Sistemi respirator

1. Pershkrimi i sistemit respirator

2. Hunda:

Pjesa e jashtme
Zgavra e hundes

3. Sinuset paranasale
4. Trakti i poshtem respirator:

Laringu
Trakea dhe bronket

5. Mushkerit dhe pleura

SPLANCHNOLOGY

Sistemi respirator
Sistemi respirator,
systema respiratorium
Shkembimi i
gazrave nen
presionin
negativ te ajrit
Rruget perquese
rruget respiratore
Rruget perquese
ne mushkeri

Zeri laringu
Ndjeshmeria e aromes
zgavra e hundes

Prof. Dr. Nikolai Lazarov

SPLANCHNOLOGY

Pjeset e sistemit respirator

Rruget respiratore:
Trakti i siperm:
hunda
faringu

Trakti i poshtem respirator:

laringu
trakea
bronket
bronkiolet terminale

Pjeset respiratore
Ne mushkeri:
bronkiole
kanalet
alveolare
qeset
alveolare
alveolet

Morfologjia

funksionale
Freskim i ajrit

Prof. Dr. Nikolai Lazarov

SPLANCHNOLOGY

Hunda

Hunda nasus (Gr. rhis,

rhinos):

Organ i nuhatjes
Rol ne formimin e timbrit

Pjeset anatomike:
Hunda e jashtme, nasus
externus
Zgavra e hundes cavitas nasi

Prof. Dr. Nikolai Lazarov

SPLANCHNOLOGY

Hunda
Pjesa e jashtme e hundes
(nasus externus):
Gjendet ne pjesen qendrore te
fytyres
Ka formen e piramides

Pjeset anatomike:
Baza, basis nasi
Pjeset laterale
krahet, alae nasi

Shpina, dorsum nasi

rrenja, radix nasi
maja, apex nasi

Vrimat e hundes, nares

Ndarsja e hundes
Prof. Dr. Nikolai Lazarov

SPLANCHNOLOGY

Skeleti i hundes
Skeleti ashteror
apertura piriformis:
ossa nasalia
processus frontalis maxillae

Kerca, cartilagines nasi:

te paciftezuara
Cartilago septum nassi

Te ciftezuara:
cartilago nasi lateralis
cartilago alaris major
cartilagines alares minores
cartilagines nasales accessoriae
Prof. Dr. Nikolai Lazarov

SPLANCHNOLOGY

Muret e hundes
Muskujt e hundes:
m. procerus
m. nasalis
m. depressor septi
nasi
m. apicis nasi
variable
m. compressor
nares
m. levator labii
superioris alaequae
nasi

Indi lidhor
Lekura:
Qimet
Gjendrrat djersore
Gjendrat dhjamore

Prof. Dr. Nikolai Lazarov

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Nasal cavity
Nasal cavity,
cavum (cavitas) nasi:

vestibule, vestibulum nasi

nasal cavity proper,
cavum nasi proprium

Nasal septum,
septum nasi:
pars ossea

vomer
lamina perpendicularis
ossis ethmoidalis

pars cartilaginea

cartilago septi nasi

cartilagines alares
majores
organum vomeronasale
(Jacobsoni)

locus Kiesselbachi

pars membranacea

Prof. Dr. Nikolai Lazarov

SPLANCHNOLOGY

Nasal vestibule
Nasal cavity, cavum (cavitas) nasi:
anterior (external) nares,
nostrils
personality and racial
traits

posterior (internal)
nares,
choanae

Vestibule, vestibulum
nasi:
limen nasi
agger nasi
regio cutanea
sweat and sebaceous
glands
stiff (guard) hairs,
vibrissaeof sweat and sebaceous
absence
transitional
glands
region
stratified squamous
non-keratinized

Prof. Dr. Nikolai Lazarov

SPLANCHNOLOGY

Nasal cavity proper

Bony nasal cavity,
cavitas nasalis ossea:
bony skeleton walls
floor hard palate
roof:
o nasal bone
o ethmoid bone
o sphenoid bone

medial wall nasal

septum
lateral wall:
o maxilla
o lacrimal bone
o labyrinth of the ethmoid
o perpendicular plate of the
o
conchae
nasales, superior, media et inferior
palatine
bone
o sphenoid bone
Prof. Dr. Nikolai Lazarov

