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Prof.Dr. Koeshartono, SpAn K.IC. PGD.Pall.Med (ECU) Bag / SMF Anestesiologi & Reanimasi ( Kedokteran Gawat Darurat ) FK. Unair - RSU Dr. Soetomo Surabaya
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The airway system an open path that leads atmospheric air through the nose, mouth and bronchi to the alveoli Each breath takes 1,2 liters of air Dead space 250 cc it is not available to the body to be used for oxygenation
The upper airway Nasal cavity pharynx Oral caavity naso, oro, hypo Nasal cavity Warming Humidifying Filtering Below the pharynx Esophagus trachea The next Stomach Lower airway
VI. The first portion of the trachea Larynx which contains The vocal cord & muscles Vestibular fold Arytenoid cartilage Epiglottis acting a gate air into the trachea solids & liquids into the esophagus
Lower airway Right & left main stem bronchus Primary, secondary, tertiary bronchi Broncholes = very small bronchial tubes Alveoli :
Tiny air sacs Surrounded by capillaries Resp. syst meets circ syst. gas exchange occurs
VIII. Physiology
Oxygen moves into the red blood cells from the alveoli They are transferred to the cell on the hemoglobin molecule After leaving the hemoglobin molecule the oxygen travels into the tissue cell Carbondioxide travels in the reverse direction but not on the hemoglobin molecule It travels both in the plasma and in the red blood cell it self as carbondioxide
Gas exchanging process oxygen is exchanged with carbondioxide is known pulmonary diffusion Oxygenated red blood cell deliver their oxygen which the cell then use it, carbondioxide is the released into the blood plasma this process is called celluler perfusion Ventilation is essential for the elimination of carbondioxide The size of each breath = tidal volume
The minute volume If the minute volume should Fall below normal = hypoventilation
X. Trauma Impact Trauma can effect the resp. systs ability in six ways 1. Decreased neurologic function 2. Obstruction of the airway 3. Decreased expansion of the lung 4. Decreased absorption of oxygen across the A-C membrane 5. Decreased blood flow to the alveoli 6. Inability of the air to reach the alveoli
Mechanical airway obstructions Airway Control Manual Mechanical Transtracheal Suctioning Oxygenation & ventilation
Masks Bag Valve Mask (BVM) Manualy triggered (oxygen powered) devices