Download - Basic Pulmonary anatomy
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Basic Pulmonary Anatomy
Dr. Mohanad
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Lung is porous, highly elastic and spongy
It crepitates on touch and floats on water
Color : -In new born it is rosy pink -Becomes darker slat grey due to
deposition of carbonacious particles
Lungs
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Lungs Located within the thoracic cavity, surrounded by the double-layered pleural membrane –
parietal pleura – lines cavity wall
visceral pleura – covers the lungs
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Lungs- Anatomical Features
Apex – extends 1” above clavicle
Base – rests on diaphragm
Right lung Left
lung
Superior lobe
Middle lobe
Inferior lobe
Horizontal fissure
Oblique fissure
Superior lobe
Inferior lobe
Oblique fissure
Cardiac notch
Hilum – at medial surface; where primary bronchus, pulmonary artery & veins enter/exit lung
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Hilum
Cardiac notch of Lt. lung
Lung – medial surfaceGroove for aorta
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Right lung
Upper lobeMiddle lobeLower lobe
Left lung
Upper lobeLower lobe
Right lung Left lung
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Each lung has a primary bronchus entering at the Hilus.
Each lobe of a lung has a secondary (a.k.a. lobar) bronchus
Lobes are functionally divided into bronchopulmonary segments & each segment has a tertiary (segmental) bronchus
Segments are functionally divided into many lobules & each lobule receives a terminal bronchiole
Airways within Lungs
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Trachea Bronchus Tertiary bronchus Bronchiole Respiratory bronchiole
Epithelium Pseudostratified
Columnar Cuboidal
Goblet cells +++ ++ ++ + Absent
Clara cells Absent Absent Absent + +
Muscularis mucosae Absent + ++ +++ +++
Mucous glands +++ ++ + Absent Absent
Cartilage +++ ++ + Absent Absent
Alveoli Absent Absent Absent Absent +
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Terminal Bronchioles 16th to 19th generation Average diameter is 0.5 mm Cilia and mucous glands begin to
disappear totally End of the conducting airway Canals of Lambert-interconnect this
generation,provide collateral ventilation
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Respiratory Zone
Defined by the presence of alveoli; begins as terminal bronchioles feed into Respiratory bronchioles
Respiratory bronchioles lead to alveolar ducts, then to terminal clusters of alveolar sacs composed of alveoli
Approximately 300 million alveoli: Account for most of the lungs’ volume Provide tremendous surface area for gas exchange
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Alveoli 200-300 million in a normal lung Between 75 µ to 300 µ in diameter- Total area-
75 square meters Most gas exchange takes place at alveolar-
capillary membrane
85-95% of alveoli covered by small pulmonary capillaries
The cross-sectional area or surface area is approximately 70m2
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Alveoli are expanded chambers of epithelial tissue that are the exchange surfaces of the lungsMultiple alveoli usually share a common alveolar duct, creating “alveolar sacs”
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Acinus or Lobule
Each acinus (unit) is approximately 3.5 mm in diameter
Each contains about 2000 aveloli
Approximately 130,000 primary lobules in the lung
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Alveolar Sac
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Alveolar epithelium Two principle cell types:
Type I cell, squamous pneumocyte
Type II cell, granular pneumocyte
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Type I Cell (Pneumocytes) 95% of the alveolar surface is made
up of squamous pneumocyte cells Between 0.1 µ and 0.5µ thick Major site of gas exchange Preventing leakage of blood from
capillaries to the alveolar lumen Form Blood Air barrier
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Type I Pneumocytes
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Type II Cell 5% of the surface of alveoli
composed of granular pneumocyte cells
Cuboidal in shape with microvilli Primary source of pulmonary
surfactant Involved with reabsorption of fluids
in the dry, alveolar spaces
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Type II pneumocytes
Also known as Septal cells Rounded or cuboidal secretory cells with microvilli Secretory granules are made of several layers- Multilamellar
bodies. Is constantly renewed. Pulmonary Surfactant – is the fluid secreted that spreads
over the alveolar surface.
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Pulmonary Surfactant
Surfactant contains phospholipids, proteins and glycosaminoglycans, reduces the surface tension and prevents collapse of the alveolus during expiration.
The reduced surface tension in the alveoli decreases the force that is needed to inflate alveoli during inspiration.
Therefore surfactant stabilizes the alveolar diameters, facilitates their expansion and prevents their collapse by minimizing the collapsing forces.
Surfactant also has bactericidal properties
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Canals of Lambert/Pores of Kohn
Provide for collateral ventilation of difference acinii or primary lobules
Additional ventilation of blocked units May explain why diseases spread so
quickly at the lung tissue (paremchymal) level
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Alveolar macrophages So-called Type III cell Remove bacteria and foreign
particles May originate as
Stem cells precursors in bone marro Migrate as monocytes through the
blood and into the lungs
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Intersitium/interstial space Surround, supports, and shapes
the alveoli and capillaries Composed of a gel like substance
and collagen fibers Contains tight space and loose
space areas
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Interstitium Water content in loose space can
increase by 30% before there is a significant change in pulmonary capillary pressure
Lymphatic drainage easily exceeded Collagen limits alveolar distensibility
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Respiratory Membrane
Respiratory membrane Alveolar wall – type I and type II alveolar cells Epithelial basement membrane Capillary basement membrane Capillary endothelium Very thin – only 0.5 µm thick to allow rapid diffusion of
gases Permit gas exchange by simple diffusion
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Components of Alveolus
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Blood Air Barrier
Consist of a thin layer of surfactant Basement membrane of Pneumocytes I Basement membrane of capillary endothelial cell
It exists to prevent air bubbles form forming in the blood, and from blood entering alveoli
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Nutrition of the lung
The lung gets nutrition from two sources:
1.Conducting part up to the beginning of respiratory bronchiole is supplied by Bronchial artery
2. Respiratory part is supplied by pulmonary artery via Pulmonary capillary plexus
•Primary purpose is to deliver blood to lungs for gas exchange
•Right lung has one bronchial artery and left lung has two Bronchial artery
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Bronchial arteries Also nourish
Mediastinal lymph nodes Pulmonary nerves Some muscular pulmonary arteries
and veins Portions of the esophagus Visceral pleura
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Bronchial venous system 1/3 blood returns to right heart
Azygous Hemiazygous Intercostal veins
This blood comes form the first two or three generations of bronchi
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Bronchial venous return 2/3 of blood flowing to terminal bronchioles drains
into pulmonary circulation via “bronchopulmonary anastomoses”
Then flows to left atrium via pulmonary veins Contributes to “venous admixture” or “anatomic
shunt” (ca. 5% of C.O.)
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Pulmonary Capillaries Walls are les than 0.1µ thick Total external thickness is about
10µ Selective permeability to water,
electrolytes, sugars Produce and destroy biologically
active substances
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Lymphatic System
Lymphatic vessels remove fluids and protein molecules that leak out of the pulmonary capillaries
Transfer fluids back into the circulatory system
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Lymphatics Lymphatic vessels arise within loose
spaces of connective tissue, not in the walls of the alveoli.
Vessels then follow bronchial airways, pulmonary airways, pulmonary arteries and veins to the hilum
Vessels end in pulmonary and bronchopulmonary lymph nodes within and outside of lung parenchyma
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Thank You