Physiology of Upper

Respiratory Tract
th
Anthony’s Textbook of Anatomy & Physiology Ed 20
Guyton Ed 12 th
General Functions of Nasal
1. Olfactory ( smelling ) : Terdapat Olfactory cells sebagai sel reseptor untuk smell
sensation
2. Respiration ( Upper Respiratory Tract ) : Nasal Cavity, Paranasal Sinuses,
Pharynx, and Larynx

3. Filtration of Dust ( dust from air )

• Vibrissae/ hair of nasal : Menyaring partikel besar yang masuk bersamaan
udara

4. Humidification / Air conditioning ( air inspiring and warming ) :

• Terdapat 3 fungsi respirasi normal oleh Nasal Cavity ; udara dihangatkan oleh
permukaan Conchae dan Septum, udara hampir sepenuhnya dilembabkan saat
melewati hidung, udara dibersihkan sebelum masuk ke paru-paru
Nose
• The nose serves as a passageway for air going to and from the lungs. However, if the nasal passages are
obstructed, it is possible for air to bypass the nose and enter the respiratory tract directly through the mouth

• Air that enters the system through the nasal cavity is filtered of impurities, warmed, moistened, and
chemically examined (by olfaction) to detect substances that might prove irritating to the deli- cate lining of the
respiratory tract.
• The vibrissae, or nasal hairs, in the vestibule serve as an initial “filter” that screens particulate matter from air
that is entering the system.
• The conchae, or turbinates, then serve as baffles to slow and stir the air as well as provide a large mucus-
covered surface area over which air must pass before reaching the pharynx.
• The respiratory membrane produces copious quantities of mucus and possesses a rich blood supply, especially
over the inferior conchae, which permits rapid warming and moistening of the dry inspired air.
Paranasal Sinuses
There are 4 different types of sinuses:
• Ethmoid sinus. This sinus is located inside the
face, around the area of the bridge of the nose.
It is present at birth, and continues to grow.
• Maxillary sinus. This sinus is located inside the
face, around the area of the cheeks. It is also
present at birth, and continues to grow.
• Frontal sinus. This sinus is located inside the
face, in the area of the forehead. It does not
develop until around 7 years of age.
• Sphenoid sinus. This sinus is located deep in
the face, behind the nose. It does not typically
develop until the teen years
• The four pairs of paranasal sinuses are air-containing spaces that lighten the weight of the skull and open, or
drain, into the nasal cavity.

• Like the nasal cavity, each paranasal sinus is lined by respiratory mucosa. The mucous secretions produced in
the sinuses are con- tinually being swept into the nose by the ciliated surface of the respiratory membrane.
Pharynx
The pharynx serves as a common pathway for the
respiratory and digestive tracts, because both air and food
must pass through this structure before reaching the
appropriate tubes—the trachea (air) and esophagus (food). It
also affects phonation (speech production). For example,
only by changing the shape of the pharynx can the different
vowel sounds of speech be formed.

