ANATOMICAL BASIS OF THE

HUMAN RESPIRATORY SYSTEM

Erial Bahar
2018
 Lecture Outline
1. Anatomy of the respiratory system.
2. Overview of physiology of the respiratory
system.
3. Some common respiratory disorders.
 Functions of the Respiratory
System
1. Provides oxygen.
2. Eliminates carbon dioxide.
3. Regulates the blood’s hydrogen-ion concentration
(pH).
4. Forms speech sounds (phonation).
5. Defends against microbes.
6. Influences arterial concentrations of chemical
messengers by removing some from pulmonary
capillary blood and producing and adding others to
this blood.
7. Traps and dissolves blood clots.
 External and internal respiration.
During external respiration in the lungs, CO2 leaves blood and O2 enters blood.
During internal respiration in the tissues, O2 leaves blood and CO2 enters blood.
Mader: Human Biology, 7th Ed.
 The respiratory system
A. Nasal cavities—filter, warm, and moisten air
B. Pharynx (throat)—carries air into respiratory tract and food into
digestive tract
C. Larynx (voice box)—contains vocal cords
– Glottis- space between the vocal cords
– Epiglottis—covers larynx on swallowing to help prevent food from entering
D. Trachea (windpipe)
E. Bronchi—branches of trachea that enter lungs and then subdivide
– Bronchioles—smallest subdivisions
F. Lungs
– Organs of gas exchange
– Lobes: three on right; two on left
1. Alveoli
• Tiny air sacs where gases are exchanged
• Surfactant—reduces surface tension in alveoli; eases expansion of lungs
G. Pleura—membrane that encloses the lung
– Visceral pleura—attached to surface of lung
– Parietal pleura—attached to chest wall
– Pleural space—between layers
H. Mediastinum—space and organs between lungs
 Introduction
• The trillions of cells making
up the body require a
continuous supply of
oxygen to carry out vital
functions
• We can survive only a few
minutes without oxygen
• As cells use oxygen, they
give off carbon dioxide a
waste product of cellular
respiration which the body
must eliminate
• The major function of the
respiratory system is to
supply the body with
oxygen and dispose of
carbon dioxide
• To achieve this function four
distinct processes,
collectively called
respiration occur
1. Pulmonary ventilation
2. External respiration
3. Transport of respiratory
gases
4. Internal respiration (cellular
respiration
Introduction, cont.

• Pulmonary ventilation
– Air must be moved in and out of the lungs so that the gases in
the air sacs (alveoli) of the lungs are continually changed and
refreshed
– This air movement is commonly called ventilation or breathing
• External respiration
– Gas exchange (oxygen loading and carbon dioxide unloading)
must occur between the blood and the air-filled alveoli of the
lungs
• Transport of respiratory gases
– Oxygen and carbon dioxide must be transported between the
lungs and tissue cells of the body
– This is accomplished by the cardiovascular system, which uses
blood as the transporting fluid
• Internal respiration
– At the systemic capillaries, gas exchanges (oxygen unloading and
carbon dioxide loading) must be made between the blood and
tissue cells
 Respiratory System
• The organs of the
respiratory system
include :
• the nose, nasal cavity,
and paranasal sinuses
• pharynx,
• larynx,
• Trachea and bronchi,
• the lungs which contain
the terminal air sacs or
alveoli
 Respiratory tracts
1. Nasal cavities
2. Pharynx
Upper respiratory tracts
3. Glottis
4. Larynx
5. Trachea
6. Bronchi Lower respiratory tracts
7. Bronchioles
8. Lungs
 Respiratory System
• Functionally, the
respiratory structures
are divided into :
1. Conducting zones:
Visible structures
(air conduction
pathways)
2. Respiratory zone:
small structures lie
deep within the
lungs (gas
exchanges)
Conducting Zones
1. Nose and Paranasal sinuses
2. Pharynx
3. Larynx
 The Nose
• The functions of
the nose include:
1.Providing an airway
for respiration
2.Moistening and
warming entering air
3.Filtering inspired air
and cleansing it of
foreign matter
4.Serving as a
resonating chamber
for speech
5.Housing the olfactory
(smell) receptors
 The Nose
• The structures of the
nose are divided into
the
– External nose
– Nasal cavity
• Surface features
– Root (between eyes)
– Bridge
– Dorsum nasi
– Apex
– Philtrum
– External nares
– Alae nasi
The Nose - Nasal Cavity
• The nasal cavity lies in and posterior to the
external nose
• During breathing air enters the external
cavity by passing through the external nares
or nostrils
• The nasal cavity is divided by a midline nasal
septum
• The nasal cavity is continuous posteriorly
with the nasal portion of the pharynx
through the internal nares
The Nose - Nasal Cavity,cont.
• The roof of the nasal cavity is formed by the
ethmoid and sphenoid bones of the skull
• The floor is formed by the palate which
separates it from the oral cavity below
• Anteriorly, where the palate is supported by
the maxillary processes and the palatine
bones is considered the hard palate
• The unsupported posterior portion is the
muscular soft palate
The Nose - Nasal Cavity - Vestibule
• The vestibule is
lined with skin
containing
sebaceous and
sweat glands and
numerous hair
follicles
• The hair, or
vibrissae, filter
coarse particles
from inspired air
The Nose - Nasal Cavity – Mucous membrane

