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RESPIRATORY SYSTEM RESPIRATORY SYSTEM Achmad aminuddin Achmad aminuddin

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  • RESPIRATORY SYSTEMAchmad aminuddin

  • RESPIRATORY SYSTEMSTRUCRURALLY UPPER RESPIRATORY SYSTEM the nose, pharynx, and associated structur LOWER RESPIRATORY SYSTEM the larynx, trachea, bronchi and lungFUNCTIONALLY THE CONDUCTING ZONE the nose, pharynx, larynx, trachea, bronchi, bronchioles, and terminal bronchioles,. that filter, warm, and moisten air THE RESPIRATORY ZONE the respiratory bronchioles, alveolar ducts, alveolar sacs and alveoli, the main sites of gas exchange.

  • NOSETHE NASAL CAVITIESRIGHT N.C.LEFT N.C.THE FUNCTIONS OF THE NOSE AND NASAL CAVITIESOLFACTION.RESPIRATION.FILTRATION OF DUST.HUMIDIFICATION OF INSPIRED AIR.RECEPTION AND ELIMINATION OF SECRETION FROM PARANASAL SINUSES AND NASOLACRIMAL DUCT.

  • THE BONY PART OF THE NOSENASAL BONES.FRONTAL PROCESSES OF THE MAXILLAE.NASAL PART OF THE FRONTAL BONE AND ITS NASAL SPINE.BONY PART OF THE NASAL SEPTUM.

  • THE CARTILAGINOUS PARTTWO LATERAL CARTILAGES.TWO ALAR CARTILAGES.A SEPTAL CARTILAGE.

  • THE NASAL SEPTUMTHE PERPENDICULAR PLATE OF THE ETHMOID.THE VOMER.THE SEPTAL CARTILAGE.THE NASAL CREST OF THE MAXILLARY.THE NASAL CREST OF THE PALATINE.

  • NASAL CAVITIESTHE NARES.THE CHOANAE.MUCOSA LINES THE NASAL CAVITIES, EXCEPT THE NASAL VESTIBULE WHICH IS LINED WITH SKIN.COMMUNICATE WITH :THE NASOPHARYNX.THE PARANASAL SINUS.THE LACRIMAL SAC AND CONJUNCTIVA.

  • THE NASAL MUCOSACONSIST OFTHE RESPIRATORY AREA - inferior 2/3 rd.THE OLFACTORY AREA - superior 1/3 rd.THE BOUNDARIESTHE ROOF.THE FLOOR.THE MEDIAL WALL.THE LATERAL WALL.

  • THE NASAL CAVITYROOFFRONTONASAL PART.ETHMOIDAL PART.SPHENOIDAL PART.FLOORTHE PALATINE PROCESS OF THE MAXILLA.THE HORIZONTAL PLATE OF THE PALATINE BONE.

  • THE NASAL CAVITYTHE MEDIAL WALLTHE NASAL SEPTUM.THE LATERAL WALLNASAL CONCHAESUPERIOR.MIDDLE.INFERIOR

  • THE NASAL CAVITYSPHENOETHMOIDAL RECESS.SUPERIOR MEATUS.MIDDLE MEATUS.INFERIOR MEATUS.COMMON NASAL MEATUS.

  • THE ARTERIAL SUPPLY OF THE MEDIAL AND LATERAL WALL OF THE NASAL CAVITYANTERIOR ETHMOIDAL A.POSTERIOR ETHMOIDAL A.SPHENO PALATINE A.GREATER PALATINE A.SEPTAL BRANCH OF THE SUPERIOR LABIAL A. ( FROM THE FACIAL A. )

  • KIESSELBACH AREAANTERIOR PART OF THE NASAL SEPTUM.AN AREA RICH IN CAPILLARIES WHERE ALL FIVE ARTERIES SUPPLYING THE SEPTUM ANASTOMOSE.

  • THE VENOUS DRAINAGERICH PLEXUS OF VEIN DEEP TO NASAL MUCOSASPHENOPALATINE V.FACIAL V.OPHTHALMIC V.