10

SPLANCHNOLOGY

Nasal cavity proper

Nasal mucosa:
medial wall

regio respiratoria
regio olfactoria

lateral wall

nasal conchae
nasal meatuses:
o
o
o
o
o

meatus nasi superior

meatus nasi medius
meatus nasi inferior
meastus nasi communis
meatus nasopharyngeus

openings of nasal sinuses:

o recessus sphenoethmoidalis
o hiatus semilunaris,
o
plica lacrimalis
infundubulum
PPrrooff.. DDrr.. NNiikkoollaaii

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SPLANCHNOLOGY

Nasal cavity proper

Microscopic anatomy:
olfactory mucosa 5-10 cm2
olfactory epithelium
o epithelium olfactorium
olfactory and supporting cells
o lamina propria gll. olfactoriae (Bowman)

absent tela submucosa

respiratory mucosa 1-3 mm
lamina epithelialis pseudostratified
ciliated columnar epithelium 3 cell
types: ciliated columnar, goblet and basal
cells
lamina propria

Prof. Dr. Nikolai Lazarov

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sinus
sinus
sinus
sinus

Paranasal sinuses,
sinus paranasales

maxillaris (antrum Highmori)

frontalis
ethmoidalis
sphenoidalis

Prof. Dr. Nikolai Lazarov

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Sinusi maxillar,
sinus maxillaris

Sinusi maxillar:

Sinusi m i madh n trupin

e maxills
hiatus maxillaris
hiatus semilunaris
drainage
meatus nasi medius

Prof. Dr. Nikolai Lazarov

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SPLANCHNOLOGY

Sinusi frontal,

sinus frontalis

Sinusi frontal:

N kockat frontale
septum sinuum frontalium
ductus nasofrontalis 12-16 mm
drainage infundibulum of
meatus nasi medius

Prof. Dr. Nikolai Lazarov

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SPLANCHNOLOGY

Sinusi ethmoidal,
sinus ethmoidalis

Qelizat ethmoidale 10 (5-16):

Qelizat ethmoidale e prparme
2-3 n numr
drenazh

meatus nasi medius

Qelizat ethmoidale e mesme incl.

bulla ethmoidalis
3-4
drenazh

meatus nasi medius

Qelizat ethmoidale e pasme 4-5

drenazh meatus nasi superior
(meatus nasi supremus)

Prof. Dr. Nikolai Lazarov

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Sinusi sphenoidal,
sinus sphenoidalis

Sinusi sphenoidal:

N trupin e sphenoidit
septum sinuum
sphenoidalium
apertura sphenoidalis
drainage

recessus sphenoethmoidalis

Prof. Dr. Nikolai Lazarov

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Laringu, larynx
Laringu, larynx:
Form tubit jo e regullt
kuti e zrit phonation

Pozita anatomike:
Pjesa perparme e qafs
N nivel e vertebrave C3-C6

Prof. Dr. Nikolai Lazarov

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Skeleti e laryngut
Krcet e laryngut
krcet elastike :
Tek:
krc tiroide
krc cricoide
krc epiglottike

ift :
Krcet arytenoide
krcet corniculate
krcet cuneiform
krc triticea
krcet sesamoide,e

prparme dhe t pasm

Prrooff.. DDrr..

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Skeleti e laryngut

Ligamentet e laryngut:
syndesmoses (ligamente dhe membrana)
membrana thyrohyoidea
o
lig. thyrohyoideum
medianum et laterale

lig. thyroepiglotticum
membrana fibroelastica conus elasticus
o

lig. vocale

lig. cricothyroidem (lig. conicum)

lig. cricoarytenoideum
membrana quadrangularis

lig. ventriculare
lig. cricotracheale

Articulacionet:
art. cricothyroidea
art. cricoarytenoidea

Prof. Dr. Nikolai Lazarov

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SPLANCHNOLOGY

Muskujt e laryngut
Muskujt e jashtme
mm. levatores laryngis
m. stylohyoideus
m. geniohyoideus
m. digastricus

mm. detractores laryngis

m. constrictor pharyngis
inferior

Prof. Dr. Nikolai Lazarov

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SPLANCHNOLOGY

Muscles of the larynx

Intrinsic muscles:
open the glottis
m. cricoarytenoideus posterior

close the glottis

m. cricoarytenoideus lateralis
m. arytenoideus transversus

elongation of the vocal folds

m. cricothyroideus (anticus)

relax and shorten the vocal folds

m. thyroarytenoideus, m. vocalis

close the larynx opening

m. aryepiglotticus
m. arytenoideus obliquus

open the larynx opening

m. thyroepiglotticus
Prof. Dr. Nikolai Lazarov

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SPLANCHNOLOGY

Microscopic anatomy
Tunica mucosa laryngis:
lamina epithelialis

stratified ciliated columnar epithelium

stratified squamous nonketarinized
vocal folds, vestibule

lamina propria oedema laryngis

laryngeal glands

o gll. epiglotticae
o gll. ventriculi laryngis
lymphatic follicles, tonsilla laryngis

