SYSTEMA RESPIRATORIA 2013

8/17/2019 SYSTEMA RESPIRATORIA 2013

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SYSTEMA RESPIRATORIUMBERNARD SM HUTABARAT, dr, PAK

FACULTY OF MEDICINE – UPHLIPPO VILLAGE - KARAWACI

DEFINITION

S YSTEMA RESPIRATORIUM IS A SYSTEM WHICH FUNCTION

IS RESPIRATION

RESPIRATION ( RESPIRATIO ) IS THE PROCESS OF GASEXCHANGE BETWEEN CO AND O IN ALVEOLI!

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LEARNING OB"ECTIVEAFTER LECTURE STUDENS ARE ABLE TO EXPLAIN #$! EMBRYOLOGY AND DEVELOPMENT OF SYSTEMA

RESPIRATORIUM!! CONGENITAL MALFORMATION OF SYSTEMA RESPIRATORIUM

%! DIVISION OF SYSTEMA RESPIRATORIUM%! LOCATION OF SYSTEMA RESPIRATORIUM

&! THORACIC CAVITY AND ITS CONTENTS'! RESPIRATORY TRACTS AND ORGANS

! PRO"ECTION OF PLEURAL REFLEXION! PLEURAL RECESSUSES

*! LUNGS AND PARTS

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DIVISION$! TRACTUS RESPIRATORIUS $!$! PARS SUPERIOR TRACT! RESP !+

$!$!$! CAVITAS NASI$!$! ! NASO LARYNGOPHARYNX

$! ! PARS INFERIOR TRACT! RESP!$! !$! LARYNX ++

$! ! ! TRACHEA +++ $! !%! BRONCHUS AND ITS

BRANCHES ++++

+ #CRANIUM ( HEAD )++ # COLLUM ( NECK )+++ #COLLUM THORAX

++++ #THORAX DIAPHRAGMA! ORGANAE RESPIRATORIAE ++++

!$! PULMONES DEXTER ET SINISTER

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EMBRYOLOGIA SYSTEMA RESPIRATORIUM

EMBRYOLOGICLY SYSTEMA RESPIRATORIUM ORIGINATED FROMINTERACTION BETWEEN GERM LAYERS #

$! ENTODERM # RESPIRATORY TRACTS AND ORGANS! MESODERM # LINING MEMBRANES, CARTILAGE, MUSCLES AND

CONNECTING TISSUES OF RESPIRATORY SYSTEM!WEEK # VENTRAL WALL OF ND PART OF FOREGUT #

DIVERTICULUM RESPIRATORIA

OESOPHAGUSGASTER

DIVERTICULUM HEPATICA

MEMBRANA BUCCOPHARYNGEALIS 405/15/16



DEVELOPMENT OF DIVERTICULUM RESPIRATORIA

DIVERTICULUM RESPIRATORIA OESOPHAGUS

CRISTA TRACHEO-OESOPHAGEALIS ( TRACHEOESOPHAGEAL RIDGE )

SEPTUM TRACHEO-OESOPHAGEALIS

DIVERTICULUM RESPIRATORIA

DAY '- # BIFURCATE

DIVERTICULAE BRONCHIALES ( LUNG BUDS )

EXPAND CAUDALLY

EXPAND DICHOTOMOUSLYTOWARD CAUDAL

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DEVELOPMENT OF DIVERTICULAE BRONCHIALES

OESOPHAGUS

TRACHEA

DIVERTICULAE BRONCHIALES DEXTER ET SINISTER

PRIMARY BRONCHI DEXTER ET SINISTER!

BRONCHI LOBARES DEXT ( % )!

BRONCHI LOBARES SIN!( )

WEEK & # ENLARGED

BIFURCATE

EXPAND TO CAUDALDICHOTOMOUSLI

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DEVELOPMENT OF BRONCHUS LOBARISWEEK ' # BRONCHI LOBARIS ( SECONDARY BRONCHUS ) EXPANDDICHOTOMOUSLY TO FORM TERTIARY BRONCHUS ( BRONCHUSSEGMENTORIUM . $/ ON THE RIGHT AND ON THE LEFT )

COVERED BY VISCERAL AND SOMATIC MESODERMS!

