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Transcript of Kuliah Sistem Pernafasan (Dr.yani)
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Respiratory System
Dr.Yani Istadi
Bagian Anatomi
FK Unissula Semarang
R espirat or y I nt r o You may be asking, what is the
Respiratory system? Well, the
Respiratory system is the system
that helps you breath in and out,
so oxygen (02) can be pumpedthrough your body and carbon
dioxide (CO2) can be removed
from the blood stream. You must
remember that the Respiratorysystem is made up of many
different organs.
Learning objective
Organization and Functions of the
Respiratory System
Mechanics of Breathing
Respiratory Diseases
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Human Respiratory System
Nasal Passage
Pharynx
Trachea
Bronchus
Larynx
Bronchioles
Alveoli
Organization and Functions of
the Respiratory System Structural classifications:
upper respiratory tract
lower respiratory tract.
Organization and Functions of
the Respiratory System Functional classifications:
Conducting portion: transports air.
Nose
nasal cavity
Pharynx
Larynx
Trachea
progressively smaller airways, from the primary bronchito the bronchioles
Respiratory portion: carries out gas exchange.
respiratory bronchioles
alveolar ducts
air sacs called alveoli
Upper respiratory tract is all conducting
Lower respiratory tract has both conducting and respiratoryportions
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Upper Respiratory Tract
Composed of
the nose
the nasal cavity
the paranasal sinuses
the pharynx (throat)
and associated structures.
All part of the conducting portion of the
respiratory system.
Nose
Two nasal cavities separated by nasal septum
The Nasal Septum is made up of cartilage & bone
Function
Warming of Air
Filtration of Air To keep nasal passage moist
Sensation of smell
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Paranasal Sinuses Paranasal sinuses:
In four skull bones
paired air spaces decrease skull bone weight
Named for the bones in which they are housed. frontal ethmoidal
sphenoidalmaxillary
Communicate with the nasal cavity by ducts. Covered with the same pseudostratified ciliated
columnar epithelium as the nasal cavity.
Pharynx
Common to both the respiratory and digestivesystems.
Commonly called the throat.
Funnel-shaped slightly wider superiorly and narrower infer iorly.
Originates posterior to the nasal and oralcavities
Extends inferiorly near the level of thebifurcation of the larynx and esophagus.
Common pathway for both air and food.
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Pharynx Walls:
lined by a mucosa
contain skeletal muscles primarily used for
swallowing.
Flexible lateral walls
distensible
to force swallowed food into the esophagus.
Partitioned into three adjoining regions:
nasopharynx
oropharynx
laryngopharynx
Nasopharynx Superiormost region of the pharynx.
Location:
posterior to the nasal cavity superior to the soft palate
separates it from the posterior part of the oral cavity.
Normally, only air passes through.
Soft palate Blocks material from the oral cavity and oropharynx
elevates when we swallow.
Auditory tubes paired
In the lateral walls of the nasopharynx
connect the nasopharynx to the middle ear .
Pharyngeal tonsil
posterior nasopharynx wall
single
commonly called the adenoids.
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Oropharynx
The middle pharyngeal region.
Location:
Immediately posterior to the oral cavity.
Bounded by the soft palate superiorly,
the hyoid bone inferiorly.
Common respiratory and digestive pathway
both air and swallowed food and drink passthrough.
Oropharynx
2 pairs of muscular arches
anterior palatoglossal arches
posterior palatopharyngeal arches
form the entrance from the oral cavity.
Lymphatic organs
provide the “first line of defense” againstingested or inhaled foreign materials.
Palatine tonsils on the lateral wall between the arches
Lingual tonsils At the base of the tongue.
Laryngopharynx
Inferior, narrowed region of the pharynx.
Location: Extends inferiorly from the hyoid bone
is continuous with the larynx and esophagus.
Terminates at the superior border of the esophagus
is equivalent to the inferior border of the cricoid cartilage in thelarynx.
