RESPIRATORY SYSTEM

Achmad aminuddin

RESPIRATORY SYSTEM
STRUCRURALLY
UPPER RESPIRATORY SYSTEM
the nose, pharynx, and associated structur
LOWER RESPIRATORY SYSTEM
the larynx, trachea, bronchi and lung
FUNCTIONALLY
THE CONDUCTING ZONE
the nose, pharynx, larynx, trachea, bronchi,
bronchioles, and terminal bronchioles,.
that filter, warm, and moisten air
THE RESPIRATORY ZONE
the respiratory bronchioles, alveolar ducts, alveolar sacs
and alveoli,
the main sites of gas exchange.

NOSE
THE NASAL CAVITIES
RIGHT N.C.
LEFT N.C.

THE FUNCTIONS OF THE NOSE AND NASAL

CAVITIES

OLFACTION.
RESPIRATION.
FILTRATION OF DUST.
HUMIDIFICATION OF INSPIRED AIR.
RECEPTION AND ELIMINATION OF SECRETION
FROM PARANASAL SINUSES AND NASOLACRIMAL
DUCT.

THE BONY PART OF THE NOSE

NASAL BONES.
FRONTAL PROCESSES OF THE
MAXILLAE.
NASAL PART OF THE FRONTAL BONE
AND ITS NASAL SPINE.
BONY PART OF THE NASAL SEPTUM.

THE CARTILAGINOUS PART

TWO LATERAL CARTILAGES.

TWO ALAR CARTILAGES.
A SEPTAL CARTILAGE.

THE NASAL SEPTUM

THE PERPENDICULAR PLATE OF THE
ETHMOID.
THE VOMER.
THE SEPTAL CARTILAGE.
THE NASAL CREST OF THE MAXILLARY.
THE NASAL CREST OF THE PALATINE.

NASAL CAVITIES
THE NARES.
THE CHOANAE.
MUCOSA LINES THE NASAL CAVITIES,
EXCEPT THE NASAL VESTIBULE WHICH
IS LINED WITH SKIN.
COMMUNICATE WITH :

THE NASOPHARYNX.
THE PARANASAL SINUS.
THE LACRIMAL SAC AND CONJUNCTIVA.

THE NASAL MUCOSA

CONSIST OF
THE RESPIRATORY AREA - inferior 2/3 rd.
THE OLFACTORY AREA
- superior 1/3 rd.

THE BOUNDARIES
THE ROOF.
THE FLOOR.
THE MEDIAL WALL.
THE LATERAL WALL.

THE NASAL CAVITY

ROOF
FRONTONASAL PART.
ETHMOIDAL PART.
SPHENOIDAL PART.

FLOOR
THE PALATINE PROCESS OF THE MAXILLA.
THE HORIZONTAL PLATE OF THE PALATINE
BONE.

THE NASAL CAVITY

THE MEDIAL WALL
THE NASAL SEPTUM.

THE LATERAL WALL

NASAL CONCHAE
SUPERIOR.
MIDDLE.
INFERIOR

THE NASAL CAVITY

SPHENOETHMOIDAL RECESS.
SUPERIOR MEATUS.
MIDDLE MEATUS.
INFERIOR MEATUS.
COMMON NASAL MEATUS.

THE ARTERIAL SUPPLY OF THE

MEDIAL AND LATERAL WALL OF
THE NASAL CAVITY

ANTERIOR ETHMOIDAL A.
POSTERIOR ETHMOIDAL A.
SPHENO PALATINE A.
GREATER PALATINE A.
SEPTAL BRANCH OF THE SUPERIOR
LABIAL A. ( FROM THE FACIAL A. )

KIESSELBACH AREA
ANTERIOR PART OF THE NASAL
SEPTUM.
AN AREA RICH IN CAPILLARIES WHERE
ALL FIVE ARTERIES SUPPLYING THE
SEPTUM ANASTOMOSE.

THE VENOUS DRAINAGE

RICH PLEXUS OF VEIN DEEP TO
NASAL MUCOSA
SPHENOPALATINE V.
FACIAL V.
OPHTHALMIC V.

