RESPIRATORY SYSTEM (CONDUCTING PORTION)

I. Background
- Consists of the paired lungs and a series of air passages that lead to and from the
lungs
- Within the lung, the air passages branch into increasingly smaller tubes until the
alveoli are reached
- Three principal functions:
1. Air conduction
2. Air filtration
3. Gas exchange (occurs in the alveoli)
- Lungs develop in the embryo as a ventral evagination of the foregut thus the
epithelium of the respiratory lining is of endodermal origin
- Initial respiratory diverticulum grows into the thoracic mesenchyme
- Bronchial cartilages, smooth muscle, and other connective tissue elements are
derived from the thoracic mesenchyme
- Air passages of the respiratory system consist of:
1. Conducting portion: those air passages that lead to sites of respiration within
the lung where gas exchange takes place; conducting passages include those
located outside as well as within the lungs; passages external to the lungs
consist of:
a. Nasal cavities
b. Oral cavities (during forced breathing)
c. Nasopharynx and oropharynx
d. Larynx
e. Trachea
f. Paired main (primary) bronchi
Within the lungs, the main bronchi undergo extensive branching to give rise
to the distributing bronchioles which represent the terminal part of the
conducting passages; internal bronchi and the bronchioles constitute the
respiratory tree
2. Respiratory portion: where gas exchange occurs and includes:
a. Respiratory bronchioles
b. Alveolar ducts
c. Alveolar sacs
d. Alveoli
- Blood vessels enter the lung with the bronchi; arteries branch into smaller
vessels as they follow the bronchial tree in the substance of the lung; capillaries
come into intimate contact with the alveoli
- Intimate relationship between alveolar air spaces and pulmonary capillaries is
the structural basis for gas exchange within the lung parenchyma
- Air passing through the respiratory passages must be conditioned before
reaching the alveoli
- Conditioning of the air occurs in the conducting portion and includes warming,
moistening, and removal of particulate materials
- Secretions (mucous, serous) moisten the air and trap particles that have
managed to slip past vibrissae (short thick hairs) in the nasal cavity
- Mucus prevents dehydration of the underlying epithelium by the moving air and
covers almost the entire luminal surface of the conducting passages and is
continuously produced by goblet cells and mucus-secreting glands in the walls of
the passages
- Mucus and other secretions are moved toward the pharynx by means of
coordinated sweeping movements of cilia and are then normally swallowed

II. Nasal cavities

- Paired chambers separated by a bony and cartilaginous septum
- Each chamber communicates anteriorly with the external environment through
the nares and posteriorly with the nasopharynx through the choanae
- Chambers are divided into three regions: 1. Vestibule, 2. Respiratory segment, 3.
Olfactory segment
A. Vestibule of the nasal cavity
- Lined by stratified squamous epithelium and contains stiff hairs (vibrissae) that
entrap large particulate matter before it is carried in the air stream to the rest of
the cavity
- Sebaceous glands and their secretions assist in the entrapment
- Posteriorly, where the vestibule ends, the stratified squamous epithelium
becomes thinner and undergoes a transition to the pseudostratified epithelium
that characterizes the respiratory segment (absent sebaceous glands)
B. Respiratory segment of the nasal cavity
- Constitute most of the volume of the nasal cavities
- Lined with ciliated, pseudostratified columnar epithelium and the underlying
lamina propria is attached to the periosteum of the adjacent bone
- Medial wall of the respiratory segment (nasal septum) is smooth but the lateral
walls are thrown into folds by the presence of three shelflike bony projections
(turbinates/conchae) which increase surface area and cause turbulence in airflow
to allow more efficient conditioning of inspired air
- Ciliated pseudostratified columnar epithelium of the respiratory portion is
composed of five cell types:
1. Ciliated cells: tall columnar cells with cilia that project into the mucus
covering the surface epithelium
2. Goblet cells: synthesize and secrete mucus
3. Brush cells: with short blunt microvilli
4. Small granule cells: resemble basal cells but contain granules
5. Basal cells: stem cells from which the other cell types arise
C. Olfactory segment of the nasal cavity
- Located on the part of the dome of each nasal cavity, the contiguous lateral and
medial walls
- Lined with specialized olfactory mucosa (yellow-brown in color due to pigment in
the olfactory epithelium and associated olfactory glands)
- Lamina propria of the olfactory mucosa is directly contiguous with the
periosteum of the underlying bone
- Connective tissue contains numerous blood and lymphatic vessels, unmyelinated
olfactory nerves, myelinated nerves, and olfactory glands
- Olfactory epithelium is pseudostratified, lacks goblet cells, and composed of the
following cell types:
1. Olfactory cells, bipolar neurons- span the thickness of the epithelium
2. Supporting/sustentacular cells- columnar cells that provide mechanical and
metabolic support to the olfactory cells
3. Basal cells- progenitors of other mature cell types
4. Brush cells- specialized for transduction of general sensation
- Olfactory glands (Bowmans glands), a characteristic feature of the olfactory
mucosa are branched tubuloalveolar serous glands that deliver their
proteinaceous secretions via ducts onto the olfactory surface
- Serous secretions of the olfactory glands serve as trap and solvent for
odoriferous substances
- Identifying feature of the olfactory region of the nasal mucosa is the presence of
olfactory nerves in combination with olfactory glands in the lamina propria
D. Paranasal sinuses
- Air-filled spaces in the bones of the walls of the nasal cavity
- Extensions of the respiratory segment of the nasal cavity and are lined by
respiratory epithelium
- Named after the bone where they are found (e.g. ethmoid, frontal, sphenoid,
maxillary)
- Sinuses communicate with the nasal cavities via narrow openings onto the
respiratory mucosa
 - Mucosal surfaces of the sinuses is a thin, ciliated, pseudostratified columnar
epithelium with numerous goblet cells
- Mucus produced in the sinuses is swept into the nasal cavities by coordinated
ciliary movements
- Sinuses are often subject to acute infection after viral infection of the upper
respiratory tract

