MICRO HSB A

HISTOLOGY OF THE RESPIRATORY SYSTEM

Dr. Bardelosa/Dr. Borlaza

OVERVIEW
ANATOMY OF RESPIRATORY SYSTEM

• Goblet Cells
o Mucus secretion
o Numerous
o Contain basal nuclei and apical domains filled with
granules of mucin glycoproteins
• Brush Cells
o Must less numerous
o Columnar with sparse blunt microvilli
▪ Chemosensory receptors
▪ Resemble gustatory cells
▪ Similar signal transduction components
and synaptic contact with afferent nerve
endings on their basal surfaces
• Kulchitsky Cells/Small Granule Cells
o Possess numerous dense core granules
• Upper Respiratory System: structures above the larynx o 100-300nm in diameter
• Lower Respiratory System: structures below the larynx o Part of diffuse neuroendocrine system
• Conducting Portion o Comprise 3% of respiratory cells
o Nasal cavities, nasopharynx, larynx, trachea, • Basal Cells
bronchi, bronchioles, and terminal bronchioles o Mitotically active stem and progenitor cells
• Respiratory Portion o Give rise to other epithelial cell types
o Gas exchange occurs
o Respiratory bronchioles, alveolar ducts, alveoli OLFACTORY EPITHELIUM

WALLS OF RESPIRATORY PASSAGES

• Rigid, prevents collapse of the lumen of the conducting
portion
• Mucosa
o Covers the luminal surface
o Pseudostratified ciliated columnar epithelium with
mucous goblet cells
o Thin lamina propria
• Fibrocartilaginous layer
o Supports the walls
o Composed of hyaline and elastic cartilage
o Bundles of smooth muscles (caudally and dorsally) • Specialized region of mucous membrane covering superior
• Tunica Adventitia conchae at the roof of the nasal cavity
o Loosely connects both previous layers with • Contain olfactory chemoreceptors for sense of smell
surroundings • Thick, pseudostratified columnar epithelium
o Composed of loose connective tissue • Olfactory Neurons
o Contains blood vessels and nerve bundles o Responds to odiferous substances
o Bipolar neurons present throughout the
RESPIRATORY EPITHELIUM epithelium
• Lines most of the nasal cavities and the respiratory o Nuclei form an irregular row near the middle of
system’s conducting portion the epithelium
• Ciliated pseudostratified columnar epithelium o Dendrite End
• 5 major cell types are all in contact with unusually thick ▪ Apical (luminal) pole of each olfactory
basement membrane cell
• Ciliated Columnar cells ▪ Has a knob-like swelling with ~12 basal
o Most abundant bodies
o Have 250-300 cilia on the apical surface o Long cilia with non-motile axonemes emerge from
o Cilia: move foreign bodies and mucus the basal bodies
 o Axons leave the epithelium, unite in the lamina • Mucous Membrane
propria, and form the olfactory nerve in the brain o Thin tissue that lines the nose, sinuses, and throat
o Synapse with other neurons in the olfactory bulb o Warms and moistens air
• Supporting Cells o Makes sticky mucus that helps clean the air of
o Columnar with broad, cylindrical apexes dust and other small particles
containing nuclei and narrower bases • Turbinates/Conchae
o Microvilli o Curved, bony ridges located on each side
▪ Located on their free surfaces o Shelf-like projections that extend from each
▪ Submerged in a fluid layer lateral wall
o Bound to olfactory cells by well-developed o Lined with mucus membrane
junctional complexes o Warm and moisten air
o Express abundant ion channels o Middle and Inferior Conchae: Respiratory
▪ Help maintain a microenvironment Epithelium
conducive to olfactory function and o Superior Conchae: Olfactory Epithelium
survival
• Basal Cells
o Small, spherical or cone-shaped cells near the
basal lamina
o Stem cells for the other 2 types
▪ Replace olfactory neurons every 2-3
months
▪ Replace support cells less frequently
• Lamina Propria
o Possesses Olfactory Glands of Bowman
▪ Large serous glands
▪ Produce a constant flow of fluid
surrounding olfactory cilia PARANASAL SINUSES
▪ Facilitate the access of new odoriferous • Bilateral cavities in the frontal, maxillary, ethmoid, and
substances sphenoid bones
• Epithelium: thinner respiratory epithelium with fewer
goblet cells
• Lamina Propria
o Contains few small glands
o Continuous with underlying periosteum
• Communicate with nasal cavities through small openings
o Mucus produced here is moved to nasal passages
via ciliated epithelial cells