THE NERVE SUPPLY OF THE

NASAl MUCOSA
POSTEROINFERIOR TO 2/3
THE MAXILLARY N. ( C.N. V2 ).- CHIEFLY.
THE NASOPALATINE N. NASAL SEPTUM.
POSTERIOR LATERAL BRANCHES OF THE
GREATER PALATINE N. LATERAL WALL

THE ANTEROSUPERIOR PART

THE ANTERIOR ETHMOIDAL N. BRANCHES
OF THE NASOCILIARY N. ( C.N.V1 ).

PARANASAL SINUSES
AIR-FILLED EXTENSION OF THE
RESPIRATORY PART OF THE NASAL
CAVITY IN TO THE FOLLOWING CRANIAL
BONES
FRONTAL BONE.
SPHENOID BONE.
ETHMOID BONE.
MAXILLARY BONE.

FRONTAL SINUS
POSTERIOR TO THE SUPERCILIARY
ARCHES AND THE ROOT OF THE NOSE
EACH SINUS DRAINS FRONTO NASAL
DUCT INFUNDIBULUM SEMILUNAR
HIATUS OF THE MIDDLE MEATUS.
INNERVATED BY BRANCHES OF THE
SUPRAORBITAL N. ( C.N. V1 ).

ETHMOIDAL SINUS
LOCATED IN THE LATERAL MASS OF THE ETHMOID
BETWEEN THE NASAL CAVITY AND ORBIT.
THE ANTERIOR ETHMOIDAL CELLS DRAINS DIRECTLY
OR INDIRECTLY IN FUNDIBULUM MIDDLE MEATUS.
THE MIDDLE ETHMOIDAL CELLS OPEN DIRECTLY IN
TO THE MIDDLE MEATUS.
THE POSTERIOR ETHMOIDAL CELLS OPEN DIRECTLY
IN TO THE SUPERIOR MEATUS.
INNERVATED BY ANTERIOR AND POSTERIOR
ETHMOIDAL BRANCHES OF THE NASOCILIARY N.
( C.N. V1).

SPHENOIDAL SINUS
OCCUPY THE BODY OF THE SPHENOID, MAY EXTEND
IN THE WING.
ONLY THIN PLATES OF BONE SEPARA YE THE
SINUSES FROM SEVERAL IMPORTANT STRUCTURE;
THE OPTIC N AND OPTIC CHIASM, THE PITUITARY
GLAND, INTERNAL CAROTED A. AND CAVERNOUS
SINUSES.
SEVERAL POSTERIOR ETHMOIDAL CELLS INVADE
THE SPHENOID, GIVING RISE TO MUL TIPLE
SPHENOIDAL SINUSES THAT OPEN SEPARATELY IN
TO THE SPHENOIDAL RECESS.
THE POSTERIOR ETHMOIDAL A. AND N. SUPPLY
SPHENOID SINUS.

THE MAXILLARY SINUSES

THE APEX OF THE SINUS EXTENDS TOWARD
AND OFTEN IN TO THE ZYGOMATIC BONE.
THE BASE OF THE SINUS FORM THE
INFERIOR PART OF THE LATERAL WALL OF
THE NASAL CAVITY.
THE ROOF IS FORMED BY THE FLOOR OF THE
ORBIT.
THE FLOOR IS FORMED BY THE ALVEOLAR
PART OF THE MAXILLA.
EACH SINUS DRAIN BY AN OPENING THE
MAXILLARY OSTIUM IN TO MIDDLE MEATUS

THE MAXILLARY SINUS

ARTERIAL SUPPLY
MAINLY FROM SUPERIOR ALVEOLAR
BRANCHES OF THE MAXILLARY A.
THE GREATER PALATINE A FLOOR.

INNERVATION
THE ANTERIOR, MIDDLE AND POSTERIOR
SUPERIOR ALVEOLAR N., BRANCHES OF
THE MAXILLARY N. ( C.N. V2 ).

PHARYNX
THE PART OF THE ALIMENTARY CANAL
POSTERIOR TO THE NASAL AND ORAL CAVITY.
EXTENDS FROM THE BASE OF THE CRANIUM
TO THE INFERIOR BORDER OF THE CRICOID
CARTILAGE ANTERIORLY AND THE INFERIOR
BORDER OF V.C.6 POSTERIORLY.
DIVIDED IN TO

NASOPHARYNX.
OROPHARYNX.
LARYNGOPHARYNX.

