Histology of Respiratory Tract

Asst. Prof. Wisuit Pradidarcheep

Department of Anatomy, Faculty of Medicine
Srinakharinwirot University, Thailand
Respiratory Tract: Clinic

upper respiratory
tract
nose, mouth,
pharynx, epiglottis,
larynx and (trachea)

lower respiratory
tract
bronchial tree and
lungs
 Respiratory Tract: Anatomy
Nasal cavity

Pharynx
* Pseudostratified
Larynx
ciliaed columnar
Trachea
with goblet cells
Bronchus
* Most area Primary bronchiole

Terminal bronchioles
Respiratory bronchioles
* Simple squamous Alveolar duct
* Most area Alveolar sac

Alveoli
Epithelium of Respiratory Tract

1. Conducting portion
nasal cavity terminal bronchiole
* Most area: Pseudostratified ciliated columnar
epithelium with goblet cells = respiratory
epithelium

2. Respiratory portion
respiratory bronchiole alveoli
* Most area: Simple squamous epithelium
 Functions of Conduction Portions

1. Cleaning of air
2. Humidification of air
3. Warming or cooling air
4. Olfaction
5. Phonation

1-3 is for “conditioned the inspired air”.

 Functions of Respiratory Portions

1. Air-blood barrier (exchange)

provide oxygen to blood and remove CO2 from it.

2. Secrete surfactant
3. Phagocytosis
Nasal Cavity
Nasal Cavity

3 area
1. Vestibule area
keratinized epithelium

2. Respiratory area
pseudostratified columnar cilia
epithelium with goblet cells

3. Olfactory area
olfactory epithelium
Respiratory area : Inferior concha
espiratory area: Respiratory Epithelium
Nasal Conchae

- Pseudostratified ciliated columnar epithelium with goblet cells

- Serous and mucous gland = mixed gland
- Large thin walls veins lie under the epithelium
Medical fact: The mucosa of the nose has
many thin-walled veins. During a viral infection t
hese become dilated, causing a blocked nose
espiratory Epithelium with Goblet Cell
Muco-ciliary escalator

The mucociliary
The mucociliary escalator covers escalator is a major
most of the bronchi, bronchioles barrier against infection.
and nose. It is composed of two
basic parts;
1. the mucus-producing goblet cells
2. the ciliated epithelium
Medical fact: The cilia are paralysed by cigarette
smoking and viral infections, causing the
accumulation of mucus.
Kartagener's Syndrome (or immotile cilia syndrome)
is a rare genetic birth defect.
 Olfactory Area
Olfactory area is located on both
medial and lateral walls of
the superior concha

2.5 cm2

Olfactory area lies with

olfactory epithelium
 Tall Respiratory Epithelium without Goblet Cells

Gland

Nerve

The olfactory mucosa is served by a richly vascularized

lamina propria that also contains the olfactory
nerves and numerous serous glands.
3 Olfactory Epithelial Cell Types
Nasal cavity 3 Olfactory
Epithelial
Cell Types

1. Supporting
cell
2. Olfactory cell
(bipolar
neuron)
3. Basal cell
Cribiform plate Bowman’s gland

Fila Olfactoria (unmyelinated NF)

Myelinated NF (CN5)
 Paranasal air sinus

Respiratory epithelium + few goblet cells

Thin lamina propria
 Pharynx

respiratory epithelium

stratified squamous epithelium

Type of epithelial lining of
the pharynx depends on
stratified squamous epithelium
regions.
 Epiglottis
Superior surface

Inferior surface
Elastic cartilage

Mixed seromucous glands

Larynx

VM
TC

CC
 Coronal Section Through the Larynx

epiglottis (E), false vocal folds (FVF), true vocal folds (VF),
thyroid cartilage (TC), cricoid cartilage (CC),
lateral saccule (LS) and trachea (T).
 Vocal fold (cord) region of the larynx

Epiglottis (E) at the top, false vocal folds (FVF), true vocal folds (VF),
lateral saccule (LS), vocalis muscle (VM) which is a skeletal muscle, and
thyroid hyaline cartilage (TC).
 Metaplasia