Tela submucosa

membrana fibroelastica

laryngis

Prof. Dr. Nikolai Lazarov

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SPLANCHNOLOGY

Laryngeal cavity
Three clinical compartments
hour-glass configuration:
supraglottic space, vestibule,
vestibulum laryngis
laryngeal inlet, aditus
laryngis

transglottic space
vestibular folds rima
vestibuli
vocal folds (m. vocalis)
rima glottidis (glottis)
o intermembranous part,
pars intermembranacea
o intercartilagineous part,
pars intercartilaginea

infraglottic cavity,
cavitas infraglottica

Prof. Dr. Nikolai Lazarov

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Trachea,
Trachea, trachea
:
trachea

windpipe
in the neck and thorax,
pars cervicalis et pars thoracica
length 11-13 cm; 2.5 cm in diameter
15-20 C-shaped rings of hyaline cartilage

Topography:

anterior to the esophagus, thyroid gland

begin C6-C7
inferior end, bifurcatio tracheae Th4-Th5

Prof. Dr. Nikolai Lazarov

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Primary bronchi,
bronchi principales

Primary bronchi, bronchi principales:

bifurcatio tracheae Th4-Th5;

Th2 (newborns)-Th7 (in elderly person)

angle

55-65 (adults); 70-80

(infants)

carina tracheales

Bronchus principalis sinister:

more horizontal
longer

length 4-5 cm
9-12 cartilages
narrower 10-11 mm

Bronchus principalis dexter:

more vertical
shorter

length 3 cm
6-9 cartilages
slightly wider 15-16 mm

Prof. Dr. Nikolai Lazarov

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Structure of tracheal wall

Mucosa, tunica mucosa respiratoria:
lamina epithelialis
pseudostratified columnar ciliated
epithelium

lamina propria
elastic fibers and
blood vessels
lymph follicles
BALT

tela submucosa
gll. tracheales
lamina fibrarum
elasticum

Tunica

fibromusculocartila
ginea:
cartilagines
tracheales
m. trachealis

Prof. Dr. Nikolai Lazarov

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Microscopic anatomy
tunica mucosa respiratoria:
lamina epithelialis

pseudostratified columnar ciliated

epithelium:
ciliated cells,
epitheliocyti ciliati
250-300 kinocilia

goblet cells,
exocrinocyti
caliciformis
basal cells
brush cells

microvilli, receptor
cells

granular cells of Kulchitsky

neuroendocrine cells
interciliary cells mucous
production

PPrrooff.. NNiikkoollaaii

28

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Structure of the bronchial wall

Mucosa, tunica mucosa respiratoria:
lamina epithelialis
stratified columnar ciliated
epithelium

lamina propria
elastic fibers and
blood vessels
BALT

tela submucosa
gll. bronchiales
lamina fibrarum
elasticum

Tunica
fibromusculocartilagi
nea:
cartilagines
bronchiales
m. bronchialis

Prof. Dr. Nikolai Lazarov

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Lungs
Lung, pulmo (Gr. pneumon):
gas exchange (external breathing)
functional features:
respiratory passages
blood vessels functional and
nutritional
parenchyma

Lungs in situ:
in thoracic cavity
mediastinum
resting on the diaphragm
covered by pleura,
pleura visceralis
Prof. Dr. Nikolai Lazarov

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SPLANCHNOLOGY

Macroscopic anatomy
Structure of the lungs :
shape conical

base, basis pulmonis

blunt peak, apex pulmonis
three surfaces:
o facies costalis
o facies diaphragmatica
o facies mediastinalis

size variable:

length ~25 cm
anterior-posterior ~16 cm
width ~10 (right); 7 cm (left)
lung
color age-dependent
redbrown until birth
pinkish white at birth
a dark slaty gray in adult life
consistency spongy and soft
Prof. Dr. Nikolai Lazarov

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SPLANCHNOLOGY

Macroscopic anatomy
Costal surface,
facies costalis:
fissura obliqua

fissura horizontalis

lobes of the lungs:

right 3 lobes
left 2 lobes

facies interlobalis

Diaphragmatic surface,
facies diaphragmatica
Mediastinal surface,
facies mediastinalis
hilum pulmonis
radix pulmonis
anteriorly
posteriorly
superiorly

