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8/19/2019 K1 - Anatomi Sistem Respirasi
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Fitranto Arjadi
Anatomy, Medical Faculty UNSOED
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Nose
• 2 openings called nostrils separated by nasal
septum• The lateral margin ala of nose rounded and
mobile.
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The frameworkof the externalnose is made of:
nasal bonesthe maxillaebone
frontal bone
Belo! the bone#arts its ormed o
plates ofhyalinecartilage
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Divided into tworegions :
&he e'ternal nose and theinternal nasal cavitySe#arated by a midlinenasal septumEach nasal cavity has a
oor, roof, medial wall,and lateral wall(ateral to the nasalcavities are the orbits
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&he anterior
a#ertures o thenasal cavities are
naresnares, !hicho#en onto the
inerior surace othe nose)
&he #osterior
a#ertures are thechoanae, !hicho#en into thenaso#haryn')
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Sinuses
Ductus
nasolacrimalis
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rom oral cavity belo!by the hard palate
rom the cranial cavity
above by #arts o thefrontal, ethmoid, andsphenoid bones)
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Nasal septum:
* Above:#er#endicular #lateo the ethmoid)
* Belo! and in
ront: se#talcartila"e)
* Belo! andbehind: vomer)
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Walls, oor, and roof
Medial wallnasal septum, !hich
is oriented vertically
in median sa"ittal#lane and se#aratesri"ht and let nasalcavities
eptum of :
!"septal cartilage#"vertical plate of
the ethmoid$"vomer"
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Ethmiod boneEthmoid bone &he sin"le ethmoid bone
is one o the most
com#le' bones in thes+ull)
t contributes to theroo, lateral !all, andmedial !all o both nasal
cavities, and containsthe ethmoidal cells-ethmoidal sinuses.)
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Nasal %avity
/ &he cavity o the nose is subdivided intori"ht and let halves by the nasal septum.
/ &he t!o halves o#en anteriorly on the acethrou"h the nostrils -anterior nares., ando#en #osteriorly into the naso#haryn'throu"h the #osterior nasal a#erture)
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&egionsEach nasal cavity consists o 0
"eneral re"ionsthe nasal vestibule is a small
dilated s#ace just internal to thenaris that is lined by s+in andcontains hair ollicles1
the respiratory region is the
lar"est #art o the nasal cavity, hasa rich neurovascular su##ly, and islined by res#iratory e#itheliumcom#osed mainly o ciliated andmucous cells1
the olfactory region is small, is atthe a#e' o each nasal cavity, islined by olactory e#ithelium, andcontains the olactory rece#tors)
n addition to housin" rece#tors orthe sense o smell -olaction., thenasal cavities adjust thetem#erature and humidity o
res#ired air, and tra# and remove#articulate matter rom the air!ay)
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'ony skeleton of the nose
(" &oof, formed by: / Anterior #art////// Nasal #art o the
rontal bone 2 Nasal bone)
/ Middle #art ////// 3ribriorm #late o
the ethmoid bone)
/ 4osterior #art//////Body o the
s#henoid bone)(" )loor, ormed by:
/ Anteriorly: 4alatine #rocess o the
ma'illa)
/ 4osteriorly : 5ori%ontal #lates o the
#alatine bone)(((" *edial wall +nasal septum,
formed by:
/ 4ostero/inerior///////6omer)
/ Su#eriorly ///// 4er#endicular #late othe ethmoid bone)
/ Antero/inerior /////Se#tal cartila"e)
-$oo, 7oor, andmedial !all o the
nose.
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Roof
narro!)ormed by :
8)cribriorm #late o
the ethmoid bone9)nasal and rontal
bones, and#osteriorly
s#henoid Bone)
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FloorIt consists of:
palatine process ofmaxilla & horizontal plateof the palatine bone,which together form thehard palate.
The naris opensanteriorly into the floor.
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-ateral wall of the noseb. Middle meatus : t has
* Bulla ethmoidalis: . t is a rounded elevation !here
the middle ethmoidal air sinuso#ens in it)
* Hiatus semilunaris: / t is a crescenteric "roove -. lyin"
belo! the bulla ethmoidalis) / t receives the ollo!in" o#enin"s:
i) Anterior ethmoial air sinus)
ii) Frontal air sinus)
iii) Ma'illary air sinus)
c. Inferior meatus (below theinferior nasal concha):
/ t receives the nasolacrimal duct)d. Spheno-ethmoidal recess:/ t is a trian"ular ossa bet!een the
su#erior concha and the roo othe nose)
/ t receives the o#enin" o the
s#henoidal air sinus)
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nose!" phenopalatine artery/ t is a branch rom the ma'illary artery
-main arterial su##ly.)
