Anatomy of the Respiratory System

Respiration
Respiration is the act of breathing:

Inhaling. The act of breathing in oxygen.

Exhaling. The act of breathing out carbon dioxide.

Respiratory system
The respiratory system is made up of the organs included in the
exchange of oxygen and carbon dioxide. These are the parts:
Nose
Mouth
Throat (pharynx)
Voice box (larynx)
Windpipe (trachea)
Large airways (bronchi)
Small airways (bronchioles)
Lungs

The upper respiratory tract is made up of the:

Nose
Nasal cavity
Sinuses
Larynx
Trachea
The lower respiratory tract is made up of the:
Lungs

Bronchi and bronchioles

Air sacs (alveoli)

Lungs
The lungs take in oxygen. Your body's cells need oxygen to live and carry
out their normal functions. The lungs also get rid of carbon dioxide, a
waste product of the cells.
The lungs are a pair of cone-shaped organs made up of spongy, pinkish-
gray tissue. They take up most of the space in the chest (thorax).
The lungs are surrounded by a membrane (pleura).
The lungs are separated from each other by the mediastinum, an area
that contains the:

Heart and its large vessels

Trachea
Esophagus
Thymus gland
Lymph nodes

The right lung has 3 sections, called lobes. The left lung has 2 lobes.
When you breathe in:

Air enters your body through your nose or mouth.

Air then travels down the throat through the larynx and trachea.

Air goes into the lungs through tubes called main-stem bronchi.

One main-stem bronchus leads to the right lung and one to the left lung:

In the lungs, the main-stem bronchi divide into smaller bronchi.

The smaller bronchi divide into even smaller tubes (bronchioles).

Bronchioles end in tiny air sacs (alveoli) where the exchange of oxygen
and carbon dioxide occurs.

You then breathe out carbon dioxide.

 Trachea (histology)

The trachea is a tubular organ that directs air from the larynx further into the bronchi , while
improving its properties. The cross-section shows its basic structure: the horseshoe-shaped hyaline
cartilage discs, both ends of which are connected by a straight paries membranaceus made of
smooth muscle and elastic fibers.

Tunica mucosa

Lamina epithelialis

The trachea is mostly lined by a multilayered cylindrical epithelium with cilia and goblet cells , the
number of which increases aborally. Mucus formed by goblet cells and displaced by lashes
together forms an important cleansing mechanism . The exception is carina tracheae , which is
protected by a more resistant layered squamous epithelium . At the point where the trachea is
divided into bronchi, the air flows turbulently , which puts more strain on the mucosa.

Lamina propria mucosae

A layer of very cellular sparse collagenous connective tissue , it contains blood vessels ,
unmyelinated nerves and seromucinous glands . There are also more or less numerous plasma cells
and lymphocytes , which can even form follicles ( BALT ).

Tunica submucosa

Unlike other organs, the submucosa consists of a sparse ligament similar to the lamina propria .
Due to this, and due to the absence of muscles of the lamina muscularis mucosae, it is difficult to
find the boundary between the lamina propria and the submucosa. Numerous lymphatic
infiltration from the lamina propria intervenes here, and larger blood and lymphatic vessels and
seromucinous glands are entrapped in the ligament itself .

Tunica fibromusculocartilaginea

Cartilagines tracheales are hyaline cartilages in the shape of a horseshoe , with the ends open in
the dorsal direction. Neighboring rings are connected by a dense collagen connective tissue,
originating from the perichondria of individual cartilages. The cartilage forms a skeleton of the
trachea, without which its lumen would collapse when exhaled.
 Paries membranaceus is a skeleton made of smooth muscle (m. Trachealis) and elastic fibers, which
complements the open form of cartilage at the back. The tension of the elastic fibers prevents
excessive spreading, the rate of muscle contraction regulates the lumen of the trachea.

Tunica adventitia

It consists of a sparse collagen ligament , into which a number of blood and lymphatic vessels and
nerves are taken . It connects to the perichondrium (dense collagen connective tissue) from the
outside and passes into the interstitium of the surrounding structures of the neck and
mediastinum.

Histology Of Lungs
The lungs are covered by the serous membrane, the pleural membrane,
which has two layers - the parietal and the visceral layer. The visceral
pleura of the lung is lined by a mesothelial layer with underlying
connective tissue and elastic fibers. An elastin stain may be used to
identify the elastic layer.
The lung consists of airways and structures for gas exchange.
The trachea divides into a primary bronchus for each lung. The smaller intrapulmonary airways are devoid of cartilage and
glands in their walls.

 Primary (Muscular) Bronchioles (not present in this specimen)

 Epithelium changes from pseudostratified columnar to simple, ciliated columnar epithelium as they decrease in diameter.
 Club Cells - dome-shaped secretory cells with short microvilli. (Do not have cilia.)
 Smooth Muscle - variable amounts present.
 Terminal Bronchioles - conducting airways.

 Epithelium changes from simple, ciliated columnar epithelium to cuboidal epithelium.

 Club Cells - become more prominent.
 Smooth Muscle - variable amounts present.

 Respiratory Bronchioles (#1, #2 and #3) - mixture of conducting epithelium and alveoli where respiration occurs.