  • THE NERVE SUPPLY OF THE NASAl MUCOSAPOSTEROINFERIOR TO 2/3THE MAXILLARY N. ( C.N. V2 ).- CHIEFLY.THE NASOPALATINE N. NASAL SEPTUM.POSTERIOR LATERAL BRANCHES OF THE GREATER PALATINE N. LATERAL WALLTHE ANTEROSUPERIOR PART THE ANTERIOR ETHMOIDAL N. BRANCHES OF THE NASOCILIARY N. ( C.N.V1 ).

  • PARANASAL SINUSESAIR-FILLED EXTENSION OF THE RESPIRATORY PART OF THE NASAL CAVITY IN TO THE FOLLOWING CRANIAL BONESFRONTAL BONE.SPHENOID BONE.ETHMOID BONE.MAXILLARY BONE.

  • FRONTAL SINUSPOSTERIOR TO THE SUPERCILIARY ARCHES AND THE ROOT OF THE NOSEEACH SINUS DRAINS FRONTO NASAL DUCT INFUNDIBULUM SEMILUNAR HIATUS OF THE MIDDLE MEATUS.INNERVATED BY BRANCHES OF THE SUPRAORBITAL N. ( C.N. V1 ).

  • ETHMOIDAL SINUSLOCATED IN THE LATERAL MASS OF THE ETHMOID BETWEEN THE NASAL CAVITY AND ORBIT.THE ANTERIOR ETHMOIDAL CELLS DRAINS DIRECTLY OR INDIRECTLY IN FUNDIBULUM MIDDLE MEATUS.THE MIDDLE ETHMOIDAL CELLS OPEN DIRECTLY IN TO THE MIDDLE MEATUS.THE POSTERIOR ETHMOIDAL CELLS OPEN DIRECTLY IN TO THE SUPERIOR MEATUS.INNERVATED BY ANTERIOR AND POSTERIOR ETHMOIDAL BRANCHES OF THE NASOCILIARY N. ( C.N. V1).

  • SPHENOIDAL SINUSOCCUPY THE BODY OF THE SPHENOID, MAY EXTEND IN THE WING.ONLY THIN PLATES OF BONE SEPARA YE THE SINUSES FROM SEVERAL IMPORTANT STRUCTURE; THE OPTIC N AND OPTIC CHIASM, THE PITUITARY GLAND, INTERNAL CAROTED A. AND CAVERNOUS SINUSES.SEVERAL POSTERIOR ETHMOIDAL CELLS INVADE THE SPHENOID, GIVING RISE TO MUL TIPLE SPHENOIDAL SINUSES THAT OPEN SEPARATELY IN TO THE SPHENOIDAL RECESS.THE POSTERIOR ETHMOIDAL A. AND N. SUPPLY SPHENOID SINUS.

  • THE MAXILLARY SINUSESTHE APEX OF THE SINUS EXTENDS TOWARD AND OFTEN IN TO THE ZYGOMATIC BONE.THE BASE OF THE SINUS FORM THE INFERIOR PART OF THE LATERAL WALL OF THE NASAL CAVITY.THE ROOF IS FORMED BY THE FLOOR OF THE ORBIT.THE FLOOR IS FORMED BY THE ALVEOLAR PART OF THE MAXILLA.EACH SINUS DRAIN BY AN OPENING THE MAXILLARY OSTIUM IN TO MIDDLE MEATUS

  • THE MAXILLARY SINUSARTERIAL SUPPLYMAINLY FROM SUPERIOR ALVEOLAR BRANCHES OF THE MAXILLARY A.THE GREATER PALATINE A FLOOR.INNERVATIONTHE ANTERIOR, MIDDLE AND POSTERIOR SUPERIOR ALVEOLAR N., BRANCHES OF THE MAXILLARY N. ( C.N. V2 ).

  • PHARYNXTHE PART OF THE ALIMENTARY CANAL POSTERIOR TO THE NASAL AND ORAL CAVITY.EXTENDS FROM THE BASE OF THE CRANIUM TO THE INFERIOR BORDER OF THE CRICOID CARTILAGE ANTERIORLY AND THE INFERIOR BORDER OF V.C.6 POSTERIORLY.DIVIDED IN TONASOPHARYNX.OROPHARYNX.LARYNGOPHARYNX.