RESPIRATORY PASSAGES
NASAL CAVITY
• Hollow space behind the nose where air flows through
• Right and left nasal cavity have 2 components
o Vestibule
▪ External, dilated
▪ Epithelium: non-keratinized
o Nasal cavity
▪ Internal NASOPHARYNX
▪ Epithelium: pseudostratified columnar • Nasal cavities open posteriorly to nasopharynx
epithelium • First part of the pharynx, continuous caudally with
• Nares/Nostrils oropharynx
o Skin of the nose partly enters o Oropharynx: posterior part of oral cavity, leads to
o Contains sweat glands, sebaceous glands, and larynx
coarse, moist hairs (vibrissae) • Epithelium: Respiratory Epithelium
▪ Hairs: filter out particulate material from • Mucosa contains:
inspired air o Medial pharyngeal tonsil
• Septum o Bilateral openings of auditory tubes (connected to
o Thin “wall” made of cartilage and bone each middle ear cavity)
o Divides the inside of the nose into 2 chambers
 o Lower Pole/True Vocal Cords
▪ Lined by stratified squamous non-
keratinzed epithelium (protect mucosa
from abrasion and desiccation from rapid
air movement)
▪ Vocal Ligament: dense regular bundle of
elastic connective tissue, supports free
edge of each vocal fold
▪ Presence of vocalis muscle (deep to
mucosa, large bundles of striated fibers)
• Larger in males than females after puberty
o Men’s voices are typically deeper than women’s
LARYNX
• Short (4cm x 4cm) passage for air between pharynx and
trachea
• Rigid wall reinforced by cartilages
o Hyaline Cartilage: thyroid, cricoid, inferior
arytenoid cartilages
o Smaller elastic cartilages: epiglottis, cuneiform,
corniculate, superior arytenoid cartilages
o All cartilages are connected by ligaments
• Skeletal muscles move cartilages to produce sound in
phonation
• Epiglottis
o Flattened structure projecting from upper rim of
larynx
o Prevents swallowed food/fluid from entering TRACHEA
larynx • 10-12cm long in adults
o Upper/Lingual Surface: stratified squamous non- • Lined with typical respiratory mucosa
keratinized epithelium • Lamina propria has seromucous glands (watery mucus)
o Laryngeal Surface: ciliated pseudostratified • Submucosa contains about a dozen C-shaped rings of
columnar/respiratory epithelium hyaline cartilage
o Lamina Propria: contains mixed mucous and o Reinforce the wall, keeps tracheal lumen open
serous glands o Open ends of cartilage rings are on posterior
surface (against esophagus)
o Bridged by trachealis muscle and a sheet of
fibroelastic tissue attached to perichondrium
• Entire organ is surrounded by adventitia
• Trachealis Muscle
o Relaxes during swallowing
▪ Facilitates passage of food (allows
esophagus to bulge into lumen of
trachea)
▪ Elastic layer prevents excessive
distention of lumen
o Strongly contracts during cough reflex
▪ Narrows tracheal lumen
▪ Increases velocity of expelled air
▪ Loosens material in air passage
• Vestibular Folds
o Below epiglottis and laryngeal folds
o Bilateral projection of the mucosa
o Separated by a narrow space (ventricle)
o Contain seromucous glands and areolar tissue
with MALT (and often lymphoid nodules)
o Largely covered by respiratory epithelium
▪ Regions near epiglottis have stratified
squamous epithelium
o Upper Pole/False Vocal Cords
▪ Immovable
▪ Lined by typical respiratory epithelium,
seromucous glands, and lymphoid
nodules (occasionally)
▪ Laryngeal glands
 BRONCHIAL TREE AND LUNG • Submucosa
o Sparse glands
o Irregular plates of cartilage
• Adventitia contains few lymphoid tissue

BRONCHIOLE
• Intralobular airways
• <1mm in diameter
• 10th generation of branching
BRONCHUS • Lining Epithelium: ciliated columnar cells with few goblet
• Mucosa cells
o Lining Epithelium: pseudostratified ciliated with • No submucosal glands, no cartilage
lesser goblet cells
o Lamina Propria
▪ More elastin
▪ Layer of smooth muscle
• Submucosa
o Fewer small serous glands
o Primary Bronchi: most cartilage rings completely
encircle the lumen (continuous cartilage)
o Cartilage rings are gradually replaced with
isolated plates of hyaline cartilage as bronchial
diameter decreases
• Adventitia
o Blood vessels, neurons, lung tissue