The larynx (voice box) forms the anterior wall
Lined with a nonkeratinized stratified squamousepithelium (mucus membrane)
Permits passage of both food and air.
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Lower Respiratory Tract
Conducting portion
Larynx
Trachea
Bronchi
bronchioles and their associated structures
Respiratory portion of the respiratory system
respiratory bronchioles
alveolar ducts
alveoli
Larynx
Short, somewhat cylindrical airway
Location:
bounded posteriorly by the laryngopharynx,
inferiorly by the trachea.
Prevents swallowed materials from
entering the lower respiratory tract. Conducts air into the lower respiratory
tract.
Produces sounds.
Larynx Nine pieces of cartilage
three individual pieces Thyroid cartilage
Cricoid cartilage
Epiglottis
three cartilage pairs Arytenoids: on cricoid
Corniculates: attach to arytenoids
Cuniforms:in aryepiglottic fold
held in place by ligaments and muscles.
Intrinsic muscles: regulate tension on true vocalcords
Extrinsic muscles: stabilize the larynx
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Trachea A flexible, slightly rigid tubular fibromusculer
organ
often referred to as the “windpipe.”
Extends through the mediastinum
immediately anterior to the esophagus
inferior to the larynx
superior to the primary bronchi of thelungs.
Trachea
Anterior and lateral walls of the trachea aresupported by 15 to 20 C-shaped trachealcartilages.
cartilage rings reinforce and provide somerigidity to the tracheal wall to ensure thatthe trachea remains open (patent) at alltimes
cartilage rings are connected by elasticsheets called annular ligaments
The first cartilage ring devote to cricoidcartilage through cricotracheal ligament
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Trachea
VC.6 - VTh.4
Length: 9-15 cm; width: 2 cm
Fascia pretrachealis
At the level of the sternal angle, the trachea bifurcates
into two smaller tubes, called the right and left primary
bronchi (VTh.5-6)
Each primary bronchus projects laterally toward eachlung.
The most inferior tracheal cartilage separates the
primary bronchi at their origin and forms an internal ridgecalled the carina.
Trachea was divided into:
pars cervicalis and pars
thoracalis
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Inervation of trachea :
- Parasymphatic :
nervus laryngeus recurrens (it comes from
nervus vagus ) Bronchokonstriction
Secretomotoric
Sensoric
- Symphatic : ganglion cervicalis medius
: bronchodilatation
Vascularisation of trachea:
Artery thyroidea inferior
Bronchial Tree
A highly branched system
air-conducting passages
originate from the left and rightprimary bronchi.
Progressively branch into narrowertubes as they diverge throughout the
lungs before terminating in terminalbronchioles.
Bronchial Tree
Primary bronchiIncomplete rings of hyaline cartilage
ensure that they remain open.Right primary bronchus
Shorter (2,5 cm), wider, and morevertically oriented than the leftprimary bronchus.
Foreign particles are more likely tolodge in the right primary bronchus.
Vascularisation: vasa bronchialesInnervation: plexus pulmonum
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Bronchial Tree Primary bronchi
enter the hilum of each lung Also entering hilum:
pulmonary vessels
lymphatic vessels nerves.
Secondary bronchi (or lobar bronchi)
Branch of primary bronchus left lung:
two lobes two secondary bronchi(
right lung
three lobes three secondary bronchi.(1 eparteriel (lobus
superior & 2 hyparteriel (medius and inferior)
Bronchial Tree
Tertiary bronchi (or segmental bronchi)
Branch of secondary bronchi
left lung is supplied by 8 to 10 tertiary
bronchi.
right lung is supplied by 10 tertiary bronchi
supply a part of the lung called a
bronchopulmonary segment.
Respiratory Bronchioles,
Alveolar Ducts, and Alveoli Contain small saccular outpocketings called alveoli.
An alveolus is about 0.25 to 0.5 millimeter in diameter.
Its thin wall is specialized to promote diffusion of gasesbetween the alveolus and the blood in the pulmonarycapillaries.
