組織學(xué)與胚胎學(xué)13 呼吸系統(tǒng)(中英)

RespiratorySystem

1Respiratorytract呼吸道：nose、pharynx、larynx、tracheaandbronchuset.alLung:肺conductingportion：intrapulmonarybronchi→bronchiole→terminalbronchiolerespiratoryportion：respiratorybronchiole→alveolarduct→alveolarsac→pulmonaryalveoli2vestibularregion

前庭部respiratoryregion

呼吸部olfactoryregion

嗅部Nasalcavities

鼻腔epithelium：stratifiedsquamousepithelium復(fù)層扁平上皮laminapropria

：denseCT

vestibularregion

前庭部Mucosa（epithelium＋laminapropria）3

Respiratoryregion

呼吸部：Olfactoryregion

嗅部：olfacoryepithelium

（嗅上皮）假復(fù)層柱狀上皮laminapropria：thinCT，bloodvessels，unmyelinatedolfacorynerves，無髓神經(jīng)纖維serousolfactorygland（嗅腺），分泌的漿液可溶解氣體中的化學(xué)物質(zhì)，刺激嗅毛。epithelium

：pseudostratifiedciliatedcolumnarepitheliumwithlotsofgobletcells假復(fù)層纖毛柱狀上皮,杯狀細(xì)胞較多l(xiāng)aminapropria：looseCT，withlotsofmixedglands混合腺、venousplexus靜脈叢andlymphoidtissue。

4Olfactoryepithelium嗅上皮

pseudostratifiedcolumnarepithelium

（1）olfactorycell嗅細(xì)胞：bipolarneuron雙極神經(jīng)元

dendrite：細(xì)長，末端膨大為嗅泡，發(fā)出10－30根靜纖毛，稱嗅毛，為嗅覺感受器，浸埋于嗅腺分泌物中。

axon：進(jìn)入固有層，施萬細(xì)胞包裹→無髓神經(jīng)纖維→嗅神經(jīng)5（2）supportingcell支持細(xì)胞：高柱狀，微絨毛，胞核位于上部，胞質(zhì)中含色素顆粒。支持、保護(hù)、分隔。（3）basalcell基細(xì)胞圓形或錐形，可增殖分化為以上細(xì)胞。6Tracheaandbronchus氣管和支氣管粘膜粘膜下層外膜粘膜粘膜下層外膜7Mucosa:黏膜1.Epithelium:Pseudostratifiedciliatedcolumnarepitheliumwithmuchthickerbasementmembrane.8(1).Ciliatedcell纖毛細(xì)胞:

Theciliabeatsimultaneouslytowardslarynx.(2).Gobletcell杯狀細(xì)胞:Thesecretioncoverstheepitheliumsurface.(3).Basalcell基細(xì)胞:Stemcell.Separatedfromtheepitheliumsurface.9(4).Brushcell刷細(xì)胞:Sensorycell.

Columnarinshapeandhaslongermicrovilli.Thesynapses突觸areformedwhentheirbasalsurfacesareconnectedtonerveendings.(5).smallgranulecell小顆粒細(xì)胞:.Containsmanysecretorygranulesinwhichexistmanykindsofbioactivesubstances.BelongstoDNES.10112.Laminapropria固有層:LCTinwhichtheelasticfiberspredominate.B.Submucosa粘膜下層:

LCTcontainingmixedglandsandfewlymphatictissue.IgA,whichissecretedbyplasmacell,willcombinewithsecretoryproteinproducedbyglandsandepitheliumtoformSIgA,anantibodyreleasedtoinnersurfaceofrespiratorytrack.C.Adventitia:外膜LCTcontaining"C"shapedhyalinecartilageProvidessupport.SmoothmuscleElasticfiber12

creviceislinkedbyelasticfiberandbundlesofsmoothmuscles13CoveredbymesotheliumTheparenchymaaresurroundedbyLCTcontainingbloodvessels.etc.bronchialtree支氣管樹IV.Lung肺14漿膜：胸膜臟層肺實(shí)質(zhì)：肺葉、肺段支氣管小支氣管

細(xì)支氣管肺終末細(xì)支氣管小呼吸性細(xì)支氣管葉肺泡管呼吸部肺泡囊(換氣部)

肺泡肺間質(zhì)：結(jié)締組織、血管、淋巴神經(jīng)等導(dǎo)氣部15Conductingportion:導(dǎo)氣部Conductsairflow.1.loblarbronchiandsmallbronchi

:肺葉、小支氣管

Thebranchesoftrachea.Giveriseto2~3lobarbronchi.Laminapropriacontainsmanylymphocytes.Hyalinecartilagesgraduallybecomeirregularandappearasplates.

Smoothmusclesarerelativelyprominent.Richinelasticfibersandglands.①上皮均為假復(fù)層纖毛柱狀，含有前述幾種細(xì)胞，但上皮薄，杯狀細(xì)胞漸少；②腺體逐漸減少；③軟骨呈不規(guī)則片狀，并逐漸減少；④平滑肌相對增多，從分散排列漸成環(huán)形肌束環(huán)繞管壁

162.Bronchioles:

細(xì)支氣管Thebranchesofsmallbronchusandhasadiameterabout1mm.Eachbronchiolesuppliesonepulmonarylobule肺小葉.

a.pseudostratifiedciliatedcolumnarepitheliumwithfewgobletcellsgraduallyturnintosimpleciliatedcolumnarepithelium.b.hyalinecartilage

platesandglandsgraduallydisappear.c.Smoothmusclefibersgraduallypredominate.Hasirregularinnersurface.17上皮由假復(fù)層纖毛柱狀漸變?yōu)閱螌永w毛柱狀，也含有前述各種細(xì)胞，但杯狀細(xì)胞減少或消失。腺和軟骨也很少或消失，環(huán)行平滑肌則更明顯

183.Terminalbronchiole:終末細(xì)支氣管Linedbysimpleciliatedcolumnarcellsorsimplecuboidalepi.andsurroundedbysmoothmusclefibers.Nogobletcell,glandandcartilagecanbefound.Hasirregularinnersurface.“三消失，一環(huán)層”Claracells:分泌細(xì)胞akindofstemcellsthatarefoundamongciliatedcolumnarcells,arenon-ciliatedandcontainrichsecretorygranules,andareresponsibleformucusclottingclearance.