TERMINAL BRONCHIOLE
• Smallest diameter passages of purely conducting portion
• Lining Epithelium: cuboidal cells (majority)
• Club/Clara Cells
o Many low non-ciliated columnar cells in between
cuboidal cells
o Found in terminal & respiratory bronchioles
o Exocrine bronchiolar cells
o Dome-shaped in apical ends
o Secretory granules at the tips
o Functions
▪ Produces surfactant-like materials
(lipoproteins and mucins)
▪ Detoxification of inhaled noxious
SEGMENTAL BRONCHUS substances
• Tertiary Bronchus ▪ Secretion of antimicrobial peptides
• Mucosa cytokines for immune defense
o Lining Epithelium: columnar, little
pseudostratification, less Goblet cells
o Lamina Propria: thin and elastic
▪ Completely encircled by smooth muscles
in spiral manner
 • Alveolar Cells
o Type I Pneumocytes
▪ Single layer of squamous epithelium
▪ Line 95% of alveolar surfaces
▪ Desmosomes, occluding junctions
(prevent leakage of tissue fluid into
alveolar spaces)
o Type II Pneumocytes
▪ Cuboidal cells
▪ Provide progenitor cells for type I
▪ Divide to replace own population after
injury
▪ Secretes pulmonary surfactant (lowers
surface tension, prevents alveolar
collapse)
o Alveolar Macrophages/Dust Cells
RESPIRATORY BRONCHIOLES ▪ Engulfs erythrocytes and airborne
• The first respiratory region of the respiratory system particulate matter
• Mucosa is structurally similar to terminal bronchioles ▪ Slightly darker than type II cells
o EXCEPT for few openings to alveoli ▪ Bronchoalveolar fluid is bacteriostatic
• Lining Epithelium: ciliated cuboidal with club cells
o Simple squamous cells are located at alveolar
openings and extend into the alveolus
• Alveoli are more numerous and closer together moving
distally along the respiratory bronchioles
• Lamina Propria: smooth muscle and connective tissue

ALVEOLAR DUCTS
• Branches of the distal ends of respiratory bronchioles
• Completely lined by openings of alveoli
• Lining Epithelium: squamous cells
• Lamina Propria
o Extremely thin
o Strand of smooth muscle cells
o Network of elastic and collagen/reticular fibers
▪ Encircle the alveolar opening
▪ Closely surrounds each alveolus BLOOD-AIR BARRIER
o Network of capillaries also surround each alveolus • Respiratory membrane
• Where gas exchange between air and blood occurs
• Membranous barrier between each alveolus and the
capillaries surrounding it
• Components
o Alveolar Type I cells
o Capillary endothelial cells
o Fused basement membranes