Gas exchange can take place in the respiratorybronchioles and alveolar ducts as well as in the lungs,which contain approximately 300–400 million alveoli.
The spongy nature of the lung is due to the packing ofmillions of alveoli together.
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Paru-paru (lungs) Merupakan organ penting
untuk pernafasan
Jaringan yang bukan
merupakan jaringan
respiratorik didarahi oleh
arteri bronchialis dan
dialirkan ke vena pulmonalis Paru – paru berbentuk kurang
lebih sebagai conus dengan
basis dan apex
Paru-paru pada dinding paru dapat dibedakan :
Facies costalis merupakan dinding
ventral, lateral dan dorsal Facies mediastinalis merupakan dinding
medial
Facies diafragmatica merupakan basis
Antara facies diafragmatica danfacies costalis, terdapat margoinferior
Antara facies costalis disebelahventral dan facies mediastinalis,terdapat margo anterior
Basisnya terletak di atas permukaankonveks diafragma, descendenselama inspirasi dan ascendenselama ekspirasi
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Paru-paru Kanan Apexnya menonjol ke dalam pangkal leher
dan yang kanan lebih kecil dari yang kiri
Biasanya menerima satu arteri bronchialis
Adalah lebih berat dan lebih pendek daripada
yang kiri, disebabkan kubah kanan diafragma
lebih tinggi dan lebih luas karena jantung
lebih menonjol ke kiri
Dibagi menjadi lobus superior, medius, dan
inferior oleh fissura obliqua dan horizontal
Mempunyai 3 bronchus lobaris (sekunder)
dan 10 bronchi segmentalis (tertiar)
- Impressiones pulmo kanan ini
adalah:
Impressio cardiaca
Sulcus vena cava superior
Sulcus arteri subclavia
Sulcus vena azygos
Sulcus oesophagus
- Pada hilus pulmonalis pulmo
kanan terdapat: Bronchus eparterial
Arteri pulmonalis
Bronchus hyparterial
Vena Pulmonalis
Paru Kiri Biasanya menerima 2 arteri
bronchialis Mempunyai 2 lobus : superior
dan inferior
Mempunyai 1 fissura obliqua
yang mengikuti garis iga
keenam
Mempunyai satu Lingula yang
merupakan suatu bagian seperti
bentuk lidah pada lobus
superiornya yang sesuai dengan
lobus medius pada paru kanan.
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- Pada facies mediastinalisterdapat impressiones
berikut:
- Impressio cardiaca
- Sulcus arcus aorta
- Sulcus aorta descendens
- Pada hilus pulmonalisterdapat :
Bronchus eparterial
Arteri pulmonalis
Vena pulmonalis
Pleura and Pleural Cavities
The outer surface of each lung and the adjacent internalthoracic wall are lined by a serous membrane calledpleura, which is formed from simple squamousepithelium.
The outer surface of each lung is tightly covered by thevisceral pleura, while the internal thoracic walls, thelateral surfaces of the mediastinum, and the superior
surface of the diaphragm are lined by the parietal pleura. The parietal and visceral pleural layers are continuous at
the hilum of each lung.
Pleura and Pleural Cavities
The outer surface of each lung is tightly covered by the visceralpleura, while the internal thoracic walls, the lateral surfaces of the
mediastinum, and the superior surface of the diaphragm are lined by
the parietal pleura.
The potential space between these serous membrane layers is a
pleural cavity.
The pleural membranes produce a thin, serous fluid that circulates in
the pleural cavity and acts as a lubricant, ensuring minimal frictionduring breathing.
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Pelipatan pleura parietalis yang satu
ke pleura parietalis lainnya akan
membentuk suatu recesus / sinus.
Macam –macam sinus:
1. Sinus phrenicocostalis: dibentuk
oleh pelipatan pleura diafragmatica
dan pleura costalis.
2. Sinus costomediastinalis: dibentuk
oleh pelipatan pleura costalis dan
pleura mediastinalis.