NASOPHARYNX
HAS A RESPIRATORY FUNCTION.
LIES SUPERIOR TO THE SOFT PALATE AND IS
THE POSTERIOR EXTENSION OF THE
NASALCAVITY.
THE PHARYNGEAL TONSIL ( ADENOID )
ORIFICE OF THE PHARYNGOTYMPANIC TUBE.
TUBAL TONSIL.
THE SALPINGOPHARYNGEAL FOLD Salpingo
pharyngeal m. opening of the pharyngeal orifice
during swallowing.

OROPHARYNX
DIGESTIVE FUNCTION
BOUNDARIES
ANTERIOR
SOFT PALATE.
BASE OF THE TONGUE.

LATERAL
PALATOGLOSSAL ARCH.
PALATOPHARYNGEAL ARCH.

EXTENDS FROM THE LEVEL OF THE SOFT

PALATE TO THE SUPERIOR BORDER OF THE
EPIGLOTTIS.

DEGLUTION
DEGLUTION , is the complex process that
transfers a food bolus from the mouth
through the pharynx and esophagus in to
the stomach.
STAGE I : voluntary ; the bolus is
compressed against the palate and pushed
from the mouth into the oropharynx, mainly
by ovement of the muscles of the tongue
and soft palate.

DEGLUTION
STAGE 2 : involuntary and rapid ; the soft palate is
elevated, sealing off the nasopharynx from the
oropharynx and laryngopharynx. The pharynx
widens and shortens to receive the bolus of food
as the suprahyoid muscles and longitudinal
pharyngeal muscle contract, elevating the larynx.
STAGE 3 : involuntary ; sequential contraction of
all three muscles forces the food bolus inferiorly
into the esophagus.

THE PALATINE TONSILS

COLLECTION OF LYMPHOID TISSUE ON
EACH SIDE OF THE OROPHARYNX.
LIES IN THE TONSILAR BED, BETWEEN
THE PALATOGLOSSAL AND
PALATOPHARYNGEAL ARCHES.
THE BED IS FORMED BY THE SUPERIOR
CONSTRICTOR OF THE PHARYNX AND
THE PHARYNGOBASILAR FASCIA.

LARYNGOPHARYNX
POSTERIOR TO THE LARYNGEAL INLET AND
THE VESTIBULE AND VENTRICLE OF THE
LARYNX.
EXTENDS FROM THE SUPERIOR BORDE OF
THE EPIGLOTTIS TO THE ESOPHAGU AT THE
LEVEL OF THE INFERIOR BORD DER OF THE
CRICOID CARTILAGE.
POSTERIORLY IS RELATED TO THE BO DIES
OF C4 THROUGH C6 VERTEBRAE.
COMMUNICATES WITH THE LARYNX
THROUGH THE LARYNGEAL INLET

THE NERVE SUPPLY TO THE

PHARYNX
PHARYNGEAL PLEXUS OF NERVE
MOST OF SENSORY AND MOTOR
PHARYNGEAL BRCH OF THE C.N. X - MOTOR.
GLOSSOPHARYNGEAL ( C.N.)
- SNSR.
SYMPATHETIC BRCH FROM THE SUPERIOR
CERVICAL GANGLION.

PHARYNGEAL LYMPHOID
RING

PALATINE TONSIL.
LINGUAL TONSIL.
PHARYNGEAL TONSIL.
TUBAL TONSIL.

RESPIRATORY LAYER OF THE

CERVICAL VISCERA
I.E
LARYNX.
TRACHEA.

MAIN FUNCTION
ROUTING AIR AND FOOD INTO THE
RESPIRATORY TRACT AND ESOPHAGUS.
PROVIDING A PATENT AIR WAY AND A
MEANS OF SEALING IT OFF TEMPORARILY.
PRODUCING VOICE.

LARYNX
LIES IN THE ANTERIOR PART OF THE
NECK AT THE LEVEL OF THE BODIES OF
C3 THROUGH C6 VERTEBRAE.
COMPOSED OF 9 CARTILAGE.
CONTAINING THE VOCAL FOLD.
GUARD THE AIR PASSAGES,
ESPECIALLY DURING SWALLOWING

THE LARYNGEAL SKELETON

THREE CARTILAGE ARE SINGLE
THYROID CARTILAGE.
CRICOID CARTILAGE.
EPIGLOTTIC CARTILAGE.

THREE CARTILAGE ARE PAIRED

ARYTENOID CARTILAGE.
CORNICULATE CARTILAGE.
CUNEIFORM CARTILAGE.