Medical fact: Cigarette smoking causes irritation to

the mucosa of the larynx, resulting in changes of the
epithelium. The respiratory epithelium will change into
squamous epithelium, and if the irritation continues thi
s will change into squamous cell carcinoma.
Trachea
Lung
-Pleura

Bronchus
Bronchiole
Alveolar duct
Alveolar sac
Alveoli
Trachea
 Trachealis muscle = smooth muscle

Cartilage ring= C- shaped hyaline cartilage

 Trachea
Trachealis muscle

C-shape hyaline cartilage

 Characteristics of Trachea
a. Mucosal epithelium - respiratory
epithelium

b. Lamina propria contains

many
lymphocytes that are
supported by a meshwork
of
elastic and reticular fibers.

c. The submucosa is
composed of
loose connective tissue and
contains the secretory
components of serous and
d. mucous
-C-shaped ringswhose
glands of hyaline
ducts
cartilage
empty into the tracheal
-Trachealis muscle
lumen.
* Trachealis muscle (smooth
muscle) connects the ends of * The cartilage and muscle
the “C” formed by the cartilage make the trachea a very rigid
rings. structure.
Fibro-elastic CT
Trachea
Lung (mouse)

Visceral pleura
 Visceral pleura
AS
Visceral pleura of the lung.

1. Alveolus
2. Blood vessel
3. Mesothelial cells
4. Pleura
5. Collagen fibers
6. Interalveolar
septum
Medical fact: The walls of the pleural cavity
are very permeable to water and other substa
nces, and therefore fluid accumulation (pleura
l effusion) occurs frequently
Trachea
Lung
-Pleura

Bronchus
Bronchiole
Alveolar duct
Alveolar sac
Alveoli
Bronchus
 Bronchus
a. Cartilage rings are
reduced to irregular plates
of cartilage.

b. A band of spirally wound

smooth muscle present in
lamina propria. Some texts
may call this smooth
muscle layer the mucularis
mucosa (probably not a
good name for it).

c. Goblet cells in the

epithelium become less
numerous.

d. Epithelium becomes
reduced in height with less
cilia.

e. Lymphatic nodules may be

present in lamina propria,
Bronchus
Medical fact: The whole respiratory system is very exposed
to infection. The bronchi have abundant lymphoid tissues in t
he form of nodules containing B- and T- lymphocytes. These
interact with the lung macrophages. This is called BALT (bro
nchus-associated lymphoid tissue).
 Bronchioles

The bronchioles are the first airway

branches that no longer contain cartilage.
They are branches of the bronchi, and are
smaller than one millimeter in diameter.

- Primary bronchiole
- Terminal bronchiole
- Respiratory bronchiole
 Characteristics of Bronchioles

* Epithelium is simple columnar to simple

cuboidal with fewer cilia.

* Non-ciliated Clara cells are present in

epithelium.

* No goblet cells and no glands in

submucosa.

* Only smooth muscle layer is present.

* Bronchioles lack of cartilage.

Bronchiole

io le
ch
r on
yb
ar
im
Pr
Primary Bronchiole
Terminal bronchiole
Respiratory Bronchiole
 Epithelium of
Primary bronchiole
- Low respiratory
epithelium + few
goblet cells

(simple ciliated columnar)

 Epithelium of
Terminal bronchiole
- Simple ciliated
columnar or cuboid
- Clara cells
Epithelium of Respiratory Bronchiole
- Simple ciliated cuboid+ Clara cell
 Clara cell: Bronchiole
Clara cells were originally described by Max Clara in 1937

Clara cells are non-mucous and non-ciliated secretory

cells found in the bronchioles of the lungs.

