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Respiratory System
Dr.Yani Istadi
Bagian Anatomi
FK Unissula Semarang
Respi r at or y I nt r o
You may be asking, what is the
Respiratory system? Well, the
Respiratory system is the system
that helps you breath in and out,
so oxygen (0
2
) can be pumped
through your body and carbon
dioxide (CO
2
) can be removed
from the blood stream. You must
remember that the Respiratory
system is made up of many
different organs.
Learning objective
Organization and Functions of the
Respiratory System
Mechanics of Breathing
Respiratory Diseases
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Human Respiratory System
Nasal Passage
Pharynx
Trachea
Bronchus
Larynx
Bronchioles
Alveoli
Organization and Functions of
the Respiratory System
Structural classifications:
upper respiratory tract
lower respiratory tract.
Organization and Functions of
the Respiratory System
Functional classifications:
Conducting portion: transports air.
Nose
nasal cavity
Pharynx
Larynx
Trachea
progressively smaller airways, from the primary bronchi
to the bronchioles
Respiratory portion: carries out gas exchange.
respiratory bronchioles
alveolar ducts
air sacs called alveoli
Upper respiratory tract is all conducting
Lower respiratory tract has both conducting and respiratory
portions
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Upper Respiratory Tract
Composed of
the nose
the nasal cavity
the paranasal sinuses
the pharynx (throat)
and associated structures.
All part of the conducting portion of the
respiratory system.
Nose
Two nasal cavities separated by nasal septum
The Nasal Septum is made up of cartilage & bone
Function
Warming of Air
Filtration of Air
To keep nasal passage moist
Sensation of smell
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Paranasal Sinuses
Paranasal sinuses:
In four skull bones
paired air spaces
decrease skull bone weight
Named for the bones in which they are housed.
frontal
ethmoidal
sphenoidal
maxillary
Communicate with the nasal cavity by ducts.
Covered with the same pseudostratified ciliated
columnar epithelium as the nasal cavity.
Pharynx
Common to both the respiratory and digestive
systems.
Commonly called the throat.
Funnel-shaped
slightly wider superiorly and narrower inferiorly.
Originates posterior to the nasal and oral
cavities
Extends inferiorly near the level of the
bifurcation of the larynx and esophagus.
Common pathway for both air and food.
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Pharynx
Walls:
lined by a mucosa
contain skeletal muscles primarily used for
swallowing.
Flexible lateral walls
distensible
to force swallowed food into the esophagus.
Partitioned into three adjoining regions:
nasopharynx
oropharynx
laryngopharynx
Nasopharynx
Superiormost region of the pharynx.
Location:
posterior to the nasal cavity
superior to the soft palate
separates it from the posterior part of the oral cavity.
Normally, only air passes through.
Soft palate
Blocks material from the oral cavity and oropharynx
elevates when we swallow.
Auditory tubes
paired
In the lateral walls of the nasopharynx
connect the nasopharynx to the middle ear.
Pharyngeal tonsil
posterior nasopharynx wall
single
commonly called the adenoids.
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Oropharynx
The middle pharyngeal region.
Location:
Immediately posterior to the oral cavity.
Bounded by the soft palate superiorly,
the hyoid bone inferiorly.
Common respiratory and digestive pathway
both air and swallowed food and drink pass
through.
Oropharynx
2 pairs of muscular arches
anterior palatoglossal arches
posterior palatopharyngeal arches
form the entrance from the oral cavity.
Lymphatic organs
provide the first line of defense against
ingested or inhaled foreign materials.
Palatine tonsils
on the lateral wall between the arches
Lingual tonsils
At the base of the tongue.
Laryngopharynx
Inferior, narrowed region of the pharynx.
Location:
Extends inferiorly from the hyoid bone
is continuous with the larynx and esophagus.
Terminates at the superior border of the esophagus
is equivalent to the inferior border of the cricoid cartilage in the
larynx.
