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Chapter 24 Respiratory system Black carbon deposits seen in the large holes. The alveoli that used to occupy those spaces have broken down, creating large, rather than small sacs. • I. Functions • A. Functions: • 1. Allows oxygen from air to enter blood & carbon dioxide in blood to leave body in exhaled air. • - Inspiration & Expiration • 2. help maintain proper acid-base balance of blood –CO2 in blood = carbonic acid • 3. produces vocal sounds through phonation • B. Divisions • 1. Upper respiratory system: Nose, paranasal sinuses, pharynx, nasal cavity. • “condition the air”: humidify, warm, filter (nose hairs, mucus). Protect lower respiratory systems from debris, pathogens & temp. extremes. • 2. Lower respiratory system: larynx, trachea, bronchi, lungs • • • • • • • • • • • • • II. Upper Respiratory System A. Nasal cavity 1. superior, middle, inferior nasal conchae: for air turbulence & increase surface area for warming & humidifying. 2. superior, middle, inferior meatus: spaces between conchae 3. nasal septum (made from ethmoid & vomer bones) 4. eustacian tube opening B. Paranasal sinuses 1. Frontal sinuses(2), sphenoid air cells, ethmoid air cells, maxillary sinuses(2) 2. Reduce weight of skull, help voice resonate C. Epithelium 1. Stratified squamous near nares. 2. ciliated pesudostratified columnar with goblet cells (respiratory epithelium) 3. olfactory epithelium Figure 24.1 Structures of the Respiratory System Frontal sinus Nasal cavity Nasal conchae Nose Sphenoidal sinus Internal nares Tongue Nasopharynx UPPER RESPIRATORY SYSTEM LOWER RESPIRATORY SYSTEM Hyoid bone Larynx Esophagus Trachea Bronchus Clavicle Bronchioles RIGHT LUNG Ribs LEFT LUNG Diaphragm Figure 24.4a Respiratory Structures in the Head and Neck, Part II Frontal sinus Nasal cavity Superior Middle Internal nares Inferior Nasal conchae Nasopharynx Nasal vestibule Pharyngeal tonsil External nares Entrance to auditory tube Hard palate Soft palate Palatine tonsil Oral cavity Oropharynx Tongue Epiglottis Mandible Aryepiglottic fold Lingual tonsil Hyoid bone Laryngopharynx Thyroid cartilage Glottis Cricoid cartilage Vocal fold Trachea Esophagus Thyroid gland A sagittal section of the head and neck © 2012 Pearson Education, Inc. Figure 24.4b Respiratory Structures in the Head and Neck, Part II Ethmoidal air cell Medial rectus muscle Cranial cavity Frontal sinus Right eye Lens Lateral rectus muscle Superior nasal concha Superior meatus Middle nasal concha Nasal septum Perpendicular plate of ethmoid Vomer Hard palate Middle meatus Maxillary sinus Inferior nasal concha Inferior meatus Tongue Mandible A coronal (frontal) section of the head showing the positions of the paranasal sinuses and nasal structures Figure 24.2a Histology of the Respiratory Epithelium Movement of mucus to pharynx Ciliated columnar epithelial cell Mucous cell Stem cell Mucous layer Lamina propria Diagrammatic view of the respiratory epithelium III. Lower Respiratory Tract A. Larynx - Superiorly, attaches to hyoid bone. Inferiorly it is continuous with the trachea. 1. Epiglottis- elastic cartilage 2. 9 cartilages support the larynx & vocal cords. 1. Thyroid cartilage (2)- large, 2 cartilage plates. Laryngeal prominence 2. Cricoid cartilage- only cartilage forms a complete ring. 3. Arytenoid cartilage (2) anchor the vocal cords 4. Corniculate cartilage (2) 5. Cuneiform cartilage (2) 3. Ligaments & Membranes 1. Thyrohyoid ligament 2. Thyroid membrane 3. Cricothyroid ligament 4. Cricotracheal ligament Figure 24.5 Respiratory Structures in the Head and Neck, Part III (Part 1 of 1) Inferior nasal concha Hard palate Arbor vitae of cerebellum Choroid plexus Soft palate Foramen magnum External occipital crest Dens of axis (C2) Atlas (C1) (posterior arch) C3 Laryngopharynx Tongue Nasopharynx Uvula Atlas (C1) (anterior arch) Oropharynx Mandible Epiglottis C4 Spinal cord Hyoid bone C5 Ventricular fold C6 Spinous processes of vertebrae C7 Vocal fold Thyroid cartilage Cricoid cartilage T1 Tracheal cartilages Esophagus T2 Trachea T3 External jugular vein Right common carotid artery Manubrium of sternum Aortic arch Pleural cavity Left brachiocephalic vein Body of sternum B. Vocal Cords 1. Vestibular ligament (false vocal cord) – superior play no part in producing sound. 