19細(xì)胞頂部呈圓頂狀突向管腔，頂部胞質(zhì)中含分泌顆粒，內(nèi)含蛋白水解酶，可分解管腔內(nèi)粘液；胞內(nèi)還含有較多的氧化酶系，可將毒性物質(zhì)進(jìn)行生物轉(zhuǎn)化，降低毒性。Clara細(xì)胞（分泌細(xì)胞）202122

肺導(dǎo)氣部管壁變化規(guī)律：管徑漸細(xì)，上皮由假復(fù)層纖毛柱狀變?yōu)閱螌永w毛柱狀進(jìn)而到單層柱狀杯狀細(xì)胞逐漸減少直到消失腺體逐漸減少直到消失軟骨逐漸減少直到消失平滑肌增多直到成層231.葉支氣管小支氣管

“三減少，一增多”假復(fù)層纖毛柱狀上皮，杯狀細(xì)胞、腺體、軟骨減少；平滑肌逐漸增多。2.細(xì)支氣管

1mm,假復(fù)層纖毛柱狀單層纖毛柱狀上皮，杯狀細(xì)胞、腺體、軟骨減少或消失；平滑肌成層——環(huán)形。3.終末細(xì)支氣管

“三消失，一環(huán)層”

0.5mm,單層柱狀上皮（Clara細(xì)胞和少量纖毛細(xì)胞），杯狀細(xì)胞消失；腺體和軟骨消失；平滑肌增多成層呈完整環(huán)形。24小支氣管：“三減少，一增多”終末細(xì)支氣管：“三消失，一環(huán)層”25Respiratorybronchiole:

呼吸性細(xì)支氣管a.thewallispopulatedwithmoreandmorealveoli.肺泡b.linedbycuboidalcellswithciliaandClaracells.c.surroundedbythinanddiscontinuouslayerofLCTandafewsmoothmuscleandelasticfibers.2.Alveolarduct:肺泡管a.thewallisdifficulttoseeduetonumerousopeningtoalveolarsacsandalveoli.b.knobsappearinthewallbecauseofthecontractionofsmoothmuscles.B.Respiratoryportion:

Capableofairexchange.26273.Alveolarsac:

肺泡囊Thesharedopeningofseveralsurroundingalveoli.若干肺泡的共同開口28Linedby2typesofsimpleepithelium.Surroundedbyrichcontinuouscapillaries.4.Alveoli:肺泡200μmindiameter,300~400millionTerminalblindendsofthetree.Themainplacewheretheairexchangesoccur.29a.typeIalveolarcellsⅠ型肺泡細(xì)胞(squamousalveolarcells):cover95%ofthealveolarsurface.0.1~0.2μmthick.Pinocytoticvesicles吞飲小泡areresponsibleforinnersurfaceclearance,andtightjunctionsamongthem.3031b.typeIIalveolarcells:Ⅱ型肺泡細(xì)胞

(Giantalveolarcells):InterspersedamongthetypeIcells.MorethantypeIcells.cuboidalwithmicrovilli.HavetightjunctionsanddesmosomeswithtypeIcells.Haveacidophilicandfoamycytoplasm.3233EM:

osmiophiliclamellarbodies嗜鋨性板層小體,whicharecapabletorelease

thepulmonarysurfactant表面活性物質(zhì)tocoverthealveolarsurfacetolowerthesurfacetension.CandifferentiateintoTypeIcells.分泌表面活性物質(zhì)，降低肺泡表面張力，穩(wěn)定肺泡大??；可增殖分化為Ⅰ型肺泡細(xì)胞Becomematurein7-month-oldfetus.34嗜鋨性板層小體（內(nèi)成分為二棕櫚酰卵磷脂）RERGlogi35C.Interalveolarseptum:肺泡隔ThinlayerofLCTbetweenadjacentalveoli.SeveralstructuresexistinInteralveolarseptum:1.ContinuousCaps:Branchesofpulmonaryartery.TherichestCapnetworkinthebody.2.Abundantelasticandreticularfibers:Functionwhenalveoliareenlarged.3.Alveolarmacrophages:Alsocalleddustcellsorheartfailurecells.4.Alveolarpores:肺泡孔Windowsbetweentheadjacentalveolithatcanequalizetheairpressure.36ElasticfibersAlveolarmacrophages37D.Blood-airbarrier:氣－血屏障Thestructurethatthegashastopenetrateduringtheairexchanges.Composedof

typeIcellscoveredbysurfactant,(LCT),fusedbasementmembraneandendothelium.38①

Fluid:

surfactant肺泡表面液體層②

typeIalveolar

cellsandit’sbasementmembraneⅠ型肺泡細(xì)胞與基膜③

thinLCT薄層結(jié)締組織④

continuous

capillarybasementmembraneandendothelium連續(xù)毛細(xì)血管基膜與內(nèi)皮About0.2-0.5μm.3940Interstit