  • NASOPHARYNXHAS A RESPIRATORY FUNCTION.LIES SUPERIOR TO THE SOFT PALATE AND IS THE POSTERIOR EXTENSION OF THE NASALCAVITY.THE PHARYNGEAL TONSIL ( ADENOID )ORIFICE OF THE PHARYNGOTYMPANIC TUBE.TUBAL TONSIL.THE SALPINGOPHARYNGEAL FOLD Salpingo pharyngeal m. opening of the pharyngeal orifice during swallowing.

  • OROPHARYNXDIGESTIVE FUNCTIONBOUNDARIESANTERIORSOFT PALATE.BASE OF THE TONGUE.LATERALPALATOGLOSSAL ARCH.PALATOPHARYNGEAL ARCH.EXTENDS FROM THE LEVEL OF THE SOFT PALATE TO THE SUPERIOR BORDER OF THE EPIGLOTTIS.

  • DEGLUTIONDEGLUTION , is the complex process that transfers a food bolus from the mouth through the pharynx and esophagus in to the stomach.STAGE I : voluntary ; the bolus is compressed against the palate and pushed from the mouth into the oropharynx, mainly by ovement of the muscles of the tongue and soft palate.

  • DEGLUTIONSTAGE 2 : involuntary and rapid ; the soft palate is elevated, sealing off the nasopharynx from the oropharynx and laryngopharynx. The pharynx widens and shortens to receive the bolus of food as the suprahyoid muscles and longitudinal pharyngeal muscle contract, elevating the larynx.STAGE 3 : involuntary ; sequential contraction of all three muscles forces the food bolus inferiorly into the esophagus.

  • THE PALATINE TONSILSCOLLECTION OF LYMPHOID TISSUE ON EACH SIDE OF THE OROPHARYNX.LIES IN THE TONSILAR BED, BETWEEN THE PALATOGLOSSAL AND PALATOPHARYNGEAL ARCHES.THE BED IS FORMED BY THE SUPERIOR CONSTRICTOR OF THE PHARYNX AND THE PHARYNGOBASILAR FASCIA.

  • LARYNGOPHARYNXPOSTERIOR TO THE LARYNGEAL INLET AND THE VESTIBULE AND VENTRICLE OF THE LARYNX.EXTENDS FROM THE SUPERIOR BORDE OF THE EPIGLOTTIS TO THE ESOPHAGU AT THE LEVEL OF THE INFERIOR BORD DER OF THE CRICOID CARTILAGE.POSTERIORLY IS RELATED TO THE BO DIES OF C4 THROUGH C6 VERTEBRAE.COMMUNICATES WITH THE LARYNX THROUGH THE LARYNGEAL INLET

  • THE NERVE SUPPLY TO THE PHARYNXPHARYNGEAL PLEXUS OF NERVEMOST OF SENSORY AND MOTORPHARYNGEAL BRCH OF THE C.N. X - MOTOR.GLOSSOPHARYNGEAL ( C.N.) - SNSR.SYMPATHETIC BRCH FROM THE SUPERIOR CERVICAL GANGLION.

  • PHARYNGEAL LYMPHOID RINGPALATINE TONSIL.LINGUAL TONSIL.PHARYNGEAL TONSIL.TUBAL TONSIL.

  • RESPIRATORY LAYER OF THE CERVICAL VISCERAI.E LARYNX.TRACHEA.MAIN FUNCTIONROUTING AIR AND FOOD INTO THE RESPIRATORY TRACT AND ESOPHAGUS.PROVIDING A PATENT AIR WAY AND A MEANS OF SEALING IT OFF TEMPORARILY.PRODUCING VOICE.

  • LARYNXLIES IN THE ANTERIOR PART OF THE NECK AT THE LEVEL OF THE BODIES OF C3 THROUGH C6 VERTEBRAE.COMPOSED OF 9 CARTILAGE.CONTAINING THE VOCAL FOLD.GUARD THE AIR PASSAGES, ESPECIALLY DURING SWALLOWING

  • THE LARYNGEAL SKELETONTHREE CARTILAGE ARE SINGLETHYROID CARTILAGE.CRICOID CARTILAGE.EPIGLOTTIC CARTILAGE.THREE CARTILAGE ARE PAIREDARYTENOID CARTILAGE.CORNICULATE CARTILAGE.CUNEIFORM CARTILAGE.

