Anatomy of Tracheobronchial Tree and Bronchopulmonary Segments with summary of Histology
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Anatomy of Tracheobronchial Tree and Bronchopulmonary Segments with summary of Histology
- 1. Presented by Jega Subramaniam – Student Guided by Dr Venugopal, Dr Manah Chandra, Dr Gargi Sonni & Dr Ravindra Tracheobronchial Tree and Bronchopulmonary Segments With Summary Of Histology
- 2. Upper respiratory tract Lower respiratory tract Anatomy of Respiratory System Nose, nasal cavity, and paranasal sinuses Pharynx and larynx Trachea Bronchi and bronchioles Lungs and alveoli Intro
- 3. Organization of Respiratory System Conducting portion Nose nasal cavity pharynx larynx trachea primary bronchi to the terminal bronchioles Respiratory Portion respiratory bronchioles alveolar ducts alveoli Anatomical Dead Space Intro
- 4. 4 Trachea Right and Left Principal Bronchus ( Primary Bronchus ) Lobar Bronchi(Secondary Bronchus) Segmental Bronchi(Tertiary Bronchus) Terminal Bronchioles(25000 in no.) Respiratory Bronchioles Alveolar ducts ACINUS Alveolar sacs Alveoli Passage of air from trachea Intro
- 5. • Trachea divides into Right and Left Principle Bronchus • Each Principle Bronchus divides into Lobar Bronchus • Each Lobar bronchus devides into Segmental Bronchus • Segmental Bronchus devide the Lobes of the Lungs into smaller segments = Bronchopulmanory Segment • Trachea – Principle Bronchus – Lobar Bronchus- Segmental Bronchus Tracheobronchial Tree C-shaped rings of cartilage Overlaping Cartigilanous PlateDegrades It’s a Invasion of Primary Bronchus into hilum of the lungs and their branching structure of airways supplying air to the lungs.
- 6. • Divides from trachea into Right and Left Princple Bronchus • Enter the both lungs at the hilum of the lungs • Right = 2-3 cm long and wider then Left, more vertical • Left = 5 cm and narrower • Lined by Pseudostratified Ciliated columnar epithelium (Infact it , Lines all Bronchus – From Principle until Segmental Bronchus , buts it shortens in size as they move towards periphery . Thus most of the segmental bronchus will be lined by Simple Cuboidal Ep.) • Supported by C-shaped cartilage • Further devides into Lobar bronchus Principle Bronchus = Primary Bronchi
- 7. • Divides from Principle Bronchus • Enter into Each lobe of the both Lungs • Left Lung ; Superior Lobar Bronchus ; Inferior Lobar Bronchus • Right Lung ; Superior Lobar Bronchus ; Middle Lobar Bronchus ; Inferior Lobar Bronchus Lobar Bronchus = Secondary Bronchi
- 8. Right lung = 10 Segmental Bronchus Superior Lobar Bronchus gives off ;- – Apical – Posterior – Anterior Middle lobar Bronchus gives off :- – Lateral – Medial Inferior Lobar Bronchus gives off : Med to Lat – Superior – Medial – Anterior – Posterior – Lateral AUNTY PINKY AND LINKY MARRIED SUNDAY MORNING AT PULAU LANGKAWI Segemental Bronchus = Tertiary Bronchus Segmental Bronchus Segmental Bronchus Basal Segmental Bronchus
- 9. Left lung = 10 Segmental Bronchus Superior Lobar Bronchus gives off ;- – Apical – Posterior – Anterior – Superior Lingular – Inferior Lingular Inferior Lobar Bronchus gives off : Mid to Lat – Superior – Medial – Anterior – Posterior – Lateral Cranial Branch Caudal / Lingular Branch Segmental Bronchus AUNTY PINKY AND LINKY MARRIED SUNDAY MORNING AT PULAU LANGKAWI Basal Segmental Bronchus Its = middle Lobar Bronchus of Right Lung
- 11. T R A C H E A S.L.B COLORED = SEGMENTAL BRONCHUS APICAL POSTERIOR ANTERIOR APICAL POSTERIOR ANTERIOR MEDIAL LATERAL SUPERIOR LINGULAR INFERIOR LINGULAR Superior Medial Basal ANTERIOR BASALPost Basal Post Basal Lateral Basal Lateral Basal 3 3 + 2 2 - 5 5 RIGHT Lung LEFT Lung SUPERIOR LOBE MIDDLE LOBE INFERIOR LOBE Tracheobronchial Tree No of Segmental Bronchus
- 12. • Well defined portions of the lungs which is aerated by Segmental / Tertiary Bronchus • Pyramidal in shape - Apex directed towards root of the lungs , Base towards Surface • The name of the Segmental Bronchus corresponds to the name of the Segment Ex : Apical Segment – Apical Segmental Bronchus • It is a individual units consisting its own ;- 1 branch of Pulmanory Artery 1 or 2 branches of Pulmonary Vein 1 Segmental bronchus Autonomic Nerves Lymph Vessels Broncopulmanory Segements
