RESPIRATORY SYSTEM

Jean Flor C. Casauay

UPCP Department of Pharmacy
Ph 112: AY 2014-2015

Functions

promotes gas exchange

helps regulate blood pH
contains receptors for the sense of smell
filters inspired air
produces vocal sounds
excretes small amounts of water & heat

Structural Classification
Upper Respiratory System
nose, pharynx, & associated structures
Lower Respiratory System
larynx, trachea, bronchi, lungs

Functional Classification
Conducting Zone
nose, pharynx, larynx, trachea, bronchi,
bronchioles, terminal bronchioles
Volume: 150mL
Respiratory Zone
respiratory bronchioles, alveolar ducts, alveolar
sacs, & alveoli
Volume: 5-6L

Terms
Otorhinolaryngology
diagnosis & treatment of diseases of the ears,
nose & throat
Pulmonologist
specialist in the diagnosis & treatment of
diseases of the lungs

1. NOSE
External Nose
Bony framework
Cartilaginous framework
External nares or nostrils
Internal Nose

Lateral walls
Nasal cavity
Internal nares
Olfactory epithelium

External Nose

Functions of the Interior Structures of the

External Nose
warming, moistening, & filtering incoming air
detecting olfactory stimuli
modifying speech vibrations as they pass through the
large, hollow resonating chambers.

INTERNAL NOSE
Large cavity in the:
Anterior aspect of the skull
Lies inferior to the nasal bone
Lies superior to the mouth
Composed of:
Lateral walls
Nasal cavity
Internal nares
Olfactory epithelium

Internal Nose
lateral walls: ethmoid, maxillae, lacrimal, palatine, &
inferior nasal conchae bones

Internal Nose
nasal cavity: space within
vestibule:
anterior portion just inside the nostrils
lined by skin containing coarse hairs that filter out large
dust particles

nasal septum: vertical partition that divides it into

right & left sides
conchae: subdivide each side of it into a series of
groovelike passageways - the meatuses

Internal Nose
internal nares or choanae: two openings
posterior to the nasal cavities opening into the
nasopharynx
olfactory epithelium: olfactory receptors

Air enters the nostrils.

It passes through the vestibule.
It is warmed by blood in the capillaries as
inhaled air whirls around the
conchae & meatuses.
Mucus moistens the air & traps dust particles.
The cilia move the mucus & trapped dust
particles toward the pharynx.

2. Pharynx
throat
funnel-shaped tube
starts at the internal nares & extends to the
level of the cricoid cartilage
Location:
Posterior to the nasal and oral cavities
Superior to the larynx
Anterior to the cervical vertebrae

Pharynx
functions:
passageway for air &
food
provides a resonating
chamber for speech
sounds
houses the tonsils

Nasopharynx
superior portion
Has 5 openings in its wall:
2 internal nares
2 openings that lead into auditory tubes
Opening into the oropharynx
Posterior wall houses the pharyngeal tonsil

Nasopharynx
Functions:
Receives air from the nasal cavity and receives
packages of dust-laden mucus
Cilia in the nasopharynx move the mucus down
towards the most inferior part of the pharynx
Exchanges small amounts of air with the auditory
tubes to equalize air pressure between the
pharynx and the middle ea

Oropharynx
intermediate portion
Lies posterior to the oral cavity
Has only one opening; fauces (opening from
the mouth)
Houses palatine & lingual tonsils
Function: a common passageway for air,food
and drink

Laryngopharynx
Inferior portion ;
hypopharynx
Begins at the level of hyoid
bone
It opens into esophagus
inferiorly
It opens into the larynx
anteriorly
functions:
respiratory & digestive
functions

3. Larynx
voice box
short passageway that connects the laryngopharynx
with the trachea
Lines in the middle
of the neck
Anterior to the C4-C6

3. Larynx
The wall is composed of 9 cartilages:
epiglottis, thyroid & cricoid cartilages
arytenoid, cuneiform, & corniculate cartilages (in
pairs)