The larynx (voice box) forms the anterior wall
Lined with a nonkeratinized stratified squamous
epithelium (mucus membrane)
Permits passage of both food and air.
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Lower Respiratory Tract
Conducting portion
Larynx
Trachea
Bronchi
bronchioles and their associated structures
Respiratory portion of the respiratory system
respiratory bronchioles
alveolar ducts
alveoli
Larynx
Short, somewhat cylindrical airway
Location:
bounded posteriorly by the laryngopharynx,
inferiorly by the trachea.
Prevents swallowed materials from
entering the lower respiratory tract.
Conducts air into the lower respiratory
tract.
Produces sounds.
Larynx
Nine pieces of cartilage
three individual pieces
Thyroid cartilage
Cricoid cartilage
Epiglottis
three cartilage pairs
Arytenoids: on cricoid
Corniculates: attach to arytenoids
Cuniforms:in aryepiglottic fold
held in place by ligaments and muscles.
Intrinsic muscles: regulate tension on true vocal
cords
Extrinsic muscles: stabilize the larynx
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Trachea
A flexible, slightly rigid tubular fibromusculer
organ
often referred to as the windpipe.
Extends through the mediastinum
immediately anterior to the esophagus
inferior to the larynx
superior to the primary bronchi of the
lungs.
Trachea
Anterior and lateral walls of the trachea are
supported by 15 to 20 C-shaped tracheal
cartilages.
cartilage rings reinforce and provide some
rigidity to the tracheal wall to ensure that
the trachea remains open (patent) at all
times
cartilage rings are connected by elastic
sheets called annular ligaments
The first cartilage ring devote to cricoid
cartilage through cricotracheal ligament
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Trachea
VC.6 - VTh.4
Length: 9-15 cm; width: 2 cm
Fascia pretrachealis
At the level of the sternal angle, the trachea bifurcates
into two smaller tubes, called the right and left primary
bronchi (VTh.5-6)
Each primary bronchus projects laterally toward each
lung.
The most inferior tracheal cartilage separates the
primary bronchi at their origin and forms an internal ridge
called the carina.
Trachea was divided into:
pars cervicalis and pars
thoracalis
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Inervation of trachea :
- Parasymphatic :
nervus laryngeus recurrens (it comes from
nervus vagus )
Bronchokonstriction
Secretomotoric
Sensoric
- Symphatic : ganglion cervicalis medius
: bronchodilatation
Vascularisation of trachea:
Artery thyroidea inferior
Bronchial Tree
A highly branched system
air-conducting passages
originate from the left and right
primary bronchi.
Progressively branch into narrower
tubes as they diverge throughout the
lungs before terminating in terminal
bronchioles.
Bronchial Tree
Primary bronchi
Incomplete rings of hyaline cartilage
ensure that they remain open.
Right primary bronchus
Shorter (2,5 cm), wider, and more
vertically oriented than the left
primary bronchus.
Foreign particles are more likely to
lodge in the right primary bronchus.
Vascularisation: vasa bronchiales
Innervation: plexus pulmonum
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Bronchial Tree
Primary bronchi
enter the hilum of each lung
Also entering hilum:
pulmonary vessels
lymphatic vessels
nerves.
Secondary bronchi (or lobar bronchi)
Branch of primary bronchus
left lung:
two lobes
two secondary bronchi(
right lung
three lobes
three secondary bronchi.(1 eparteriel (lobus
superior & 2 hyparteriel (medius and inferior)
Bronchial Tree
Tertiary bronchi (or segmental bronchi)
Branch of secondary bronchi
left lung is supplied by 8 to 10 tertiary
bronchi.
right lung is supplied by 10 tertiary bronchi
supply a part of the lung called a
bronchopulmonary segment.
Respiratory Bronchioles,
Alveolar Ducts, and Alveoli
Contain small saccular outpocketings called alveoli.
An alveolus is about 0.25 to 0.5 millimeter in diameter.
Its thin wall is specialized to promote diffusion of gases
between the alveolus and the blood in the pulmonary
capillaries.