• The nasal cavity is lined with two types of

mucous membrane
1. The olfactory mucosa, lining the slitlike
superior region of the nasal cavity, contain the
receptors for the sense of smell
2. The balance of the nasal cavity is lined with
respiratory mucosa
The Nose - Respiratory Mucosa

• The respiratory mucosa is made up of

pseudostratified columnar epithelium,
containing scattered goblet cells, that rests
on a lamina propria
• This lamina propria is richly supplied with
compound tubuloalveolar glands that
contain mucous and serous cells
• Mucous cells secrete mucus, whereas
serous cells in glands secrete a watery fluid
containing digestive enzymes
The Nose - Respiratory Mucosa,cont.

• Each day the mucous glands secrete about a

quart of sticky mucous containing lysozyme,
an antibacterial enzyme
• The mucous traps inspired dust, bacteria and
other debris, while lysozyme attacks and
destroys bacteria chemically
• The epithelial cells of the respiratory mucosa
also secrete defensins, natural antibotics that
help to get rid of invading microbes
The Nose - Respiratory Mucosa- Ciliated cells

• The ciliated cells of the respiratory mucosa

create a gentle current that moves the
sheet of contaminated mucus posteriorly
toward the throat where it is swallowed
and digested by stomach juices
• These ciliated cells become sluggish in cold
weather allowing mucus to accumulate in
the nasal cavity where it “runs” on a cold
day when you come inside
The Nose - Respiratory Mucosa - Sneeze reflex

• The nasal mucosa is richly supplied with

sensory nerve endings
• A sneeze reflex is stimulated when irritating
particles (dust, pollen) contact this sensitive
mucosa
• The sneezing propels air outward in a violent
burst, expelling the irritant from the nose
The Nose - Respiratory Mucosa - Blood flow

• A rich plexus of thin walled capillaries

underlies the lamina propria of the nasal
mucosa and warms the incoming air as it flows
across the mucosal surface
• Blood flow increases when the temperature
decreases
• Because of its superficial location and the
extent of vessels, nosebleeds are common and
often profuse
 The Nose - Nasal Conchae
• Protruding medially
from each lateral wall
of the nasal cavity are
three mucosa-covered
projections, the
superior, middle of the
ethmoid bone and
inferior conchae
which is a separate
bone
 The Nose - Nasal Conchae - Meatus
• The groove inferior to
each concha is a
meatus
• As inhaled air moves
over the concha the
turbulance created
increases the amount
of contact between
the nasal mucosa and
this inspired air
• This acts to trap
particulates in mucus
The Nose - Nasal Conchae - Functions

