RESPIRATORY SYSTEM

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RESPIRATORY SYSTEM
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Anatomy

• Upper respiratory tract
• Nasal cavity
• Paranasal sinuses
• Nasopharynx
• Lower respiratory tract
• Larynx
• Trachea
• Bronchial tree
• Respiratory part

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Airways wall

• Epithelium of the respiratory tract
• Lamina propria
• Submucosa

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Epithelium of the RT

• pseudostratified columnar with the cilia
• columnar ciliated cells
• goblet (mucous) cells
• brush cells (microvilli)
• Kultchitski cells (DNES)
• secretory cells (granulated)
• basal cells
• stratified sqamous epithelium

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Nasus et cavitas nasi

• function
• cavitas nasi mucosa
  - vestibulum ? lumen
  nasi
  
• regio respiratoria et olfactoria

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Sinus paranasales

• sinus maxillaris (15 cm3)
• sinus frontalis (8 cm3)
• sinus sphenoidalis (6 cm3)
• cellulae etmoidales (ant. et post.)
• the development
• epithelium
• function

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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
  - Waldeyers circle

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Larynx

• cartilage
• epiglottis
• lingual surface
• laryngeal surface
• vocal cords
• true
• false

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Larynx - cartilages

• cartilago thyroidea
• cartilago cricoidea
• cartilago epiglottica
• cartilago arytenoidea
• cartilago corniculata, cuneiformis et triticea

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Cavitas laryngis

• Aditus
• Vestibulum
  - plica vestibularis -
  lig.vestibularia -
  rima vestibuli, ventriculus
• Glottis
  - plica
  vocalis, rima glottidis
• Cavitas infraglottica
• lamina propria
• submucosa laryngis

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D1 - epiglottis (HE)
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D2 - larynx (HE)
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Trachea

• pars cervicalis thoracica
• bifurcatio tracheae (Th4)
• epithelium of the respiratory tract
• submucosa - glandulae tracheales
• cartilagines tracheales
• ligamenta anularia
• paries membranaceus (tracheal muscles, ligaments)

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D3 - trachea (HE)
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Bronchial tree

• Primary bronchi (bronchus pricipalis dx. et sin.)
• Secondary bronchi (bb. lobares ? bb.
  segmentales)
• Terminal bronchioles
• Respiratory bronchioles
• Alveolar corridors (ductus ? sacculi)
• Alveoli

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Bronchi

• cartilage - here and there
• smooth muscles - spiral
• epithelium - pseudostratified, ciliated
• lamina propria
  - seromucinous glands, elastic
  fibres
• lymphocytes, lymphatic follicles

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D4

Intrapulmonary bronchus (HE)

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Bronchioles

• epithelium
  - gradually simple cuboidal
  - Clara cells
• elastic fibres, smooth muscles
• no cartilage, no glands
  neither lymphatic follicles

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The lung

• Respiratory bronchi
• Alveolar corridors
• Alveoli
• Pleura

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Respiratory bronchioles

• simple, cuboidal, ciliated epithelium
  
• into alveoli
  - squamous epithelium
• bronchioles gradually transform into
  the alveolar corridors

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Alveoli

• 200 µm large,
  many-sided, thin wall
  
• alveolar epithelium
• alveolar septum

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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)

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Alveolar septum

• fibroblasts (collagen
  type I, III)
• endothelial capillary cells
• pericytes
• dust cells, lymphocytes
• alveolar cells
• reticular and elastic fibres
• inter-alveolar pores (10µm)

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D5 The lungs (HE)
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Alveolar-capillary barrier

• 0,1- 0,5µm
• alveolar cells (type I) cytoplasm
• basal membranes
• endothelial (capillary) cells
• respiratory surface 140 m2

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Surfactant

• 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

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Defence mechanism

• Nose airways - mucous, vibrissae
• Respiratory ciliated epithelium
• Alveolar macrophages
• T a B lymphocytes

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Pleura

• serose membrane - mezothelium
• parietal and visceral sheet
• cupula pleurae
• recessus pleurales (costodiaphragmaticus, costo-,
  phrenico- a vertebromediastinalis)
• pleural cavity - liquosus pleurae

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Respiratory system

• - the development

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The development of the RT

• begins in week 4
• day 24-26 - laryngotracheal groove
  gt laryngnotracheal diverticulum
  gt lung bud ? bronchial buds...
• tracheo-oesophageal septum gt
  ventral (laryngotracheal tube)
  dorsal (oropharynx, eosophagus)
  - parts of the foregut
• tracheoesophageal fistula

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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

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The development of the trachea

• endodermal lining
  gt epithelium and glands
• splanchnic mesoderm
  gt cartilages, connective tissue and muscles
  of the trachea

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The development of the bronchi and the lungs

• lung bud gt bronchial buds
• week 5 - primary bronchi gt lobar bronchi
• week 7 - segmental bronchi
  mesenchym gt bronchopulmonal segment
• the end of the week 24 - level 17 respiratory
  bronchiole
• the origin of the visceral, parietal pleura

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The maturation of the lungs

• 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

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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

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D6 Fetal lungs (HE)
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