3. Sinus phrenicomediastinalis :
dibentuk oleh pelipatan pleura
diafragmatica dan pleura
mediastinalis.
Perdarahan/vascularisasi pleura :
1. Pleura costalis : vasa intercostalis
2. Pleura mediastinalis : vasa pericardiacophrenica
3. Pleura diafragmatica : vasa intercostalis dan vasa
mammaria interna.
4. Pleura visceralis : a. bronkialis
Persarafan pleura :
1. Nervus intercostalis ( pleura costalis dan bagian
perifer pleura diafragmatika )
2. Nervus phrenicus ( sisa pleura diafragmatika dan
pleura mediastinalis )
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Lymphatic Drainage
Lymph nodes and vessels are located within the
connective tissue of the lung as well as around
the bronchi and pleura.
The lymph nodes collect carbon, dust particles,
and pollutants that were not filtered out by the
pseudostratified ciliated columnar epithelium.
Thoracic Wall Dimensional
Changes During Respiration
Lateral dimensional changes occur with ribmovements.
Elevation of the ribs increases the lateral
dimensions of the thoracic cavity, while
depression of the ribs decreases the
lateral dimensions of the thoracic cavity.
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Muscles that Move the Ribs The scalenes help increase thoracic cavity dimensions
by elevating the first and second ribs during forcedinhalation.
The ribs elevate upon contraction of the external
intercostals, thereby increasing the transversedimensions of the thoracic cav ity during inhalation.
Contraction of the internal intercostals depresses the
ribs, but this only occurs during forced exhalation.
Normal exhalation requires no active muscular effort.
A small transversus thoracis extends across the innersurface of the thoracic cage and attaches to ribs 2–6. Ithelps depress the ribs.
Muscles that Move the Ribs Two posterior thorax muscles also assist with
respiration. These muscles are located deep to the
trapezius and latissimus dorsi, but superficial to theerector spinae muscles.
The serratus posterior superior elevates ribs 2–5 during
inhalation, and the serratus posterior inferior depressesribs 8–12 during exhalation.
In addition, some accessory muscles assist withrespiratory activities.
The pectoralis minor, serratus anterior, andsternocleidomastoid help with forced inhalation, while the
abdominal muscles (external and internal obliques,
transversus abdominis, and rectus abdominis) assist inactive exhalation.
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I
n
tr
o
to
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ia
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hr a
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m
Now we will look at the Diaphragm.
You might be wondering, what does
the Diaphragm do? The
Diaphragm is an important factor in
breathing.
Diagram of Diaphragm
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Here is an experiment thatyou can try.
D iaphragm Exper iment
Mechanics of Breathing
Gas Exchange Between the Bloodand Alveoli
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The blood-air barrier
The surfactant layer
Regulation of Breathing
Figure 10.13
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Carotid and aortic bodies: sensitive tocarbon dioxide, pH, and oxygen levels
Conscious control: resides in higher braincenters; ability to modify breath is limited
Regulation of Breathing:Nervous System Involvement
Summary
Organs in the Respiratory SystemSTRUCTURE FUNCTION
nose / nasal cavitywarms, moistens, & filters air as it is
inhaled
pharynx (throat) passageway for air, leads to trachea
larynxthe voice box, where vocal chords are
located
trachea (windpipe)
keeps the windpipe "open"
trachea is lined with fine hairs calledcilia which filter air before it reaches the
lungs
bronchitwo branches at the end of the trachea,
each lead to a lung
bronchioles
a network of smaller branches leading from
the bronchi into the lung tissue &
ultimately to air sacs
alveolithe functional respiratory units in the lung
where gases are exchanged
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Respiratory Diseases
Malfunctions & Diseases of the Respiratory System
asthma
severe allergic reactioncharacterized by the
constriction of bronchioles
bronchitisinflammation of the lining of
the bronchioles
emphysema
condition in which the alveoli
deteriorate, causing the lungs
to lose their elasticity
pneumonia
condition in which the alveolibecome filled with fluid,
preventing the exchange of
gases
lung cancer
irregular & uncontrolled
growth of tumors in the lung
tissue
Asthma – contraction of the muscles of the
___________________ obstructing the
passage of air
• cause - ____________________________________
____________________________________
____________________________________
• attacks occur without warning
• treatment –
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_____________________________ - disease in which the
alveoli burst and blend to form fewer sacs for gas exchange
• caused by
___________________________________________________
_____________________________ – inflammation of the bronchi
resulting in excessive mucus secretion
• inflammation due to irritants such as
_______________________________________________________
• ___________________________common
Pneumonia – inflammation of the lungs caused by viruses or
bacteria
• ________________________fill with fluid
• greatly inhibits O2 and CO2 exchange
• if many alveoli are infected,
___________________________________________ may result
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Disorders of the Respiratory System
Tuberculosis -
___________________________
___________________________
• alveoli are slowly destroyed
• bloody sputum common
• nearly eliminated by antibiotics
but cases are increasing in U.S.
