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the respiratory system {3 Nov 2011_
Je sLarL wlLh Lhe resplraLory sysLem elLher you have covered Lhe resplraLory sysLem ln Lhe
anaLomy ok so leL's lnLegraLe lnformaLlon LhaL you already know ln anaLomy wlLh whaL's happenlng
ln hlsLology So resplraLory sysLem ls a sysLem LhaL ls responslble for exchange of gases off course lL
goL someLhlng Lo do wlLh vo|ce product|on LhaL's anoLher funcLlon Lhe Lhlrd funcLlon ls ac|d base
ba|ance SomeLlmes excret|on of cerLaln maLerlal occurs vla Lhe lungs Je mlghL ask whaL could be
excreLed MeLabollsm of alcohol many of Lhese slde producLs are released vla Lhe lungs Je can
check lf someone ls drunk or noL Je ask hlm Lo breaLhe ouL Je can smell alcohol from hls exhaled
breaLhlng 1haL's how we use Lo check ouL drunken people when we work ln forenslc medlclne
8lghL
So Lhese are Lhe baslc funcLlon gases exchange producLlon of volce malnLenance of acld
base balance and excreLlon of cerLaln end producLs now resplraLory sysLem as you have Laken ln
anaLomy ls dlvlded lnLo 2 maln porLlons LhaL ls anaLomlcally Lhe upper resplraLory sysLem or Lhe
|ower resplraLory sysLem and funcLlonally as whaL? As Lhe conduct|ve porLlon of Lhe resplraLory
sysLem and Lhe resp|ratory porLlon
now whaL l wanL you Lo Lhlnk abouL Lhe resplraLory passage ls a Lube lL sLarLs aL Lhe
exLernal nares nose nasopharynx larynx Lrachea 2 maln bronchl 1he dlvlslon of Lhe bronchl
from maln Lo secondary from secondary Lo LerLlary and Lhen flnally Lhe Lermlnal bronchlole AfLer
LhaL we have Lhe regular/resplraLory bronchlole 8lghL? Jhere we end up aL Lhe alveoll slLes Ck
6oyylb!
1hlnk abouL lL Lhls way when we breaLhe we breaLhe exLernal alr 1he exLernal alr ls
polluLed wlLh dlfferenL polluLanLs 1he exLernal alr ls noL ln proper LemperaLure lL could be hoL lL
could be cold 8lghL? lL needs Lo be humldlfled So Lhere are cerLaln processes LhaL have Lo Lake
place before Lhe alr reach Lhe acLual exchange slLe 1here you have Lo fllLer Lhe alr geL rld of Lhe
polluLanLs you have Lo humldlfy Lhe alr and you have Lo condlLlon Lhe alr now we expecL Lo flnd
sLrucLures LhaL are responslble for Lhese processes correcL? lllLraLlon sLarLs aL Lhe vesLlbule of Lhe
nose where we have Lhe vlbrlssae or halr rlghL? Ck
1here how dld we descrlbed resplraLory eplLhellum before? Je sald lL ls whaL?
seudosLraLlfled clllaLed eplLhellum correcL? Je sald Lhe funcLlon of cllla ls whaL? 1o move
whaLever secreLlon on Lhe surface Ck 1haL was quesLlon of Lhe exam Je have gobleL cell lL ls a
unlcellular gland LhaL produces mucous 1haL's anoLher exam quesLlon1he mucous acLs as whaL? As
a magneL Lo caLch up dusLs parLlcles/polluLanLs rlghL? So Lhe vlbrlssae/halr we have Lhe gobleL cell
LhaL secreLe mucous Je have Lhe cllla Ck now Lhls ls Lhe llnlng of Lhe Lube LhaL would be llnlng
eplLhellum or mucosa now Lhe oLher porLlon of Lhe Lube as we sLarL wlLh resplraLory sysLem we
move down Lo Lhe area where we have larynx Lrachea and so on you have sLudled LhaL and we