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DEVELOPMENT OF THE SYSTEMA RESPIRATORIUM

CONSISTS OF STAGES #$! GLANDULAR STAGE # WEEK – $' . REPEATED BRANCHING

! CANALICULAR STAGE # WEEK $' – # DEVELOPMENT BRONCHIOLI!%! SACCULAR STAGE # WEEK – %' . PRIMARY ALVEOLI

! ALVEOLAR STAGE # WEEK %' – / . ALVEOLI MATURINGPOST NATALLY NEW ALVEOLI CONTINUE TO BE FORMED TILL THE AGEOF YEARS OLD!

EXPAND CAUDOMEDIOLAT!

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CONGENITAL ABNORMALITIES$! BORN BEFORE WEEKS OF GESTATION SURVIVAL CHANCE

IS VERY SMALL DUE TO LACK OF PULMONARY ALVEOLI!! BORN AT % – %' WEEKS OF GESTATION USUALLY SUFFERS

RESPIRATORY DISTRESS SYNDROME DUE TO LACK OFSURFACTANT SECRETED AT THE ALVEOLAR STAGE!

%! TRACHEOESOPHAGEAL FISTULAS ( TEFS ) DUE TODISTURBANCE AT THE DEVELOPMENT OF DIVERTICULUM

TRACHEO-ESOPHAGEALIS! %!$! INCINDENCE # $ OF %/// BIRTHS! %! ! KIND OF CASES # %! !$! ATRESIA OESOPHAGUS WITH TRACHEAL FISTULA #

+ BLIND POUCH OF ESOPHAGUS UPPER ENDING + LOWER SEGMENT FISTULA WITH TRACHEA + */0

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TRACHEO-ESOPHAGEAL FISTULA

%! ! ! ISOLATED ESOPHAGEAL ATRESIA ( 0 )%! !%! H – TYPE TRACHEO-ESOPHAGEAL FISTULA ( 0 )

%! ! ! OTHER VARIATIONS ( $0 )

%! ! ! %! !%! %! ! !

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CHEST WALL$! S TRATUM SUPERFICIALIS ( S TRATUM EXTERNUS ) $!$! CUTIS ( SKIN )

$! ! SUBCUTIS ( SUBCUTANEUS TISSUE ) # $!%! FASCIA MUSCULI

! S TRATUM INTERMEDIUS #

!$! MM!DORSALES ( MUSCLES OF THE BACK ) ! ! MM! ABDOMINALES ( MUSCLES OF THE ABDOMINAL WALL ) !%! MM!MEMBRI SUPERIORIS ( MUSCLES OF THE UPPER LIMB )

%! STRATUM PROFUNDUS ( S TRATUM INTERNUS )# %!$! OSSA THORACALES ( BONES OF THE CHEST ) %! ! MM! INTERCOSTALES EXTERNI ET INTERNI %!%! A1V INTERCOSTALES %! ! NN! INTERCOSTALES

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ARTERIAE INTERCOSTALES ORIGIN $! R R!INTERCOSTALES ANTERIORES #

$!$! I – VI # A!THORACICA INTERNA

$! ! VII – IX # A!MUSCULO – PHRENICA( A! THORACICA INTERNA )

! AA!INTERCOSTALES POSTERIORES

!$! I – II # A! INTERCOSTALIS SUPREMA(TRUNCUS COSTOCERVICALIS)

! ! III – XI # AORTA THORACALIS

.

.

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PARACENTHESIS THORACISPARACENTHESIS THORACIS ( PUNCTIO CAVUM PLEURAE ) #PROCEDURE TO TAP PLEURAL CAVITY

DIAGNOSTIC AND CURATIVE

PARACENTHESIS THORACIS

( PUNCTIO CAVUM PLEURAE ) #$! LATERAL ( DORSAL LINEA AXILLARIS )# CRANIAL MARGIN OF RIB !VENTRAL LINEA AXILLARIS # IN THE MIDLLE OF ICS!