  • THE LARYNGEAL CAVITYEXTEND FROM THE LARYNGEAL INLET TO THE LEVEL OF THE INFERIOR BORDER OF THE CRICOID CARTILAGE.DIVIDE INTO 3 PARTLARYNGEAL VESTIBULEBETWEEN THE LARTNGEAL INLET AND THE VESTIBULAR FOLD.MIDDLE PART OF THE LARYNGEAL CAVITYTHE CENTRAL CAVITY BETWEEN THE VESTIBULAR AND AND VOCAL FOLDS.LARYNGEAL VENTRICLERECESSES EXTENDING LATERALLY FROM THE NIDDLE PART OF THE LARYNGEAL CAVITY BETWEEN FESTIBULAR AND VC FOLDINFRA GLOTTIC CAVITYFROM THE FOCAL FOLDS TO THE INFERIOR BORDER TO THE CRICOID CARTILAGE.

  • THE VOCAL FOLDEACH VOCAL FOLD INCLUDESA VOCAL LIGAMENTA VOCAL MUSCLESTHE SOURCE OF SOUND THAT COME FROM THE LARYNXAS THE MAIN SPHINCTER OF THE RESPIRATORY TRACT

  • MUSCLES OF THE LARYNXTHE EXTRINSIC LARYNGEAL MUSCLESMOVE THE LARYNX AS A WHOLE.DEPRESSORINFRAHYOID M.ELEVATORSUPRAHYOID M.STYLOPHARYNGEUS M.THE INTRINSIC LARYNGEAL MUSCLESMOVE THE LARYNGEAL PARTS.MAKING THE ALTERATIONS IN THE LENGTH AND TENSION OF THE VOCAL FOLD ANDS AND IN THE SIZE AND SHAPE OF THE RIMA GLOTTIDIS

  • VESSELS OF LARYNXARTERIAL SUPPLYTHE INFERIOR LARYNGEAL A.THE SUPERIOR LARYNGEAL A.LARYNGEAL VEINSTHE INFERIOR LARYNGEAL V.THE SUPERIOR LARYNGEAL V.LYMPHATICS DRAINAGESUPERIOR TO THE VOCAL FOLDACCOMPANY THE SUPERIOR LARYNGEAL A. SRAINS INTO THE SUPERIOR DEEP CERVICAL L.N.INFERIOR TO THE VOCAL FOLDDRAIN INTO THE PRE TRACHEAL OR PARATRACHEAL L.N. AND THEN TO INFERIOR DEEP CERVICAL L.N.

  • NERVES OF THE LARYNXTHE SUPERIOR LARYNGEAL N.ARISES FROM THE INFERIOR VAGAL GANGLIONTHE INTERNAL LARYNGEAL N.THE EXTERNAL LARYNGEAL N.THE INFERIOR LARYNGEAL N.THE CONTINUATION OF THE RECURRENT LARYNGEAL N ( A BRANCH OF C.N. X ).THE ANTERIOR BRANCH.THE POSTERIOR BRANCH.

  • TRACHEAA FIBROCARTILAGINOUS TUBE, IS SUPPORTED BY INCOMPLETE CARTILA GINOUS TRACHEAL RING, THE POSTER IOR GAP IS SPANNED BY THE INVOLUNTARY TRACHEALIS MUSCLE.EXTENDS FROM THE LEVEL OF THE V.C 6 THROUGH THE STERNAL ANGLE ( THE T4-T5 IV DISC )

  • TRACHEOSTOMYTRANSVERSE INCISSION OF THE SKINTHE INFRAHYOID MUSCLES ARE RETRACTED LATERALLYTHE ISTHMUS OF THE THYROID GLAND IS EITHER DEVIDED OR RETRACTED SUPERIORLYAN OPENING IS MADE BETWEEN THE FIRST AND SECOND TRACHEAL RING OR THE SECOND THROUGH 4TH RINGA TRACHEOSTOMY TUBE IS THEN INSERTED INTO THE TRACHEA AND SECURED

  • THE TRACHEA AND BRONCHITHE TRACHEA BIFURCATES AT THE LEVEL OF THE TRANSVERSE THORACIC PLANE INTORIGH MAIN ( PRIMARY ) BRONCHUSTHREE LOBAR ( SECONDARY ) BRONCHISEGMENTAL ( TERTIARY ) BRONCHIBRONCHOPULMONARY SEGMEN.LEFT MAIN ( PRIMARY ) BRONCHUSTWO LOBAR ( SECONDARY ) BRONCHISEGMENTAL ( TERTIARY ) BRONCHIBRONCHOPULMONARY SEGMEN.

