(医学各论课件)21、Respiratory System

among ciliated cells and often project into the lumen of the bronchioles. They are dome-
shaped cells without cilia and contain apical granules (visible only with a special stain);
Trachea
Mucosa/Submucosa/ Adventitia
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A. Mucosa: 1. Epithelium: Pseudostratified ciliated columnar epithelium with much thicker basement membrane.
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1. Ciliated cell 2. Goblet cell 3. Basal cell 4. Brush cell 5. Diffuse neuroendocrine
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alveolar sac
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Lined by few brush cells and 2 types of simple epithelium. Surrounded by rich continuous capillaries.
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pulmonary alveolar
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a. type I cells (squamous alveolar cells): squamous,
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Model photo for Clara cells
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EM for Clara cells
G secreted granules
S SER
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Clara cells, terminal bronchioles. Clara cells are secretory cells that are scattered

Several types of patients should receive a reduced number of particles for perfusion imaging.
① Patients with severe pulmonary hypertension and right-to-left shunts should be given only half the conventional dosage.
Pulmonary segments with decreased or absent blood flow show diminished radioactivity.
2.2 Methods
2.2.1 Radiopharmaceuticals
99mTc-labeled macroaggregated albumin (99mTcMAA) is the most frequently used radiopharmaceutical to imaging lung perfusion. The MAA has a mean size of 40 um with a range of 10 to 90 um.
Typically, 100,000 to 700,000 particles are injected to ensure reliable count statistics and image pulmonary arterial trees are temporarily and safely occluded.
2. Lung Perfusion Imaging
2.1 Principle
Pulmonary perfusion imaging is based on the principle of capillary blockade.

Breaking is a complex process
It involves the contract and relaxation of muscles, the movement of air through the passages, and the exchange of gases at the alveoli
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Trachea and Bronchi
The structure of the tracea and bronchi
要点一
Trachea
要点二
Bronchi
The Trachea, also known as the windpipe, is a cartilaginous tube that extends from the Larynx to the bifurcation at the level of the fourth tropical vertebra It serves as a passage for air to reach the lungs The trajectory is composed of C-shaped rings of cartilage and is covered by mucous membrane
Tonsillitis
Tonsillitis is an inflation of the Tonsils (lands at the back of the stroke) that can cause pain, fever, and diversity switching It is often caused by viruses but can also be bacterial

特点：是潜在的腔隙，间隙内仅有 少许浆液，可减少摩擦。
胸膜隐窝plcural recesses
是各部壁胸膜相互移行处的胸膜腔。包 括：肋膈隐窝，肋纵隔隐窝和膈纵隔隐 窝。
肋膈隐窝costodiaphragmatic recess 肋胸 膜与膈胸膜返折形成，位置最低。
肋纵隔隐窝costomediastinal recess 纵隔 胸膜与肋胸膜相互移行处。
声襞vocal fold侧壁下方的粘膜皱襞。 喉前庭laryngeal vestibule位于喉口与
前庭襞之间，呈上宽下窄漏斗状。
喉 腔（3）
喉中间腔（intermedial cavity of larynx）：是喉腔中声襞与前庭襞之间 的部位。
喉室（ventricle of larynx）：是喉 中间腔向两侧经前庭襞和声襞间的裂隙。
壁胸膜分为四部分： 肋胸膜costal pleura 衬覆于肋骨、胸骨、
肋间肌、胸内筋膜等内面的浆膜。。 膈胸膜diaphragmatic pleura 覆盖于膈
上面。 纵隔胸膜mediastinal pleura 衬覆于纵隔
两侧面。 胸膜顶cupula of pleura 是肋胸膜和纵隔
• 肺底：肺前缘锐利膈面 diaphragmatic surface。
肺（lung）（8）
• 肺前缘锐利膈面diaphragmatic surface即 肺 底。
• 左肺前缘下部acnotch,下方右肺水left lung。
• 后缘在脊柱两侧的肺沟中，为肋面与纵 隔面在后方的移行处。
• 下缘inferiorborder位于膈肌上，是肺三 个面
环甲关节（cricothyroid joint）由环状软 骨外侧部关节面和甲状软骨下角构成。