Gas exchange can take place in the respiratory
bronchioles and alveolar ducts as well as in the lungs,
which contain approximately 300400 million alveoli.
The spongy nature of the lung is due to the packing of
millions of alveoli together.
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Paru-paru (lungs)
Merupakan organ penting
untuk pernafasan
Jaringan yang bukan
merupakan jaringan
respiratorik didarahi oleh
arteri bronchialis dan
dialirkan ke vena pulmonalis
Paru paru berbentuk kurang
lebih sebagai conus dengan
basis dan apex
Paru-paru
pada dinding paru dapat dibedakan :
Facies costalis merupakan dinding
ventral, lateral dan dorsal
Facies mediastinalis merupakan dinding
medial
Facies diafragmatica merupakan basis
Antara facies diafragmatica dan
facies costalis, terdapat margo
inferior
Antara facies costalis disebelah
ventral dan facies mediastinalis,
terdapat margo anterior
Basisnya terletak di atas permukaan
konveks diafragma, descenden
selama inspirasi dan ascenden
selama ekspirasi
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Paru-paru Kanan
Apexnya menonjol ke dalam pangkal leher
dan yang kanan lebih kecil dari yang kiri
Biasanya menerima satu arteri bronchialis
Adalah lebih berat dan lebih pendek daripada
yang kiri, disebabkan kubah kanan diafragma
lebih tinggi dan lebih luas karena jantung
lebih menonjol ke kiri
Dibagi menjadi lobus superior, medius, dan
inferior oleh fissura obliqua dan horizontal
Mempunyai 3 bronchus lobaris (sekunder)
dan 10 bronchi segmentalis (tertiar)
- Impressiones pulmo kanan ini
adalah:
Impressio cardiaca
Sulcus vena cava superior
Sulcus arteri subclavia
Sulcus vena azygos
Sulcus oesophagus
- Pada hilus pulmonalis pulmo
kanan terdapat:
Bronchus eparterial
Arteri pulmonalis
Bronchus hyparterial
Vena Pulmonalis
Paru Kiri
Biasanya menerima 2 arteri
bronchialis
Mempunyai 2 lobus : superior
dan inferior
Mempunyai 1 fissura obliqua
yang mengikuti garis iga
keenam
Mempunyai satu Lingula yang
merupakan suatu bagian seperti
bentuk lidah pada lobus
superiornya yang sesuai dengan
lobus medius pada paru kanan.
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- Pada facies mediastinalis
terdapat impressiones
berikut:
- Impressio cardiaca
- Sulcus arcus aorta
- Sulcus aorta descendens
- Pada hilus pulmonalis
terdapat :
Bronchus eparterial
Arteri pulmonalis
Vena pulmonalis
Pleura and Pleural Cavities
The outer surface of each lung and the adjacent internal
thoracic wall are lined by a serous membrane called
pleura, which is formed from simple squamous
epithelium.
The outer surface of each lung is tightly covered by the
visceral pleura, while the internal thoracic walls, the
lateral surfaces of the mediastinum, and the superior
surface of the diaphragm are lined by the parietal pleura.
The parietal and visceral pleural layers are continuous at
the hilum of each lung.
Pleura and Pleural Cavities
The outer surface of each lung is tightly covered by the visceral
pleura, while the internal thoracic walls, the lateral surfaces of the
mediastinum, and the superior surface of the diaphragm are lined by
the parietal pleura.
The potential space between these serous membrane layers is a
pleural cavity.
The pleural membranes produce a thin, serous fluid that circulates in
the pleural cavity and acts as a lubricant, ensuring minimal friction
during breathing.
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Pelipatan pleura parietalis yang satu
ke pleura parietalis lainnya akan
membentuk suatu recesus / sinus.
Macam macam sinus:
1. Sinus phrenicocostalis: dibentuk
oleh pelipatan pleura diafragmatica
dan pleura costalis.
2. Sinus costomediastinalis: dibentuk
oleh pelipatan pleura costalis dan
pleura mediastinalis.
