Respiratory System

Presented By:
Miss Sharel Samson
(Msc.N, Bsc.N)
 Respiratory System
The organs of the respiratory system are:
• Nose
•Pharynx
• Larynx
• Trachea
• Two bronchi (one bronchus to each lung)
• Bronchioles and smaller air passages
• Two lungs and their coverings, the pleura
• Muscles of breathing – the intercostal muscles and the
diaphragm.
 Position and structure

• The nasal cavity is the main route of air entry, divided into two
equal passages by a septum. The posterior bony part of the
septum is formed by the perpendicular plate of the ethmoid
bone and the vomer. Anteriorly, it consists of hyaline cartilage.
• The roof is formed by the cribriform plate of the ethmoid bone
and the sphenoid bone, frontal bone and nasal bones.
• The floor is formed hard palate in front and the soft palate
behind.
• The hard palate is composed of the maxilla and palatine bones
and the soft palate consists of involuntary muscle
 Cont…
• The medial wall is formed by the septum.
• The lateral walls are formed by the maxilla, the ethmoid bone
and the inferior conchae.
• The posterior wall is formed by the posterior wall of the
pharynx.
• lined with very vascular ciliated columnar epithelium (ciliated
mucous membrane which contains mucus-secreting goblet
cells.
 Openings into the nasal cavity

• The anterior nares, or nostrils, are the openings from the

exterior into the nasal cavity. Nasal hairs are found
here,coated in sticky mucus.
• The posterior nares are the openings from the nasal cavity
into the pharynx.
 Paranasal sinuses
The paranasal sinuses are cavities in the bones of the face
and the cranium, containing air.
Sinuses are lined with mucous membrane, continuous with
that of the nasal cavity.
The main sinuses are:
• maxillary sinuses in the lateral walls
• frontal and sphenoidal sinuses in the roof
• ethmoidal sinuses in the upper part of the lateral walls.
 Cont…
• Frontal Sinuses: Located in the frontal bone just above the
eyebrows.
• Maxillary Sinuses: Found in the maxillary bones, the largest
of the paranasal sinuses, located on either side of the nose,
below the eyes.
• Ethmoidal Sinuses: These sinuses are present within the
ethmoid bone, which is located between the eyes and behind
the bridge of the nose.
• Sphenoidal Sinuses: Situated within the sphenoid bone at the
base of the skull, behind the ethmoidal sinuses.
 Position