- 13. Refers to - Single infected segment can be surgically removed without affecting its neighbours. Infections - never crosses the intersegmental septa and are restricted to one bronchopulmonary segment except Tuberculosis and Cancer . Excessive accumulation of secretions in bronchi may lead to infection Postural drainage - Such secretions can be drain out of the lungs by placing the patient in a posture that helps the fluid to be drain from the lungs by gravity . Clinical Importance 1. Segmental Resection (Segmentectomy). 2. Postural drainage
- 14. • Right lung • Subdivided into three lobes with ten segments: Right upper lobe 1. Apical 2. Posterior 3. Anterior Right middle lobe 4. Lateral 5. Medial Right lower lobe 6. Superior 7. Medial Basal 8. Anterior Basal 10 Posterior Basal 9 Lateral Basal Broncopulmanory Segements Costal aspect Medial Surface
- 15. • Left Lung • Subdivided Into Two Lobes With Ten Segments : • Left Upper Lobe – 1. Apical – 2. Posterior – 3. Anterior – 4. Superior Lingular – 5. Inferior Lingular • Left Lower Lobe – 6. Superior – 7. Medial Basal – 8. Anterior Basal – 10. Posterior Basal – 9. Lateral Basal Broncopulmanory Segements Costal aspect Medial Surface
- 16. Relations to pulmonary artery and vein • Pulmonary artery gives branches to accompany the bronchi • Each segment has its own arterial supply •Pulmonary Vein do not accompany the bronchi or pulmonary arteries •They run in intersegmental planes forming segmental veins •Each segment has more then 1 vein
- 17. • Segmental bronchi several million bronchioles • Bronchioles - < 1mm in diameter • Cartilagenous rings replaced by cartilagenous plates as the size of bronchioles decrease. • Size reaches to 0.6mm - completely disappear • To make it simple , just remember bronchioles have no cartilage • Lined by Ciliated Cuboidal Epithelium and well developed layer of smooth muscle. • Bronchioles 50 to 80 terminal bronchioles - still in the conducting zone • Terminal Bronchiole 2 or > respiratory bronchioles which mark the beginning of the respiratory region. Bronchiole
- 18. • Acinus = Distal to each Terminal Bronchial - consists of three to four orders of respiratory bronchioles. • Respiratory bronchioles 2 to 10 alveolar ducts. • Walls of alveolar ducts consist of alveolar sacs or the mouths of alveoli. • Lined by Non-Ciliated Simple Squmous • Smooth muscles are found in the walls of the airways upto the level of alveolar ducts. •Respiratory zone - Resp Bronchiole , A.Duct , A.Sac and Alveoli •Respiratory bronchioles and the alveolar ducts are responsible for 10% of the gas exchange. • The alveoli are responsible for the other 90%.
- 20. Alveolus • Singular - alveolus , plural: alveoli Latiin - "little cavity“ • Outcrop from either alveolar sacs or alveolar ducts which are both sites of gas exchange with the blood • Typical pair of human lungs - 700 million alveoli - 70m2 of surface area • Each alveolus is wrapped in a fine mesh of capillaries covering about 70% of its area • Diameter of adult alveolus – 200 mictometers and during inhalation
- 21. • Type I cells (simple squamous epithelium) 95 % • Type II cells (cuboidal epithelium) 5 % Secrete surfactant – Prevents alveoli from collapsing by reducing the surface tension of the fluid lining the alveolar surface Repair damaged alveolar epithelium • Macrophages (Dust Cells ) that destroy foreign materials, such as bacteria • Surfactant is a mixture of phospholipids(dipalmitoyl- phosphatidyl-choline) 21 Alveolus
- 22. • Contain some collagen and elastic fibres • Elastic fibers - allow the alveoli to stretch and Spring back during and inhalation and exhalation • Each alveolus Interconnect by way of alveolar pores ( Pores of Kohn ) Alveolus
- 23. • Histology of alveoli
- 24. • Is the barrier between alveolar air and blood • A.K.A alveolar–capillary barrier or membrane • Permeable to molecular O2 , CO2 , CO and many other gases. • Only simple squamous alveolar cells and squmous endothelial cells of capilary • Their both basement membrane are fused Respiratory Membrane
- 25. • Prevents air bubbles from forming in the blood and blood from entering the alveoli. • Extremely thin approximately 2μm-600 nm - to allow sufficient oxygen diffusion • Type 4 Collagen fibers will provide strength to the barrier.