3. Sinus phrenicomediastinalis :
dibentuk oleh pelipatan pleura
diafragmatica dan pleura
mediastinalis.
Perdarahan/vascularisasi pleura :
1. Pleura costalis : vasa intercostalis
2. Pleura mediastinalis : vasa pericardiacophrenica
3. Pleura diafragmatica : vasa intercostalis dan vasa
mammaria interna.
4. Pleura visceralis : a. bronkialis
Persarafan pleura :
1. Nervus intercostalis ( pleura costalis dan bagian
perifer pleura diafragmatika )
2. Nervus phrenicus ( sisa pleura diafragmatika dan
pleura mediastinalis )
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Lymphatic Drainage
Lymph nodes and vessels are located within the
connective tissue of the lung as well as around
the bronchi and pleura.
The lymph nodes collect carbon, dust particles,
and pollutants that were not filtered out by the
pseudostratified ciliated columnar epithelium.
Thoracic Wall Dimensional
Changes During Respiration
Lateral dimensional changes occur with rib
movements.
Elevation of the ribs increases the lateral
dimensions of the thoracic cavity, while
depression of the ribs decreases the
lateral dimensions of the thoracic cavity.
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Muscles that Move the Ribs
The scalenes help increase thoracic cavity dimensions
by elevating the first and second ribs during forced
inhalation.
The ribs elevate upon contraction of the external
intercostals, thereby increasing the transverse
dimensions of the thoracic cavity during inhalation.
Contraction of the internal intercostals depresses the
ribs, but this only occurs during forced exhalation.
Normal exhalation requires no active muscular effort.
A small transversus thoracis extends across the inner
surface of the thoracic cage and attaches to ribs 26. It
helps depress the ribs.
Muscles that Move the Ribs
Two posterior thorax muscles also assist with
respiration. These muscles are located deep to the
trapezius and latissimus dorsi, but superficial to the
erector spinae muscles.
The serratus posterior superior elevates ribs 25 during
inhalation, and the serratus posterior inferior depresses
ribs 812 during exhalation.
In addition, some accessory muscles assist with
respiratory activities.
The pectoralis minor, serratus anterior, and
sternocleidomastoid help with forced inhalation, while the
abdominal muscles (external and internal obliques,
transversus abdominis, and rectus abdominis) assist in
active exhalation.
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IntrotoDiaphragm
Now we will look at the Diaphragm.
You might be wondering, what does
the Diaphragmdo? The
Diaphragmis an important factor in
breathing.
Diagram of Diaphragm
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Here is an experiment that
you can try.
Di aphr agm Exper i ment
Mechanics of Breathing
Gas Exchange Between the Blood
and Alveoli
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The blood-air barrier
The surfactant layer
Regulation of Breathing
Figure 10.13
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Carotid and aortic bodies: sensitive to
carbon dioxide, pH, and oxygen levels
Conscious control: resides in higher brain
centers; ability to modify breath is limited
Regulation of Breathing:
Nervous System Involvement
Summary
Organs in the Respiratory System STRUCTURE FUNCTION
nose / nasal cavity
warms, moistens, & filters air as it is
inhaled
pharynx (throat) passageway for air, leads to trachea
larynx
the voice box, where vocal chords are
located
trachea (windpipe)
keeps the windpipe "open"
trachea is lined with fine hairs called
cilia which filter air before it reaches the
lungs
bronchi
two branches at the end of the trachea,
each lead to a lung
bronchioles
a network of smaller branches leading from
the bronchi into the lung tissue &
ultimately to air sacs
alveoli
the functional respiratory units in the lung
where gases are exchanged
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Respiratory Diseases
Malfunctions & Diseases of the Respiratory System
asthma
severe allergic reaction
characterized by the
constriction of bronchioles
bronchitis
inflammation of the lining of
the bronchioles
emphysema
condition in which the alveoli
deteriorate, causing the lungs
to lose their elasticity
pneumonia
condition in which the alveoli
become filled with fluid,
preventing the exchange of
gases
lung cancer
irregular & uncontrolled
growth of tumors in the lung
tissue
Asthma contraction of the muscles of the
___________________ obstructing the
passage of air
cause -
____________________________________
____________________________________
____________________________________
attacks occur without warning
treatment
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_____________________________- disease in which the
alveoli burst and blend to form fewer sacs for gas exchange
caused by
___________________________________________________
_____________________________ inflammation of the bronchi
resulting in excessive mucus secretion
inflammation due to irritants such as
_______________________________________________________
___________________________common
Pneumonia inflammation of the lungs caused by viruses or
bacteria
________________________fill with fluid
greatly inhibits O
2
and CO
2
exchange
if many alveoli are infected,
___________________________________________ may result
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Disorders of the Respiratory System
Tuberculosis -
___________________________
___________________________
alveoli are slowly destroyed
bloody sputum common
nearly eliminated by antibiotics
but cases are increasing in U.S.