have seen LhaL Lhe Lrachea ls made of rlngs of hyallne carLllage noL flbrocarLllage as l have seen ln
one of your noLes ln anaLomy
AlrlghL hyallne carLllage Lhey are connecLed vla connecLlve Llssue membrane/llgamenLs
JhaL ls Lhe Lhlrd componenL LhaL forms Lhls sLrucLure of Lhls Lube? So we have Lalked abouL Lhe
llnlng or Lhe mucosa whlch ls Lhe llnlng surface eplLhellum Lhen we Lalked abouL proLecLlve layer
LhaL ls Lhe carLllage alrlghL?? 1he carLllage aL Lhe level of Lhe Lrachea lL's made of r|ng carLllages
wlLh Lhe open parL of C faclng posLerlorly/backward because lL has Lo accommodaLe Lhe esophagus
as Lhe esophagus ls behlnd Lrachea As we move down Lo Lhe maln bronchl Lhey are compleLe rlng
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So whaL ls Lhe funcLlon of Lhls rlng of carLllage ls cerLalnly protect|on Lo malnLaln Lhe Lube because
Lhe Lube ls open lf we have proLecLlon lL ls Lo malnLaln Lhe Lube
AlrlghL as Lhe bronchlal Lree moves ln lnLo Lhe Lhoraclc cavlLy whlch ls proLecLed exLernally
by Lhe Lhoraclc cage rlbs lnLercosLal muscle and so on So as lL peneLraLes deeper we don'L need
Lhls proLecLlon Lo conLlnue AlrlghL so Lhe carLllage componenLs wlll sLarL Lo decrease JhaL ls Lhe
Lhlrd componenL? SmooLh muscle JhaL ls Lhe funcLlon of smooLh muscle Agaln Lhe same funcLlon
as we Lalked abouL ln cardlovascular sysLem we sald vasodllaLlon and vasoconsLrlcLlon LhaL wlll alLer
Lhe dlameLer of Lhe blood vessel Lo regulaLe blood pressure ln resplraLory sysLem we have also
vasodllaLlon and vasoconsLrlcLlon of Lhese smooLh muscles Lo regulaLe Lhe dlameLer of Lhe Lermlnal
bronchloles lf Lhere ls any defecLs ln Lhe smooLh muscle Lhere wlll be a dlsease called asLhma Je'll
glve Lhe paLlenL asLhma lnhaler LhaL conLalns bronchodllaLor Lo dllaLe Lhe bronchl AlrlghL ok!
now one flnal polnL before l move lnLo Lhe deLalls aL Lhe resplraLory slLes do we need any
carLllage? no! CerLalnly we don'L have any carLllage aL Lhe resplraLory slLe rlghL? Ck! uo we need
any smooLh muscle? no! uo we need gobleL cells? CerLalnly noL we don'L need Lhese cells Any fluld
presenLs ln Lhe lungs ls paLhologlcal aL Lhe level of alveoll Je don'L need any fluld so Lhere ls no
need Lo secreLe any mucous aL LhaL slLe/Llme because afLer all Lhe mucous have goL a cerLaln llquld
conLenL
Ck! AL Lhe level of alveoll of gaseous exchange we have Laken Lhls ln Lhe eplLhellum we sald
Lhe eplLhellum ls whaL Lype? Slmple squamous eplLhellum rlghL? 1he alveoll are made of slmple
squamous eplLhellum alveoll cells 1he caplllarles LhaL are ad[olnlng Lhose alveoll agaln Lhey are
llned by whaL? Slmple squamous eplLhellum! So l wanL you Lo undersLand LhaL Lhese Lhree
componenLs LhaL make up Lhe wall of Lhe Lube of Lhe resplraLory passage wlll modlfy and wlll
gradually undergo LranslLlon so LhaL Lhe clllaLed pseudosLraLlfled eplLhellum flnally wlll be slmple
squamous eplLhellum 1he carLllage gradually wlll decrease and when we reach Lhe level of Lhe
Lermlnal bronchlole we don'L need any carLllage So we have a gradual LranslLlon ln Lhose sLrucLures
alrlghL!