• The conchae and nasal mucosa not only

function during inhalation to filter, heat, and
moisten air, but also act during exhalation to
reclaim this heat and moisture
• This reclamation mechanism minimizes the
amount of moisture and heat lost from the
body through breathing, helping us to survive
in dry and cold climates
The Nose - Paranasal Sinuses
• The nasal cavity is
surround by sinuses
located in the frontal,
sphenoid, ethmoid
and maxillary bones
• They function to
1. Produce mucus
2. Lighten the skull
3. Warm the air
4. Voice resonance
 The Pharynx
• The pharynx is the
funnel shaped
passage way than
connects the nasal
cavity and mouth
superiorly to the
larynx and the
esophagus
inferiorly
• Nasopharynx,
oropharynx,
laryngopharynx
 The Pharynx
• The pharynx serves as a common
pathway for food and air
• The pharynx extends for about 5
inches from the base of the skull to
the level of the sixth cervical
vertebrae
• In the context of the digestive
tract, the pharynx is commonly
called the throat
• The muscular wall of the pharynx On the basis of location
consists of skeletal muscle and function, the pharynx
throughout its length, but the is divided into :
nature of the mucosal lining varies
among the three pharyngeal 1. Nasopharynx,
regions 2. Oropharynx,
3. Laryngopharynx
 The Nasopharynx
• The nasopharynx lies
above the point of
food entry, it serves
only as an air
passageway
• During swallowing the
uvula reflects
posteriorly to close off
the nasopharynx and
prevent food from
entering the nasal
cavity
 The Nasopharynx - Adenoids
• The nasopharynx is
continuous with the
nasal cavity through
the internal nares
• It ciliated pseudo-
stratified epithelium
produces mucus
• Mucosa high on the
posterior wall contains
masses of lymphatic
tissue, the pharyngeal
tonsils or adenoids
 The Oropharynx
• The oropharynx lies
posterior to the oral
cavity and is
continuous with it
through an archway
called the fauces
• Both swallowed food
and air pass through
• Lined with stratified
squamous epithelium
for protection from
food abrasion and
chemical trauma
The Oropharynx - Tonsilae
• Two tonsils lie
embedded in the
oropharyngeal
mucosa
– Paired palatine tonsils
– Lingual tonsil
(posterior surface of
the tongue)
 The Laryngopharynx
• The laryngopharynx
serves as a common
pathway for food and
air and is lined with
stratified squamous
epithelium
• It lies directly
posterior to the
upright epiglottis and
extends to the larynx
where the digestive
and respiratory
pathways diverge
 The Laryngopharynx,cont.
• The esophagus
conducts food to the
stomach while air
enters the larynx
anteriorly
• During swallowing
food has the “right of
way” and air passage
temporarily stops
 The Larynx
• The larynx attaches
to the hyoid bone
superiorly and opens
into the
laryngopharynx
• Inferiorly is is
continuous with the
trachea
The Larynx - Functions
• The larynx has three important functions
1. It provides an airway for respiration
2. Act as a switching mechanism to route air and
food into the proper channels
3. Vocal cords housed in larynx are used in voice
production
 The Larynx
• The framework of
the larynx is an
arrangement of nine
cartilages connected
by membranes and
ligaments
• Except for the
epiglottis, all
laryngeal cartilages
are made of hyaline
 The Larynx - Cartilages
• There are nine
cartilages that make the
framework of larynx:
1. Thyroid
2. Cricoid
3. Epiglottis
4. arytenoid, anchors the
vocal cords
5. cuneiform
6. corniculate form part
of the lateral and
posterior walls of the
larynx
The Larynx - Cartilages
• The large, shield
shaped thyroid
cartilage is formed
by the fusion of two
cartilage plates
• The laryngeal
prominence marks
the midline fusion
point
• The cricoid cartilage
is anchored to the
trachea inferiorly
 The Larynx
• The ninth cartilage
the flexible, spoon
shaped epiglottis is
composed of elastic
cartilage
• It is almost entirely
covered by mucosa
• The epiglottis
extends from the
posterior aspect of
the tongue to its
anchoring point on
the thyroid cartilage
 The Larynx
• When only air is
flowing into the
larynx, the inlet to
the larynx is open
wide and the free
edge of the epiglottis
projects upward
• During swallowing
the larynx is pulled
superiorly and the
epiglottis tips to
cover the laryngeal
inlet
 The Vocal Folds
• The vocal ligaments
attach the arytenoid
and thyroid cartilages
• These ligaments are
composed of elastic
fibers
• The vocal cords
vibrate, producing
sound as air rushes
up from lungs
 The Vocal Folds
• The opening through
which air passes is
the glottis
• Superior to the vocal
cords are the
vestibular cords
which play no part in
voice production
 Vocal Folds
• Stratified squamous epithelium lines the
superior portion of the larynx, an area subject
to food contact
• Below the vocal folds the epithelium is
pseudostratified ciliated columnar epithelium
• Cilia move the mucus away from our lungs
 Voice Production
• Speech involves the intermittent release of
expired air and opening and closing of the
glottis
• The length of the true vocal cords and the size
of the glottis are altered by the action of the
intrinsic laryngeal muscles most of which
move the arytenoid cartilages
• As the length and tension of the vocal folds
change, the pitch of the sound is altered
 Voice Production
• The glottis is wide when we produce deep
tones and narrows to a slit for high pitched
sounds
• Length and thickness of the vocal folds
changes for males during puberty
• Loudness of the voice depends on the force
with which the airstream rushes across the
vocal cords
• The greater the force, the stronger the
vibration and the louder the sound
 Sphincter Functions of Larynx
• The vestibular folds can perform a sphincter
function under certain conditions
• In abdominal straining associated with
defecation and urination, inhaled air is held
temporarily in the lower respiratory tract by
closing the epiglottis
• The abdominal muscle then contract and the
interabdominal pressure rises
• The action know as the Valsalva manuever
can also stabilize the trunk when one lifts a
heavy load
 Innervation of the Larynx
• The larynx receives its sensory and motor
innervation through the superior laryngeal
branch of each vagus nerve and from the
recurrent laryngeal nerves, which branch off
the vagus in the superior thorax and loop
superiorly to ascend through the neck
• The backtracking course these nerves is
unusual
 The Tracheal Wall