recently - why?
___________________________
___________________________
___________________________
___________________________
Cystic fibrosis - inherited disease in which a lung membrane
transport protein is not produced
result is that mucus is not transported properly and becomes very
thick and ______________________________________
thick mucus is a breeding ground for many bacteria; thus,
_________________________________ are common
mean age for death is _________
Cystic fibrosis
Treatment:
Disease is managed by
______________________________
to dislodge mucus in lungs
Several new drugs are helpful
New finding - ________________
responsible for
cystic fibrosis has been found and may
lead to a cure by gene therapy
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Disorders of the Respiratory System
Lung cancer cancerous cells replace normal lung cells
how common - ____________________________________
__________________________________________________
tar in lungs cancerous nodules
Bronchitis, emphysema, and lung cancer are
entirely avoidable.
They are caused by ______________________
______________________________________
- the chief avoidable cause of death in our
society, resulting in _____________ deaths/year
in the U.S.
Some facts about smoking
Smokers have a 10 times greater chance of
developing bronchitis, emphysema, and lung cancer
than non-smokers.
Risk for smoking-related diseases increases the
earlier one begins to smoke.
Smokers are more likely to contract heart disease.
Other cancers - mouth, laryngeal, esophageal,
pancreatic, and kidney - strike smokers at increased
rates.
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Some facts about smoking
Smoking during pregnancy causes preterm births
and low birth rates. Smokers are more likely to have
miscarriages.
Nicotine in smoke is highly additive and is a
________________________. It strengthens the
desire to smoke and makes it difficult to quit.
Cigarettes do not calm your nerves. They actually
create stress in the smoker.
Smokers are 100 times more likely to smoke pot and
use other illicit drugs.
Some examples of Smoking-induced Disorders
Lung Cancers - taken from autopsies
What about this dont you
understand?
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These disorders are entirely preventable.
The single, best thing you can do to prolong
your life is to simply not smoke.
Smoking is not cool anymore.
So - dont start.
And if you do smoke, QUIT NOW!
All it will do is save your life!
Deformities of the chest wall are rare in children. The diagnosis of
these deformities will often not be made until adolescence due to their
prolonged development and usually benign nature. The major chest wall
deformities that are seen in children are Pectus Excavatum ("funnel
chest") and Pectus Carinatum ("Pigeon Breast").
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Literature
Human Anatomy, First Edition McKinley &
O'Loughlin
Atlas sobota Atlas sobota
Ethel Sloane, Anatomi dan Fisiologi, Penerbit Ethel Sloane, Anatomi dan Fisiologi, Penerbit
EGC EGC
Kyung Won Chung, Gross Anatomi, Penerbit Kyung Won Chung, Gross Anatomi, Penerbit
Binarupa Aksara Binarupa Aksara
Keith L.Moore dan Arthur F.Dalley. Clinically Keith L.Moore dan Arthur F.Dalley. Clinically
oriented Anatomy oriented Anatomy