  • TRACHEOBRONCHIAL TREE

  • SEVERAL CHANGES IN THE BRONCHIAL TREETHE MUCOUS MEMBRANE - PSEUDOSTRATIFIED CILIATED COLUMNAR EPITHELIUM - primary bronchus - secondary bronchus - tertiary bronchus - CILIATED SIMPLE COLUMNAR EPITHE- LIUM WITH SOME GOBLET CELLS - large bronchioles - MOSTLY CILIATED SIMPLE CUBOIDAL EPITHELIUM WTH NO GOBLET CELLS - smaller bronchioles. - MOSTLY NON CILIATED SIMPLE CUBOIDAL EPITHELIUM - termial bronchioles

  • SEVERAL CHANGES IN THE BRONCHIAL TREEPLATES OF CARTILAGE GRADUALLY REPLACE - INCOMPLETE RING OF CARTILAGE - primary bronchus - DISAPPEAR - distal bronchiolesTHE AMOUNT OF CARTILAGE DECREASES, THE AMOUNT OF SMOOTH MUSCLE INCREASES. SMOOTH MUSCLE ENCIRCLES THE LUMEN IN SPIRAL BANDS

  • BRONCHOPULMONARY SEGMEN

  • BRONCHOPULMONARY SEGMENPYRAMIDAL-SHAPE SEGMEN OF THE LUNG.THE LARGEST SUBDIVISION OF THE LUNG.SEPARATED FROM ADJACENT SEGMEN TS BY CONNECTIVE TISSUE SEPTA.SUPPLIED INDEPENDENTLY BY A SEGM ENTAL BRONCHUS AND A TERTIARY BRANCH OF THE PULMONARY ARTERY.NAMED ACCORDING TO THE SEGMENTAL BRONCHI SUPPLYING THEM.DRAINED BY INTERSEGMENTAL PARTS OF THE PULMONARY VEINSSURGICALLY RESECTABLE.USUALLY 10 IN THE RIGHT LUNG , 8 10 IN THE LEFT LUNG.

  • ALVEOLITHE WALLOF ALVEOLI - TWO TYPES OF ALVEOLAR EPITHELIAL CELLS - TYPE I ALVEOLAR CELLS - simple squmous epithelial - the main sites of gas exchange - TYPE II ALVEOLAR CELLS - between type I cells - containing microvilli - secrete alveolar fluid . Surfactans - keep the surface between cells and the air moist * ALVEOLAR MACROPHAGE ( DUST CELLS ) - ELASTIC BASEMENT MEMBRANE

  • THE RESPIRATORY MEMBRANETHE ALVEOLAR WALL - type I alveolar cells. - type II alveolar cells. - alveolar macrophagesAN EPITHELIAL BASEMENT MEMBRANE - underlying the alveolar wall.A CAPILLARY BASEMENT MEMBRANE - often fused to the epithelial basement membraneTHE CAPILLARY ENDOTHELIUM

  • VASULATURE OF THE LUNG AND PLEURAEPULMONARY ARTERY.PULMONARY VEINS.BRONCHIAL ARTERIES -Two left bronchial arteries thoracic aorta -Single right bronchial artery. Most commonly from proximal part of one of the upper posterior intercostal arteries, or from the common trunk with the left superior bronchial arteryVENTILATION-PERFUSION COUPLING

  • VASCULATUREOF THELUNGBRONCHIAL VEINS - Right bronchial vein --- azygos vein - Left bronchial vein --- accessory hemi azygos vein, or left superior inter costal vein. - Receive some blood from esophageal veins