#" eptal branch of the superiorlabial artery from facial artery" s+in o the ala and lo!er #art o these#tum are by branches
$" /scending branch of the
greater palatine artery rom thema'illary artery "
/ There is anastomoses between theabove three arteries to form12ieselbach3s plexus4 on theantero-inferior part of the nasalseptum +-ittle5s area"
/ &his area is a common site orepistais -bleedin" rom the nose.)
6" /nterior and posteriorethmoidal branches of theophthalmic artery" su##ly the rooand u##er #arts o the lateral !all andse#tum)
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nose
(" -ateral wall
/ 7lfactory area -8 cm. Olactory nerves) -this area includes the roo and u##er #arts o the se#tum and lateral nasal !alls.
/ 0estibular area nraorbital nerve)
/ &espiratory area of the lateral wall:
a) /ntero.superior anterior ethmoidal N)
b) /ntero.inferior -in) concha. nternal nasal nerve-rom anterior ethmoidalN.
c) 8ostero.superior (ateral #osterior su#erior nasal brs)
d) 8ostero.inferior (ateral #osterior inerior nasal brs -rom "reater #alatine N.)
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Nerve su##ly8/ensory:
o#hthalmicdivision -68. andma'illary division-69. o the
tri"eminal nerve &he inratrochlear
and e'ternal nasalbranches o theoph.thalmic
nerve +%N 0"nraorbital brancho the maxillarynerve +%N 0"
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Nerves ofnasal cavity:
8/ensory: o#hthalmicdivision -68. andma'illary division-69. o thetri"eminal nerve
9/ 7lfactorynerve: (t is thenerve of smell)t su##lies theolfactorymucosa !hich issituated in theroof o the nasalcavity)
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phenopalatine 9anglionType: 4arasym#athetic
"an"lion)
ite: n the #tery"o#alatineossa)
&oots +preganglionic bers:!" ensory: From the ma'illary
nerve)
#" ympathetic supply: Dee##etrosal nerve !hich arises
rom the sym#athetic #le'usaround the internal carotidartery)
$" 8arasympathetic: ;reater#etrosal nerve -rom acial N.
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phenopalatine 9anglion
+branches8) 4ost"an"lionic secreto/
motor ) Naso#alatine nerve)- lon" s#heno#alatine.
?) 4haryn"eal branch to the#haryn')
@) Branches to the orbital#eriosteum)
NB: The postganglionic branchesof the sphenopalatine ganglion
supply the mucous glands of the
palate, nose, nasopharynx and
the lacrimal gland.
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((" Nasal septum/ Olactory area Olactory N)/ Anterior #art nternal nasal N) -rom the anterior ethmoidal nerve.)
/ 4ostero/su#erior #art Medial #osterior su#erior nasal branches) -roms#heno#alatine "an"lion.)
/ 4ostero/inerior #art Naso#alatine nerve) - lon" s#heno#alatine nerve.)
N"': &he naso#alatine nerve, "reater and lesser #alatine nerves, medial
and lateral #osterior su#erior nasal nerves, and the #osterior ineriornasal nerve are branches rom the s#heno#alatine "an"lion)
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Denition: / &hey are air/
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Types:
!" *axillary sinus //////// nside
the body o the ma'illa)#" )rontal sinus ///////////
Bet!een the t!o #lates o therontal bone)
$" phenoid //////////////// nsidethe body o the s#henoid bone)
6" ;thmoid ///////////////// nsidethe lateral #art o the ethmoidbone
- All the sinuses are present atbirth except the frontal sinuswhich appears during thesecond year.
