RESPIRATORY SYSTEMBy Sawiji AmaniMobile phone: 081 328 028333E-mail: sawijiamani@gmail.com

Basic Sciences DepartmentMuhammadiyah Gombong UniversityCentral Java Indonesia

Respiratory SystemProviding an extensive area for gas exchange between air and circulating blood. Moving air to and from the exchange surfaces of the lungs. Protecting respiratory surfaces from dehydration, temperature changes, or other environmental variations and defending the respiratory system and other tissues from invasion by pathogens. Producing sounds involved in speaking, singing, and nonverbal communication. Providing olfactory sensations to the central nervous system from the olfactory epithelium in the superior portions of the nasal cavity

RespirationVentilation: Movement of air into and out of lungsExternal respiration: Gas exchange between air in lungs and bloodTransport of oxygen and carbon dioxide in the bloodInternal respiration: Gas exchange between the blood and tissues

The upper respiratory system : consists of the nose, nasal cavity, paranasal sinuses, and pharynx The lower respiratory system :consists of the larynx (voice box), trachea (windpipe), bronchi, bronchioles, and alveoli of the lungs

area konduksi : hidung brochiolus area respirasi : alveoli

Respiratory System

Conducting ZoneInsert fig. 16.5All the structures air passes through before reaching the respiratory zone.Warms and humidifies inspired air.Filters and cleans:Mucus secreted to trap particles in the inspired air.Mucus moved by cilia to be expectorated.

Respiratory ZoneRegion of gas exchange between air and blood.Includes respiratory bronchioles and alveolar sacs.Must contain alveoli.

HidungDorsum : cartilago nasalNares anteriorSeptum nasi : os vomer dan lamina perpendicularis os etmoidalisChoane : nares posteriorChonca nasalisMeatus nasalisPlexus Keiselbach : sering epistaxis

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Sinus paranasalisSinus etmoidalisSinus frontalisSinus maxillarisSinus spenoidalis

Lubang keluar Sinus frontalis : meatus mediaSinus etmoidalis : meatus media meatus superiorSinus sphenoidalis : meatus superiorSinus maxillaris : meatus media

Meatus inferior : ductus nasolacrimalis

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NasopharynxDisebut juga dengan epipharynxDibatasi cranialnya oleh choanaeAtapnya : fornix pharyngeusDinding belakang ada tonsila pharyngea, klinisnya?Dinding lateral ada ostium pharyngeum tubae auditiva ! (opening of auditory tube)fungsi..? Klinis.?

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Oropharynx Masuk sistem digestiveBerhubungan dengan cavum oris oleh ishmus fauciumBatas :atas : palatum mollelateral : arcus palatoglosuscaudal : radix linguaeFossa tonsillaris..?Tonsila lingualis.?LaryngopharynxMembentang dari tepi atas cartilago epiglotica sampai tepi bawah cart.cricoideaSebelah anteriornya terdapat aditus laryngis

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LarynxMerupakan pipa fibrocartilagineaFungsi :..?Kerangka terdiri atas 9 cartilago, yaitu:tunggal : thyroidea, cricoidea, epiglotis (=3)pasang : arytenoidea, corniculata, cuneiformis (3x2 = 6)

Otot otot larynx - extrinsik : a. depresor larynx b. levator larynx - intrinsik : .?Cavitas laryngis- aditus laryngis- vestibulum laryngis- rima vestibuli- ventriculus laryngis- rima glotidis- cavitas infraglottica

Neurovasculer larynx nervi : nervus Xarteri : a.laryngea superior, cab. a.thyroidea sup. a.laryngea inferior, cab. A.thyroidea inf.vena : idemAspek klinis- cricothyroidotomy- tracheostomy- laryngitis- laryngoskop

Vocal FoldsFunctions:Maintain an open passageway for air movement (thyroid and cricoid)Epiglottis and vestibular folds prevent swallowed material from moving into larynxVocal folds are primary source of sound production

TracheaMerupakan pipa cartilagineaBermula dari vertebrae cervicalis VI sampai vertebrae thoracalis IV-VSebelah dorsalnya : OeshopagusSebelah lateral ada glandula thyroidea (cincin 2,3,4)Cartilago hyalin berbentuk tapal kudaMembran dari otot polosBifurcatio trachealis setinggi Vertebrae thorax IV-VCarina?Inervasi outonom

TracheaWindpipeDivides to formPrimary bronchiCarina: Cough reflexInsert Fig 23.5 all but bDense regular connective tissue and smooth muscle reinforced with c-shaped cart. on the ant. surface.Post. Trachea consists of elastic lig. and a bundle of muscle called the trachealis muscleThe lining of the trachea is pseudostratified ciliated columnar epithelium with goblet cells

Trachea terbagi atas :menurut letaknya : pars cervicalis dan pars thoracalisMenurut susunan dindingnya : pars cartilaginea, pars membranacea