  • PULMONARY LYMPHATIC PLEXUSESSUPERFICIAL LYMPHATIC PLEXUS - Lie deep to the visceral pleura - Drain into the bronchopulmonary lymp nodDEEP LYMPHATIC PLXUS - In the submucosa of the bronchi and in the peribronchial connective tissue. - Drain initially to the pulmonary lymph node along the lobar bronchiLymph from the superficial and deep lymphatic plecusesDrain in to the superior and inferior tracheobronchial lymph Nodes, than to the right and left bronchomediastinal lymphTrunk, than to the venoun angle

  • NERVES OF THE LUNG AND PLEURAEPULMONAY PLEXUSES ANTERIOR AND POSTERIOR.N. VAGUS - Cell bodies of post synaptic parasympa thetic neuron are in the pulmonry plexuses and along the branches of the bronchial tree.SYMPATHETIC TRUNKS - cell bodies of post synaptic sympathetic neuron are inthe paravertebral sympathetic ganglia.

  • NERVES OF THE LUNG AND PLEURAEN. VAGUS - Motor to the smooth muscle of the bronchial tree ( broncho constrictor ). - Inhibitory the pulmonry vessels ( vasodiltr ) - Secretory to the glands of the bronchial tree ( secretomotor )

  • REFLEXIVE VISCERAL AFFERENT FIBERS OF CN XBronchial mucosa, probanly in association with tactile sensation for cough reflexes.Bronchial muscles, possibly involved in strectch receptions.Interalveolar connective tissue, in associatio with Hering Breuer reflexes.Pulmonary arteries serving pressor receptors.Pulmonary veins, serving chemoreceptors

  • NERVES OF THE LUNGVisceral afferent fibers mediating nociceptive impulses from the visceral pleura and bronchi accompany the sympathetic fibers.whereas those from the trachea accompany the parasympathetic fbrThe sympathetic fibers are inhibitory to the bronchial muscle ( bronchodilator ), motor to the pulmonary vessels ( vasoconstrictor ), and inhibitory to the alveolar glands of the bronchial tree type 2 secretory epithelial cells of the alveoli

  • NERVES OF THE LUNGThe nerves of the parietal peura derived from the intercostal and phrenic nerves.The costal pleura and the peripheral part of the diaphragmatic pleura are suppliied by theintercostal nerves.The central part of the diaphragmatic pleura and the mediatinal pleura are supplied by the phrenic nerves.

  • NERVES OF THE LUNG AND PLEURAEDeived from the pulmonary plexuses anterior and ( mainly ) posterior to the root of the lung.Parasympathetic fibers from the CN X.Cells bodies of postsynaptic neurons are in the pulmonary plexuses and along the branches of the bronchial tree.Parasympathetic are motor to the smoth muscle of the bronchial tree ( bronchoconstrictor ), inhibitory to the pulmonary vessels ( vasodilator ), and secretory to the glands of bronchial tree ( secretomotor )Reflexive visceral afferent fibers of CN X

  • REFLEXIVE VISCERAL AFFERENT FIBERS OF CNX Bronchial mucosa ( tactile receptor- cough )Bronchial muscles ( stretch receptors )Interalveolar connective tissue ( H.Breuer )Pulmonary arteries ( pressor receptors )Pulmonary veins ( chemoreceptors )

  • NERVES OF THE LUNGS AND PLEURAECell bodies of postsynaptic sympathetic neurons,are in the paravertebral sympathetic ganglia of the sympathetic trunks.The sympathetic fibers are inhibitory to the bronchial muscle ( bronchodilator ), motor to the pulmonary vessels ( vasoconstrictor ), and inhibitory to the alveolar glands of the bronchial tree type II secretory epithelial cells of the alveoli

  • INNERVATION OF THE PLEURA AND DIAPHRAGMThe parietal pleura derive from the intercostal and phrenic nerves.The costal pleura and the peripheral part of the diaphragmatic pleura are supplied by the intercostal nerves.The central part of the diaphragmatic pleura and the mediastinal pleura are supplied by the phrenic nerves.Visceral afferent fibers mediating nociceptive impulses from the visceral pleura and bronchi accompany the sympathetic fibers, where those from the trachea accompany the parasympathetic fibers of the CN X.