• Fungsi : Respirasi, Pencernaan

(menelan), Resonansi suara, Artikulasi.
• Menghubungkan nasal dan rongga
mulut ke larynx
• Terdiri dari : Nasopharynx, Oropharynx,
Laryngopharynx
LAPISAN PHARYNX
• Lapisan Mukosa, bersifat kuat dan elastis, pada lapisan ini ada epitel yang mempunyai sel goblet sebagai penghasil
mukus (cairan kental). Mukus tersebut berfungsi melindungi dinding faring.
• Lapisan Fibrosa, adalah jaringan yang kuat dan sedikit elastis. Jaringan tersebut disusun oleh serat kolagen.
• Lapisan Muskular (otot), Otot pada faring terdiri atas otot sirkular (melingkar) serta otot memanjang (Longitudinal).
Kombinasi dari kontraksi kedua otot itu akan menggerakkan makanan ke bagian pencernaan selanjutnya.
Nasopharynx
• Bagian superior dari pharynx
• Hanya bisa dilewati udara
• Ukuran 2-4 cm
• Dilapisi oleh epitel kolumnar bersilia
 Oropharynx
• Bagian pharynx yg ada di belakang rongga mulut
• Dapat dilewati udara dan makanan sehingga berperan dalam
sistem pernapasan serta sistem pencernaan.
• memiliki klep yang berfungsi mengatur makanan supaya tidak
masuk ke saluran pernapasan, klep ini dinamakn epiglotis.
• Pada bagian dinding lateral (kiri dan kanan)nya ada tonsil
palatina yang merupakan massa jaringan limfatik, tonsil ini
berfungsi guna melindungi dari infeksi.
• Ruang resonansi suara
• Bersama laringofaring merupakan jaringan limfoid cincin
( Waldeyer)
Laryngopharynx
• Bagian akhir dari pharynx
• Bisa dilewati udara dan makanan
• Dilapisi sel epitel skuamosa
berlapis
• Tempat pertemuan antara
saluran pernafasan dengan
saluran pencernaan
• Mengatur buka-tutup saluran
pernafasan dan pencernaan
Larynx
• The larynx functions in respiration because it constitutes part of the vital airway to the lungs.
• This unique passageway, like the other components of the upper respiratory tract, is lined with a ciliated
mucous membrane that helps in removal of dust particles and in warming and humidification of inspired
air.
• In addition, it protects the airway against the entrance of solids or liquids during swallowing.
• It also serves as the organ of voice production hence its popular name, the voice box. Air being expired through
the glottis, narrowed by partial adduction of the vocal folds, causes them to vibrate. Their vibration produces
the voice. Several other structures besides the lar- ynx contribute to the sound of the voice by acting as
sounding boards or resonating chambers. Thus the size and shape of the nose, mouth, pharynx, and bony
sinuses help determine the quality of the voice.
Part of Larynx
 Immunology of
Upper Respiratory Tract

Tutor 2
Introduction : Immune Response in URT

• The respiratory system is in intimate contact with the environment

through the inhalation of large volumes of air every day (∼10,000 L).
• Protecting the respiratory system from pathogens and toxins while
avoiding unnecessary inflammation when harmless proteins are inhaled
is a challenge.
• Immune response mechanism
•

• Innate Immune Response

• Adaptive Immune Response
Innate Immune Response in URT

• Physical barriers such as the filtration of air by the nose and upper
airways and the mucociliary apparatus
• Airway epithelium of the trachea and large airways is protected by
1) airway surface liquid, which contains antibacterial proteins,
2) mucus, which traps large, inhaled particulates and transports them
to the pharynx by mucociliary transport, and
3) immune cells, which produce chemokines, cytokines, and lipid
mediators in response to PAMPs.
Innate Immune Response in URT

• The airway epithelial cells have the capacity to ingest bacteria and have
a variety of receptors, such as Toll-like receptors, on their surface that
may lead to activation of the epithelium on exposure to bacterial or viral
products (e.g., DNA, RNA, lipopolysaccharide) (PAMPs).
• Activated epithelium secretes chemoattractant molecules that will attract
neutrophils, eosinophils, and lymphocytes, depending on the particular
need. Cytokines secreted by the epithelium may also promote
inflammation.
• Defensins are proteins that are secreted by epithelial cells that may bind
to microbial cell membranes and create pores that assist in killing
organisms.
Adaptive Immune Response in URT
• Under the epithelium, there is a network of dendritic cells. These large
cells have projections that protrude between epithelial cells into the
airway lumen and may sample foreign antigenic substances.
• After ingestion of foreign protein, these cells migrate to regional lymph
nodes, where they present an antigenic fragment of the protein to CD4+
T cells with a T-cell receptor with a high affinity for the antigenic peptide.
• The subsequent T-cell reaction may lead to the clonal expansion of the
cells and their differentiation into one of several subsets of CD4+ cells.
These cells recirculate and may home to the site of origin of the dendritic
cell, where they may now produce cytokines that play a key role in
directing the type of inflammation.