Vascularisasi :r.trachealis a.thyroidea superiorCab.a.thyroidea inferiorA.bronchialis

Tracheobronchial TreeConducting zoneTrachea to terminal bronchioles which is ciliated for removal of debrisPassageway for air movementCartilage holds tube system open and smooth muscle controls tube diameterRespiratory zoneRespiratory bronchioles to alveoliSite for gas exchange

Tracheobronchial Tree1234567Respiratory zoneConducting zone

BronchusDipercabangkan dari tracheaDescenden masuk ke hilus pulmonalis setinggi corpus vert. IV dan V, di sebelah belakang vasa pulmonalis.Perbedaan bronchus primer dexter & sinister

nokategoridextersinister123PanjangLebar diameterposisi>pendek>lebar>tegak>panjang>sempit>mendatar

Pulmo : terdapat 10 segmen lobularDari bronchus tertier/segmentalis , berlanjut sebagai bronchiolus bronchiolus terminalis.Selanjutnya dinding tidak mengandung cartilago lagi ( bronchiolus respiratorius, ductus alveolaris, sacculus alveolaris, alveoli )

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Alveolus and Respiratory Membrane

LungTwo lungs: Principal organs of respirationRight lung: Three lobesLeft lung: Two lobesDivisionsLobes, bronchopulmonary segments, lobules

PULMOBentuk konus :- basis- apex, diperkuat o/. Fascia SIBSON ( membrane suprapleuralis )- facies costalis - facies medialis : pars. Vertebralis dan pars mediastinalis: menampakan impresiones organ2 mediastinumligamentum pulmonalis- hilus pulmonalis

Lobus dan fisura.- fisura obliqua dan horisontal ( setinggi cart.costa VIHilus pulmonalis, tersusun dari depan ke belakang : vena, bronchus, arteriVascularisasi :- oksigenasi : arteri pulmonalis- nutrisi : arteri bronchialisInervasi : n.X dan truncus symphaticus

PLEURA merupakan kantong serous tertutup, menyelubungi paru rongganya disebut : cavum pleurae, berisi cairan serous hasil mesotelium pleura parietalis : berbatasan langsung dengan dinding thorax pleura visceralis : melapisi pulmo, mengikuti setiap lekuk pulmo

PleuraPleural fluid produced by pleural membranesActs as lubricantHelps hold parietal and visceral pleural membranes together

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Thoracic CavityDiaphragm:Sheets of striated muscle divides anterior body cavity into 2 parts.Above diaphragm: thoracic cavity:Contains heart, large blood vessels, trachea, esophagus, thymus, and lungs.Below diaphragm: abdominopelvic cavity:Contains liver, pancreas, GI tract, spleen, and genitourinary tract.Intrapleural space:Space between visceral and parietal pleurae.

Pleura parietalis :- pl. Costalis, pl diafragma, pl mediastinalis, cupula pleuraBagian pulmo yang tidak diliputi pl visceralis : radix pulmoRefleksi pleuraRecessus costodiafragmaticaRadix pulmoVascularisasi pleura :- aa.intercostalis, a.mamaria interna, a.musculophrenicaInervasi : n. Intercostalis n. phrenicus

Thoracic WallsMuscles of Respiration12

OTOT INSPIRASIm. sternocleidomastoideusm. serratus anteriorm. skalenusm. interkostalis eksternusDiafragma

1,2,3,4 pernafasan thoracal5 pernafasan abdominal

OTOT EKSPIRASIm. interkostalis internusm. rectus abdominalm. transversusm. obliquus

1 pernafasan thoracal2,3,4 pernafasan abdominal

ControlMedullary Resp CentersDorsal Resp Group (DRG) Pacemaker (inspiration)Ventral Resp Group (VRG) Forced breathingPons Resp CenterPneumotaxic Center DepthApneustic Center Breath holding

Pons Respiratory CentersActivities of medullary rhythmicity center is influenced by pons. Apneustic center:Promotes inspiration by stimulating the I neurons in the medulla. Pneumotaxic center:Antagonizes the apneustic center.Inhibits inspiration.

ChemoreceptorsInsert fig. 16.272 groups of chemo-receptors that monitor changes in blood PC02, P02, and pH.Central:Medulla.Peripheral:Carotid and aortic bodies. (Fig. 16.26)Control breathing indirectly via sensory nerve fibers to the medulla (X, IX).

ControlPulmonary Irritant Reflexes constriction and coughingThe Inflation Reflex as lungs stretch receptors fire which inhibit the Medulary centersHigher BrainHypthalamic EmotionCortical - VoluntaryChemicalPCO2 As levels of CO2 increase hypervent occursPO2 As levels of O2 drop Vent is increasedpH As pH drops Vent increases

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