Epithelium of bronchiole
Immunohistochemistry using a rabbit polyclonal antibody labeling CC10 (Clara
cell specific 10 kD) protein discloses numerous clara cells in the bronchiolar epi
thelium of Sprague-Dawley rats with characteristic apical cytoplasmic protrusio
Functions of Clara cells in Bronchiole

- Protect the bronchiolar epithelium

- Clara cell secretory protein (CCSP) :
: inhibit pulmonary inflammation
- Lung surfactant

- Responsible for detoxifying harmful substances

inhaled into the lungs

- Cytochrome P450 enzymes found in
their smooth endoplasmic reticulum

- Multiply and differentiate into ciliated cells to

regenerate the bronchiolar epithelium
Pathol Res Pract. 1999;195(7):487-9
 The differences and similarities between the trachea,
bronchus and bronchiole can be summarized as follows:
Histological Trachea Bronchus Bronchiole
component

Epithelium Respiratory Respiratory Columnar

Elastic tissue Present as lamina Longitudinal bands Fibres only
elastica
Cartilage C-shaped Plates None
Glands Goblet and in Goblet and between None
submucosa muscle and cartilage
Clara cells Absent Absent Present
Medical fact: Contraction of bronchiolar smooth
muscle is an important factor in asthma, causing
increased airway resistance. In small babies the
smooth muscle is not well developed, therefore
medications acting on the smooth muscle is not
effective in treating babies with bronchiolitis.
Pulmonary lobule
Respiratory bronchiole

Alveolar duct

Alveolar sac

Alveoli
Respiratory Bronchiole, Alveolar Duct,
Alveolar Sac and Alveoli
Respiratory Portions
Respiratory Bronchiole, Alveolar Duct
Smooth muscle , elastic fibers
Alveoli
 Interalveolar septum

1. Collagen fibers
2. Elastic fibers
3. Capillaries
4. Alveolar
epithelium
Interalveolar septum

1. Alveolar epithelium
2. Elastic fibers
3. Collagen fibers
4. Capillary lumen
5. Endothelial cells
6. Alveolus
Alveolar Epithelium
Alveolar Epithelium
 Alveolar Epithelium

30 Microns

Type I pneumocyte (blue) ~ 95%

Type II pneumocyte = septal cell (green) ~ 5%
Macrophage = dust cell (red)
 30 Microns

The alveoli bring RBCs into close proximity with inspired air.

Type I pneumocytes (blue) are the squamous cells type

that form a component of the air-blood barrier.

The cuboidal Type II pneumocytes (green) secrete surfactant

that reduces surface tension and prevents atelectasis.
Air-blood barrier
Air-blood barrier
Thickness ~ 300 nm.

a. The blood-air barrier prevents air

in gaseous form from mixing with the
blood.

b. In certain situations, the blood air

barrier may be broken

* Called an embolism (arterial or

venous gas embolism).

* Can result in the release of

gaseous air into the blood
circulatory system

* These air bubbles can cause

blockages of blood circulation in
 Air-blood barrier
Alveolus
Surfactant
Epithelium
Basal lamina of epithelium
Basal lamina of endothelium
Endothelium
Lumen
Red blood cell
Alveolar Pore (of Kohn)
Alveolar Pore (of Kohn)
Medical fact: The pneumocytes type II produce surfactant. A
deficiency of surfactant causes respiratory distress syndrome in n
ewborns, and is associated with prematurity. It is the leading caus
e of death in premature babies. In the normal newborn, the onset
of breathing is associated with a massive release of stored surfact
ant, which lowers the surface tension in the alveoli. Surfactant als
o has a bactericidal effect.
Medical fact: Alveolar pores and Lambert sinuses
are very important safety mechanisms in the
lungs. If a specific area in the lung is obstructed (
e.g., carcinoma in a bronchus), air can still reach
the affected area through these short circuits. It a
lso helps to equalize the pressure in various area
s of the lungs.
 Functions of Conduction Portions
Cleaning of air:
muco-ciliary escalator
Humidification of air:
serous from submucosal gland
Warming or cooling air:
blood flowing in the venous plexus
Olfaction
Phonation
 Functions of Respiratory Portions

. Air-blood barrier
Type I pneumocyte and endothelium
. Secrete surfactant
Type II pneumocyte
. Phagocytosis
Alveolar macrophage

http://www.up.ac.za/academic/medicine/
telemed/Hist/lugwee/index3.html
http://www.youtube.com/watch?
v=U6LqEr4vVis&feature=related