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RESPIRATORY SYSTEM 
(Basic Anatomy) 
DR TINKU JOSEPH 
DM Resident 
Department of Pulmonary Medicine 
AIMS, Kochi 
Email: tinkujoseph2010@gmail.com
Respiratory System starts at the nares 
Major Functions 
Upper respiratory system: 
1. Air conditioning (warming) 
2. Defense against pathogens 
3. Gas Transport 
Lower respiratory system: 
1. Speech & other 
respiratory sounds 
2. Gas exchange (ventilation) 
3. Maintenance of 
homeostasis, e.g. pH
Respiratory Epithelium 
• Histology? Pseudo… 
• Mucus produced by 
numerous goblet cells 
• Defense by means of 
• filtering hairs 
• turbinates 
• ciliary escalator 
(mucociliary blanket) 
• sticky mucus
Respiratory Muscles 
Diaphragm: depresses on contraction  
inhalation 
External intercostals: elevate ribs  inhalation 
Internal intercostals: depress ribs  active 
exhalation 
(Accessory muscles - serratus anterior, scalenes, pectoralis 
minor, sternocleidomastoid, internal and external obliques, 
transverse abdominus, rectus abdominus)
Upper Respiratory 
System 
1. Nose 
2. Nasal Cavity 
3. Paranasal sinuses 
4. Pharynx
Upper Respiratory 
System 
1) Nose 
 External and internal nares = 
Nostrils 
 Nose Hairs = vibrissae 
 Alar cartilages on the nose 
 Paranasal Sinuses
Upper Respiratory 
System 
• 3) Nasal Cavity 
• Nasal Conchae: 
– Superior, middle and 
inferior 
– Other name: “Turbinate 
bones” because they 
create 
– Advantage ? 
• nasal septum 
• hard palate, soft palate
Upper Respiratory 
System 
3)Paranasal Sinuses 
• Named after their 
bones 
– Frontal 
– Ethmoid 
– Sphenoid 
– Maxillary
Upper Respiratory 
System 
4) Pharynx 
Shared passageway for respiratory and digestive systems 
Nasopharynx - part above uvula and posterior to internal 
nares 
Oropharynx – portion visible in mirror when mouth is wide 
open 
fauces = the opening 
uvula - posterior edge of soft palate 
Laryngopharynx – between the hyoid bone & the esophagus
Lower Respiratory 
System = Anything inferior to the Pharynx 
Larynx: Cartilaginous 
cylinder (from C4- C7) 
Made up of 9 cartilages 
– 3 large unpaired (know 
these!) Thyroid, Cricoid, 
and Epiglottis 
– 3 small paired (involved in 
construction of voice box)
Larynx (voice box) 
 Hyoid Bone 
 Epiglottis 
 Thyroid Cartilage 
 Adam’s Apple 
 Cricoid Cartilage 
 Vocal Folds
Larynx, cont’d 
 The pitch of sound is from tension of the elastic 
fibers of the vocal folds 
 Resonance from shape of pharynx and mouth 
 The glottis is the opening between the vocal 
folds 
 Innervation via laryngeal nerves 
 Branches of CN X 
 Left recurrent laryngeal nerve loops around aorta
From Bronchi to Lungs: The Bronchial 
Tree 
 1 bronchi (enter lungs at 
hilus, complete cartilage 
rings) 
 2 bronchi (from now on 
cartilage plates) 
 3 bronchi 
 Bronchioles 
 Terminal bronchioles 
 Respiratory bronchioles 
 Alveolar ducts 
 Alveolar sacs 
Conducting 
portion 
Respiratory portion
Lungs 
 Light, soft, spongy 
 Conical in shape, apex, base, costal surface, medial 
surface, hilus. Note various impressions 
 Right lung 
 Three lobes; superior, middle and inferior 
 Oblique and horizontal fissure 
 Left Lung 
 Two lobes; superior and inferior also Lingula and Cardiac 
notch, oblique fissure
Right Lung
Right Lung
Right Lung
Left Lung
Left Lung
Left Lung