 Epithelium is a mixture of simple columnar and simple cuboidal epithelia.

 Club Cells - become more prominent.
 Smooth Muscle - only small amounts are present.


Histology Of Plura
A pleura is a serous membrane that folds back on itself to form a two-layered membranous pleural sac. The
outer layer is called the parietal pleura and attaches to the chest wall. The inner layer is called the visceral
pleura and covers the lungs, blood vessels, nerves, and bronchi. There is no anatomical connection between
 the right and left pleural cavities.[1] With the addition of pleural fluid, the lung pleura allows for easy
movement of the lungs and inflation during breathing.
The mediastinum is a central compartment in the thoracic cavity between the pleural sacs of the lungs. It is
divided into two major parts, the superior and inferior portions. The inferior portion is then further divided
into the anterior, middle, and posterior portions. Each region of the mediastinum contains specific groups of
structures.[2]


Superior mediastinum: Organs: thymus, trachea, esophagus; Arteries: aortic arch, brachiocephalic
trunk, left common carotid artery, left subclavian artery; Veins and lymphatics: superior vena cava,
brachiocephalic vein, thoracic duct; Nerves: vagus nerve, left recurrent laryngeal nerve, cardiac
nerve, phrenic nerve.


Anterior mediastinum: Organs: thymus; Arteries: small arterial branches; Veins and lymphatics:
small branches; Nerves: none.


Middle mediastinum: Organs: heart, pericardium; Arteries: ascending aorta, pulmonary trunk,
pericardiacophrenic arteries; Veins and lymphatics: superior vena cava, azygos vein, pulmonary
vein, pericardiacophrenic vein; Nerve: phrenic


Posterior mediastinum: Organs: esophagus; Arteries: thoracic aorta; Veins and lymphatics: Azygos
vein, hemiazygos vein, thoracic duct; Nerve: the vagus nerve.

Paranasal Air Sinus

he paranasal sinuses are air-filled extensions of the nasal cavity. There are four paired
sinuses – named according to the bone in which they are located – maxillary, frontal,
sphenoid and ethmoid. Each sinus is lined by a ciliated pseudostratified epithelium,
interspersed with mucus-secreting goblet cells.

The function of the paranasal sinuses is a topic of much debate. Various roles have been
suggested:

 Lightening the weight of the head

 Supporting immune defence of the nasal cavity
 Humidifying inspired air
 Increasing resonance of the voice

The paranasal sinuses are formed during development by the nasal cavity eroding into the
surrounding bones. All the sinuses therefore drain back into the nasal cavity – openings to
the paranasal sinuses can be found on the roof and lateral nasal walls.

In this article, we shall look at the anatomy of the paranasal sinuses – their structure,
anatomical relations and innervation.

 Adobe Stock, Licensed to TeachMeSeries Ltd

Fig 1 – Location of the paranasal sinuses.
Frontal Sinuses
There are two frontal sinuses located within the frontal bone of the skull. They are the most
superior of the paranasal sinuses, and are triangular in shape.

Drainage is via the frontonasal duct. It opens out at the hiatus semilunaris, within the middle
meatus of the nasal cavity.

Sensation is supplied by the supraorbital nerve (a branch of the ophthalmic nerve), and

arterial supply is via the anterior ethmoidal artery (a branch of the internal carotid).
Sphenoid Sinuses
The sphenoid sinuses are situated within the body of the sphenoid bone. They open out
into the nasal cavity in an area supero-posterior to the superior cocha – known as the
spheno-ethmoidal recess.

They are innervated by the posterior ethmoidal nerve (a branch of the ophthalmic nerve), and
branches of the maxillary nerve. They recieve blood supply from pharyngeal branches of
the maxillary arteries.

Clinical Relevance - Transsphenoidal Surgery

The sphenoid bone shares a close anatomical relationship with the pituitary gland. Indeed,
the pituitary can be accessed surgically by passing instruments through the sphenoid bone
and sinus.
 This type of surgery is known as endoscopic trans-sphenoidal surgery (ETSS), and is the
usual treatment of choice for pituitary adenomas. It allows for the surgical management of
pituitary pathology without the need for a more extensive craniotomy.

 By TeachMeSeries Ltd (2023)

Fig 2 – The transsphenoidal approach to pituitary surgery.

Ethmoidal Sinuses
There are three ethmoidal sinuses located within the ethmoid bone:

 Anterior – Opens onto the hiatus semilunaris (middle meatus)

 Middle – Opens onto the lateral wall of the middle meatus
 Posterior – Opens onto the lateral wall of the superior meatus

They are innervated by the anterior and posterior ethmoidal branches of the nasociliary nerve
and the maxillary nerve. The anterior and posterior ethmoidal arteries are responsible for
arterial supply.
Maxillary Sinuses
The maxillary sinuses are the largest of the sinuses. They are located laterally and
slightly inferiorly to the nasal cavities.

They drain into the nasal cavity at the hiatus semilunaris, underneath the frontal sinus
opening. This is a potential pathway for spread of infection – fluid draining from the frontal
sinus can enter the maxillary sinus.

 By TeachMeSeries Ltd (2023)
Fig 3 – The conchae have been removed, showing the various openings on the lateral wall of
the nasal cavity.