sistem pernafasan
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ANATOMI DAN FISIOLOGIPERNAFASAN
Dr. Aidi Nasrul
AKBID SUMBARLUBUK ALUNG
2008
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Introduction to Pulmonary Physiology
• The pulmonary system, in tandem withthe cardiovascular system, works tocarry out three functions:– Ventilation– Perfusion– Diffusion
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Anatomy
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Upper Airways
• Structures– Nasopharynx– Oropharynx– Tongue– Epiglottis– Larynx
• Function– Protection– Humidification– Filtration
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Lower Airways
• Structures– Trachea
– Mainstem bronchi
– Bronchioles
– Terminal bronchioles
• Function– Filtration
– Transmission of air
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Structural Considerations
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Structural Considerations
• Cilia: beat 100times/second
• MAST cells secretesticky substance filledwith WBCs
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Alveolus
• 100 million alveoli ineach lung
• Single cell thick wall
• Immediately adjacentto pulmonarycapillary
• Gas exchanges viadiffusion
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1. Ventilation
• Definition: movement ofair from the externalenvironment to thealveoli
• Components:• Brain• Innervation• Chest wall• Upper airways• Lower airways
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Inspiration
• Increasedintrathoracic space
• Negative pressure• Bronchioles dilate• Air enters
airways/alveoli(unless a hole ispresent in the chestwall)
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Expiration
• Diaphragm &intercostals relax
• Thoracic space getssmaller
• Increasedintrathoracic pressure
• Air passively exits viaairways
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What Happens to the Airways?
• Smooth-muscle linedairways (bronchioles)naturally changediameter withinspiration andexpiration
• (This will beimportant when wediscuss obstructivelung disease)
Inspiration
Expiration
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2. Perfusion
• Definition of perfusion:adequate blood flowthrough the pulmonarycapillary bed
• Components:– Intact pulmonary capillary
bed– Adequate cardiac function– Adequate blood volume
R Heart L Heart
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Pulmonary Capillary Bed
May be damaged by:• Clots (pulmonary
emboli)• Crushing injuries
(pulmonarycontusion)
R Heart L Heart
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Cardiac Function
• The pulmonary capillarybed is part of thecardiopulmonary circuit
• Impairment of flowthrough any chamber orvalve will impactpressures and flow
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Blood Volume
• Adequate perfusion requires adequateblood volumes AND composition
• Reduction of volume, or decreased/inadequate RBCs will diminish perfusion
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3. Diffusion
– Definition of diffusion:movement of gasesbetween the alveoli andthe pulmonary capillarybed
– Components:• Alveolus• Basement membrane
(interstitial space)• Capillary wall
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Diffusion?
• The passive exchangeof gases along aconcentrationgradient (high to low)
• Exchange continuesuntil theconcentrations areequal
O2CO2 CO2
O2
O2
CO2CO2 O2
Before diffusion
After diffusion
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Diffusion?
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Basement Membrane
• Includes the walls of thealveolus and capillary
• Most importantly,includes the interstitialspace between the wallsof the capillary andalveoli
• Drainage via lymphatics
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Capillary Wall
• If capillary wall isthickened, diffusionwill be impaired
• If capillary wall isdamaged, diffusionwill be impaired
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Terima Kasih
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