Bronchioles then divide into three types: conducting, terminal, and respiratory.

There are 20-25 branching

generations of conducting bronchioles after the tertiary segmental bronchi. As the bronchioles become smaller in
width, they become terminal bronchioles which mark the end of the conducting zone of the respiratory system.
The terminal bronchioles divide further to form several generations of respiratory bronchioles, which are the
narrowest airways in the lungs that give rise to alveolar ducts and alveolar sacs (respiratory bronchioles and alveoli
form the respiratory zone)

 Kanan lebih curam

Lung disease is any problem in the lungs that prevents the lungs from working properly. There are three main
types of lung disease:

1. Airway diseases -- These diseases affect the tubes (airways) that carry oxygen and other gases into and out
of the lungs. They usually cause a narrowing or blockage of the airways. Airway diseases
include asthma, COPD and bronchiectasis. People with airway diseases often say they feel as if they're
"trying to breathe out through a straw."
2. Lung tissue diseases -- These diseases affect the structure of the lung tissue. Scarring or inflammation of the
tissue makes the lungs unable to expand fully (restrictive lung disease). This makes it hard for the lungs to
take in oxygen and release carbon dioxide. People with this type of lung disorder often say they feel as if
they are "wearing a too-tight sweater or vest." As a result, they can't breathe deeply. Pulmonary
fibrosis and sarcoidosis are examples of lung tissue disease.
3. Lung circulation diseases -- These diseases affect the blood vessels in the lungs. They are caused by clotting,
scarring, or inflammation of the blood vessels. They affect the ability of the lungs to take up oxygen and
release carbon dioxide. These diseases may also affect heart function. An example of a lung circulation
disease is pulmonary hypertension. People with these conditions often feel very short of breath when they
exert themselves.
Why don’t lungs collapse between breaths?

1. Residual Volume (RV).

RV is the volume of air that stays in the lung after maximal exhalation i.e. if you force all the air out of
your lungs, with maximal effort, there would still be some air remaining in the lungs — about 1–1.2
liters — that no matter what, you cannot get rid of. Residual Volume has two functions:
a. It prevents lungs from totally deflating and collapsing between breaths. It’s a blessing because the
effort to open a collapsed lung after each breath would be tremendous compared to inhaling against a
partially deflated lung (so to say).
b. It keeps blood oxygenated between breaths.
2. Surfactant. It is a substance that reduces surface tension in lungs. Lungs are covered in a film of water
and its surface comes in contact with air. This gives rise to surface tension. Remember high school
chemistry?

At liquid–air interfaces, surface tension results from the greater attraction of liquid molecules to each
other (due to cohesion) than to the molecules in the air (due to adhesion). The net effect is an inward
force at its surface that causes the liquid to behave as if its surface were covered with a stretched
elastic membrane.[1]

In effect, higher the surface tension = higher the tendency of the lung to collapse.

Surfactant, reduces surface tension and also improves lung compliance i.e. improves lungs’ ability to
expand.

Pneumothorax is defined as the presence of air or gas in the pleural cavity (ie, the potential space between the
visceral and parietal pleura of the lung). The clinical results are dependent on the degree of collapse of the lung on
the affected side. Pneumothorax can impair oxygenation and/or ventilation.
There are four types of pneumothorax. They are:

 traumatic pneumothorax. This occurs when an injury to the chest (as from a car wreck or gun or knife
wound) causes the lung to collapse.
 tension pneumothorax. This type can be fatal. It occurs when pressure inside the pleural cavity is greater
than the outside atmospheric pressure. It can force the entire lung to collapse and can push the heart
toward the lung, putting pressure on both.
 primary spontaneous pneumothorax. This happens when a small air bubble on the lung ruptures. These
may happen for no obvious reason or while undergoing changes in air pressure (like when scuba diving or
mountain climbing).
 secondary spontaneous pneumothorax. This typically happens to those who already have lung disease. As
the lung is already compromised by disease and may have diminished capacity, this can be a serious
complication.

Development of the lungs

 lung tissue starts to form around the bronchial tree starting at about the 5th week and is generally broken
into 4 stages:
o Pseudoglandular period (5-17 weeks)
 the developing lung at this point resembles a branched, compound gland of endodermal
air-conducting tubules (hence the term "pseudoglandular")
 at this point, there are NO ALVEOLI, so respiration is NOT POSSIBLE and premature
infants born during this period cannot survive
o Canalicular period (16-26 weeks)
 Respiratory bronchioles and alveolar ducts with some terminal sacs start to appear by
week 24 and the vascularization increases such that gas exchange is possible by the end
of this stage.
 Surfactant production by type II pneumocytes begins around week 20-22, but overall is
not enough to prevent airway collapse (atelactstasis)
 Premature infants born at this stage have a VERY POOR prognosis
o Terminal sac period (24 weeks – birth)
 The overall number of terminal sacs and degree of vascularization increases dramatically
 Surfactant production also increases such that airway collapse is less likely
 Premature infants born at the beginning of this stage can survive, but will likely need
ventilation assistance and administration of exogenous surfactant
 The degree of alveolar vascularization and surfactant levels are the key factors
affecting survival

o Alveolar period (week 29 to 8 years)

 Terminal sacs develop into alveolar ducts and alveolar sacs with numerous alveoli.
 Expansion of the alveolar tree continues up until age 8 postnatally. In fact, a newborn
has about 1/6 the number of alveoli compared to an adult.

II. Growth of lungs into the body cavity and development of the diaphragm

 lateral folding of the body wall encloses the foregut endoderm such that it is suspended within
the intraembryonic coelom (or body cavity) by a "sling" of dorsal mesentery, which is mesoderm derived.
 the inside of the body wall is covered by a parietal peritoneum, which is derived from somatic
mesoderm.
 the gut tube is covered by a visceral peritoneum, which is derived from splanchnic, or
visceral, mesoderm.
  as the lungs develop from the foregut endoderm, they essentially "punch" into the coelom around the
lungs, which is therefore called the pleural cavity. Against the body wall, the pleural cavity is lined
by parietal pleura (akin to parietal peritoneum) whereas the lungs are covered by visceral pleura (akin to
visceral peritoneum).

A. Separation of the pleural and pericardial cavities

 at about 5 weeks, two longitudinal folds of mesoderm called the pleuropericardial folds appear in
between the developing lungs and heart.
 The pleuropericardial folds grow from the lateral body wall toward the midline to separate the pericardial
cavity (ventrally) from the pleural cavity (dorsally).
 development of the mediastinum further divides the pleural cavity into left and right halves.

B. Separation of the abdominal and thoracic cavities

 with cranio-caudal folding, a block of connective called the septum transversum forms in between the
heart and future liver
 the septum transversum grows in a roughly transverse plane from front (ventral) to back (dorsal)
 initially forms at about C1, but is displaced caudally with differential growth of the embryo
 during weeks 5-6, the septum transversum is moving through the regions between C3, 4, and 5 and
receives myoblasts that will eventually develop into the skeletal muscle of the diaphragm. These
myoblasts are innervated by the ventral rami of C3, 4, and 5 and "drag" this innervation with them as the
developing diaphragm is displaced caudally, thus accounting for the course of the phrenic nerve.
 the septum continues to grow dorsally until it meets the gut tube at about week 8 and then stops;
differential growth of the embryo is such that the front (ventral) edge of the septum is at about T7 but the
back (dorsal) edge is at about T12
 at this point, there are still two open channels called the pericardioperitoneal canals on either side of the
gut tube along the back of the body wall. Closure of these canals is accomplished by the growth of two
shelves called the pleuroperitoneal membranes from the lateral body toward the septum transversum.