Parts and functions

Epiglottis
Large leaf-shaped piece of elastic cartilage
closes the glottis (vocal folds + rima glottidis)
Thyroid Cartilage (Adams apple)
Consists of two-fused hyaline cartilage that form the
anterior wall of the larynx
usually larger in males
Thyrohyoid membrane

Functions
Epiglottis: the leaf is the broad superior portion that
is unattached and is free to move up and down like a
trap door

Functions
Cricoid Cartilage
landmark for making an emergency airway
(tracheostomy)
Cricotracheal ligament attaches the cricoid cartilage to
the first ring cartilage of trachea
Cricothyroid ligament- connects the thyroid cartilage to
the cricoid cartilage

Functions
Arytenoid Cartilages
Triangular pieces of hyaline cartilage located at the
posterior, superior border of the cricoid cartilage
influence changes in position & tension of the vocal folds
(true vocal cords for speech)
Corniculate Cartilages
Horn-shaped pieces of elastic cartilge located at the apex
of each arytenoid cartilage
supporting structures for the epiglottis
Cuneiform Cartilages
support the vocal folds & lateral aspects of the epiglottis

Structures of Voice Production

ventricular folds (false vocal cords)
vocal folds (true vocal cords)
thicker & longer in males (androgens) slow
vibration

rima vestibuli or rima glottidis

space between the ventricular folds

laryngeal sinus
lateral expansion of the middle portion of the
laryngeal cavity

Laryngitis
inflammation of the larynx
common causes:
respiratory infection
irritants

hoarseness or loss of voice

interfering with the contraction of the folds
causing them to swell to the point where they
cannot vibrate freely

CA of the Larynx
found almost exclusively in individuals who
smoke
hoarseness, pain on swallowing, or pain
radiating to an ear
treatment: radiation therapy &/or surgery

4. Trachea
windpipe
tubular passageway for air
anterior to the esophagus
extends from the larynx to the superior border
of T5
Composed of 16-20 incomplete horizontal
rings of hyaline cartilage that resemble the
letter C

Trachea
C-shaped hyaline cartilage rings
slight expansion of the esophagus into the trachea
during swallowing
semirigid support so that the tracheal wall does
not collapse inward (inhalation) & obstruct the air
passageway

trachealis muscle & elastic connective tissue

stabilize the open ends of the cartilage rings

TRACHEA
Layers of the tracheal wall (deep to
superficial):

Causes of Tracheal Obstruction

rings of cartilage may
collapse due to a crushing
injury to the chest
inflammation of the mucous
membrane
vomit or a foreign object
may be aspirated into it
cancerous tumor may
protrude into the airway

Management for tracheal obstructioN

1. tracheostomy
operation to make an opening into the
trachea
A skin incision is followed by a short
longitudinal incision into the trachea inferior
to the cricoid cartilage.
The patient can then breathe through a metal
or plastic tracheal tube inserted through the
incision.

Management for tracheal obstructioN

2.Intubation
tube is inserted into the mouth or nose &
passed inferiorly through the larynx & trachea
The firm wall of the tube pushes aside any
flexible obstruction, & the lumen of the tube
provides a passageway for air;
any mucus clogging the trachea can be
suctioned out through the tube.

5. Bronchi
The trachea divides
into right & left
primary bronchi
right: more
vertical, shorter,
& wider

Bronchi
carina
internal ridge at the
point where the trachea
divides into right & left
primary bronchi
Widening and distortion
usually indicates
carcinoma

Trachea
Primary Bronchi
Secondary (Lobar) Bronchi
pseudostratified ciliated columnar epithelium

Tertiary (Segmental) Bronchi

pseudostratified ciliated columnar epithelium

Bronchioles
ciliated simple columnar epithelium w/ some goblet cells
(larger bronchioles)
ciliated simple cuboidal epithelium w/ no goblet cells
(smaller bronchioles)

