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Jalan Nafas
Airway Anatomy
Upper airway structures include the:
Mouth Nose
Pharynx
Oropharynx
The lower airway structures include the:
Larynx
Trachea
Bronchi
Bronchioles Alveoli
Lungs
.
Nose
Nasal cavity
Pharynx
Larynx
Trachea
Conducting zone
Transport, cleanse, warm and
humidify incoming air
Not involved in gas exchange
Anatomical Dead Space
Bronchi
Bronchioles
Respiratory bronchioles
Alveolar ducts
Alveoli
Respiratory
zone
Function in gas
exchange
MOUTH
hard palate
soft palate
teeth
tongue
lips
oropharyng
mandible
NOSE
sphenoid
sinus
frontal sinus
Concha superior
Concha medius
Concha inferior
PHARYNG:
- Nasopharyng
- Oropharyng
(throat)
- Laryngopharyng
frontal sinus
sphenoid
sinus
eustachian opening
hard palate
conch
a
nasopharyn
g soft palate
uvula
tongue
tonsilla palatina
oropharyng
epiglottis
laryngopharyng
vocal cord
UPPER
trache
a
LOWER
LARYNG
(VOICE BOX)
- separates pharyng and
trachea
- cartilages, membrane,
ligaments
45 mm long, 35 mm
- 35 mm long, 25 mm
-
FUNCTION
- Patent airway
To act as a switching
Framework of the
Larynx
thyrohyoi
d
ligament
CRICOTHYROTOMY
SELLICKS MANEUVRE
Sellicks
Manuever
Movements of
Vocal Cords
Glottis &
Epiglottis
epiglottis
glottis
TRACHEA
BRONCHIAL TREE
primary bronchus
secondary
bronchus
tertiary
bronchus
bronchiole
terminal
bronchiole
respiratory zone
Respiratory bronchioles,
alveolar ducts, alveolar
sacs
Alveolar sacs
Alveolar sacs
look like
clusters of
grapes
The individual
grapes are
alveoli
Alveoli
air-blood barrier
Respiratory Physiology
Breathing
Two phases
Inspiration: Breathing in
Active process
Passive process
Boyles Law:
Boyles Law
As the size of
closed container
decreases,
pressure inside
is increase
Same number
of molecules
striking a
smaller
surface area
Patm
pleura
parietalis
Pip
Palv
pleural cavity
pleura
visceralis
(attach to the
lung)
alveoli
Lung Tissue
Inspiration
Inspiration
EXPIRATION
EXPIRATION
Pulmonary Ventilation
3 Major Factors
Alveolar surface tension
Compliance
Airway resistance
Compliance
Ratio of volume changes caused by pressure changes V/P
Lung Compliance
Low compliance
To get desired volume there must be higher pressure
High compliance
Low pressure will give high tidal volume
COMPLIANCE (COMPL)
BALLOON
stiff
LOW
COMPLIANCE
Elastis
HIGH
COMPLIANCE
P-V LOOP
EKSPIRATION
Vol
NORMAL
500
500
250
250
LOW
COMPLIANCE
500
HIGH
COMPLIANCE
250
P
0
15
30
PEEP 5
Spontaneus
breathing
15
INSPIRATION
30
15
30
Resistance
Asthma
Inflammation due to infection
Emphysema
AIRWAY RESISTANCE
(RAW)
FLOW =
BRONCHOCONSTRICTION:
HISTAMIN
PRESSURE
RESISTANCE
OBSTRUCTION:
MUCUS / SECRET
AIRWAY
RESISTANCE (RAW)
TOO SMALL
ETT
FLOW =
PRESSURE
RESISTANCE
BRONCHOSPASM
TUMOUR / SECRET
COLLAPSE/ATELECTASIS
Partial Pressure
PCO2=40 mm Hg
Pulmonary vein:PAO2=100
PCO2=40 mm Hg
Exchange of O2 and
CO2
O2 and CO2 Diffuse from areas of
higher partial pressures to areas of
lower partial pressure
V/Q > 1
V/Q < 1
shunt
TERIMA KASIH