III. Pharynx
- Connects the nasal and oral cavities to the larynx and esophagus
- Serves as a passageway for air and food and acts as a resonating chamber for
speech
- Located posterior to the nasal and oral cavities and is divided regionally into the
nasopharynx and oropharynx
- Auditory (Eustachian) tubes connect the nasopharynx to each middle ear
- Diffuse lymphatic tissue and lymphatic nodules are present in the wall of the
nasopharynx
- Concentration of lymphatic nodules at the junction between the superior and
posterior walls of the pharynx is called the pharyngeal tonsil

IV. Larynx
- Passageway for air between the oropharynx and trachea
- Formed by irregularly shaped plates of hyaline and elastic cartilage
- Serves as the organ for speech
A. Vocal folds/cords control the flow of air through the larynx and vibrate to
produce sound
- Vocal cords are two folds of mucosa that project into the lumen of the larynx and
are oriented in an anteroposterior direction and define the lateral boundaries of
the opening of the larynx (rima glottis)
- Supporting ligament and skeletal muscle (vocalis muscle) is contained within
each vocal fold
- Ligaments and the intrinsic laryngeal muscles join the adjacent cartilaginous
plates and are responsible for generating tension in the vocal cords and for
opening and closing the glottis
- Extrinsic laryngeal muscles insert on cartilages of the larynx but originate in
extralaryngeal structures, and move the larynx during deglutition
- Expelled air passing through the glottis can be induced to cause vocal folds to
vibrate and vibrations are altered by modulating tension on the vocal folds and
by changing the degree of glottal opening to produce sounds of different pitch
B. Ventricular folds located above the vocal folds are the false cords
- Have no intrinsic muscular investment of the true vocal cords and therefore do
not modulate phonation
- Important in creating sound resonance
C. The larynx is lined by stratified squamous and ciliated pseudostratified
epithelium
- Luminal surface of the vocal cords is covered with stratified squamous epithelium
as well as most of the epiglottis
- Epithelial lining serves to protect the mucosa from abrasion caused by rapidly
moving air stream
- Rest of the larynx is lined with ciliated pseudostratified epithelium
- Connective tissue contains mixed mucoserous glands that secrete through ducts
onto the laryngeal surface