Surface Anatomy
Surface Anatomy
Surface Anatomy
Airways 
 Trachea, primary bronchi, secondary bronchi, tertiary 
bronchi out to 25 generations 
 All comprised of hyaline cartilage 
 Trachea 
 Begins where larynx ends (about C6) 
 10 cm long, half in neck, half in mediastinum 
 20 U-Shaped rings of hyaline cartilage – keeps lumen intact 
but not as brittle as bone 
 Lined with epithelium and cilia which work to keep foreign 
bodies/irritants away from lungs
Airways 
 Primary Brochi 
 One to each lung – continuation of trachea 
 Right bronchus is wider and shorter 2.5 cm as opposed to 
5 cm and branches from the trachea at a greater angle 
 Secondary bronchi – one to each lobe, three in right, 
two in left 
 Tertiary – one to each bronchopulmonary segment – 
approximately 10 per lung 
 All of the above are hyaline cartilage with no ability 
to change diameter
Bronchoscope
Tumor
Tumor
Tumor
In and Out
Bronchopulmonary Segments
Bronchopulmonary Segments
Bronchopulmonary Segments
Bronchioles 
 First level of airway surrounded by smooth 
muscle; therefore can change diameter as in 
brocho-constriction and broncho-dilation 
 Terminal 
 Respiratory 
 3-8 orders 
 alveoli
Bronchioles
Bronchioles 
 Gas Exchange 
 Pulmonary arteries carry deoxygenated blood to 
aleoli 
 Gas exchange occurs via diffusion through the 
capillary beds 
 Returned to heart via pulmonary veins
Gas Exchange
Innervation 
 Pleura via intercostal (thoracic) nerves 
 Tracheobronchial tree 
 Parasympathetic via CN X efferent function = 
broncho-constriction via smooth mm., also to 
epithelial cells in trachea; afferent = responsible for 
cough reflex 
 Sympathetic from T1-T5 efferent = brocho-dilation
Intercostal to Pleura
Innervation
Pleural Cavities and Membranes 
 Two cavities separated by 
mediastinum 
 Lining of cavities 
– Parietal Pleura 
– Visceral Pleura 
– Pleural Cavity 
 Pleurisy 
 Pneumothorax, 
(hemothorax, pyothorax, 
pleural effusion)
Respiratory system anatomy  Dr.Tinku Joseph
Respiratory system anatomy  Dr.Tinku Joseph
Respiratory system anatomy  Dr.Tinku Joseph

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Respiratory system anatomy Dr.Tinku Joseph

  • 1. RESPIRATORY SYSTEM (Basic Anatomy) DR TINKU JOSEPH DM Resident Department of Pulmonary Medicine AIMS, Kochi Email: tinkujoseph2010@gmail.com
  • 2. Respiratory System starts at the nares Major Functions Upper respiratory system: 1. Air conditioning (warming) 2. Defense against pathogens 3. Gas Transport Lower respiratory system: 1. Speech & other respiratory sounds 2. Gas exchange (ventilation) 3. Maintenance of homeostasis, e.g. pH
  • 3. Respiratory Epithelium • Histology? Pseudo… • Mucus produced by numerous goblet cells • Defense by means of • filtering hairs • turbinates • ciliary escalator (mucociliary blanket) • sticky mucus
  • 4. Respiratory Muscles Diaphragm: depresses on contraction  inhalation External intercostals: elevate ribs  inhalation Internal intercostals: depress ribs  active exhalation (Accessory muscles - serratus anterior, scalenes, pectoralis minor, sternocleidomastoid, internal and external obliques, transverse abdominus, rectus abdominus)
  • 5.
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  • 8.
  • 9. Upper Respiratory System 1. Nose 2. Nasal Cavity 3. Paranasal sinuses 4. Pharynx
  • 10.