THE LARYNGEAL CAVITY

EXTEND FROM THE LARYNGEAL INLET TO THE LEVEL
OF THE INFERIOR BORDER OF THE CRICOID
CARTILAGE.
DIVIDE INTO 3 PART
LARYNGEAL VESTIBULE

BETWEEN THE LARTNGEAL INLET AND THE VESTIBULAR FOLD.

MIDDLE PART OF THE LARYNGEAL CAVITY

THE CENTRAL CAVITY BETWEEN THE VESTIBULAR AND AND
VOCAL FOLDS.

LARYNGEAL VENTRICLE
RECESSES EXTENDING LATERALLY FROM THE NIDDLE PART OF
THE LARYNGEAL CAVITY BETWEEN FESTIBULAR AND VC FOLD

INFRA GLOTTIC CAVITY

FROM THE FOCAL FOLDS TO THE INFERIOR BORDER TO THE
CRICOID CARTILAGE.

THE VOCAL FOLD

EACH VOCAL FOLD INCLUDES
A VOCAL LIGAMENT
A VOCAL MUSCLES

THE SOURCE OF SOUND THAT COME

FROM THE LARYNX
AS THE MAIN SPHINCTER OF THE
RESPIRATORY TRACT

MUSCLES OF THE LARYNX

THE EXTRINSIC LARYNGEAL MUSCLES
MOVE THE LARYNX AS A WHOLE.
DEPRESSOR
INFRAHYOID M.

ELEVATOR
SUPRAHYOID M.
STYLOPHARYNGEUS M.

THE INTRINSIC LARYNGEAL MUSCLES

MOVE THE LARYNGEAL PARTS.

MAKING THE ALTERATIONS IN THE LENGTH AND
TENSION OF THE VOCAL FOLD ANDS AND IN THE
SIZE AND SHAPE OF THE RIMA GLOTTIDIS

VESSELS OF LARYNX
ARTERIAL SUPPLY
THE INFERIOR LARYNGEAL A.
THE SUPERIOR LARYNGEAL A.

LARYNGEAL VEINS
THE INFERIOR LARYNGEAL V.
THE SUPERIOR LARYNGEAL V.

LYMPHATICS DRAINAGE
SUPERIOR TO THE VOCAL FOLD
ACCOMPANY THE SUPERIOR LARYNGEAL A. SRAINS INTO THE
SUPERIOR DEEP CERVICAL L.N.

INFERIOR TO THE VOCAL FOLD

DRAIN INTO THE PRE TRACHEAL OR PARATRACHEAL L.N. AND
THEN TO INFERIOR DEEP CERVICAL L.N.

NERVES OF THE LARYNX

THE SUPERIOR LARYNGEAL N.
ARISES FROM THE INFERIOR VAGAL
GANGLION
THE INTERNAL LARYNGEAL N.
THE EXTERNAL LARYNGEAL N.

THE INFERIOR LARYNGEAL N.

THE CONTINUATION OF THE RECURRENT
LARYNGEAL N ( A BRANCH OF C.N. X ).
THE ANTERIOR BRANCH.
THE POSTERIOR BRANCH.

TRACHEA
A FIBROCARTILAGINOUS TUBE, IS
SUPPORTED BY INCOMPLETE CARTILA
GINOUS TRACHEAL RING, THE POSTER
IOR GAP IS SPANNED BY THE
INVOLUNTARY TRACHEALIS MUSCLE.
EXTENDS FROM THE LEVEL OF THE V.C
6 THROUGH THE STERNAL ANGLE ( THE
T4-T5 IV DISC )

TRACHEOSTOMY
TRANSVERSE INCISSION OF THE SKIN
THE INFRAHYOID MUSCLES ARE RETRACTED
LATERALLY
THE ISTHMUS OF THE THYROID GLAND IS
EITHER DEVIDED OR RETRACTED
SUPERIORLY
AN OPENING IS MADE BETWEEN THE FIRST
AND SECOND TRACHEAL RING OR THE
SECOND THROUGH 4TH RING
A TRACHEOSTOMY TUBE IS THEN INSERTED
INTO THE TRACHEA AND SECURED

THE TRACHEA AND BRONCHI

THE TRACHEA BIFURCATES AT THE LEVEL OF
THE TRANSVERSE THORACIC PLANE INTO
RIGH MAIN ( PRIMARY ) BRONCHUS
THREE LOBAR ( SECONDARY ) BRONCHI
SEGMENTAL ( TERTIARY ) BRONCHI
BRONCHOPULMONARY SEGMEN.

