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The Trachea

The trachea is a flexible tube that extends from the larynx to the bronchi. It is supported by C-shaped cartilage rings and lined with ciliated pseudostratified columnar epithelium. At the carina, the trachea bifurcates into the two primary bronchi, which enter the lungs and continue branching into smaller bronchioles. Compression or obstruction of the trachea can be relieved through tracheostomy, an opening created between the tracheal rings. Care must be taken to avoid surrounding structures like veins and the esophagus during the procedure.

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65 views16 pages

The Trachea

The trachea is a flexible tube that extends from the larynx to the bronchi. It is supported by C-shaped cartilage rings and lined with ciliated pseudostratified columnar epithelium. At the carina, the trachea bifurcates into the two primary bronchi, which enter the lungs and continue branching into smaller bronchioles. Compression or obstruction of the trachea can be relieved through tracheostomy, an opening created between the tracheal rings. Care must be taken to avoid surrounding structures like veins and the esophagus during the procedure.

Uploaded by

Matende hussein
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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The trachea

Respiratory mucosa
• A layer of pseudostratified ciliated
columnar epithelial cells that secrete
mucus
• Found in nose, sinuses, pharynx, larynx
and trachea
• Mucus can trap contaminants
– Cilia move mucus up towards mouth
Lower Respiratory Tract
• Conducting airways (trachea, bronchi, up
to terminal bronchioles).
• Respiratory portion of the respiratory
system (respiratory bronchioles, alveolar
ducts, and alveoli).
Trachea
• A flexible tube also called windpipe.
• Extends through the mediastinum and lies anterior to
the esophagus and inferior to the larynx.
• Anterior and lateral walls of the trachea supported by 15
to 20 C-shaped tracheal cartilages.
• Cartilage rings reinforce and provide rigidity to the
tracheal wall to ensure that the trachea remains open at
all times
• Posterior part of tube lined by trachealis muscle
• Lined by ciliated pseudostratified columnar
epithelium.
Trachea
• At the level of the sternal angle, the trachea
bifurcates into two smaller tubes, called the
right and left primary bronchi.
• Each primary bronchus projects laterally toward
each lung.
• The most inferior tracheal cartilage separates
the primary bronchi at their origin and forms an
internal ridge called the carina.
relations
• In the neck: Anteriorly: Skin, fascia, isthmus of the
thyroid gland (in front of the second, third, and
fourth rings), inferior thyroid vein, jugular arch,
thyroidea ima artery (if present), and the left
brachiocephalic vein in children, overlapped by the
sternothyroid and sternohyoid muscles
• Posteriorly: Right and left recurrent laryngeal nerves
and the esophagus
• Laterally: Lobes of the thyroid gland and the carotid
sheath and contents
• In the thorax
• The relations of the trachea in the superior mediastinum of the
thorax are as follows:
• Anteriorly: The sternum, the thymus, the left brachiocephalic vein,
the origins of the brachiocephalic and left common carotid
arteries, and the arch of the aorta
• Posteriorly: The esophagus and the left recurrent laryngeal nerve
• Right side: The azygos vein, the right vagus nerve, and the pleura
• Left side: The arch of the aorta, the left common carotid and left
subclavian arteries, the left vagus and left phrenic nerves, and the
pleura
Cont’n

• Nerve Supply of the Trachea


• The sensory nerve supply is from the vagi and the recurrent laryngeal
nerves.

• Blood Supply of the Trachea


• The upper two thirds is supplied by the inferior thyroid arteries and
the lower third is supplied by the bronchial arteries.

• Lymph Drainage of the Trachea


• Into the pretracheal and paratracheal lymph nodes and the deep
cervical nodes
Bronchial tree
• The primary bronchi enter the hilus of each lung
together with the pulmonary vessels, lymphatic vessels,
and nerves.
• Each primary bronchus branches into several
secondary bronchi (or lobar bronchi).
• The left lung has two secondary bronchi.The right lung
has three secondary bronchi.
• They further divide into tertiary bronchi.
• Each tertiary bronchus is called a segmental bronchus
because it supplies a part of the lung called a
bronchopulmonary segment.
Bronchial Tree
• Secondary bronchi tertiary bronchi bronchioles
terminal bronchioles
• with successive branching amount of cartilage decreases and
amount of smooth muscle increases, this allows for variation
in airway diameter
• during exertion and when sympathetic division active 
bronchodilation
• mediators of allergic reactions like histamine 
bronchoconstriction
• epithelium gradually changes from ciliated pseudostratified
columnar epithelium to simple cuboidal epithelium in
terminal bronchioles 
Clinical significancy
• Compression of the Trachea
• A dilatation of the aortic arch (aneurysm) can compress the trachea. With
each cardiac systole the pulsating aneurysm may tug at the trachea and left
bronchus, a clinical sign that can be felt by palpating the trachea in the
suprasternal notch.
• Tracheitis or Bronchitis
• The mucosa lining the trachea is innervated by the recurrent laryngeal nerve
and, in the region of its bifurcation, by the pulmonary plexus. A tracheitis or
bronchitis gives rise to a raw, burning sensation felt deep to the sternum
instead of actual pain.
• Inhaled Foreign Bodies
• Because the right bronchus is the wider and more direct continuation of the
trachea , foreign bodies tend to enter the right instead of the left bronchus.
From there, they usually pass into the middle or lower lobe bronchi.
Cont’n
• Bronchoscopy enables a physician to examine
the interior of the trachea; its bifurcation,
called the carina; and the main bronchi.
• Lodgment of a foreign body in the larynx or
edema of the mucous membrane of the larynx
secondary to infection or trauma may require
immediate relief to prevent asphyxiation. A
method commonly used to relieve complete
obstruction is tracheostomy
TRACHEOSTOMY
• An opening is made in the trachea between
the first and second tracheal rings or through
the second through fourth rings.
ANATOMICAL POSITIONING OF
A TRACHEOSTOMY TUBE
WHAT TO WATCH OUT FOR
• The inferior thyroid veins arise from a venous
plexus on the thyroid gland and descend
anterior to the trachea.
• A small thyroid ima artery is present in
approximately 10% of people; it ascends from
the brachiocephalic trunk or the arch of the
aorta to the isthmus of the thyroid gland.
• The left brachiocephalic vein, jugular venous
arch, and pleurae may be encountered,
particularly in infants and children.
• The thymus covers the inferior part of the
trachea in infants and children.
• The trachea is small, mobile, and soft in
infants, making it easy to cut through its
posterior wall and damage the esophagus.

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