Respiratory

System Part II

Grace Mendoza-Bardelosa, MD, FPDS

Department of Human Structural Biology
 Intended Learning Outcomes
•  Discuss the layers of the respiratory tract.
•  Describe the segments of the respiratory
tract.
•  Discuss the parts of the blood-air barrier.
•  Discuss the significance of surfactant.
•  Correlate common clinical condiGons affecGng
the respiratory tract.
Anatomy of the Respiratory System
 MAIN BRONCHUS

LOBAR BRONCHUS

SEGMENTAL BRONCHUS

BRONCHIOLE

TERMINAL BRONCHIOLE

RESPIRATORY BRONCHIOLE

PULMONARY CAPILLARIES ALVEOLI

 Respiratory Epithelium
1.  Ciliated columnar cells
–  Most abundant
–  250-300 cilia on apical surface
2.  Goblet cells
–  Numerous
–  Granules of mucin glycoproteins
 Respiratory Epithelium
3. Brush cells
–  Less numerous
–  Columnar with sparse, blunt microvilli
–  Chemosensory receptors
 Respiratory Epithelium
4. Small granule cells (Kulchitsky cells)
–  Dense core granules
–  Part of diffuse neuroendocrine system
–  3% of respiratory cells
5. Basal cells
–  MitoGcally acGve stem and progenitor cells
Respiratory Epithelium
Bronchial Tree
 Bronchial Tree and Lung
•  Primary bronchi
•  Secondary (lobar) bronchi
•  TerGary (segmental) bronchi
•  Bronchioles
•  Terminal bronchioles
•  Respiratory bronchioles
•  Alveolar ducts
•  Alveoli
 Primary bronchus
•  Mucosa
–  LE: respiratory epithelium
•  Less tall columnar, fewer GCs
–  LP: more elasGn; one layer of SMs separates from
submucosa
•  Submucosa
–  Fewer glands
•  Interconnected plates of carGlage
 TerGary (segmental) Bronchus
•  Mucosa
–  LE: Tall columnar with li_le pseudostraGficaGon
•  Decreased GCs
–  LP: Thin & elasGc
•  Completely encircled by SMs in spiral manner
•  Submucosa
–  Sparse glands
•  Few irregular plates of carGlage
•  AdvenGGa
–  Few lymphoid Gssue
TerGary (segmental) Bronchus
TerGary (segmental) Bronchus
Bronchial Wall
 Bronchiole
•  Intralobular airways
•  < 1mm diameter
•  10th generaGon of branching
•  LE: ciliated columnar cells with few GCs
•  (-) submucosal glands
•  (-) carGlage
Bronchiole
 Terminal Bronchiole
•  Smallest diameter passages of purely
conducGng porGon
•  LE:
–  Ciliated cuboidal cells
–  Many low columnar non-ciliated cells
•  1 or 2 layers of SMs, CT
•  Alveoli in surrounding lung Gssue
Terminal Bronchiole
Clara Cells
 Clara Cells
•  Exocrine bronchiolar cells
•  Non-ciliated
•  Dome-shaped apical ends
•  Secretory granules
 Clara Cells

•  SecreGon of surfactant lipoproteins and
mucins
•  DetoxificaGon of inhaled noxious substances
•  SecreGon of anGmicrobial pepGdes and
cytokines for immune defense
•  Act as stem cells, ability to divide
 Respiratory Bronchioles
•  Mucosa
–  Few openings to alveoli
–  LE: Ciliated cuboidal + Clara cells
Squamous cells at alveolar openings
–  LP: SMs and CT
 Alveolar Ducts
•  Completely lined by openings of alveoli
•  Both AD and alveoli
–  LE: squamous cells
–  LP: a strand of SMs, elasGc & collagen fibers
 Alveoli
•  Saclike evaginaGons
•  200 μm in diameter
•  From RB, AD, AS
•  Responsible for spongy structure
•  200 million / lung
•  Open on one side to AD or AS
 Alveoli
•  Interalveolar septa
–  Sca_ered fibroblasts
–  Sparse ECM; elasGc & reGcular fibers
–  Expand with inspiraGon; contract passively with
expiraGon
–  Prevent collapse & excessive distenGon of alveoli
–  Richest capillary network
Terminal PorGon of Respiratory Tree
 Region of Epithelium Muscle and Skeletal Other features and
Airway Support Major Func>ons
Bronchi Respiratory Prominent spiral bands of Repeated branching; conduct
smooth muscle; irregular air deeper into lungs
hyaline carGlage plates

Bronchioles Simple ciliated Prominent circular layer of Conduct air; important in

columnar with few smooth muscle; no carGlage bronchoconstricGon and
goblet cells bronchodilaGon

Terminal Simple ciliated Thin, incomplete circular Conduct air to respiratory

bronchioles cuboidal with layer of smooth muscle; no porGons of lungs; Clara cells
Clara cells carGlage with several protecGve
funcGons
Respiratory Simple ciliated Fewer smooth muscle fibers, Conduct air deeper, with some
bronchioles cuboidal with mostly around alveolar gas exchange and protecGve
Clara cells with openings Clara cells
sca_ered alveoli

Alveolar ducts Simple cuboidal Bands of smooth muscle Conduct air with much gas
and sacs between many alveoli around alveolar openings exchange

Alveoli Types I and II alveolar None but with network of Sites of all gas exchange;
cells (pneumocytes) elasGc and reGcular fibers surfactant from type II
pneumocytes; dust cells
Blood-air Barrier
 Blood-air Barrier
•  Gas exchange between air and blood
•  Membranous barrier between each alveolus
and capillaries surrounding it
1.  Alveolar type I cell
2.  Capillary endothelial cell
3.  Fused basement membranes
 Blood-air Barrier

P1
BM

Er
 Alveolar Cells
•  Type I Pneumocytes
•  Very thin cells
•  Line alveolar surfaces 95%
•  Desmosomes, occluding juncGons
–  Prevent leakage of Gssue fluid into alveolar space
Alveolar Walls
 Alveolar Cells
•  Type II Pneumocytes
•  Cuboidal cells
•  Secretes pulmonary surfactant
–  Lowers surface tension at air-epithelium interface
–  Prevents alveolar collapse
Type II Pneumocytes
 Alveolar Macrophages
•  Aka “Dust cells”
•  Phagocytose erythrocytes & airborne
parGculate ma_er
•  Slightly darker compared to type II
•  Bronchoalveolar fluid is bacteriostaGc
–  Lysozyme by Clara cells, Type II, & AMs
CLINICAL CORRELATES
 Lung Cancer
•  SCC
–  Smoking
–  Epithelial cell of segmental bronchi
•  Adenocarcinoma
–  Most common among nonsmokers
–  Epithelial cells in bronchioles & alveoli
•  Small cell carcinoma
–  Less common
–  Highly malignant
–  Kulchitsky cells in BRE
 Emphysema
•  Chronic lung disease
•  Cigare_e smoking
•  Irreversible lung damage
•  DilaGon and permanent enlargement of
bronchioles
 Infant Respiratory Distress Syndrome
•  Premature babies
•  Incomplete differenGaGon of type II
•  Deficient surfactant
•  Surfactant: overcomes the surface tension of
the collapsed fetal lungs
•  Severe acute breathing difficulGes & chronic
lung disease
 Asthma
•  Bronchospasms
–  Sudden constricGons of SMs in bronchioles
–  Mast cell degranulaGon
Thank you