ALVEOLI
• Sac-like invaginations
• 200um in diameter
• From respiratory bronchioles to alveolar ducts to alveolar
sacs
• 200 million per lung
• Alveolar Sacs
o Large clusters of alveoli
o Form the ends of alveolar ducts distally
• Interalveolar Septa
o Scattered fibroblasts
o Sparse ECM, with elastic and reticular fibers
o Expand with inspiration, contract passively with
expiration
o Prevent collapse and excessive distention of
alveoli
o Vascularized with rich capillary network
 CLINICAL NOTES LUNGS
NASAL CAVITY • Lung Cancer
• Anosmia (Hyposmia) o Squamous Cell Carcinoma (SCC)
o Loss or reduction of the ability to smell ▪ Very common among smokers
o Traumatic damage to the ethmoid bone ▪ Smoking: one of the most common
o Olfactory nerve axons causes of lung cancer
• Metaplasia ▪ Epithelial cells of segmental bronchi
o Change in lining epithelium ▪ Alveolar cell type I (most common cell
o Chronic presence/accumulation of toxins (ex: type, 95%)
smoking) o Adenocarcinoma
o Immobilization of the cilia ▪ Adeno: “glands”
▪ Most common among non-smokers
LARYNX (second-hand smokers)
• Polyp ▪ Epithelial cells in bronchioles and alveoli
o Causes o Small Cell Carcinoma
▪ Acute trauma ▪ Less common
▪ Gastroesophageal reflux ▪ Highly malignant
▪ Untreated hypothyroid states ▪ Kulchitsky cells (makes up only 3% of
▪ Chronic laryngeal allergic reactions respiratory epithelium)
▪ Chronic inhalation of irritants (industrial • Emphysma
fumes, cigarette smoke) o Chronic lung disease
o Features o Cigarette smoking
▪ Unilateral ▪ Destroys the elastic tissue of the lungs
▪ Occur at membranous cord o Irreversible lung damage
▪ Larger than a nodule o Dilation and permanent enlargement of
o Treatment bronchioles
▪ Surgical removal o CO2 is accumulated
▪ Medical treatment (initially) of other • Chronic Bronchitis: opposite of emphysema
polypoid lesions • Adult Respiratory Distress Syndrome
• Nodules o Diffuse alveolar damage
o Causes: chronic trauma (voice abuse, yelling, o Injury to alveolar epithelial and capillary
shouting, singing loudly, using unnaturally low endothelial cells
frequency) o Causes
o Features ▪ Viral and bacterial respiratory tract
▪ Bilateral infections
▪ Occur at membranous cord ▪ Inhalation of toxic gases
o Treatment ▪ Fat embolism
▪ Behavior modification (decreasing msk. • Infant Respiratory Distress Syndrome
laryngeal tension when speaking) o Premature babies
▪ Voice therapy o Incomplete differentiation of type II cells
▪ Antireflux therapy o Deficient surfactant
• Laryngitis ▪ Overcomes the surface tension of the
o Due to viral infection collapsed fetal lungs
o Usually accompanied by edema/swelling of o Severe acute breathing difficulties and chronic
lamina propria lung disease
o Changes the shape of the vocal folds/other parts • Asthma
of the larynx, o Bronchospasms
o Produces hoarseness/complete loss of voice o Sudden constrictions of smooth muscles in
bronchioles
o Mast cell degranulation
o Presence of smooth muscle in lamina propria
 SUMMARY
Glands in Muscle and Skeletal Other Features and
Region of Airway Epithelium
Lamina Propria Support Major Functions
Stratified squamous, Vibrissae (stiff hairs) and
Nasal Cavity Sebaceous and sweat
keratinized to non- Hyaline cartilage moisture; filters and
(Vestibules) glands
keratinized humidifies air
Nasal Cavity Pseudostratified Rich vasculature and
Seromucous, tubule- Bone and hyaline
(Other Areas/ Columnar Ciliated glands; warm, humidify,
alveolar glands cartilage
Respiratory Portion) (PCCE) w/ Goblet Cells and clean air
Superior Nasal Cavity Serous/Bowman’s Solubilize and detect
PCCE Ethmoid bone
(Olfactory Portion) glands (branched TA) odorant molecules in air
Pharyngeal and palatine
Nasopharynx, Respiratory (PCCE) and Bone and skeletal
Seromucous glands tonsils; conduct air to
Posterior Oropharynx stratified squamous muscle
larynx
Larynx (Upper/False Laryngeal glands,
PCCE LCT w/ elastic fibers
Vocal Fold) lymphoid tissue Epiglottis; site for
Larynx (Lower/True Stratified Squamous Vocalis ligament (elastic phonation
Vocal Fold) Non-Keratinized fibers), vocalis muscle
LCT w/ elastic fibers, C-
Some MALT; conducts
Trachea PCCE w/ Goblet Cells Lymphoid tissue shaped hyaline rings,
air to primary bronchi
smooth (trahealis) m.

Region of Airway Epithelium Muscle and Skeletal Support Other Features and Major Functions
Prominent spiral bands of smooth
Repeated branching; conduct air deeper into
Bronchi Respiratory muscle; irregular hyaline cartilage
lungs
plates
Simple Ciliated Columnar Prominent circular layer of Conduct air; important in
Bronchioles
w/ few Goblet cells smooth muscle; no cartilage bronchoconstriction and bronchodilation
Terminal Simple Ciliated Cuboidal w/ Thin, incomplete circular layer of Conduct air to respiratory portions of lungs;
Bronchioles Club cells smooth muscle; no cartilage Club cells with several protective functions
Simple Ciliated Cuboidal w/
Respiratory Fewer smooth muscle fibers, Conduct air deeper with some gas exchange
Club cells and scattered
Bronchioles mostly around alveolar openings and protective Club cells
alveoli
Alveolar Ducts Simple Cuboidal between Bands of smooth muscle around
Conduct air with much gas exchange
and Sacs* many alveoli alveolar openings
None; network of elastic and Sites of all gas exchange; surfactant from
Alveoli Types I and II Pneumocytes
reticular fibers type II pneumocytes; dust cells
*alveolar ducts and alveoli: squamous
FNFCT