Respiratory:

13.

 Lung parenchyma consists of airways (bronchi / bronchioles) and alveoli

 The pulmonary lobule, also known as the acinus / terminal respiratory unit, contains 3 - 5 terminal
bronchioles, alveolar ducts and alveoli; it is the smallest anatomic unit delineated by connective
tissue
 In the bronchi, there is no clear distinction between the mucosa and submucosa
 The entire respiratory tree, except the vocal cords and alveoli, is lined by pseudostratified, tall,
columnar, ciliated epithelial cells with neuroendocrine (Kultschitsky) cells, mucus secreting goblet
cells in walls of trachea and bronchi, basal cells, brush cells, Clara cells and inflammatory cells
 The cells of the airways produce a mucociliary elevator protecting against particulate injury,
providing immunologic protection, and provide moisture and warmth to inspired air
 In more distal airways, there are fewer goblet cells and more Clara cells

 Alveolar capillary basement membrane: fuses with alveolar epithelium to form a single
membrane for oxygen and carbon dioxide diffusion
 Alveoli: lined almost exclusively by type I and II pneumocytes
 Canals of Lambert: connections between nonrespiratory bronchioles and adjacent alveoli; they
function as a means of collateral ventilation and likely are origin of peribronchiolar metaplasis
found during repair
 Clara cells: increase towards terminal bronchiole, have secretory function, main progenitor cell
after bronchiolar injury, and have apical PAS+ diastase resistant secretory granules
 Lymphatics: present in pleura, septa and along pulmonary veins and bronchovascular bundles;
not present in alveolar walls
 Neuroendocrine cells: numerous in neonatal bronchial and bronchiolar epithelium; rare in adults
except as clusters within epithelium of bronchi and bronchioles
 Pores of Kohn: perforations in alveolar walls, normally function as means of collateral ventilation;
in pneumonia permit passage of bacteria and exudate between alveoli
 Pulmonary arteries: have internal and external elastic membrane, compared to a single elastic
layer in pulmonary veins
 Submucosal glands: contain serous and mucus cells with myoepithelial lining and may have
oncocytic changes with age
 Type I (squamoid) pneumocytes: 95%, flattened
 Type II (cuboidal) pneumocytes: 5%, produce surfactant (lamellar bodies on EM); during repair,
type II pneumocytes are able to give rise to type I cells

 Normal findings in alveoli: alveolar macrophages, corpora amylacea, blue bodies (calcium
carbonate) and megakaryocytes
 Normal findings in interstitium: anthracotic pigment, scattered silica crystals