AORTA A! INTERCOSTALIS POSTERIOR

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PLEURA

IS MEMBRANOUS COVERING OF THE PULMONES

CONSISTS OF #

$! PLEURA PARIETALIS

--CAVUM PLEURAE---

! PLEURA VISCERALIS

PARENCHYMA PULMONALIS

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PLEURA PARIETALIS CONSISTS OF # $! PARS CERVICALIS PLEURAE

( CUPULA PLEURAE )

HYPOVENTILATIO PULMONALIS

TUBERCULOSIS PARS COSTOVERTEBRALIS PLEURAE THE STRONGEST, THICKEST AND EASILY DETACHED, EXCEPT BETWEEN CAPITULUM COSTAE AND COLUMNA

VERTEBRALIS! %! PARS DIAPHRAGMATICAE PLEURAE

THIN, COVERS FACIES DIAPHRAGMATICAE PULM!! PARS MEDIASTINALIS PLEURAE

COVERS !MEDIASTINAL SURFACE OF LUNG 1705/15/16



PRO"ECTION OF PLEURAL REFLEXION ARTIC! STERNOCLAVICULARE $!TRIGONUM THYMICUM

( THYMUS +) ANGULUS LUDOVIGI ANGULUS LUDOVIGI

PRALLEL R L SIDE PRALLEL R L SIDE

RIGHT LEFTLATERAL TO STERNAL

MARGIN! PROC! XIPHOIDEUS

PARALLEL ARC!COSTARUM ' (TILL CARTIL!COSTA )

LINEA MIDCLAVICULAR LINEA MIDCLAVIC! ! TRIG! CARDIACUM(COR)

$/ LINEA AXILLARIS $/ LINEA AXILLARIS

$ COLLUM COSTAE $ COLLUM COSTAE ADULT # +CORPUS ADIPOSUS RETROSTERNALIS ( "UGULARE )

18

CAUDOLATERAL

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RECESSUS ( SINUS ) PLEURAECAUDAL MARGINS OF THE LUNG ARE HIGHER THAN THE PLEURA BUT PLEURA NEVER REACHDIAPHRAGMA

CAUDAL TO REFLEXIO COSTALIS, DIAPHRAGMADIRECTLY CONNECTED TO THE COSTAE ANDMM!INTERCOSTALES

DORSALLY LATERALLY CAUDAL MARGIN OFLUNGS DO NOT REACH REFLEXIO COSTALIS

PLEURAE DIAPHRAGMATICAE ET COSTALIS LIECLOSE TO EACH OTHER!

POTENTIAL SPACE WITHOUT LUNGS

SINUS PHRENICO-COSTALES DEXTER ET SINISTER

SINUS COSTO-MEDIASTINALIS .

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THORACIC WOUND STAB OR GUNSHOT

AREA WITHOUT LUNGS #$! VENTRAL # ICS ( VII ), VIII – XI #

SINUS PHRENICO-COSTALIS(SINUS COSTO-PHRENICUS )#

! DORSAL # COSTA VIII – X # SINUS COSTOMEDIASTINALISICS X – XI # NO PLEURASTABS 1 GUNSHOT POSSIBILITIES#

%! HIGHEST # PULMO! HIGHER # MM!INTERCOSTALES , SINUS ,

DIAPHR! AND CAVUM ABD! $

$! VENTRAL PART OF ICS X – XIIN"URY TO MM!INTERCOSTT, DIAPHRAGMA AND CAVUM ABDOMINALIS!

BLUNT! CAIRAN ( PLEURAL EFFUSIO )

SINUS PHRENICO-COSTALIS!