Prof. Dr. Nikolai Lazarov

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Lung segments
Bronchopulmonary segments:
right lung:
lobus superior
o segmentum apicale (SI)
o segmentum posterius (SII)
o segmentum anterius (SIII)

lobus medius
o segmentum laterale (SIV)
o segmentum mediale (SV)

lobus inferior
o segmentum apicale, superius (SVI)
o segmentum basale mediale (SVII)
o segmentum basale anterius (SVIII)
o segmentum basale laterale (SIX)
o segmentum basale posterius (SX)

Prof. Dr. Nikolai Lazarov

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SPLANCHNOLOGY

Lung segments
Bronchopulmonary segments:
left lung:
lobus superior
o segmentum apicoposterius (SI+II)
o segmentum anterius (SIII)
o segmentum lingulare superius (SIV)
o segmentum lingulare inferius (SV)

lobus inferior
o segmentum apicale, superius (SVI)
o segmentum basale mediale (SVII)
o segmentum basale anterius (SVIII)
o segmentum basale laterale (SIX)
o segmentum basale posterius (SX)

Prof. Dr. Nikolai Lazarov

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SPLANCHNOLOGY

Bronchial tree,
arbor bronchialis
Lobar bronchi,
bronchi lobares:
right 3
left 2

Segmental bronchi,
bronchi segmentales
Lobular bronchi,
bronchi lobulares, d=1 mm
Terminal bronchioles,
bronchioli terminales, d~0.3
mm

Prof. Dr. Nikolai Lazarov

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Bronchial tree,
arbor
bronchialis
Structural changes:
cartilage rings
cartilage plates
smooth muscle layer
increases
mucosal alterations:

stratified ciliated
simple epithelium
goblet cells and bronchial
glands decrease
increase of
elastic fibers

Prof. Dr. Nikolai Lazarov

36

SPLANCHNOLOGY

Microscopic anatomy
tunica mucosa:

lamina epithelialis stratified

columnar ciliated epithelium

simple columnar (cuboidal)
ciliated cells
goblet cells
basal cells stem cells
brush cells receptor cells
granular cells of Kulchitsky
neuroendocrine cells
Clara cells secretory cells
GAG, CC16

lamina propria

elastic fibers and blood

vessels
BALT

tela submucosa

gll. bronchiales
lamina fibrarum elasticum

tunica fibromusculocartilaginea
tunica adventitia

Prof. Dr. Nikolai Lazarov

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Respiratory portion
Pulmonar acinus:

respiratory bronchiole
1st , 2nd and 3rd order

alveolar ducts
alveolar sacs
alveoli 300-500 million:
sac-like evaginations
size 0.2-0.3 mm
surface 30-100 m2
capillary network
interalveolar septum

Prof. Dr. Nikolai Lazarov

38

SPLANCHNOLOGY

Alveolar wall

Septum interalveolare 5 cell types:

squamous alveolar cells (type I pneumocytes) 8%

blood-air barrier 95% of the alveolar surface

great alveolar (septal) cells (type II pneumocytes)

16%
secretion of pulmonary surfactant

alveolar macrophages, dust cells 10%

phagocytosis mononuclear phagocytic system

interstitial cells 36%:

fibroblasts
mast cells

capillary endothelial cells 30%

porus septi (pores of Kohn)
elastic and reticular fibers

Prof. Dr. Nikolai Lazarov

39

SPLANCHNOLOGY

Histological structure

Prof. Dr. Nikolai Lazarov

40

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Blood supply of lungs

Functional pulmonary circulation:
pulmonary circuit
aa. pulmonales deoxygenated blood
vv. pulmonales oxygenated blood

Prof. Dr. Nikolai Lazarov

41

SPLANCHNOLOGY

Blood supply of lungs

Bronchial arteries

nutritive pulmonary

circulation:

systemic circuit oxygenated blood

rr. bronchiales

aorta thoracica, a. subclavia, aa.

intercostales

vv. bronchiales

v. azygos et v. hemiazygos accessoria

Prof. Dr. Nikolai Lazarov

42

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Pleura, pleura
tunica serosa:
lamina epithelialis

simple squamous epithelium

(mesothelium)

lamina propria serosae

loose connective tissue

tela subserosa

collagen and
elastic fibers, smooth muscle cells

parietal pleura

pleura costalis,
pleura mediastinalis,
pleura
diaphragmatica
cupula pleurae
recessus s. sinus
pleurales

costodiaphragmatic
,
costomediastinal
recesses

visceral pleura
lig. pulmonalis

Prof. Dr. Nikolai Lazarov

43

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Thank
you ...

Prof. Dr. Nikolai Lazarov

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