recently - why?
___________________________
___________________________
___________________________
___________________________
Cystic fibrosis - inherited disease in which a lung membrane
transport protein is not produced
• result is that mucus is not transported properly and becomes very
thick and ______________________________________
• thick mucus is a breeding ground for many bacteria; thus,
_________________________________ are common
• mean age for death is _________
Cystic fibrosis
Treatment:
• Disease is managed by
______________________________
to dislodge mucus in lungs
• Several new drugs are helpful
• New finding - ________________
responsible for
cystic fibrosis has been found and may
lead to a cure by gene therapy
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Disorders of the Respiratory System
Lung cancer – cancerous cells replace normal lung cells
• how common - ____________________________________
__________________________________________________
tar in lungs cancerous nodules
Bronchitis, emphysema, and lung cancer are
entirely avoidable.
They are caused by ______________________
______________________________________
- the chief avoidable cause of death in our
society, resulting in _____________ deaths/year
in the U.S.
Some facts about smoking
• Smokers have a 10 times greater chance of
developing bronchitis, emphysema, and lung cancerthan non-smokers.
• Risk for smoking-related diseases increases the
earlier one begins to smoke.
• Smokers are more likely to contract heart disease.
• Other cancers - mouth, laryngeal, esophageal,
pancreatic, and kidney - strike smokers at increased
rates.
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Some facts about smoking• Smoking during pregnancy causes preterm births
and low birth rates. Smokers are more likely to have
miscarriages.
• Nicotine in smoke is highly additive and is a
________________________. It strengthens the
desire to smoke and makes it difficult to quit.
• Cigarettes do not calm your nerves. They actually
create stress in the smoker.
• Smokers are 100 times more likely to smoke pot and
use other illicit drugs.
Some examples of Smoking-induced Disorders
Lung Cancers - taken from autopsies
What about this don’t you
understand?
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These disorders are entirely preventable.
The single, best thing you can do to prolong
your life is to simply not smoke.
Smoking is not cool anymore.
So - don’t start.
And if you do smoke, QUIT NOW!
All it will do is save your life!
Deformities of the chest wall are rare in children. The diagnosis of
these deformities will often not be made until adolescence due to theirprolonged development and usually benign nature. The major chest wall
deformities that are seen in children are Pectus Excavatum ("funnelchest") and Pectus Carinatum ("Pigeon Breast").
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Literature
Human Anatomy, First Edition McKinley &O'Loughlin
Atlas sobota Atlas sobota
Ethel Sloane, Anatomi dan Fisiologi, PenerbitEthel Sloane, Anatomi dan Fisiologi, PenerbitEGCEGC
Kyung Won Chung, Gross Anatomi, PenerbitKyung Won Chung, Gross Anatomi, PenerbitBinarupa AksaraBinarupa Aksara
Keith L.Moore dan Arthur F.Dalley. ClinicallyKeith L.Moore dan Arthur F.Dalley. Clinicallyoriented Anatomyoriented Anatomy