Terminal Bronchioles
nonciliated simple cuboidal epithelium

Amount of Cartilage

pseudostratified ciliated columnar epithelium

Amount of Smooth Muscle

pseudostratified ciliated columnar epithelium

BRONCHI
Structural changes in the bronchial tree:
1. Type of epithelium in the mucous membrane
2. Plates of cartilage gradually replace the
incomplete rings of cartilage in the primary
bronchi and finally disappear in the distal
bronchioles
3. Amount of cartilage decreases, the amount
of smooth muscle increases

6. Lungs
paired cone-shaped organs in the thoracic
cavity
separated by the heart & other structures in
the mediastinum

Lungs
right lung:
thicker & broader
shorter than the left lung
superior, middle, & inferior lobes

left lung:
about 10% smaller than the right lung
superior & inferior lobes

Pleural Membrane
Layers:
parietal pleura: superficial; lines the wall of the
thoracic cavity
visceral pleura: deep; covers the lungs themselves
Pleural cavity
small space between the pleurae
contains a small amount of lubricating fluid
secreted by the membranes

terms
pleurisy or pleuritis: inflammation of the pleural
membrane
pleural effusion: excess fluid accumulates in the
pleural space

Pneumothorax & Hemothorax

Pneumothorax (air)
causes: surgical opening of the chest, stab or gunshot
wound
may cause the lungs to collapse (atelectasis)
Hemothorax (blood)
Treatment: evacuation of air or blood from the
pleural space

pneumothorax

Thoracentesis
removal of excessive fluid in the pleural cavity
inserting a needle anteriorly through the 7th
intercostal space

Surface Anatomy of the Lungs

base

broad inferior portion

concave & fits over the convex area of the diaphragm

apex

narrow superior portion

cardiac notch
concavity in the left lung
in which the heart lies

Surface Anatomy of the Lungs

costal surface

surface of the lung lying

against the ribs
matches the rounded
curvature of the ribs

mediastinal (medial)
surface

contains the hilum: through

which bronchi, pulmonary
blood vessels, lymphatic
vessels, & nerves enter & exit

Surface Anatomy of the Lungs

Fissures divide each lung into lobes:
oblique fissure
both lungs
horizontal fissure
right lung
subdivides the superior lobe forming the middle
lobe

Lobe of the lungs

Each lobe receives its own secondary bronchus.
Right primary bronchus give rise to superior, middle
and inferior secondary bronchi
Left primary bronchus give rise to superior and
inferior secondary bronchi

Secondary bronchi give rise to tertiary bronchi.

There are ten tertiary bronchi in each lung.

Bronchopulmonary Segment
segment of lung tissue that each tertiary bronchus
supplies
Bronchial & pulmonary disorders (such as tumors or
abscesses) that are localized in a bronchopulmonary
segment may be surgically removed w/o seriously
disrupting the surrounding lung tissue.
has many small compartments called lobules

lobule
wrapped in elastic connective tissue
contains a lymphatic vessel, an arteriole, a venule, &
a branch from a terminal bronchioles
Terminal bronchioles subdivide into microcopic
branches called respiratory bronchioles
Respiratory bronchioles subdivide into several
alveolar ducts

Alveoli & Alveolar Sac

alveoli
cup-shaped outpouching
300M, provides an immense surface area of 70m2

alveolar sac
2 or more alveoli that share a common opening

Alveolar Wall
-consist of two types of alveolar epithelial cells:
type I alveolar cells
The predominant cells
Main sites of gas exchange
type II alveolar cells
Septal cells
Found between type I alveolar cells
Secretes alveolar fluid

Alveolar fluid
keeps the surface between the cells & the air
moist
contains, surfactant
a complex mixture of phospholipids & lipoproteins
Lowers the surface tension of alveolar fluid which
reduces the tendency of alveoli to collapse

Alveolar Wall
alveolar macrophages (dust cells)
Wandering phagocytes that remove fine dust
particles & other debris from the alveolar spaces

Respiratory Membrane
Allows rapid diffusion of gases between the
lungs and the blood
Consists of 4 layers:
Alveolar wall consists of type I and II alveolar
cells and alveolar macrophages
Epithelial basement membrane
Capillary basement membrane
Endothelial cells of the capillary

END