferior lobes

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Right Lung Left Lung

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 The left lung

Has superior and inferior lobe divided by an

oblique fissure
Large cardiac notch found on the mediastinal surface

Lingula - an anterior projection of the superior lobe

below cardiac notch overlies the anterior aspect of the
heart

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 Differences between right and left lung
Right lung Left lung
Size Larger and heavier Small and lighter
(700gm) (600gm)
Length and width Shorter & broader Longer and narrower

Anterior border Straight Cardiac notch &

lingula
Lobes and fissures Three lobes & two Two lobes & one
fissures fissure
Arterial supply One bronchial Two bronchial
artery arteries
Hilar structures PA between bronchi, Pulmonary artery
2 bronchi higher, 1 bronchus
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 Blood supply of the Lungs
Pulmonary arteries
• Two in number; one for each lung
• Derived from the bifurcated pulmonary trunk
• Carry poorly oxygenated blood to lungs for oxygenation
Bronchial arteries
• Supply blood to root of lungs, supporting tissue and
visceral pleura
Bronchial veins
• Drain only regions supplied by bronchial arteries; the rest
is drained by pulmonary veins

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 Pulmonary veins
• Four in number; two for each lung
• Carry well-oxygenated blood

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Alveoli: is a cupshaped outpouching lined by simple
squamous epithelium and supported by a thin elastic
basement membrane
 An alveolar sac consists of two or more alveoli that
share a common opening.
 The walls of alveoli consist of two types of alveolar
epithelial cells.
Type I alveolar(pneumocyte) cells, the predominant cells.
The thin type I alveolar cells are the main sites of gas
exchange.
Respiratory Zone of Lower Respiratory Tract
 Type II alveolar cells, also called septal cells, are fewer
in number and are found between type I alveolar cells.
 Type II alveolar cells, which are rounded or cuboidal
epithelial cells with free surfaces containing microvilli,
secrete alveolar fluid.
 This fluid keeps the surface between the cells and the air
moist. Included in the alveolar fluid is surfactant, a
complex mixture of phospholipids and lipoproteins.
 Surfactant lowers the surface tension of alveolar fluid,
which reduces the tendency of alveoli to collapse
  Surfactant lowers the surface
tension of alveolar fluid,which
reduces the tendency of alveoli to
collapse
Respiratory movements
• Breathing or pulmonary ventilation consists of
two phases
Inspiration: the period when air flows into
the lungs
Expiration: the period when gases exit the
lungs
• Lungs expand during inspiration and retract
during expiration. 39
Inspiration
• During inspiration the lungs increase in volume by
enlarging in all dimensions

• Air flows from areas of high pressure to areas of low

pressure to equalize the pressure within the lung to that
outside the lung

• During normal quiet inspiration, the diaphragm and

external intercostal muscles produce the muscle
movement
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 Action of diaphragm during Inspiration

• When the dome shaped

diaphragm contracts, it
moves inferiorly and
flattens
• As a result, the vertical
dimension of the
thoracic cavity
increases

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 Action of intercostal during Inspiration
• The external intercostal
muscles contract to raise the
ribs
• Because the ribs normally
extend anterio-inferiorly
from the vertebral column,
lifting them enlarges both the
lateral and anterior
dimensions

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 Deep inspiration
• During deep or forced inspiration, additional muscles
contract and further increase thoracic volume
• The rib cage is elevated by the scaleni and sterno-
cleidomastoid muscle
• Scapulae are elevated and fixed by trapezius, levator
scapulae, rhomboids so that serratus anterior and
pectoralis minor act on ribs

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Expiration
• As the respiratory muscles relax,
the rib cage drops under the
force of gravity and the
relaxing diaphragm moves
superiorly
• At the same time, the many
elastic fibers within the lungs
recoil
• As a result, the volume of the
thorax and lungs decrease
simultaneously, which pushes
air from the lungs

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Forced expiration
• Quiet expiration in healthy people is a passive process
• Forced expiration is an active process produced by the
contraction of muscles in the abdominal wall, primarily
the external & internal oblique and transverse
abdominis muscles
• These contractions
Increase the intrabdominal pressure which forces the
diaphragm superiorly
Sharply depresses the rib cage and thus decreases thoracic
volume
• The internal intercostal muscles, quadratus lumborum
and the latissimus dorsi also help to depress the rib
cage

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