Transcript Weinmann Schulung Medumat Transport

Medical Training
- Anatomy For internal use only
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Objective of the Presentation
• This presentation on the subject of anatomy of the respiratory
system gives participants an overview of the anatomical structures
required for normal respiration in a human being.
2
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Contents
•
•
•
•
•
•
Conducting airways
Gas exchange system
Lungs, thorax, diaphragm
Central controller
Upper and lower airways
Oxygen transport
3
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Overview
• The respiratory system includes – in addition to the air-conducting
and gas exchanging respiration tract – all other structures involved
in breathing.
• They are categorized in groups according to anatomical descriptions
(upper/lower airways) or to basic functions (air-conducting/gasexchanging system).
4
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Conducting Airways
The conducting airways are divided into:
• Nose
• Mouth
• Pharynx
• Larynx
• Trachea
• Bronchial tree
Within the conducting airways the air is warmed, moistened and
transported.
5
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Gas Exchange System
•The gas exchange system is subdivided into
– alveoli
– capillary network
Within the gas exchange system oxygen is taken up by the blood and
carbon dioxide is removed from the lungs.
6
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Lungs
Two lungs:
right lung and left lung
Hilum of lung: main bronchus and vessels
Right:
Superior lobe (3 segments)
Median lobe (2 segments)
Inferior lobe (5 segments)
Left:
Superior lobe (4 – 5 segments)
Inferior lobe (5 segments)
Base of lung (basis pulmonis)
Apex of lung (apex pulmonis)
Visceral pleura (= pleura pulmonalis)
7
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Thorax and Diaphragm
• Osseous Thorax
– Thoracic spine
– Ribs (costae)
– Breastbone (sternum)
– Parietal pleura
• Diaphragm
• Intercostal muscles
8
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Respiratory Controller
• Respiratory center in
brainstem
• Medulla oblongata
9
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Upper Airways
• The upper airways begin with the mouth or nose and come together
in the pharynx and end near the larynx.
• The upper airways also contain the pathway for nutrition
(oropharyngeal area).
• Airway assistance such as nasopharyngeal (Wendl) tubes or
oropharyngeal (Guedel) tubes can be used within the upper airways.
10
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Nasal Cavity
•
•
•
•
Organ for inspiration and expiration
Warms respiratory air
Moistens respiratory air
Filters out foreign bodies (by means of nasal hair and cilia)
11
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Pharynx
•
•
•
•
Throat
Part of the respiratory and digestive systems
Mucosal covering
Component of upper airways
12
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Larynx
• = voice box
• Transition from upper to lower airways
• Made up of three large pieces of cartilage
– Thyroid cartilage (cartilage thyroidea)
– Cricoid cartilage (cartilago cricoidea)
– Epiglottis
• Function: closes off the airways
– to swallow
– to cough
– to generate sound
13
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Lower Airways
• The lower airways start at the subglottis
• The lower airways contain the trachea, main bronchus, segmental
bronchi
• The lower airways run to the alveoli level and, together with the
upper airways, form the air-conducting system.
14
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Trachea
•
•
•
•
= windpipe
Length: approximately 10 – 12 cm
Width: approx. 16 –18 mm
16 – 20 rings of cartilage with membrane of connective tissue and
muscles
• Mucus membrane: ciliated epithelium with goblet cells
• Bifurcation: Division of trachea (at 70° angle)
into right and left main bronchus
15
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Bronchial Tree
• Two (left and right) main
bronchi (bronchi principales)
• Two to three lobar bronchi
(bronchi lobares )
• Two to five segmental
bronchi
• Subsegmental bronchi
• Bronchioles
• Terminal bronchioles
• Respiratory bronchioles
• Alveoli system (alveolar
ducts, alveolar atria, alveolar
sacs)
16
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Surfactant
•
•
•
•
•
•
Surface active agent
Surface active substance on the interior surface of alveoli
Reduction of surface tension by a factor of 15 to 20
Reduction of “opening pressure” of small alveoli
To increase pulmonary compliance
To prevent collapse of alveoli at end of expiration
17
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Alveoli
Cells of alveoli wall
• Pneumocyte Type I
• Pneumocyte Type II
• Capillary endothelium
• Interstitial cells (fibrocytes,
lymphocytes, mastocytes)
• Alveolar macrophage
18
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Gas Exchange
• Transfer of O2 from the
alveoli into blood or of CO2
from blood into alveoli by
means of alveolar-capillary
membrane
19
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Alveolar-Capillary Membrane
Alveolar epithelium
Interstitium
Capillary endothelium
Plasma
Erythrocyte
20
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Oxygen Transport
• 98.5 % binds to hemoglobin (Hb)
– Hemoglobin = red blood pigment in erythrocytes
– Cooperative binding of four oxygen molecules
– 1 gram Hb can bind 1.34 ml oxygen
• 1.5 % physiologically dissolved
21
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training Anatomy, June 2008
Summary
• Basic knowledge of anatomy of airways makes respiratory disorders
more understandable.
• Basic knowledge of anatomy is a prerequisite for understanding
respiratory physiology.
• Basic knowledge of anatomy and physiology are fundamental
prerequisites for patient adaptive ventilation.
22