LEFT MAIN ( PRIMARY ) BRONCHUS

TWO LOBAR ( SECONDARY ) BRONCHI
SEGMENTAL ( TERTIARY ) BRONCHI
BRONCHOPULMONARY SEGMEN.

TRACHEOBRONCHIAL TREE

SEVERAL CHANGES IN THE

BRONCHIAL TREE
THE MUCOUS MEMBRANE
- PSEUDOSTRATIFIED CILIATED
COLUMNAR EPITHELIUM
- primary bronchus
- secondary bronchus
- tertiary bronchus
- CILIATED SIMPLE COLUMNAR EPITHELIUM WITH SOME GOBLET CELLS
- large bronchioles
- MOSTLY CILIATED SIMPLE CUBOIDAL EPITHELIUM
WTH NO GOBLET CELLS
- smaller bronchioles.
- MOSTLY NON CILIATED SIMPLE CUBOIDAL EPITHELIUM
- termial bronchioles

SEVERAL CHANGES IN THE

BRONCHIAL TREE
PLATES OF CARTILAGE GRADUALLY REPLACE
- INCOMPLETE RING OF CARTILAGE
- primary bronchus
- DISAPPEAR
- distal bronchioles
THE AMOUNT OF CARTILAGE DECREASES,
THE AMOUNT OF SMOOTH MUSCLE
INCREASES.
SMOOTH MUSCLE ENCIRCLES THE LUMEN IN
SPIRAL BANDS

BRONCHOPULMONARY SEGMEN

BRONCHOPULMONARY SEGMEN

PYRAMIDAL-SHAPE SEGMEN OF THE LUNG.

THE LARGEST SUBDIVISION OF THE LUNG.
SEPARATED FROM ADJACENT SEGMEN TS BY
CONNECTIVE TISSUE SEPTA.
SUPPLIED INDEPENDENTLY BY A SEGM ENTAL
BRONCHUS AND A TERTIARY BRANCH OF THE
PULMONARY ARTERY.
NAMED ACCORDING TO THE SEGMENTAL BRONCHI
SUPPLYING THEM.
DRAINED BY INTERSEGMENTAL PARTS OF THE
PULMONARY VEINS
SURGICALLY RESECTABLE.
USUALLY 10 IN THE RIGHT LUNG , 8 10 IN THE LEFT
LUNG.

ALVEOLI
THE WALLOF ALVEOLI
- TWO TYPES OF ALVEOLAR EPITHELIAL
CELLS
- TYPE I ALVEOLAR CELLS
- simple squmous epithelial
- the main sites of gas exchange
- TYPE II ALVEOLAR CELLS
- between type I cells
- containing microvilli
- secrete alveolar fluid . Surfactans
- keep the surface between cells and the air moist
* ALVEOLAR MACROPHAGE ( DUST CELLS )
- ELASTIC BASEMENT MEMBRANE

THE RESPIRATORY MEMBRANE

THE ALVEOLAR WALL
- type I alveolar cells.
- type II alveolar cells.
- alveolar macrophages
AN EPITHELIAL BASEMENT MEMBRANE
- underlying the alveolar wall.
A CAPILLARY BASEMENT MEMBRANE
- often fused to the epithelial basement membrane
THE CAPILLARY ENDOTHELIUM

VASULATURE OF THE LUNG

AND PLEURAE
PULMONARY ARTERY.
PULMONARY VEINS.
BRONCHIAL ARTERIES
-Two left bronchial arteries thoracic aorta
-Single right bronchial artery.
Most commonly from proximal part of one of
the upper posterior intercostal arteries, or
from the common trunk with the left superior
bronchial artery
VENTILATION-PERFUSION COUPLING

VASCULATUREOF THELUNG
BRONCHIAL VEINS
- Right bronchial vein --- azygos vein
- Left bronchial vein --- accessory hemi
azygos vein, or
left superior inter
costal vein.
- Receive some blood from esophageal veins

