RESPIRATORY SYSTEM

1. RESPIRATORY SYSTEM

2. Anatomy • Upper respiratory tract • Nasal cavity • Paranasal sinuses • Nasopharynx • Lower respiratory tract • Larynx • Trachea • Bronchial tree • Respiratory part

3. Airways wall • Epithelium of the respiratory tract • Lamina propria • Submucosa

4. Epithelium of the RT • pseudostratified columnar with the cilia • columnar ciliated cells • goblet (mucous) cells • brush cells (microvilli) • Kultchitski cells (DNES) • secretory cells (granulated) • basal cells • stratified sqamous epithelium

5. Nasus et cavitas nasi • function • cavitas nasi mucosa : - vestibulum  lumen nasi • regio respiratoria et olfactoria

6. Sinus paranasales • sinus maxillaris (15 cm3) • sinus frontalis (8 cm3) • sinus sphenoidalis (6 cm3) • cellulae etmoidales (ant. et post.) • the development • epithelium • function

7. Nasopharynx • cranial part of the pharynx • epithelium of the respiratory tract • mouth of the tubae auditivae in a level of the meatus nasi inferior • tonsilla pharyngea - Waldeyer´s circle

8. Larynx • cartilage • epiglottis • lingual surface • laryngeal surface • vocal cords • true • false

9. Larynx - cartilages: • cartilago thyroidea • cartilago cricoidea • cartilago epiglottica • cartilago arytenoidea • cartilago corniculata, cuneiformis et triticea

10. Cavitas laryngis • Aditus • Vestibulum - plica vestibularis - lig.vestibularia - rima vestibuli, ventriculus • Glottis - plica vocalis, rima glottidis • Cavitas infraglottica • lamina propria • submucosa laryngis

11. D1 - epiglottis (HE)

14. D2 - larynx (HE)

15. Trachea • pars cervicalis + thoracica • bifurcatio tracheae (Th4) • epithelium of the respiratory tract • submucosa - glandulae tracheales • cartilagines tracheales • ligamenta anularia • paries membranaceus (tracheal muscles, ligaments)

17. D3 - trachea (HE)

19. Bronchial tree • Primary bronchi(bronchus pricipalis dx. et sin.) • Secondary bronchi(bb. lobares  bb. segmentales) • Terminal bronchioles • Respiratory bronchioles • Alveolar corridors (ductus  sacculi) • Alveoli

20. Bronchi • cartilage - here and there • smooth muscles - spiral • epithelium - pseudostratified, ciliated • lamina propria - seromucinous glands, elastic fibres • lymphocytes, lymphatic follicles

21. D4 Intrapulmonary bronchus (HE)

22. Bronchioles • epithelium - gradually simple cuboidal - Clara cells • elastic fibres, smooth muscles • no cartilage, no glands neither lymphatic follicles

23. The lung • Respiratory bronchi • Alveolar corridors • Alveoli • Pleura

24. Respiratory bronchioles • simple, cuboidal, ciliated epithelium • into alveoli - squamous epithelium • bronchioles gradually transform into the alveolar corridors

25. Alveoli • 200 μm large, many-sided, thin wall • alveolar epithelium • alveolar septum

26. Alveolar epithelium • Membranous pneumocytes (type I) • 97%; desmosomes, zonulae occludentes • squamous, thin - 25 nm • organelles around the nucleus, pinocytal pouches • Granular pneumocytes (type II) • ovoid shape, microvilli • lamellar bodies (1,5 μm) - surfactant • proliferation and differentiation (lining renewal)

27. Alveolar septum • fibroblasts (collagen type I, III) • endothelial capillary cells • pericytes • dust cells, lymphocytes • alveolar cells • reticular and elastic fibres • inter-alveolar pores (10μm)

29. D5 The lungs (HE)

32. Alveolar-capillary barrier 0,1- 0,5μm • alveolar cells (type I) cytoplasm • basal membranes • endothelial (capillary) cells • respiratory surface = 140 m2

34. Surfactant • reduces tension on the surface of alveoli • resists the collapse of the alveoli in expirium • water hypophase & lipid epiphase • absorption & renovation in granular pneumocytes • passage in respiratory tract within the bronchoalveolar fluid

35. Defence mechanism • Nose airways - mucous, vibrissae • Respiratory ciliated epithelium • Alveolar macrophages • T a B lymphocytes

36. Pleura • serose membrane - mezothelium • parietal and visceral sheet • cupula pleurae • recessus pleurales (costodiaphragmaticus, costo-, phrenico- a vertebromediastinalis) • pleural cavity - liquosus pleurae

38. Respiratory system - the development

39. The development of the RT • begins in week 4 • day 24-26 - laryngotracheal groove => laryngnotracheal diverticulum => lung bud bronchial buds... • tracheo-oesophageal septum => ventral (laryngotracheal tube) dorsal (oropharynx, eosophagus) - parts of the foregut • tracheoesophageal fistula

40. The development of the larynx • epithelium-pseudostratified, columnar, ciliated • origin of the cartilages and muscles • aditus laryngis - adhesion (month 1), recanalisation • ventriculus laryngis • eminentia hypobranchialis - epiglottis

41. The development of the trachea • endodermal lining => epithelium and glands • splanchnic mesoderm => cartilages, connective tissue and muscles of the trachea

42. The development of the bronchi and the lungs • lung bud => bronchial buds • week 5 - primary bronchi => lobar bronchi • week 7 - segmental bronchi + mesenchym => bronchopulmonal segment • the end of the week 24 - „level 17“; respiratory bronchiole • the origin of the visceral, parietal pleura

43. The maturation of the lungs • pseudoglandular phase (week 5-17) • canalicular phase (week16-25) • terminal pouches phase (week 24 ad partus) • alveolar phase (late fetal period, childhood) • adequate space of the chest • fetal breathing movements • adequate volume of the amnion fluid

44. Adaptive changes to the autonomic breathing • sufficient amount of the surfactant • conversion of the function of the lungs (secretory fce - respiratory fce) • parallel lungs and body circulation • fluid removal of the lungs: in a course of the delivery lungs capillaries and vessels, lymphatic vessels

45. D6 Fetal lungs (HE)