Ck now leL's move on wlLh Lhe deLalls So we sald LhaL Lhe llnlng eplLhellum ls sLraLlfled
squamous eplLhellum clllaLed sLraLlfled squamous eplLhellum AL Lhe exLernal ***** (we couldn'L
hear Lhe word buL maybe lL ls 'nares' buL lL seems unloglcal) we have keraLln so lL become
pseudosLraLlfled clllaLed eplLhellum now ln Lhe pharynx (Lhe pharynx whlch ls consldered as a parL
of Lhe Cl sysLem and anoLher parL of Lhe resplraLory sysLem) Lhe parL where Lhe nose open opposlLe
Lhe pharynx we call lL nasopharynx and Lhe parL opposlLe Lhe mouLh we call lL oropharynx (oro oral
cavlLy) Ck agaln Lhe Lype of eplLhellum wlll be resplraLory Lype of eplLhellum LhaL ls clllaLed
sLraLlfled eplLhellum
now aL Lhe enLrance of Lhls pharynx we have lymphold Llssue accumulaLlon or aggregaLlon
ln Lhe form of organ llke Lhe Lonslls [usL llke ln Lhe gasLrolnLesLlnal sysLem AlrlghL now lymphold
Llssue aggregaLe ls presenLs ln dlfferenL sysLem of Lhe body and Lhe purpose of LhaL [usL remember
one slmple senLence ls LhaL lL's Lhe slLe for maLuraLlon of lymphocyLes and Lhey are presenL ln Lhe
walls of vlsceral body llke Cl sysLem resplraLory sysLem eLc eLc Lhelr purpose and Lhelr funcLlon ls
lmmune funcLlon
AL Lhe nose cavlLy we have Lhe olfacLory reglon LhaL ls Lhe smell area ln Lhe upper parL of
Lhe rooL of Lhe nose LhaL ls medlaLed by Lhe o|factory nerve whlch ls consldered as Lhe f|rst cran|a|
nerve ?ou know whaL ls cranlal nerve?? A cranlal nerve ls Lhe nerve LhaL Lhe neurons are lnslde Lhe
braln and Lhe axons LermlnaLe aL Lhe LargeL organs now aL LhaL slLe we have cerLaln modlflcaLlon
LhaL cllla are very shorL and Lhey are noL vlslble and gobleL cells are absenL Je asked lL ln Lhe
quesLlon (and docLor sald LhaL Lhe second exam quesLlons wlll be very dlfflculL) So gobleL cells are
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absenL and Lhe cllla are absenL aL Lhe slLe where we have eplLhellum coverlng Lhe olfacLory area ln
Lhe nose Ck we don'L need Lo go lnLo Loo much deLall abouL lL

1hese are Lhe *cavlLy* parL of Lhe nose (llgure 1) we have Lhe bony parL we have Lhe llnlng
eplLhellum bone and bowman's gland

I|gure 1
AlrlghL leL's move on Lo Lhe larynx ln Lhe larynx you've Laken ln anaLomy LhaL we have vocal
cord Lrue and false vocal cord JhaL happen? 1hese vocal cords vlbraLe and move when Lhey are
pulled by muscle whlch aLLach Lo Lhe carLllages 8egardless whaL l wanL you Lo know here abouL Lhe
larynx ln Lhe larynx we have whaL we call volce box LhaL ls Lhe slLe of producLlon of vlbraLlon 1he
vlbraLlon occurred by vocal cords Je have vocal cords Lhe vocal cords are connecLed Lo carLllages
and Lhe carLllages are moved by muscle So lL's a cord llke a gulLar when you hlL LhaL cord lL wlll
produce vlbraLlons and Lhose vlbraLlons are evenLually Lhey are LranslaLed lnLo language by Lhe
movemenL of Lhe Longue and Lhe llps and so on 1he resonance of your volce flrsLly Lhe clearance of
Lhe cord secondly ln Lhe skull we have cerLaln spaces we call Lhem slnuses !ubanLerlor(lL wasn'L
clearwe cannoL hear Lhe word) 1hey are spaces wlLhln Lhe skull bone LhaL Lhey are fllled wlLh alr So
Lhese vlbraLlons are magnlfled and Lhey are glvlng Lhe resonance wlLhln Lhose spaces lf you brlng a
drum and flll up Lhe drum wlLh any sLuff or cloLhes or someLhlng you hlL Lhe drum you see LhaL Lhe
nolse ls dumb/dull 8emove Lhose Lhlngs hlL lL back lL wlll be resonance 1haL ls exacLly whaL
happen alrlghL?? So whaL l wanL you Lo know ls Lhe vocal cords are Lhe llgamenLs LhaL are presenL
wlLhln Lhe larynx Lhelr vlbraLlon produce nolse LhaL ls LranslaLed lnLo speech by Lhe movemenL of
Longue and llps eLc
Ck now Lhls area as ln oLher area lL ls covered by eplLhellum Loglcally Lhe llnlng
eplLhellum Lo Lhe vocal cords should lL be pseudosLraLlfled clllaLed eplLhellum?? CerLalnly no!!