V. Trachea
- Short, flexible, air tube about 2.5 cm in diameter and about 10 cm long which
serves as a conduit for air and its wall assists in conditioning inspired air
- Extends from the larynx to about the middle of the thorax where it divides into
the two main (primary) bronchi
 - Lumen of the trachea stays open because of the arrangement of the series of
cartilaginous rings
- Tracheal wall consists of:
1. Mucosa- composed of ciliated pseudostratified epithelium and an elastic,
fiber-rich lamina propria
2. Submucosa- composed of a slightly denser connective tissue than the lamina
propria
3. Cartilaginous layer- composed of C-shaped hyaline cartilages
4. Adventitia- composed of connective tissue that binds the trachea to adjacent
structures
- Unique feature of the trachea is the presence of a series of C-shaped hyaline
cartilages that are stacked one on top of each other to form a supporting
structure to prevent collapse of the tracheal lumen during expiration
- Fibroelastic tissue and the trachealis muscle bridge the gap between the free
ends of the C-shaped cartilages and the posterior border of the trachea, adjacent
to the esophagus
A. Tracheal epithelium is similar to respiratory epithelium in other parts of the
conducting airway
1. Ciliated cells- most numerous of the tracheal cell types and extend through
the full thickness of the epithelium
2. Mucous cells- similar in appearance to intestinal goblet cells and are
interspersed among ciliated cells; their number is increased during chronic
irritation of the air passages
3. Brush cells- columnar cells with blunt microvilli and their basal surfaces are in
contact with an afferent nerve ending thus they are regarded as receptor cells
4. Small granule cells- respiratory representatives of the general class of
enteroendocrine cells of the gut and gut derivatives; they usually occur singly
in the trachea and are sparsely dispersed among the other cell types;
distinguished by silver staining which react with the granules
5. Basal cells- serve as a reserve cell population that maintains individual cell
replacement in the epithelium; their nuclei form a row in close proximity to
the basal lamina
B. The tracheal epithelium has a characteristic thick basement membrane
- Becomes thicker as a response to mucosal irritation as seen in smokers and in
patients with chronic cough
- Lamina propria is cellular containing numerous lymphocytes, plasma cells, mast
cells, eosinophils, and fibroblasts
- Lymphatic tissue is also present in the lamina propria and submucosa of the
tracheal wall
C. Elastic membrane defines the boundary between the mucosa and submucosa
- Submucosal connective tissue has a dense character
D. Tracheal cartilage and trachealis muscle separate submucosa from adventitia

VI. Bronchi
- Described simply as right and left main bronchi
- Right bronchus is wider and shorter than the left
- Each main bronchus divides into lobar bronchi (secondary bronchi)
- Left lung is divided into two lobes while the right lung is divided into three lobes
- The right bronchus divides into three lobar bronchial branches and the left into
two lobar bronchial branches with each branch supplying one lobe
- The left lung is further subdivided into eight bronchopulmonary segments and
the right lung into ten
- In the right lung, the lobar bronchi give rise to ten segmental bronchi (tertiary
bronchi) and the lobar bronchi of the left lung give rise to eight segmental
bronchi
- The segmental bronchus and the lung parenchyma it supplies constitute a
bronchopulmonary segment
- Bronchi have the same general histologic structure as the trachea but the
structure of the bronchial wall changes at the point where the bronchi enter the
lungs to become the intrapulmonary bronchi where the cartilage rings are
replaced by irregularly-shaped cartilage plates
- The cartilage plates are distributed in a linear array around the entire
circumference of the wall giving the bronchi a circular or cylindrical shape in
contrast to the ovoid shape with a flattened posterior wall of the trachea
- As the bronchi decrease in size because of branching, the cartilage plates become
smaller and less numerous and ultimately disappear at the point where the
airway reaches a diameter of about 1 mm whereupon the branch is designated
as bronchiole
- Bronchi can be identified by their cartilage plates and a circular layer of smooth
muscle
1. Smooth muscle becomes an increasingly conspicuous layer as the amount of
cartilage diminishes (smooth muscle is arranged in interlacing bundles
forming a continuous layer initially and becomes discontinuous in the smaller
bronchi)
2. Since the smooth muscle forms a separate layer (muscularis), the bronchial
wall can be regarded as having five layers:
a. Mucosa: composed of pseudostratified epithelium with the same cellular
composition as the trachea
b. Muscularis: continuous layer of smooth muscle in the larger bronchi and
more attenuated and loosely organized in smaller bronchi
c. Submucosa: loose connective tissue with glands and adipose tissue in the
larger bronchi
d. Cartilage layer: consists of discontinuous cartilage plates that become
smaller as the bronchial diameter diminishes
e. Adventitia: dense connective tissue continuous with that of adjacent
structures e.g. pulmonary artery and lung parenchyma