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PULMONES

WEIGHT, FORM STRUCTURE

$! EMPTY # / Gr ( R ) $ Gr ( L )! CONTAIN BLOOD # ' & Gr &' Gr

CONE SHAPED FORM, ITS BASE AT THE CONVEXITY OF THEDIAPHRAGMA. TOP AT COLLUM COSTA PRIMA

NEWBORN # PINK . ADULT # DARK GREY COLOR

STILL BORN BABY # COMPACT, NO AIR , DROWN

DOCIMACIA PULMONUM HYDROSTATICA

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PARTS OF THE LUNG LOBUS SUPERIOR DEXT! LOBUS SUPERIOR SIN!LOBUS MED!

APEX PULMONIS MARGO POSTERIOR FACIES COSTALIS

MARGO ANTERIOR FACIES POSTERIOR FISSURA HORI2ONTALIS

FISSURA OBLI3UA INCISURA CARDIACA LINGULA BASIS PULMONIS ( ( FACIES DIAPHRAGMATICA )

MARGO INFERIOR LOBUS INFERIOR LOBUS INFERIOR PULMO DEXTER PULMO SINISTER

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FACIES MEDIASTINALIS PULMONIS DEXTERSULCUS A! BRACHIOCEPHALICA

SULCUS V!C!S!

HILUS PULM!$! BRONCHUS #

EPARTERIALIS HYPARTERIALIS !A! PULMONALIS

VV! PULMONALIS IMPRESSIO CARDIACA

SULCUS OESOPHAGICUS

LIG! PULMONALE

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FACIES MEDIASTINALIS PULMONIS SINISTER

SULCUS V! BRACHIOCEPHALICASINISTER

SULCUS A! SUBCLAVIA SINISTER HILUM PULMONIS # $! A! PULMONALIS

V!PULMONALIS

!BRONCHUS HYPARTERIALIS

SULCUS AORTICUS

IMPRESSIO CARDIACA LINGULA

LIG! PULMONALE

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HILUS PULMONIS

IS THE AREA OF FACIES MEDIASTINALIS PULMONIS WHERESTRUCTURES ENTER OR LEAVE THE LUNGS!

ORDERS OF STRUCTURES POSITION AT HLUS $! BEFORE BACKWARDS#

V . A . B ! ABOVE DOWNWARD # !$! RIGHT # B . A . V

! ! LEFT # A . B . V!

BRONCHUS

A! PULMONALIS V! PULMONALIS DEXTER SINISTERBRONCHUS EPARTERIALIS

BRONCHUS HYPARTERIALIS

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DIFFERENCE BETWEEN RIGHT LEFT HILUS

BASED ON POSITION OF BRONCHUS AND A! PULMONALIS

RIGHTEPARTERIALIS

BRONCHUS

A! PULMONALIS

LEFT HYPARTERIALIS

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RADIX PULMONIS

IS THE STRUCTURES THAT ENTER 1 LEAVE THE LUNG ATHILUS PULMONALIS ( T &,', )!

CONSISTS OF #

$! BRONCHUS

! A1V BRONCHIALIS%! PLEXUS NERVOSIS PULMONALIS !

! DUCTUS LYMPHATICUS ( LYMPHATIC DUCTS )!&! NN! LL! BRONCHOPULMONALES

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TRACHEA AND ITS BRANCHES TRACHEA ( C' – T& )

BRONCHUS LOBARIS LOBUS SUPERIOR DEXTRA

BRONCHUS PRINCIPALIS DEXTER( BRONCHUS PRIMARIUS DEXTER )BRONCHUS PRINCIPALIS SINISTER

BRONCHUS LOBARIS SUP!SIN

BRONCHUS SEGMENTALIS

BRONCHUS LOBARIS SUP! DEXTER # BRONCHUS EPARTERIALIS

ALL OTHER BRONCHI LOBARES # HYPARTERIALIS 2805/15/16



ARBOR BRONCHIALIS ( BRONCHIAL TREE ) TRACHEA BRONCHUS PRINCIPALIS ( BRONCHUS PRIMARIUS ) DEXTER#WIDER ,SHORTER, MORE VERTICAL

LOCATION OF CORPUS ALIENUM ( FOREIGN BODY ) BRONCHUS LOBARIS BRONCHUS SEGMENTALIS

BRONCHIOLI TERMINALIS

BRONCHIOLI RESPIRATORIUS

DUCTUS ALVEOLARIS +

ATRIA + SACCUS ALVEOLARIS + ALVEOLUS + BIFURCATIO TRACHEAE (CARINA,T&) +PULMONARY ( LUNG ) UNIT

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BRONCHI SEGMENTALES

DEXTER SINISTER$! APICALIS $4%# APICOPOSTERIOR

! ANTERIOR # ANTERIOR%! POSTERIOR

! LINGULARIS SUP! &!LINGULARIS INF!