because lL need Lhe producLlve Lype of eplLhellum ?ou need a producLlve Lype of eplLhellum aL LhaL
slLe So Lhe eplLhellum aL LhaL slLe wlll be sLraLlfled squamous eplLhellum alrlghL!! And LhaL ls Lhe
slLe where you could call lL squamous meLaplasla JhaL ls meLaplasla ln paLhology?? ModlflcaLlon
LhaL occur ln Lhe body where Lhe Lype of eplLhellum aL LhaL area ls sulLable Lo LhaL condlLlon
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uocLor shows Lhe plcLure (llgure 2) 1hls ls from Lrachea 1he llnlng of eplLhellum
pseudosLraLlfled clllaLed and Lhe llne of lamlna propla LhaL ls connecLlve Llssue 1hen we have Lhe
carLllage Lhe carLllage ls Lyplcally hyallne carLllage ?ou can see blulsh gel llke maLrlx lacunae and
wlLhln Lhe lacunae we have Lhe chondrocyLes So Lhls ls Lhe Lyplcal sLrucLure of Lhe Lube aL Lhe level
of Lrachea


I|gure
AlrlghL Lhe Lrachea we have Lhe maln bronchl secondary LerLlary and Lhese are Lhe
bronchopulmonary segmenLs (llgure 3) Je have 10 ln Lhe rlghL and ln Lhe lefL we have 9 segmenLs
8ecause ln Lhe rlghL lung we know LhaL lL ls larger Lhan lefL lung 8lghL lung has Lhree lobes Lhe lefL
lung has Lwo lobes So Lhe Lermlnal bronchopulmonary segmenLs afLer Lhe class lm noL gonna ask
you Lhls quesLlon Lhls ls anaLomlcal
now leL's move on So flnally we have Lhe regular bronchlole and we have Lhe alveoll and
along wlLh Lhe dlvlslon of Lhls bronchlole Lree we have Lhe vascular Lree ls dlvldlng also So
evenLually when you have aL Lhe level of alveoll you have evenLually caplllarles AlrlghL ok now as l
glve you an example earller Lhls ls one of Lhe regular bronchlole ?ou see Lhe few smooLh muscles
over here and Lhere no carLllages and Lhe eplLhellum lf l look aL hlgher magnlflcaLlon Lhere wlll be
as l sald gradual LranslLlon from pseudosLraLlfled clllaLed eplLhellum lL wlll be clllaLed columnar
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eplLhellum as gobleL cells wlll decrease 1hls clllaLed columnar eplLhellum wlll become clllaLed
cuboldal eplLhellum and Lhen lL wlll become [usL slmple cuboldal eplLhellum Lhen lL wlll become
slmple squamous eplLhellum LhaL ls where lL reaches Lhe level of Lhe alveoll So l wanL you Lo
undersLand LhaL Lhere ls a gradual LranslLlon ln Lhls Lype of eplLhellum from pseudosLraLlfled clllaLed
eplLhellum Llll lL reaches Lhe level of slmple squamous eplLhellum aL Lhe level of alveoll Clear??
AlrlghL Lhe carLllages componenL Lhe flnal porLlon ln Lhe bronchlole Lree Jhere do you expecL
Lo flnd carLllages because carLllages we sald LhaL aL Lhe level of Lrachea Lhey are Crlng carLllage
1hen we move on Lo Lhe maln bronchl Lhey are compleLe rlng carLllage and secondary also compleLe
rlng carLllage As we reach Lhe LerLlary level of Lhe bronchlole Lree Lhese carLllages rlng wlll sLarL
breaklng down lnLo small pleces So you see over here Lhls ls Lhe lumen and here a plece of
carLllage under Lhe mlcroscope you wlll noL see a compleLe or large [unk plece of carLllage ?ou wlll
see [usL small plaLe of carLllage Jhere LhaL occurred? AL Lhe level of LerLlary bronchlole AlrlghL? AL
Lhe level of LerLlary bronchl we have Lhe carLllage as small plaLes of carLllage we don'L have a
compleLe or a large [unk plece of carLllage Je ask LhaL ln Lhe exam!!
C AL whlch level you expecL Lo flnd Lhe carLllage componenL ls broken lnLo small plaLes??