PULMONARY LYMPHATIC
PLEXUSES
SUPERFICIAL LYMPHATIC PLEXUS
- Lie deep to the visceral pleura
- Drain into the bronchopulmonary lymp nod
DEEP LYMPHATIC PLXUS
- In the submucosa of the bronchi and in the
peribronchial connective tissue.
- Drain initially to the pulmonary lymph node
along the lobar bronchi
Lymph from the superficial and deep lymphatic plecuses
Drain in to the superior and inferior tracheobronchial lymph
Nodes, than to the right and left bronchomediastinal lymph
Trunk, than to the venoun angle

NERVES OF THE LUNG AND

PLEURAE
PULMONAY PLEXUSES ANTERIOR AND
POSTERIOR.
N. VAGUS
- Cell bodies of post synaptic parasympa
thetic neuron are in the pulmonry plexuses
and along the branches of the bronchial
tree.
SYMPATHETIC TRUNKS
- cell bodies of post synaptic sympathetic neuron
are inthe paravertebral sympathetic ganglia.

NERVES OF THE LUNG AND

PLEURAE
N. VAGUS
- Motor to the smooth muscle of the
bronchial tree ( broncho constrictor ).
- Inhibitory the pulmonry vessels ( vasodiltr )
- Secretory to the glands of the bronchial
tree ( secretomotor )

REFLEXIVE VISCERAL AFFERENT

FIBERS OF CN X
Bronchial mucosa, probanly in association
with tactile sensation for cough reflexes.
Bronchial muscles, possibly involved in
strectch receptions.
Interalveolar connective tissue, in associatio
with Hering Breuer reflexes.
Pulmonary arteries serving pressor receptors.
Pulmonary veins, serving chemoreceptors

NERVES OF THE LUNG

Visceral afferent fibers mediating nociceptive
impulses from the visceral pleura and bronchi
accompany the sympathetic fibers.whereas those
from the trachea accompany the parasympathetic
fbr
The sympathetic fibers are inhibitory to the
bronchial muscle ( bronchodilator ), motor to the
pulmonary vessels ( vasoconstrictor ), and
inhibitory to the alveolar glands of the bronchial
tree type 2 secretory epithelial cells of the alveoli

NERVES OF THE LUNG

The nerves of the parietal peura derived
from the intercostal and phrenic nerves.
The costal pleura and the peripheral part of
the diaphragmatic pleura are suppliied by
theintercostal nerves.
The central part of the diaphragmatic pleura
and the mediatinal pleura are supplied by
the phrenic nerves.

NERVES OF THE LUNG AND

PLEURAE
Deived from the pulmonary plexuses anterior and ( mainly )
posterior to the root of the lung.
Parasympathetic fibers from the CN X.
Cells bodies of postsynaptic neurons are in the pulmonary
plexuses and along the branches of the bronchial tree.
Parasympathetic are motor to the smoth muscle of the
bronchial tree ( bronchoconstrictor ), inhibitory to the
pulmonary vessels ( vasodilator ), and secretory to the
glands of bronchial tree ( secretomotor )
Reflexive visceral afferent fibers of CN X

REFLEXIVE VISCERAL
AFFERENT FIBERS OF CNX

Bronchial mucosa ( tactile receptor- cough )

Bronchial muscles ( stretch receptors )
Interalveolar connective tissue ( H.Breuer )
Pulmonary arteries ( pressor receptors )
Pulmonary veins ( chemoreceptors )

NERVES OF THE LUNGS AND

PLEURAE
Cell bodies of postsynaptic sympathetic
neurons,are in the paravertebral sympathetic
ganglia of the sympathetic trunks.
The sympathetic fibers are inhibitory to the
bronchial muscle ( bronchodilator ), motor to
the pulmonary vessels ( vasoconstrictor ),
and inhibitory to the alveolar glands of the
bronchial tree type II secretory epithelial
cells of the alveoli

INNERVATION OF THE PLEURA

AND DIAPHRAGM
The parietal pleura derive from the intercostal and
phrenic nerves.
The costal pleura and the peripheral part of the
diaphragmatic pleura are supplied by the intercostal
nerves.
The central part of the diaphragmatic pleura and the
mediastinal pleura are supplied by the phrenic nerves.
Visceral afferent fibers mediating nociceptive impulses
from the visceral pleura and bronchi accompany the
sympathetic fibers, where those from the trachea
accompany the parasympathetic fibers of the CN X.