复旦大学：《病理学 Pathology》课程英文PPT课件_Chapter VII Diseases of Respiratory System

Diseases of Respiratory System 朱荣 上海医学院病理学系 东一号楼207室 Zhurongssafudan. edu.cn

1 朱 荣 上海医学院病理学系 东一号楼207室 zhurongss@fudan.edu.cn Diseases of Respiratory System

ANATOMY and FUNcTion Upper respiratory tract nose, pharynx, larynx Lower respiratory tract trachea bronchi Right bronchus diverging at a lesser angle, foreign material more frequently aspirated Lobar, segmental, lobular a Terminal airways and alveoli respiratory bronchiole alveolar sac alveolus

2 ANATOMY and FUNCTION ◼ Upper respiratory tract — nose, pharynx, larynx ◼ Lower respiratory tract — trachea & bronchi  Right bronchus diverging at a lesser angle, foreign material more frequently aspirated  Lobar, segmental, lobular ◼ Terminal airways and alveoli — respiratory bronchiole alveolar sac alveolus

Phat Epiglottis Thyroid cartilage Trachea Pleura Aper Terminal Left bronchus Bronchioles Alveolar duct Heart space Diaphragm Alveolus

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Bronchus 1. Mucosa ciliated column cell, goblet cell, basal cell, stem cell, small granule cell(neurosecretory granules) 2. Submucosal glands- serous and mucus 3. Wall -smooth muscle, contractile elastic fibers, provide flexibility cartilage plate, for support BronchioleΦ<1mm Mucosa ciliated epithelial cell Clara cell (non-ciliated secretary cell) ★ 2. Wall smooth muscle no gland no cartilage

4 Bronchiole Φ < 1mm 1. Mucosa — ciliated epithelial cell — Clara cell (non-ciliated secretary cell) 2. Wall — smooth muscle — no gland — no cartilage Bronchus 1. Mucosa ciliated column cell，goblet cell, basal cell, stem cell, small granule cell (neurosecretory granules) 2. Submucosal glands — serous and mucus 3. Wall — smooth muscle, contractile — elastic fibers, provide flexibility — cartilage plate, for support

Terminal airway and alveolus Type I Unit of gas exchange epithelium Type I the ultimate site of gas exchange ALVEOLUS ALVEOLAR respiratory bronchioles, alveolar ducts, SPACE alveolar sac alveoli ° Alveolar type I cell 95% of the surface CAPILLARY gas permeable LUMEN ° Alveolar type ll cell 5% of the surface Type Il producing surfactant, lowering the surface tension, Endothelium involved in the re pair of alveolar epithelium Interstitial cell Endothelium 5

5 Terminal airway and alveolus • Unit of gas exchange the ultimate site of gas exchange — respiratory bronchioles, alveolar ducts, alveolar sac, alveoli • Alveolar type I cell — 95% of the surface — gas permeable • Alveolar type II cell — 5% of the surface — producing surfactant, lowering the surface tension, involved in the repair of alveolar epithelium

感会 FIGURE 22.1. Normal bronchus. The bronchus is lined by ciliated columnar epithelium (1). foci of goblet cells (2), cartilage (3) and smooth muscle(4). The small arteries seen here (5)are branches of the bronchial artery which cames oxygenated blood from the left ventricle 6

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B FIGURE 22.2. Bronchioles and alveoli. The small bronchiole(B)seen here is lined by a cuboidal epithe lium and smooth muscle. The large adjacent arteriole(A) is a branch of the pulmonary artery. The veins or venules (V) run in septa. The alveolar walls(arrow)are normally lined with flat type I epithelium. of which only the nuclei are visible. Alveolar macrophages(arrowheads) are common

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Remarks 1. Respiratory system is communicating with external environment, so it is susceptible to the diseases 2. All blood from the body will pass through the lung and the biological pathogens and embolus can be trapped in the lung

8 Remarks 1. Respiratory system is communicating with external environment, so it is susceptible to the diseases. 2. All blood from the body will pass through the lung and the biological pathogens and embolus can be trapped in the lung

3. The lung is closely related to the heart, not only by their location but also by the pulmonary circulation 4. The diseases specific to the lung(e.g damage to the wall of bronchial tree, obstruction of bronchioles and disintegration of alveolar/ capillary membrane)

9 3. The lung is closely related to the heart, not only by their location but also by the pulmonary circulation. 4. The diseases specific to the lung (e.g damage to the wall of bronchial tree, obstruction of bronchioles and disintegration of alveolar/ capillary membrane)

Pulmonary Infections Pulmonary Host Defense Mechanisms Nasal hair and Turbinates Interference from resident flora Mucociliary apparatus and cough Immunoglobulin (gg, IgM, igA) Complement production Cytokines (IL-l, TNF) Alveolar macrophages Polymorphonuclear leukocytes Cell-mediated immunity

10 Pulmonary Host Defense Mechanisms Nasal hair and Turbinates Interference from resident flora Mucociliary apparatus and cough Immunoglobulin (IgG, IgM, IgA) Complement production Cytokines (IL-1, TNF) Alveolar macrophages Polymorphonuclear leukocytes Cell-mediated immunity Pulmonary Infections