• Its cilia continually propel mucus, loaded with dust

particles and other debris, toward the larynx
 The Tracheal Wall
• Smoking inhibits and ultimately destroys the
cilia in the mucosa layer
• When their function is lost, coughing is the
only means of preventing mucus from
accumulating in the lungs
• Smokers with respiratory congestion should
avoid medications that inhibit the cough reflex
 The Tracheal Wall

• The submucosa, a connective tissue layer, contains

seromucous glands that help produce the mucus
“sheets” within the trachea
 The Tracheal Wall

• The adventitia is a connective tissue layer that is

reinforced by 16 to 20 C-shaped rings of hyaline cartilage
 The Tracheal Wall

• The cartilage rings prevent the trachea from collapsing

and keep the airway open despite the changes in
pressure that occur in breathing
 The Tracheal Wall

• The open posterior parts of the rings, which abut the

esophagus are connected by smooth muscle fibers of the
trachealis muscle and soft connective tissue
 The Tracheal Wall

• Since this portion of the tracheal wall is not rigid, the

esophagus can expand anteriorly as swallowed food
passes through it
 The Trachea
• The last tracheal
cartilage is expanded
and a spar of
cartilage called the
carina projects
posteriorly from its
inner surface,
marking the point
where the trachea
splits
• Contacting this point
results in violent
coughing
 The Trachea
• Tracheal obstruction is life threatening
• The Heimlich maneuver was developed to
expel an obstruction using the residual air in
the victim’s lungs
• The maneuver creates interthoracic pressure
that drives the obstruction from its lodging
point
 The Conducting Zone

• The right and left main (primary) bronchi are the largest
conduits in the bronchial tree
 The Conducting Zone

• The right and left primary bronchi are formed by the

division of the trachea at the level of T4 (T7 living)
 The Conducting Zone

• Each bronchi runs obliquely in the mediastinum before

plunging into the medial depression (hilus) of the lung
on each side
 Conducting Zone: Bronchial Tree

• Once inside the lungs, each primary bronchus sub-

divides into secondary and then tertiary bronchi which
then divide further (23 orders of branching)
 The Conducting Zone

• Air passages under 1mm in diameter are called

bronchioles and the smallest of these are called terminal
bronchioles and are less than 0.5mm
 The Conducting Zone
• The tissue composition of the walls of the
primary bronchi mimics that of the trachea but
as the conducting tubes become smaller, a
number of structural changes occurs
– The cartilage supports change
• Rings are replaced by plates and then none at all
– The epithelium type changes
• Pseudostratified columnar, to columnar, to cuboidal
• Debris removed by macrophages at bronchiole level
– The amount of smooth muscle increases
• A complete layer of circular smooth muscle allows for
vasoconstriction and vasodilation
 The Respiratory Zone