! LATERALIS&! MEDIALE

'! APICALE(SUPERIOR) 4 # ANTEROMEDIO

BASALE * # LATEROBASALE

'! SUPERIOR $/! POSTEROBASALE! BASALIS MEDIALIS! BASALIS LATERALIS

*! BASALIS ANTERIOR$/! BASALIS POSTERIOR 3005/15/16



VASCULARI2ATION A! PULMONALIS $! A! BRONCHIALIS

$!$!SINISTER# AORTA THORACALIS $! ! DEXTER # A! INTERCOSTALIS 1 A! BRONCHIALIS SINISTRA!

V5! BRONCHIALES V! PULMONALIS

INNERVATIO!

SYMPATHIS #T $- & . BRONCHODILATORPARASYMPATHIS #N!X (VAGUS).BRONCHOCONSTRICTOR

SECRETOMOTOR .

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LYMPHATIC DRAINAGE$! NN! LL! SUPERFICIALES!# BENEATH THE PLEURAE

! NN!LL! PROFUNDAE# ALONGSIDE PULMONARY VESSELS AND ARBORBRONCHIALES

ANGULUS VENOSUS DEXTRA ANGULUS VENOSUS SINISTRA TRUNCUS BRONCHOMEDIASTINALIS DUCTUS THORACICUS

NN!LL PARATRACHEALES

NN!LL! TRACHEOBRONCHIALESSUPERIORES DEXTRA ET SINISTRA

NN!LL! TRACHEOBRONCHIALES INFF!

NN! LL BRONCHOPULMONALES

NN!LL!PULMONALES

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SOURCES$! C USHIERI . ALFRED P ROF # DEVELOPMENT OF R ESPIRATORY

S YSTEM AND D IAPHRAGMA . D EPARTEMENT OF ANATOMY –UNIVERSITY OF MALTA !

! HAMILTON . W!" M OSSMAN .H!W# H UMAN E MBRYOLOGY

$67 8d97. T HE W ILLIAMS W ILKINS C OMPANY , B ALTIMORE

%! LANGMAN . " AN# MEDICAL E MBRYOLOGY .%rd 8d97. I GAKU S HOIN

LTD . T OKYO! S EARCH B OOKS P RESENTATION B USINESS ACADEMIC #

DEVELOPMENT . :::!6;r9<d!;=>1d=;1% &%$ $1D858?=@>8 7 = r86@9r 7=r 6 678>&! FEDERATIVE INTERNATIONAL PROGRAMME ON ANATOMICAL TERMINOLOGIES # TERMINOLOGIA ANATOMICA , ND EDITION . GEORG THIEME VERLAG STUTTGART – NEW YORK

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SOURCES

http://www.scribd.com/doc/382753171/Development

http://www.scribd.com/doc/382753171/Development



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M;Gr : – H9?? C=>@ 986 , I ; . N8: Y=r ! ! M r98< , E? 9 8 N M8?? , "= # H > A 7=> . % rd 8d97 . Add96= W86?8 L= > I ; . S Fr ;96;= ! >86=7 8?9=> ! 6<867=696 *! 8778r9> 86!;=>$/! R= 8r6 , A W # T8 7<== = A 7=> . C r; 9?? L959 67= 8 . L= d= –

T= =!$$! 6 r 9; ? =786!;=!$ ! :::!67 d <? 8!;=>$%! :::!6 r 9; ?;=r8!=r

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SYSTEMA RESPIRATORIA 2013

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