- 26. Trachea • Fibrous connective tissue • Cartilaginous Layer – Hyaline Cartilage • Mucos Membrane Histology Glandular Part Lamina Propria Secrete Mucos Has lining Epithelia - Psedostratified Ciliated Columnar •Fibrous connective tissue •Muscular Layer , which have elastic fibers in between •Cartilaganeous Layer – Hyaline Cartilage •Mucos Membrane Glandular Part Lamina Propria -Psedostratified Ciliated Columnar Ep. -Ciliated Simple Columnar Ep. -Simple Cuboidal Ep. Towards the lower parts of the Bronchus Upper Part of Bronchus Bronchus Secrete Mucos
- 27. Bronchiole • No cartilage • Smooth Muscle is major component • Lined by Simple Cuboidal Ep. • No Mucos Glands • Occasionally Goblet Cells found • Small no . of Neuroendocrine Cells – sometimes cluster to form neuroepithelial bodies • Clara Cells Present Respiratory Zone •A.Duct •Alveoli – 2 types of lining epithelia •A.Sac Septal Alveoli - Simple Squamous Ep Glandular Alveoli - Simple Cuboidal Ep
- 28. • Nose • Pharynx • Larynx • Trachea • Bronchus • Bronchiole • Alveolar Duct • Alveoli Upper Part Upper Part Lower Part Lower Glandular Septal Lower Part Ciliated Columnar Ep. Pseudostratified Ciliated Columnar Ep. Terminal Resp Simple Cuboidal Ep. Simple Squmous Ep Simple Cuboidal Ep. Ciliated Simple Columnnar Ep.
- 29. Dear Lecturers and Friends Reference Gratitude Sincere thanks to the Lectures from Dept Of Anatomy , IMS. Each of you have helped me a lot by explaining the concept of the topic and guiding my presentation. Thank You - Dr Venugopal . Dr Manah Chandra . Dr Gargi Sonni . Dr Ravindra Kumar
Editor's Notes
- R.P.B - Right Principle Bronchus L.P.B - Left Principle Bronchus S.L.B - Superior Lobar Bronhcus M.L.B - Middle Lobar Bronchus I.L.B - Inferior Lobar Bronchus C. B - Cranial Branch L.B – Lingular Bronchus ( also k.a – caudal branch )
- EXTRA KNOWLEDGE Other Surgical removal in lungs for your extra knowledge Lobectomy – surgical removal of a lobe of an organ. Often – removal of lobe of lung. It may also refer to the liver, brain, thyroid gland, and other organs. performed normaly during emphysema, lung abscesses, and tuberculosis. Sleeve Lobectomy - removal of a cancerous lobe of the lung along with part of the bronchus that attaches to it. The remaining lobe(s) is then reconnected to the remaining segment of the bronchus. This procedure preserves part of a lung, and is an alternative to removing the lung as a whole (pneumonectomy). Wedge Resection - removes a small, wedge-shaped portion of the lung containing the cancerous cells along with healthy tissue that surrounds the area. small tumor or to diagnose lung cancer. performed instead of a lobectomy (removing a complete lung lobe) when there is a danger of decreased lung function if too much of the lung is removed Pneumonectomy - is most often done for cancer of the lung that cannot be treated by removal of a smaller portion of the lung
- Pores of Kohn Collateral ventilation = when lung - partially deflated, ventilation can occur to some extent through these pores. Equalize the pressure in adjacent alveoli and thus play important role in prevention of collapse of lung. Allow the passage of other materials such as fluid and bacteria, which is an important mechanism of spread of infection in lobar pneumonia and spread of fibrin in grey hepatisation phase of recovery from the same.
- Content of Trachea and Bronchus is almost the same , but in addition , Bronchus has Muscular Layer (Smooth Muscles + Elastic Fibers). That’s why bronchus can constrict and dilate but the trachea cant And Definitely the lining epithelia differs. Altough the Upper Part of bronchus ( Principle Bronchus ) = Trachea . But Towards lower part of the bronchus it shortents to Ciliated Simple Columnar Ep and finally to Simple Cuboidal Ep.
- Clara Cells Most Numerous in Terminal Bronchial . Contains numerous mitochondria and S.E.R Functions Protect the bronchiolar epithelium. Also secretes some surfactants too. Detoxifying harmful substances inhaled into the lungs. Act as a stem cell, multiplying and differentiating into ciliated cells to regenerate the bronchiolar epithelium. Neuroendocrine Cells Small and round cells . Dark staining nuclei . Clear cytoplasm Located at basement membrane of lining epethilia Scattered throughout the bronchial tree but mostly found in bronchioles Most numerous in fetal lung Functions – Secrete hormones and active proteins ( bombesin , serotonin )
- Im sorry for any spelling or grammar mistakes . If you found any facts are wrong , please kindly let me know at jega93subra@gmail.com. thanks Hope the presentation helps you, God Bless. S.R.