• The respiratory zone begins as the terminal bronchioles

feed into respiratory bronchioles within the lungs
• Protruding from these smallest bronchioles are scattered
alveoli
 The Respiratory Zone
• The respiratory
bronchioles lead into
alveolar ducts
• The ducts lead into
terminal clusters of
alveoli called
alveolar sacs
• Respiration takes
place within the
alveoli
 The Respiratory Zone
• About 300 million air-filled alveoli crowd
together within the lungs, accounting for most
of the lung volume
• All these cells provide for a tremendous
surface area for gas exchange
• The total area of all alveoli in an average pair
of lungs is 140 square meters, or 1500 square
feet, which is 40 times greater than the
surface of the skin
 The Respiratory Zone

• The wall of each alveolus consists of a single layer

of squamous epithelial cells called Type I cells
surrounded by a delicate lamina
 The Respiratory Membrane
• The cell walls are
extremely thin to
allow for ease of gas
exchange
• The wall is 15 times
thinner than a piece
of paper
 The Respiratory Membrane
• The external surfaces of
the alveoli are densely
covered with a web of
pulmonary capillaries
• Together the alveolar
and capillary walls and
their fused basal lamina
form the respiratory
membrane with gas on
one side and blood on
the other
 The Respiratory Membrane
• Gas exchange occurs by
simple diffusion across
the respiratory
membrane
• Oxygen from the alveoli
passes into the blood
and carbon dioxide
leaves the blood to
enter the alveoli
 The Respiratory Membrane
• Scattered amid the type
I squamous cells that
form the alveoli walls
are cuboidal type II
cells
• Type II cells secrete a
fluid containing a
surfactant that coats
the alveolar surfaces
which prevents the
walls from sticking
during exhalation
 The Respiratory Membrane
• Lung alveoli have three
other features
– Surrounded by fine
elastic fibers
– Open pores connect
adjacent alveoli
• Allow for pressure
equalization
• Alternative air routes for
blocked bronchi
– Alveolar macrophages
crawl freely along the
internal alveolar surfaces
 The Respiratory Membrane
• Alveolar macrophages (dust cells) which
actually live in the air space and remove
the tiniest inhaled particles not trapped by
the mucus
• Most dust filled macrophages migrate from
the alveoli to the broncholes where ciliary
action carries them into the pharynx to be
swallowed
• By this mechanism over 2 million dust cells
are cleared each hour!
 The Pleurae
• Around each lung is a
flattened doulbe
layered sac whose
walls form a serous
membrane called the
pleurae
• There is an outer
parietal pleura and
an inner visceral
pleura
 The Pleurae
• The parietal pleura
covers the internal
surface of the
thoracic wall, the
superior surface of
the diaphragm and
the lateral surfaces of
the mediastinum
• It also enclosed the
great vessels running
to the lung root
 The Pleurae
• In the area of the
lung root the
membrane reflects
inward forming the
visceral pleura which
covers the entire
external lung surface
 The Pleurae
• The pleural cavity is
the space between
the parietal and
visceral pleurae
• It is actually a slit like
space filled with a
layer of pleural fluid
 The Pleurae
• Secreted by the pleurae, this lubricating fluid
allows the lungs to glide without friction over
the thoracic wall during breathing movements
• The fluid also holds the parietal and visceral
pleurae together, just as a film of oil or would
hold two glass plates together
 The Pleurae
• The two pleurae can easily slide from side
to side across each other, but their
separation is strongly resisted by the
surface tension of the fluid between the
membranes
• Consequently, the lungs cling tightly to the
thoracic wall and are forced to expand and
recoil as the volume of the thoracic cavity
increases and decreases during breathing
 The Pleurae
• The pleurae also help
divide the thoracic
cavity into three
separate
compartments
– Central mediastinum
with the heart
– Two lateral pleurae
each containing a
lung
 The Pleurae
• The compartments
prevent the moving
lungs or heart from
interfering with one
another
• The compartments
also limit the spread
of local infections
and the extent of
traumatic injury
 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
 The Lungs

• The anterior, lateral and posterior lung surfaces lie in

close contact with the ribs and forms a curving surface
called the costal surface
• The apex is the superior tip of the lung
 The Lungs

