LUNG ANATOMY/

Nervous system controls in the Lungs

Alessandro M. Arellano Jr.,RTRP
Lung Anatomy
Respiratory System
Lower Respiratory System
• Trachea
• Bronchial tree
• Left and right
main bronchus
• Carina
• Lobar bronchus
• Segmental bronchus
• Bronchiole
• Alveoli
Lower Respiratory Tract
Lower Respiratory Tract

Hilum

Lingula
 Regional Lymph Nodes for Lung
Superior
Aortic
mediastinal

Image Source: SEER Training Website

Pulmonary Inferior mediastinal

Respiratory tract – conducting into Respiratory
portion
• Function of the System
• Gas exchange: O2 in and CO2 out
• General principles – as one moves down into the
branches:
• epithelium changes from respiratory to cuboidal to simple
squamous epithelium
• the number of mucous cells and seromucous glands (hence
secretions) decreases
• cilia are eventually lost (not present in alveoli)
• macrophages exist in the alveolar air space
• branches from the pulmonary artery run parallel to the
bronchiolar tree and to the alveoli
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Respiratory portion: General aspects
Branch of
pulmonary artery

Bronchiole

Terminal bronchiole

Pulmonary
Branch of arteriole
pulmonary vein Pulmonary Respiratory bronchiole
capillary
beds
Pulmonary
venule Alveolar duct
Alveoli
Alveolar pores

Interalveolar
septum

Alveolar
sac

Elastic fibers

Connective tissue

(a)
Respiratory portion: accent on the lung .

structures
Bronchiole

Spiral smooth muscle

Terminal bronchiole

Pulmonary
Branch of arteriole
pulmonary vein Pulmonary Respiratory bronchiole
capillary
beds
Pulmonary
venule Alveolar duct
Alveoli
Alveolar pores

Interalveolar
septum
Alveolar
sac

Elastic fibers
Connective tissue

(a)
 The Respiratory tract: Bronchioles
• The Bronchioles
• Each tertiary bronchus branches into
multiple bronchioles (branches ~4-17)
• Bronchioles finally branch into terminal
bronchioles
• One tertiary bronchus forms about 6500 terminal
bronchioles

• Bronchiole Structure
• Bronchioles
• Have no cartilage
• Are dominated by smooth muscle – control
lumen diameter

11
 Nervous system controls in the Lungs
• Autonomic Control
• Regulates smooth muscle which
• regulates diameter of bronchioles and
• controls airflow and resistance in lungs

• Bronchodilation (norepi/Beta 2 receptors)

• dilates of bronchial airways
• caused by sympathetic ANS activation
• (muscles relax) - Reduces resistance
• Bronchoconstriction (AcH/muscarinic)
• constricts bronchi – caused by
• Parasympathetic ANS activation (muscles
constrict)
• Histamine release (allergic reactions)
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Respiratory portion: accent on the
vasculature
Branch of
pulmonary artery
Bronchiole

Terminal bronchiole

Pulmonary
arteriole
Respiratory bronchiole
Pulmonary
capillary
Branch of Pulmonary beds
Alveolar duct
pulmonary vein venule
Alveoli
Alveolar pores

Interalveolar
septum

Alveolar
sac

Elastic fibers

Connective tissue

(a)
 4. Bronchial vein

3. Bronchial artery –
only to the branches 1. Pulmonary artery
(deoxygenated) –
from the right ventricle
2. Branch of
Pulmonary vein
(oxygenated) – to
the left atrium Smooth muscle
around bronchioles

Alveoli =
Blood-Air Barrier

14
 Blood supply to/from the Lungs
• #1. Pulmonary artery (deoxygenated blood)
• from the right ventricle (from the rt. atrium)
• follows the bronchial tree all the way to the alveoli
• gas exchange occurs with the alveolar capillaries
• #2 Pulmonary veins -- after oxygenation, blood
exits
• into the left atrium … left ventricle … aorta
• #3 Bronchial arteries (oxygenated blood)
• from branches off the aorta
• provides oxygen and nutrients to tissues of conducting passageways of
lung, CT & pleura
• stop before the alveoli - goes to …
• #4 Bronchial veins (deoxygenated/venous blood
(used by the lungs) flows
• back into the right atrium or
• into pulmonary veins
15
 Blood supply for the lungs
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Aorta

Branch of
pulmonary
artery
Pulmonary Branch of
trunk pulmonary
Pulmonary vein
arteries Pulmonary
Pulmonary arteriole
veins Pulmonary
Left atrium venule

Right atrium
Left ventricle
Pulmonary
capillaries
Right
ventricle
Alveoli

Pulmonary arteries carry deoxygenated blood away from the right ventricle in the heart
to the lungs.
Pulmonary veins carry oxygenated blood from the lungs to the left atrium in the heart
 The Lungs
• Why is the proximity of the
bronchiole and pulmonary
artery important?
•Development: helps blood vessels
‘find’ the alveoli
•Coordination of air flow and
blood flow
•If bronchiolar air flow is
blocked (mucus or tumor)
blood vessels constrict to
shunt blood flow to other
areas of the lung with more O2
17
Lung Pathologies
• Asthma
• Excessive stimulation of smooth muscle cells leads to broncho-
constriction – narrowing the bronchioles and increasing resistance
• Stimulation severely restricts airflow

• COPD (chronic obstructive pulmonary disease)

• Chronic bronchitis – inflammation of the airways leads to narrowing
of the air passageways
• Emphysema – loss of alveolar walls creates fewer areas for gas
exchange

• Fibrosis – increased CT = difficulty expanding/contracting

• Many respiratory diseases lead to SOB. (shortness of breath) 18
Lung - Emphysema Normal Lung

B
B

19
Diffuse Interstitial Fibrosis Normal Lung

20
 muscle, elastic fibers and capillaries
associated with bronchioles and alveoli

Alveolar Organization: Basic Structure of a Portion of Single Lobule.