A aL Lhe level of LerLlary bronchlole
Ck now Lhls ls a larger magnlflcaLlon and lf l Lake a look aL Lhe deLall Lype of eplLhellum and
l'll move along and ln facL ln hlsLology you'll see Lhe acLual LranslLlon from clllaLed Lype of
eplLhellum columnar Lo clllaLed cuboldal Lo slmple squamous eplLhellum AlrlghL whaL l wanL you Lo
undersLand aL Lhls Lermlnal bronchlole we need whaL? SmooLh muscles! Je don'L need cllla AlrlghL
leL me ask you Lhls quesLlon cllla ls supposed Lo llfL up Lhe secreLlons on Lhe surface 8lghL? and
gobleL cells secreLe Lhe mucous 8lghL? 1he mucous acLs llke whaL? A magneL So whlch one should
LermlnaLe flrsL? ls lL Lhe cllla or gobleL cells? Jhlch one should LermlnaLe flrsL? CobleL cells or cllla
down Lhe resplraLory? Je have a bronchlal Lree down lL ls an lnverLed Lree l sald gobleL cells
produce mucous 1he mucous naLurally lL wlll gravlLaLe down accordlng Lo gravlLy rlghL? 1he cllla ls
supposed Lo plck up Lhe mucous So whlch one should LermlnaLe flrsL? Gob|et ce||s! So gobleL cells
LermlnaLe aL hlgher level

I|gure
now you see here Lermlnal bronchlole 1hls Lermlnal bronchlole wlll evenLually open up
Je're looklng aL a 3 dlmenslonal sLrucLure lL wlll open up 1he slLe where lL opens up and end up
wlLh Lhe formaLlon of Lhe alveoll 1haL slLe lL ls llke a corrldor lL ls called Lhe alveolar ducL (llgure 4
Lermlnal bronchlole alveolar ducL alveoll) So somewhere here was Lhe regular bronchlole whlch
l have shown you before So Lhls ls here somewhere So lL opens up lnLo a passage 1hls passage we
call lL alveolar ducL and evenLually Lhe alveolar ducL ls surrounded by Lhese Lermlnal chambers whlch
we call Lhem alveoll undersLand?
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now whaL ls Lhe wall of Lhe alveoll? JhaL do we call lL? Cr whaL ls lL made of? usually we
say boLh cells are slmple squamous eplLhellum 1he alveoll Lhe wall of alveoll ls made of alveolar
cells or pneumocyLes Lype 1 and Lype 2 1ype 1 consLlLuLes Lhe ma[or porLlon of alveolar cells lf you
were quesLloned whlch ls Lhe ma[or porLlon Lhe answer would be Lype 1 cells 1hey are Lhe
responslble of acLual gaseous exchange Caseous exchange Lakes place beLween Lhe alveolar type 1
cells and Lhe cap|||ar|es Ck Alveolar Lype 2 cells Lhey secreLe a maLerlal we call lL surfacLanL JhaL
are Lhe surfacLanLs? l glve you a slmple example Lhese surfacLanLs lL reduces Lhe surface Lenslon and
l wanL you Lo conslder Lhe alveoll as a balloon when you lnflaLe lL wlLh alr lL swells up and when you
deflaLe lL durlng explraLlon Lhe wall approxlmaLe each oLher AcLually Lhe lnslde of alveoll ls llned by
Lhln llke fllm of waLer subsLance whlch ls surfacLanLs So Lo prevenL Lhe adherence of Lhe wall of
alveoll you need Lhe surfacLanLs 1hese surfacLanLs are produced by alveolar Lype 2 cells And Lhese
alveolar Lype 2 cells are Lhe |atest Lo develop durlng Lhe developmenL of Lhe lungs 1hey develop
durlng Lhe lasL few weeks of pregnancy 1haL ls why lf you have a premaLure dellvery a baby LhaL ls
dellvered earller Lhan Lerm 9 monLhs Lhey keep Lhe baby ln Lhe lncubaLor 1hey have resplraLory
dlsLress syndrome Jhy? 8ecause Lhey have reduce amounL of surfacLanLs 8ecause Lhe alveolar
cells as we sald were noL glven enough Llme Lo develop properly and secreLe Lhe surfacLanLs So Lhe
ma[orlLy Lypes of cells are Lhe Lype 1 1ype 2 cells are Lhe surfacLanL produclng cells 8ecause