• The concave inferior surface that rests on the diaphragm

is called the base
• The hilus is the location where the pulmonary and
systemic circulation and the primary bronchi enter
 The Lungs
• The left lung is divided
into two lobes (upper
and lower) while the
right has three lobes
(upper, middle, lower)
• Each of the lobes
contains a number of
bronchopulmonary
segments separated by
connective tissue
• Each lung has 10 similar
segments
 The Lungs
• The bronchopulmonary segments have clinical
significance in that they limit the spread of
some diseases within the lung, because
infections do not easily cross the connective
tissue partitions between them
 The Lungs
• Furthermore,
because only small
veins span these
partitions, surgeons
can neatly remove
segments without
cutting any major
blood vessel
 The Lungs
• The smallest sub division of the lung is the
lobule
• Appearing on the lung surface as hexagons
ranging in size from the size of a pencil
eraser to the size of a penny each lobule is
served by a large bronchiole
• In most city dwellers and in smokers the
connective tissue that separates individual
lobules is blackened with carbon
 The Lungs
• The lungs consist largely of air tubes and
spaces
• The balance of the tissue, its stroma, is a
framework of connective tissue containing
many elastic fibers
• As a result the lungs are light, soft, spongy,
elastic organs that weigh only 1.25 pounds
• The elasticity helps to reduce the effort
required for breathing
 Blood Supply / Nerves of the Lungs

• The pulmonary arteries deliver oxygen poor blood

to the lungs for oxygenation
• In the lung, these arteries branch along the
bronchial tree
 Blood Supply / Nerves of the Lungs
• Generally, the arteries lie posterior to the
corresponding bronchi
• The smallest arteries feed into the
pulmonary capillary network around the
alveoli
• Oxygenated blood is carried from the alveoli
of the lungs back to the heart by the
pulmonary veins, whose tributaries generally
lie anterior to the corresponding bronchi
within the lungs
 Blood Supply / Nerves of the Lungs

• The lungs are innervated by sympathetic,

parasympathetic, and visceral sensory fibers
that enter each lung through the pulmonary
plexus on the lung root
• Parasympathetic fibers constrict the air
tubules whereas the sympathetic fibers dilate
them
 Ventilation
• Breathing or pulmonary ventilation consists of
two phases
– Inspiration is the period when air flows into the
lungs
– Expiration is the period when gases exit the lungs
 Inspiration
• During inspiration the lungs increase in
volume by enlarging in all dimensions
• Inspiration lowers the air pressure within the
lungs
• Air flows from areas of high pressure to areas
of low pressure to equalize the pressure
within the lung to that outside the lung
 Inspiration
• During normal quiet inspiration, the
diaphragm and external intercostal muscles
produce the muscle movement
 Inspiration
• When the dome
shaped diaphragm
contracts, it moves
inferiorly and
flattens
• As a result the
vertical dimension
of the thoracic
cavity increases
 Inspiration
• The external inter-
costal muscles
contract to raise the
ribs
• Because the ribs
normally extend
anterioinferiorly from
the vertebral column,
lifting them enlarges
both the lateral and
anterior dimensions
 Inspiration
• Although these
actions expand the
thoracic dimensions
by only a few
millimeters along
each plane, this
movement is
sufficient to increase
thoracic cavity
volume by almost a
pint which is equal
to normal resting
inspiration
 Inspiration
• During deep or forced
inspiration, additional
muscles contract and
further increase
thoracic volume
• The rib cage is
elevated by the
scalenes and sterno-
cleidomastoid in the
neck and the
pectoralis minor
 Expiration
• Quiet expiration in
healthy people is a
passive process
• As the respiratory
muscles relax, the
rib cage drops under
the force of gravity
and the relaxing
diaphragm moves
superiorly
 Expiration
• At the same time,
the many elastic
fibers with the lungs
recoil
• The result is that the
volume of the thorax
and lungs decrease
simultaneously,
which pushes air
from the lungs
 Expiration
• Forced expiration is an active process
produced by the contraction of muscles in
the abdominal wall, primarily the oblique and
transverse abdominis muscles
• These contractions
– Increase the interabdominal pressure which
forces the diaphragm superiorly
– Sharply depresses the rib cage and thus
decreases thoracic volume
 Expiration
• The internal intercostal muscles, quadratus
lumborum, and the latissimus dorsi also help
to depress the rib cage