  • 11. Upper Respiratory System 1) Nose  External and internal nares = Nostrils  Nose Hairs = vibrissae  Alar cartilages on the nose  Paranasal Sinuses
  • 12. Upper Respiratory System • 3) Nasal Cavity • Nasal Conchae: – Superior, middle and inferior – Other name: “Turbinate bones” because they create – Advantage ? • nasal septum • hard palate, soft palate
  • 13. Upper Respiratory System 3)Paranasal Sinuses • Named after their bones – Frontal – Ethmoid – Sphenoid – Maxillary
  • 14. Upper Respiratory System 4) Pharynx Shared passageway for respiratory and digestive systems Nasopharynx - part above uvula and posterior to internal nares Oropharynx – portion visible in mirror when mouth is wide open fauces = the opening uvula - posterior edge of soft palate Laryngopharynx – between the hyoid bone & the esophagus
  • 15.
  • 16.
  • 17. Lower Respiratory System = Anything inferior to the Pharynx Larynx: Cartilaginous cylinder (from C4- C7) Made up of 9 cartilages – 3 large unpaired (know these!) Thyroid, Cricoid, and Epiglottis – 3 small paired (involved in construction of voice box)
  • 18. Larynx (voice box)  Hyoid Bone  Epiglottis  Thyroid Cartilage  Adam’s Apple  Cricoid Cartilage  Vocal Folds
  • 19. Larynx, cont’d  The pitch of sound is from tension of the elastic fibers of the vocal folds  Resonance from shape of pharynx and mouth  The glottis is the opening between the vocal folds  Innervation via laryngeal nerves  Branches of CN X  Left recurrent laryngeal nerve loops around aorta
  • 20. From Bronchi to Lungs: The Bronchial Tree  1 bronchi (enter lungs at hilus, complete cartilage rings)  2 bronchi (from now on cartilage plates)  3 bronchi  Bronchioles  Terminal bronchioles  Respiratory bronchioles  Alveolar ducts  Alveolar sacs Conducting portion Respiratory portion
  • 21. Lungs  Light, soft, spongy  Conical in shape, apex, base, costal surface, medial surface, hilus. Note various impressions  Right lung  Three lobes; superior, middle and inferior  Oblique and horizontal fissure  Left Lung  Two lobes; superior and inferior also Lingula and Cardiac notch, oblique fissure
  • 31. Airways  Trachea, primary bronchi, secondary bronchi, tertiary bronchi out to 25 generations  All comprised of hyaline cartilage  Trachea  Begins where larynx ends (about C6)  10 cm long, half in neck, half in mediastinum  20 U-Shaped rings of hyaline cartilage – keeps lumen intact but not as brittle as bone  Lined with epithelium and cilia which work to keep foreign bodies/irritants away from lungs
  • 32.
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  • 35.
  • 36. Airways  Primary Brochi  One to each lung – continuation of trachea  Right bronchus is wider and shorter 2.5 cm as opposed to 5 cm and branches from the trachea at a greater angle  Secondary bronchi – one to each lobe, three in right, two in left  Tertiary – one to each bronchopulmonary segment – approximately 10 per lung  All of the above are hyaline cartilage with no ability to change diameter
  • 38. Tumor
  • 39. Tumor
  • 40. Tumor
  • 45. Bronchioles  First level of airway surrounded by smooth muscle; therefore can change diameter as in brocho-constriction and broncho-dilation  Terminal  Respiratory  3-8 orders  alveoli
  • 47. Bronchioles  Gas Exchange  Pulmonary arteries carry deoxygenated blood to aleoli  Gas exchange occurs via diffusion through the capillary beds  Returned to heart via pulmonary veins
  • 49. Innervation  Pleura via intercostal (thoracic) nerves  Tracheobronchial tree  Parasympathetic via CN X efferent function = broncho-constriction via smooth mm., also to epithelial cells in trachea; afferent = responsible for cough reflex  Sympathetic from T1-T5 efferent = brocho-dilation
  • 52. Pleural Cavities and Membranes  Two cavities separated by mediastinum  Lining of cavities – Parietal Pleura – Visceral Pleura – Pleural Cavity  Pleurisy  Pneumothorax, (hemothorax, pyothorax, pleural effusion)