2. Vocal ligament (true vocal cord)- inferior - Between thyroid cartilage & arytenoid cartilages. Ligament that is covered with mucosal folds. This mucosa is avascular: appear pearly white. Sound production, pitch, Glottis space btwn true vocal cords Figure 24.6a Anatomy of the Larynx Epiglottis Lesser cornu Hyoid bone Thyrohyoid ligament (extrinsic) Thyroid cartilage Larynx Laryngeal prominence Cricothyroid ligament (intrinsic) Cricoid cartilage Cricotracheal ligament (extrinsic) Trachea Tracheal cartilages Anterior view of the intact larynx © 2012 Pearson Education, Inc. Figure 24.6d Anatomy of the Larynx Hyoid bone Thyrohyoid membrane Epiglottis Thyroid cartilage Vestibular ligament (false vocal cord) Corniculate cartilage Arytenoid cartilage Vocal ligament (true vocal cord) Cricothyroid ligament Cricoid cartilage Cricotracheal ligament Tracheal cartilages ANTERIOR POSTERIOR Sagittal section of the intact larynx Figure 24.7ab The Vocal Cords Corniculate cartilage POSTERIOR Corniculate cartilage Glottis (closed) Cuneiform cartilage Glottis (open) Aryepiglottic fold Vestibular fold Vocal fold Vocal fold Vestibular fold Epiglottis Epiglottis Root of tongue ANTERIOR Glottis in the open position See vocal cords in action!- endoscope NatGeographic- Aerosmith Glottis in the closed position Figure 24.7c The Vocal Cords POSTERIOR Corniculate cartilage Glottis (open) Cuneiform cartilage in aryepiglottic fold Vocal fold Vestibular fold Epiglottis Root of tongue ANTERIOR This photograph is a representative laryngoscopic view. For this view the camera is positioned within the oropharynx, just superior to the larynx. Trachea “windpipe” • D. Trachea • Connects the larynx to primary bronchi. • 16-20 C-shaped hyaline cartilage rings. Open part of C faces the esophagus so you can swallow food. • Lined with respiratory epithelium • Carina: split of trachea Figure 24.9a Anatomy of the Trachea and Primary Bronchi Hyoid bone Larynx Annular ligaments Trachea Tracheal cartilages Location of carina (internal ridge) Root of right lung Root of left lung Superior lobar bronchus Lung tissue Primary bronchi Superior lobar bronchus Secondary bronchi Middle lobar bronchus Inferior lobar bronchi RIGHT LUNG LEFT LUNG Anterior view showing the plane of section for part (b) Lower Respiratory tract- Bronchial Tree C. Epithelium Inferior to the vocal cords: ciliated pseudostratified columnar with goblet cells = “respiratory epithelium” Mucociliary escalator Figure 24.9b Anatomy of the Trachea and Primary Bronchi Esophagus Trachealis muscle Lumen of trachea Thyroid gland Respiratory epithelium Tracheal cartilage The trachea Histological cross-sectional view of the trachea showing its relationship to surrounding structures LM 3 E. Bronchial Tree 1. Left and right primary (main) bronchi : which lead to left and right lungs. Right side is shorter & straighter, so an accidentally inhaled object will probably go into right lung. 2. Secondary bronchi (lobar) – goes into each lobe. Right lung: superior, middle, inferior lobar brochi. Left lung : only superior and inferior lobar bronchi. 3. Tertiary bronchi (segmental) - smooth muscle around smaller bronchi & bronchioles. *asthma is due to constriction of these smooth muscles & causes airway to become smaller. 3. bronchioles (Less than 1mm) in diameter - cartilaginous rings gone. Have elastin - Neither cilia nor mucus secreting cells are in the bronchioles. Any debris that are not trapped in mucus above the level of bronchioles must be removed by macrophages. 