1. göğüs cerrahisine giriş
TRANSCRIPT
![Page 1: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/1.jpg)
Göğüs Cerrahisine Giriş
Doç. Dr. Okan SolakAKU Göğüs Cerrahisi AD
![Page 2: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/2.jpg)
SAYEED & DARLING
![Page 3: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/3.jpg)
![Page 4: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/4.jpg)
![Page 5: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/5.jpg)
![Page 6: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/6.jpg)
![Page 7: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/7.jpg)
![Page 8: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/8.jpg)
![Page 9: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/9.jpg)
![Page 10: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/10.jpg)
![Page 11: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/11.jpg)
![Page 12: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/12.jpg)
![Page 13: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/13.jpg)
![Page 14: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/14.jpg)
![Page 15: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/15.jpg)
![Page 16: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/16.jpg)
![Page 17: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/17.jpg)
![Page 18: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/18.jpg)
![Page 19: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/19.jpg)
![Page 20: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/20.jpg)
![Page 21: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/21.jpg)
![Page 22: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/22.jpg)
![Page 23: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/23.jpg)
![Page 24: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/24.jpg)
![Page 25: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/25.jpg)
![Page 26: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/26.jpg)
![Page 27: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/27.jpg)
![Page 28: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/28.jpg)
![Page 29: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/29.jpg)
![Page 30: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/30.jpg)
![Page 31: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/31.jpg)
![Page 32: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/32.jpg)
![Page 33: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/33.jpg)
![Page 34: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/34.jpg)
![Page 35: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/35.jpg)
![Page 36: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/36.jpg)
Toraks Damar Yapısı
* İnterkostalarter ve ven, kotun altında ilerler. Kotun üstü girişim için idealdir.* İnterkostal arter direk aortadan çıkar. Kanama debisi yüksektir.* Midklavikuler hattın laterali mamarian arterden uzak alandır. * Girişim için midklavikuler hattın mediali tehlikeli bölgedir.
![Page 37: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/37.jpg)
Toraks Kas Yapısı
![Page 38: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/38.jpg)
Toraks Kas Yapısı
![Page 39: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/39.jpg)
Solunum Hareketleri
• Aktif: Kasların kasılmasıyla göğüs kafesi genişler, intratorasik, intraplevral ve intrapulmoner basınçlar azalır, atmosfer basıncındaki hava akciğerlere ulaşır.
• Pasif:Solunum kaslarının gevşemesiyle expiryum oluşur.
• İnspiryumda göğüs kafesinin genişlemesi 3 eksende oluşur.
• Anteroposterior eksende genişleme:Kasların kasılmasıyla en uzun olan 5-7 kotların elevasyonu ve sternumun anterior ve süperiora hareketiyle olur
![Page 40: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/40.jpg)
Solunum Hareketleri• Bilateral eksende genişleme:
İnterkostal kaslar, diyafragmanın ve 7-10. kotların hareketiyle olur.
• Superioinferior eksende genişleme: Diyafragma hareketi
• Diafragma normal solunumda 1-2 cm, derin insprium ve expiryumda 6-10cm dikey hareket sağlar. • Normal solunumda ventilasyonun %75-
80’ini diafragma, %20-25’ini interkostal ve diğer yardımcı kaslar sağlar.
![Page 41: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/41.jpg)
Plevral Yapraklar
![Page 42: 1. Göğüs Cerrahisine Giriş](https://reader035.vdocuments.site/reader035/viewer/2022081512/55b193d8bb61eb7a198b4706/html5/thumbnails/42.jpg)