• The pharynx is a passageway about 12–14 cm long. It

extends from the posterior nares, and runs behind the
mouth and the larynx to the level of the 6th cervical
vertebra, where it becomes the oesophagus. Structures
associated with the pharynx
• Superiorly – the inferior surface of the base of the skull
• Inferiorly – it is continuous with the oesophagus
• Anteriorly – the wall is incomplete because of the
openings into the nose, mouth and larynx
 Larynx
• The larynx or ‘voice box’ links the laryngopharynx and the
trachea. It lies in front of the laryngopharynx at the level of
3rd, 4th, 5th and 6th cervical vertebrae.
• It grows larger in the male, which explains the prominence of
the ‘Adam’s apple’.
 Structure
• Cartilages :
The larynx is composed of several irregularly shaped cartilages
attached to each other. The main cartilages are:
• 1 thyroid cartilage
• 1 cricoid cartilage ( hyaline cartilage )
• 2 arytenoid cartilages
• 1 epiglottis (elastic fibrocartilage).
 Cont…
• The thyroid cartilage
This is the most prominent of the laryngeal cartilages. Made of
hyaline cartilage, it lies to the front of the neck forming the
laryngeal prominence or Adam’s apple, which is easily felt and
often visible in adult males. The anterior wall is partially
divided by the thyroid notch. The cartilage is incomplete
posteriorly.
• The upper part of the thyroid cartilage is lined with stratified
squamous epithelium like the larynx, and the lower part with
ciliated columnar epithelium like the trachea. There are many
muscles attached to its outer surface
 Cont…
• The cricoid cartilage
This lies below the thyroid cartilage and is also composed of
hyaline cartilage. It is shaped like a signet ring, completely
encircling the larynx with the narrow part anteriorly and the
broad part posteriorly. The broad posterior part articulates with
the arytenoid cartilages and with the thyroid cartilage. It is
lined with ciliated columnar epithelium.
 Cont…
• The arytenoid cartilages.
These are two roughly pyramid-shaped hyaline cartilages
situated on top of the broad part of the cricoid cartilage
forming part of the posterior wall of the larynx. They are lined
with ciliated columnar epithelium.
 Cont…
• The epiglottis
This is a leaf shaped fibro elastic cartilage attached on a
flexible stalk of cartilage to the inner surface of the anterior
wall of the thyroid cartilage immediately below the thyroid
notch. It is covered with stratified squamous epithelium. If the
larynx is likened to a box then the epiglottis acts as the lid; it
closes off the larynx during swallowing, protecting the lungs
from accidental inhalation of foreign objects.
 Interior of the larynx
• The vocal cords are two pale folds of mucous membrane with
cord-like free edges, stretched across the laryngeal opening.
They extend from the inner wall of the thyroid prominence
anteriorly to the arytenoid cartilages posteriorly
• The space between the vocal cords is called the glottis.
 Structures associated with the larynx
• Superiorly – the hyoid bone and the root of the tongue
• Inferiorly – it is continuous with the trachea
• Anteriorly – the muscles attached to the hyoid bone and the
muscles of the neck
• Posteriorly – the laryngopharynx and 3rd–6th cervical
vertebrae
• Laterally – the lobes of the thyroid gland
 Trachea
• The trachea is a cartilaginous and membranous tube. It begins
in the neck as a continuation of the larynx at the lower border
of the cricoid cartilage at the level of the 6th cervical vertebra.
It descends in the midline of the neck. In the thorax, the
trachea ends below at the carina by dividing into right and left
principal (main) bronchi at the level of 5th thoracic vertebra.
 Cont…
• In adults, the trachea is about (11.25 cm) long and (2.5 cm) in
diameter. The fibroelastic tube is kept patent by the presence
of C-shaped (rings) of hyaline cartilage embedded in its wall.
• Structures associated with the trachea
• Superiorly – the larynx
• Inferiorly – the right and left bronchi
• Anteriorly – upper part: the isthmus of the thyroid gland;
lower part: the arch of the aorta and the sternum
• Posteriorly – the oesophagus separates the trachea from the
vertebral column
• Laterally – the lungs and the lobes of the thyroid gland.
 Cont…
Structure