21
Copyright 2009 Pearson Education Inc. publishing as Pearson Benjamin Cummings
Respiratory portion – fine aspects
• Function of the System
• Gas exchange - O2 in and CO2 out
• Cells involved
• thin, delicate membranes optimized for gas
exchange
• type I pneumocytes and endothelial cells = WALL
• fused basal laminae within the wall
• type II pneumocytes secrete surfactant
• connective tissue within the wall gas exchange

22
Gross – histological appearance

23
 respiratory
bronchiole
A

Alveolar
duct

Terminal
bronchiole respiratory
bronchiole

Terminal bronchiole - all cuboidal cells, last branch of the conducting portion
Respiratory bronchioles - contain cuboidal cells interrupted by alveoli (type I
pneumocytes
Alveolar ducts – all alveoli
Alveoli – thin and thick areas 24
The Lungs
• An Alveolus
• Respiratory bronchioles are connected to alveolar ducts
and both contain alveoli
• Alveolar ducts end at alveolar sacs
• Common chambers connected to many individual alveoli
• Has an extensive network of capillaries
• Is partially surrounded by elastic fibers
• no smooth muscle or cartilage

25
 RBCs

Air
space

RBCs

Air

26
 Alveoli - thin and thick areas
• Alveolar Epithelia
• Consist of simple squamous epithelium
• thin, delicate type I pneumocytes and
• short, fat type II pneumocytes (septal cells) that produce surfactant
• *Thin areas are adjacent to capillaries & active in gas exchange
• Thick areas have more CT (connective tissue)
• Patrolled by alveolar macrophages, also called dust cells =
macrophages in the air space

Thin areas are where gas exchange is optimal

27
 Alveoli – thin and thick regions

Thin region
Thin regions contain Interalveolar Nucleus of capillary
septum endothelial cell
Nucleus
capillaries positioned Erythrocyte
of alveolar
type I cell Erythrocyte Capillary

close to type I
Pulmonary
pneumocytes. Gas capillaries

exchange occurs here Alveolar Air space

type I cell
Diffusion of CO2 Diffusion of O2
Alveolar
Thick regions contain type II cell
connective tissue between Alveolar
macrophages
the capillaries and alveolar
wall Alveolus Alveolar epithelium
Alveolar pores Fused basement membranes
Respiratory Air space
of the alveolar epithelium and
Interalveolar membrane the capillary endothelium
septum Capillary endothelium
(b) Thick region
Alveoli – thin and thick regions

Type I pneumocyte Thin region

Forms most of the
alveolar wall Interalveolar
septum
Nucleus of capillary
endothelial cell
Nucleus
5% of cells & 95% of the of alveolar
Erythrocyte type I cell Erythrocyte Capillary
surface
Type II pneumocyte Pulmonary
capillaries
Produces - Surfactant
- An oily secretion of Alveolar Air space
phospholipids and type I cell

proteins Alveolar Diffusion of CO2 Diffusion of O2

type II cell
- Coats alveolar surfaces Alveolar
and reduces surface macrophages
tension
Alveolus Alveolar epithelium
- 95% of cells & 5% of the Alveolar pores Fused basement membranes
surface Respiratory Air space
of the alveolar epithelium and
Interalveolar membrane the capillary endothelium
septum Capillary endothelium
(b) Thick region
Alveolus air space

Thin areas

RBCs
30
 The Blood – Air Barrier

Interalveolar Nucleus of capillary

septum endothelial cell
Nucleus
of alveolar
Erythrocyte type I cell Erythrocyte Capillary

Pulmonary
capillaries

Alveolar
type I cell

Alveolar Diffusion of CO2 Diffusion of O2

type II cell

Alveolar
macrophages

Alveolus Alveolar epithelium

Alveolar pores
Fused basement membranes
Respiratory of the alveolar epithelium and
Interalveolar membrane the capillary endothelium
septum
Capillary endothelium
(a) (b)
 The Blood- Air Barrier

(plasma)

32
Copyright 2009 Pearson Education Inc. publishing as Pearson Benjamin Cummings
Blood-Air Barrier
Note 5 layers! CO2

O2
1.

What happens if: 2.

Erythrocyte
(Type I pneumocyte)
-one adds CT to the 3.
(Hemoglobin mol.)
thin area?
-surfactant is not 4.
made? 5. Red blood cell
membrane

33
Respiratory System
• Structures and Functions of the hilum
System
• Conducting portion = tubes only (no
alveoli)
• mouth/nose to terminal bronchioles
• series of dichotomous, asymmetric
branches
• directed passage & conditioning of air
• Respiratory portion
• Respiratory bronchioles = tubes and
alveoli
• alveolar ducts, sacs, atria
• alveoli only
• gas exchange occurs through alveolar
walls 34
Respiratory portion: General aspects
Branch of
pulmonary artery

Bronchiole

Terminal bronchiole

Pulmonary
Branch of arteriole
pulmonary vein Pulmonary Respiratory bronchiole
capillary
beds
Pulmonary
venule Alveolar duct
Alveoli
Alveolar pores

Interalveolar
septum

Alveolar
sac

Elastic fibers

Connective tissue

(a)