4. terminal bronchioles (less than 0.5mm) 5. respiratory bronchioles – have alveoli 6. Alveolar sacs with alveoli a) Alveoli are made of very thin simple squamous cells called Type I cells (0.5 µm- 15 times thinner than a sheet of tissue paper) b) Alveolar sac is surrounded by capillaries. gas exchange. “Respiratory epithelium” c) Type II cells: create surfactant: film of lipoprotein that lowers surface tension inside alveoli d) Resident macrophages * pneumonia - when the alveoli fill with fluid & gas exchange is compromised. Very dangerous condition. Figure 24.13a Trachea Left primary bronchus Secondary bronchus Tertiary bronchi Smaller bronchi Bronchioles Terminal bronchiole Respiratory bronchiole Alveoli in a pulmonary lobule -Have alveolus The structure of one portion of a single pulmonary lobule Alveolar ducts & sacs • We have about 300 million alveoli within the lungs! Surface area for gas exchange is approx. 1500 ft2. • Alveolar sac= bunch of grapes; alveoli: one grape Figure 24.13c Bronchi and Bronchioles Alveolus Alveolar sac Hyaline cartilage plate Bronchiole Smooth muscle Arteriole Epithelial cells Alveolar duct Lumen of a small bronchus Histology of the lung LM 14 Histological section of the lung showing a small bronchus and bronchiole IV. Pleura 1. Each lung is enclosed by this double serous membrane. Parietal pleura & Visceral pleura 2. Pleural cavity: Space between membranes filled with pleural fluid Pleura V. Lungs 1. External Structures: Apex: just deep to clavicle, pointed superior end. Base: concave end that contacts the diaphragm Costal surface: all surfaces that contact the ribs (anterior, lateral & posterior surfaces) Hilum: it is the indentation where blood vessels/bronchi come in & exit lung 2. Right lung 3 lobes superior middle & inferior 3. Left lung 2 lobes superior & inferior Figure 24.10a Superficial Anatomy of the Lungs Boundary between right and left pleural cavities Superior lobe LEFT LUNG RIGHT LUNG Superior lobe Oblique fissure Horizontal fissure Middle lobe Fibrous layer of pericardium Oblique fissure Inferior lobe Inferior lobe Anterior view of the opened chest, showing the relative positions of the left and right lungs and heart. Falciform ligament Liver, right lobe Liver, left lobe Cut edge of diaphragm Figure 24.10b Superficial Anatomy of the Lungs Lateral Surfaces Diagrammatic views of the lateral surfaces of the isolated right and left lungs Apex Apex Superior lobe Superior lobe Horizontal fissure Middle lobe Cardiac notch Inferior lobe Oblique fissure Base RIGHT LUNG Oblique fissure Inferior lobe Base LEFT LUNG Disorders of respiratory system Normal Emphysema Clinical Note 24.1 Chronic Obstructive Pulmonary Disease (COPD) (Part 2 of 3) VI. Muscles of Respiration A. Primary Respiratiory Muscles 1. Diaphragm 2. External intercostals (inhalation- elevate all ribs) B. Accessory Respiration Muscles Inhalation 1. sternocleidomastoid (lift sternum) 2. scalenes (lift first 2 ribs) 3. pectoralis minor (lift ribs 2-5) 4. serratus anterior (lifts ribs) Exhalation 1. Tranversus abdominis (compress abdomen) 2. internal intercostals (depress ribs) 3. rectus abdominis & obliques (compress abdomen) VI. Disorders A. Emphysema: chronic & incurable disorder Alveoli walls are damaged & distended. Surface area for gas exchange reduced. Less oxygen reaches heart & brain- heart works overtime to pump blood to these areas. B. Asthma: affects bronchi & bronchioles. Smooth muscles around bronchi & bronchioles undergo spasms when introduced to an irritant (allergen, cold air, smoke etc) Wheezing, breathlessness & cough. Treatment: Asthma can be treated with “inhalers” which contain bronchial dilators. For chronic asthma, corticosteroids may be given to suppress immune to suppress allergic response