• The tracheal wall is composed of three layers of tissue and is

held open by between 16 and 20 incomplete (C-shaped) rings
of hyaline cartilage lying one above the other. The rings are
incomplete posteriorly where the trachea lies against the
oesophagus
• The cartilages are embedded in a sleeve of smooth muscle
and connective tissue, which also forms the posterior wall
where the rings are incomplete.
• The outer layer contains fibrous and elastic tissue and
encloses the cartilages.
 Cont…
• The middle layer consists of cartilages and bands of smooth
muscle that wind round the trachea in a helical arrangement.
There is some areolar tissue, containing blood and lymph
vessels and autonomic nerves
• The free ends of the incomplete cartilages are connected by
the trachealis muscle, which allows for adjustment of tracheal
diameter.
• The lining is ciliated columnar epithelium, containing mucus-
secreting goblet cells
 Cont…
• Blood Supply of the Trachea
The upper two thirds are supplied by the inferior thyroid
arteries and the lower third is supplied by the bronchial
arteries.
• Lymph Drainage of the Trachea
The lymph drains into the pretracheal and paratracheal lymph
nodes and the deep cervical nodes.
• Nerve Supply of the Trachea
The sensory nerve supply is from laryngeal nerves.
 Bronchi
The trachea bifurcates behind the arch of the aorta into the right
and left principal (primary or main) bronchi
• The right principal (main) bronchus is wider, shorter, and
more vertical than the left and is about (2.5 cm) long. Before
entering the hilum of the right lung, the principal bronchus
gives off the superior lobar bronchus. On entering the hilum,
it divides into a middle and an inferior lobar bronchus.
• The left principal (main) bronchus is narrower, longer, and
more horizontal than the right and is about (5 cm) long. On
entering the hilum of the left lung, the principal bronchus
divides into a superior and an inferior lobar bronchus.
 Bronchopulmonary Segments
• The bronchopulmonary segments are the anatomic, functional,
and surgical units of the lungs. Each lobar (secondary)
bronchus, which passes to a lobe of the lung, gives off
branches called segmental (tertiary) bronchi.
• On entering a bronchopulmonary segment, each segmental
bronchus divides repeatedly. As the bronchi become smaller
there is irregular plates of cartilage is present.
• The smallest bronchi divide and give rise to bronchioles,
which are <1 mm in diameter. Bronchioles possess no
cartilage in their walls and are lined with columnar
ciliated epithelium.
• The bronchioles then divide and give rise to terminal
bronchioles, which show delicate outpouchings from their
walls. Gaseous exchange between blood and air takes
place in the walls of these outpouchings, which explains
the name respiratory bronchiole.
• The diameter of a respiratory bronchiole is about 0.5 mm.
The respiratory bronchioles end by branching into
alveolar ducts, which lead into tubular passages with
numerous thin-walled outpouchings called alveolar sacs.
• The alveolar sacs consist of several alveoli opening into a
single chamber. Each alveolus is surrounded by a rich
network of blood capillaries. Gaseous exchange takes
place between the air in the alveolar lumen through the
alveolar wall into the blood within the surrounding
capillaries.
 Lungs
• There are two lungs, one lying on each side of the midline in
the thoracic cavity. They are cone-shaped and have an apex, a
base, costal surface and medial surface.
• The apex
This is rounded and rises into the root of the neck, about 25
mm above the level of the middle third of the clavicle. It lies
close to the first rib.
• The base
This is concave and semilunar in shape, and lies on the upper
(thoracic) surface of the diaphragm.
 Cont…
• The costal surface
This is the broad outer surface of the lung that lies directly
against the costal cartilages, the ribs and the intercostal
muscles.
• The medial surface
The medial surface of each lung faces the other directly across
the space between the lungs, the mediastinum. A roughly
triangular-shaped area, called the hilum, at the level of the 5th,
6th and 7th thoracic vertebrae.
 Cont…
• The primary bronchus, the pulmonary artery supplying the
lung and the two pulmonary veins draining it, the bronchial
artery and veins, and the lymphatic and nerve supply enter and
leave the lung at the hilum.
• The mediastinum contains the heart, great vessels, trachea,
right and left bronchi, oesophagus, lymph nodes, lymph
vessels and nerves.
 Lobes and Fissures
• Right Lung
The right lung is slightly larger than the left and is divided by
the oblique and horizontal fissures into three lobes: the upper,
middle, and lower lobes. The oblique fissure runs from the
inferior border upward and backward across the medial and
costal surfaces until it cuts the posterior border about 2.5 in.
(6.25 cm) below the apex.
 Cont…
• The horizontal fissure runs horizontally across the costal
surface at the level of the 4th costal cartilage to meet the
oblique fissure in the midaxillary line.
• Left Lung
The left lung is divided by a similar oblique fissure into two