alveolar Lype 2 cells are smaller ln slze so wlLhln a cerLaln fleld you'll flnd a larger number of alveolar
Lype 2 Alveolar Lype 1 ls much larger Lhan alveolar Lype 2 1he whole wall of Lhe alveolus could be
made of a slngle alveolar Lype 1 cell JlLhln a cerLaln fleld Lhe number of alveolar Lype 2 ls more
Lhan Lhe alveolar Lype 1 buL Lhe overall number of Lhe alveolar Lype 1 ls much greaLer lL ls Lhe
ma[orlLy Lype lf Lhls phllosophy ls dlfflculL for you Lo undersLand forgeL abouL lL !usL remember Lhe
funcLlon of each one alrlghL? l was Lalklng LhaL because Lhe slzes of alveolar Lype 2 cells are smaller
so wlLhln a cerLaln fleld under Lhe mlcroscope we expecL Lo see more number of alveolar Lype 2 Lhan
alveolar Lype 1 8uL Lhe acLual LoLal number of alveolar Lype 1 ls much greaLer Lhan alveolar Lype 2
cells

I|gure
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now ln pracLlcal lf you were glven Lhls plcLure (llgure 3) you ask me from where for
example lf lL ls from onllne or lf lL ls under Lhe mlcroscope lL's Lhe same Lhlng ?ou asked me how Lo
sLudy? 1hls ls Lhe sllde l wlll rub Lhese words off and Lhen l'll make an arrow over here and l'll ask
you whaL ls Lhls? And you'll Lell me Lhls ls cllla lf l ask abouL Lhls you'll say lL ls clllaLed Lype of
eplLhellum lf l ask abouL Lhls you'll Lell me Lhls ls hyallne carLllage 1haL's lL! lL ls as slmple as LhaL
JheLher lL ls under Lhe mlcroscope or wheLher lL ls onllne Lhe same Lhlng under Lhe mlcroscope
you'll see Lhe same plcLure and onllne you'll see exacLly Lhe same plcLure and Lhere you have an
arrow and here you have an arrow 8lghL? so Lhls ls you Lold me cllla or lf Lhere ls a neL of clrcle over
here Lhe whole Lhlckness you'll Lell me Lhls ls clllaLed Lype of resplraLory eplLhellum 1hls ls hyallne
carLllage lf l ask you Lo ldenLlfy Lhls organ you'll Lell me Lhls ls a Lrachea 8lghL? lf you see a compleLe
rlng a Lube wlLh a compleLe rlng llke LhaL you'll Lell me Lhls ls whaL? rlmary or maln bronchl!

I|gure
LeL me move on Lo Lhe oLher Pere lf l show you Lhe sLrucLure ldenLlfy Lhe sLrucLure you Lell
me Lhls ls LerLlary bronchl Jhy? 8ecause we see plaLeleLs of carLllages ln Lhe wall (llgure 6)


I|gure
1hls ls a regular bronchlole Jhy? Je don'L see any carLllage we see smooLh muscle and we
see Lhe resplraLory Lype of eplLhellum(llgure 7)
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I|gure
Pere Lhls ls whaL l Lold you before 1hls ls regular bronchlole Lhls passage ls alveolar ducL
and Lhe lasL parL ls Lhe alveoll(llgure 8)
So lf l brlng a plcLure or under Lhe mlcroscope and Lhey are over here you Lell me Lhls ls
alveolar ducL lf Lhey are over here you Lell me Lhls ls alveolus 8lghL? 1hls plcLure agaln Lhe same
Lhlng you Lell me Lhls ls a regular bronchlole Jhy? no carLllages ln Lhe wall smooLh muscle
resplraLory Lype of eplLhellum Pere agaln alveolar ducL alveoll 1here ls noLhlng else l can ask
AcLually you know Lhe quesLlons ln Lhe pracLlcal ?ou have Lo sLudy Lhem 1haL's lL l'll save Lhls on
Lhe deskLop and l'll send Lhls Lo Lhe elearnlng along wlLh Lhe CvS and nervous sysLem so LhaL you
can sLudy lf you are golng Lo sLudy kol 3am w 2nLo bl3eer! lease Lhose who have cars please drlve
carefully !usL before l came a bus full wlLh medlcal sLudenLs from Lhls college meL an accldenL and
few of Lhem are already dead


Lhe end!
done by my frlend and l
we're sorry for our mlsLakes Lhank you for your supporL kol 3am w 2nLoo bl3eer lnshaAllah!