Lungs II

INTRODUCTION
Q. Write short note on tracheobronchial tree
Q. Write short note on principal bronchi
Q. Explain: Entry of foreign bodies commoner –
right bronchus
Lungs consist of three parts
• Bronchial tree,
• Alveoli,
• Connective tissue with blood vessels
Bronchial Tree
• Consists of principal bronchus, lobar bronchi,
tertiary bronchi, terminal bronchioles, and
respiratory bronchioles

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 Principal bronchi
• Two arise from trachea
• Trachea bifurcates – level of lower border of 4th
thoracic vertebra
• Right principal bronchus
• Shorter, wider, and more vertical
• Length: 2.5 cm (1 inch)
• Left principal bronchus
• Narrower, longer, and more horizontal
• Length: 5 cm (2 inches)
• Right principal bronchus more in line with trachea than
left principal bronchus
• Inhaled foreign bodies usually enter into right principal
bronchus

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 Clinical Integration
Foreign body aspiration
• Right principal bronchus more inclined – trachea,
foreign bodies get aspirated more on right
• Lung abscess more common on right

Bronchoscopy
• Method of visualization of interior trachea and
bronchi
• Bronchoscope – instrument having camera fitted
with flexible fiber optic cable

Carina
• Ridge of cartilage that present at bifurcation of
trachea
Fig. 9.3: Bronchoscopy

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 Lobar bronchi
(secondary bronchi)

• Principal bronchi divide into lobar bronchi

• Right principal bronchus divides into eparterial
and hyparterial bronchi
• Left principal bronchus divides into superior
and inferior lobar bronchi

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 Tertiary (segmental) bronchi

• Lobar bronchi divide into tertiary (segmental)

bronchi
• Each tertiary bronchus supplies portion of
lung called bronchopulmonary segment
• 10 tertiary bronchi on right and 10 on left

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 Bronchioles
• Tertiary bronchi divide into smaller
bronchioles with diameter <1 mm
• Do not have cartilages and glands in their
walls
• Are terminal bronchioles (diameter 0.5–1
mm) and very small respiratory bronchiole
(<0.5 mm)

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 Respiratory Bronchiolar Unit (Pulmonary Unit)
• Smallest functional unit of lung
• Consists of following parts
1. Respiratory bronchiole
2. Alveolar ducts
3. Alveolar atria
4. Air saccules
5. Alveoli
Alveoli (diameter ~200 μm)
• Thin-walled polyhedral, sac-like terminal air
spaces of respiratory system constitute actual
site of air exchange
• Each lung contains 150–250 million alveoli

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 Alveolar Septum
• Adjacent alveoli separated from each other by thin layer of connective tissue
containing blood capillaries
• Also contains fibroblasts and macrophages
• Interalveolar pores of Kohn
• Openings of alveolar septa help in communication between adjacent alveoli
• Alveoli lined by type I pneumocytes (function gaseous exchange), type II
pneumocytes (surfactant production), and sensory brush cells

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Clinical Integration
Bronchiectasis
• Lung disorder caused by permanent
widening of airway passage due –
progressive loss of elastic fibers and
smooth muscles
Emphysema
• Abnormal permanent dilatation of airway
distal – terminal bronchiole
• Cigarette smoking and air pollution
common causative agents

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 BRONCHOPULMONARY SEGMENTS
Q. Write short note on bronchopulmonary segment and
applied aspects
Q. List bronchopulmonary segments of right and left lungs
Definition
• Well-defined part of lung aerated by the segmental or
tertiary bronchus is called bronchopulmonary segment
• Each segment – wedge-shaped
• Apex of each segment – directed toward root of lung and
base directed toward the surface of lung

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 Features of Bronchopulmonary Segment
• Supplied by segmental (tertiary) bronchus
• Pyramidal or wedge-shaped
• Apex – directed toward hilum of lung
• Base – directed toward surface of lung
• Each segment has own segmental branch of pulmonary
artery
• Adjacent segments separated from each other by
intersegmental connective tissue plane
• Adjacent segments drained by tributary of pulmonary
vein

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 Features of Bronchopulmonary Segment
Intersegmental plane
• Adjacent segments separated from each other by
connective tissue layer (septum) called intersegmental
plane
• Contains pulmonary veins that drain adjacent segments
• Bronchopulmonary segment – not bronchovascular
segment
Explanation
• Each bronchopulmonary segment has separate branch
of pulmonary artery and bronchial artery but do not have
separate tributary of pulmonary vein
• 10 bronchopulmonary segments in each lung

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 Clinical Integration
Segmental involvement
• Apical segment of lower lobe and
posterior segment of upper lobe common
sites of lung abscess
• More common on right, as aspirated
material tends – go on right bronchus
(more vertical right principal bronchus)

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 Clinical Integration
Segmental resection of lung
• Each bronchopulmonary segment –
aerated by single tertiary bronchiole and
branch of pulmonary artery
• Can be surgically removed without
affecting adjacent segment
• Segmental resection – required remove
localized lesion (tumor or tuberculosis
lesion)

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Histology of lung.
• Pair of organs that are principal site of gaseous exchange
• Consist of pleural covering, connective tissue septa, and lung parenchyma with
airway passage
• Principal bronchus divides into lobar bronchus that enter lung to form
intrapulmonary bronchi
• Parenchyma consists of bronchioles and alveoli
Fig. 15.12: Intrapulmonary bronchus and terminal bronchiole (practice figure).
Fig. 15.13: Histology of lung (practice figure).
Fig. 15.15: Photomicrograph. Histology of lung (low magnification, H&E stain)
Q. List the microscopic differences between bronchus and bronchiole.
Table 15.1: Differences between bronchus and bronchiole
Characteristics Bronchus Bronchiole
Diameter Larger diameter (More than 1 mm) Smaller diameter (Less than 1 mm)
Epithelium Pseudostratified ciliated columnar Large bronchioles: Simple columnar cells with
epithelium with goblet cells few cilia and few goblet cells
Small bronchioles: Simple columnar or simple
cuboidal cells without cilia and without goblet
cells
Smooth muscle Present between mucosa and cartilage Present between mucosa and adventitia
layer layer
Cartilages Irregular plates of cartilage present Cartilages are absent
Seromucous glands Seromucous glands are present in Glands are absent
submucosa
Fig. 15.17: Cells of respiratory passage.
 Clinical Correlation
• Acute respiratory distress syndrome (ARDS) or hyaline membrane
diseases: Rapid respiratory failure due to inflammation of lung
epithelium − may be either neonatal ARDS or adult ARDS
• Neonatal ARDS occurs because of insufficient surfactant
• Bronchitis is an inflammation of bronchi and it may be acute or
chronic
Thank you………….

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