lobes: the upper and lower lobes. There is no horizontal fissure
in the left lung.
 Blood Supply of the Lungs
• The bronchi, the connective tissue of the lung, and the visceral
pleura receive their blood supply from the bronchial arteries,
which are branches of the descending aorta.
• The alveoli receive deoxygenated blood from the terminal
branches of the pulmonary arteries. The oxygenated blood
leaving the alveolar capillaries drains into the tributaries of the
pulmonary veins. Two pulmonary veins leave each lung root
to empty into the left atrium of the heart.
 Nerve Supply of the Lungs
• At the root of each lung is a pulmonary plexus composed of
efferent and afferent autonomic nerve fibers. The plexus is
formed from branches of the sympathetic trunk and receives
parasympathetic fibers from the vagus nerve.
 Lymph Drainage of the Lungs
• The lymph vessels originate in superficial and deep plexuses
they are not present in the alveolar walls.
• The superficial (subpleural) plexus lies beneath the visceral
pleura and drains over the surface of the lung toward the hilum,
where the lymph vessels enter the bronchopulmonary nodes.
• The deep plexus travels along the bronchi and pulmonary
vessels toward the hilum of the lung, passing through
pulmonary nodes, the lymph then enters the
bronchopulmonary nodes in the hilum of the lung.
• All the lymph from the lung leaves the hilum and drains into the
tracheobronchial nodes and then into the bronchomediastinal
lymph trunks.
 Pleura
The pleura consists of a closed sac of serous membrane (one
for each lung) which contains a small amount of serous fluid.
• Parietal layer
which lines the thoracic wall, covers the thoracic surface of the
diaphragm and the lateral aspect of the mediastinum.
• visceral layer
which completely covers the outer surfaces of the lungs and
extends into the depths of the interlobar fissures.
The two layers become continuous with one another by means
of a cuff of pleura that surrounds the structures entering and
leaving the lung at the hilum of each lung
 Cont…
• The parietal and visceral layers of pleura are separated from
one another by a space, the pleural cavity. The pleural cavity
normally contains a small amount of tissue fluid, the pleural
fluid, which covers the surfaces of the pleura as a thin film and
permits the two layers to move on each other with the
minimum of friction.
 Division of parietal pleura
• The cervical pleura extends up into the neck, lining the
undersurface of the suprapleural membrane. It reaches
a level 1 to 1.5 in. (2.5 to 4 cm) above the medial third of
the clavicle.
• The costal pleura lines the inner surfaces of the ribs, the
costal cartilages, the intercostal spaces, the sides of the
vertebral bodies, and the back of the sternum.
• The diaphragmatic pleura covers the thoracic surface of
the diaphragm.
• The mediastinal pleura covers and forms the lateral
boundary of the mediastinum.
 Nerve Supply of the Pleura
Parietal pleura is sensitive to pain, temperature,
touch, and pressure and is supplied as follows:
• The costal pleura is segmentally supplied by the intercostal
nerves.
• The mediastinal pleura is supplied by the phrenic nerve.
• The diaphragmatic pleura is supplied over the domes by the
phrenic nerve and around the periphery by the lower six
intercostal nerves.
 Cont…
• The visceral pleura covering the lungs is sensitive to stretch
but is insensitive to common sensations such as pain and
touch. It receives an autonomic nerve supply from the
pulmonary plexus.
 Diaphragm
Shape
• As seen from in front, the diaphragm curves up into right and
left domes. The right dome reaches as high as the upper border
of the 5th rib, and the left dome may reach the lower border of
the 5th rib. The central tendon lies at the level of the
xiphisternal joint.
• The domes support the right and left lungs, whereas the
central tendon supports the heart.
 Diaphragm
Structure
The diaphragm is a thin muscular septum that separates the
chest cavity above from the abdominal cavity below. It is
dome shaped and consists of a peripheral muscular part. The
origin of the diaphragm can be divided into three parts:
• A sternal part arising from the posterior surface of the
xiphoid process
• A costal part arising from the deep surfaces of the lower six
ribs and their costal cartilages
• A vertebral part arising by vertical columns or crura and from
the arcuate ligaments
• The right crus arises from the sides of the bodies of the first three
lumbar vertebrae and the intervertebral discs.
• The left crus arises from the sides of the bodies of the first two
lumbar vertebrae and the intervertebral disc.
• Lateral to the crura the diaphragm arises from the medial and lateral
arcuate ligaments. The medial arcuate ligament extends from the
side of the body of the second lumbar vertebra to the tip of the
transverse process of the first lumbar vertebra. The lateral arcuate
ligament extends from the tip of the transverse process of the first
lumbar vertebra to the lower border of the 12th rib.
• The medial borders of the two crura are connected by a median
arcuate ligament, which crosses over the anterior surface of the
aorta