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! phenoidal air sinuses:
*&hese are 9 sinuses !hich lie inside the body osphenoid and are se#arated rom each other by a bony
se#tum)# ;thmoidal air sinuses:
*&hese are lar"e number o intercommunicatin" cavities#resent inside the ethmoid bone and o#en into the
nose) (ies bet!een nose and orbit)
$ )rontal air sinuses:
*&hese are 9 sinuses !hich lie in the frontal bone just
above the root o the nose)*&hey are se#arated rom each other by a se#tum)
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several #aranasal sinuses have their o#enin"s inthis meatus as ollo!s:
a. Ma'illary air sinus: o#ens into the hiatussemilunaris belo! the bulla ethmoidalis)
b. Anterior ethmoidal sinus: o#ens into thehiatus semilunaris in ront o the bullaethmoidalis)
c. Middle ethmoidal sinus: o#ens on the bullaethmoidalis)
d. Frontal sinus: o#ens into the u##er #art o thehiatus semilunaris)
Openings of the middle meatus:
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7ther openings in the lateral wall ofthe nose:
a. S#henoidal sinus: o#ens into the s#heno/ethmoidal recess just above the su#eriorconcha)
b. 4osterior ethmoidal sinus: o#ens into the
su#erior meatus -belo! the su#eriorconcha.)
c. Naso/lacrimal duct: o#ens into the ineriormeatus)
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N"'": All #aranasal sinuses o#en into the middle meatus o the nosee'ce#t 9:
8. the sphenoidal sinus -into the s#heno/ethmoidal recess.)
9. the posterior ethmoidal sinus -into the su#erior meatus.)
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t is a #yramidal cavity situated inside the body o thema'illa) t is the lar"est #aranasal air sinus)
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&elations:
* Medially:nasal cavity) &he sinuso#ens intothe middlemeatus othe nose)
* Above: orbit* Belo! :
roots o themolar and#remolar
teeth)
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Descri#tion &he #haryn' is situated behind the nasalcavities, the mouth, and the laryn'
t may be divided into nasal, oral, and laryn"eal#arts
ts u##er, !ider end lyin" under the s+ull
ts lo!er, narro! end becomin" continuous !ith
the eso#ha"us o##osite the si'th cervical
vertebra
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Descri#tion &he #haryn' has a musculomembranous !all,!hich is de
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Muscles o the 4haryn' all o the #haryn' consist o the su#erior,middle, and inerior constrictor muscles
Fibers o these muscles run in a some!hatcircular direction
Stylo#haryn"eus and sal#in"o#haryn"eusmuscles
&heir
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Muscles o
the 4haryn' &he three constrictor muscles e'tend around
the #haryn"eal !all to be inserted into a
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Muscles o the 4haryn' &he lo!er #art o the inerior constrictor,!hich arises rom the cricoid cartila"e, iscalled the crico#haryn"eus muscle
&he
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Nasal 4haryn' &his lies above the sot #alate and behind thenasal cavities
n the submucosa o the roo is a collection olym#hoid tissue called the #haryn"eal tonsil
&he #haryn"eal isthmus is the o#enin" in the7oor bet!een the sot #alate and the#osterior #haryn"eal !all
On the lateral !all is the o#enin" o theauditory tube, the elevated rid"e o !hich is
called the tubal elevation
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Nasal 4haryn' &he #haryn"eal recess is a de#ression in the#haryn"eal !all behind the tubal elevation
&he sal#in"o#haryn"eal old is a vertical old
o mucous membrane coverin" thesal#in"o#haryn"eus muscle
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Oral 4haryn' &his lies behind the oral cavity &he 7oor is ormed by the #osterior one third
o the ton"ue and the interval bet!een the
ton"ue and e#i"lottis n the midline is the median "lossoe#i"lottic
old
on each side the lateral "lossoe#i"lottic old
&he de#ression on each side o the median"lossoe#i"lottic old is called the vallecula
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Oral 4haryn'
On the lateral !all on each side are the#alato"lossal and the #alato#haryn"eal arches orolds and the #alatine tonsils bet!een them
&he #alato"lossal arch is a old o mucousmembrane coverin" the #alato"lossus muscle
&he interval bet!een the t!o #alato"lossal archesis called the oro#haryn"eal isthmus
t mar+s the boundary bet!een the mouth and#haryn'
&he #alato#haryn"eal arch is a old o mucousmembrane coverin" the #alato#haryn"eus muscle
&he recess bet!een the #alato"lossal and#alato#haryn"eal arches is occu#ied by the
#alatine tonsil
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(ym#hoid &issue o
4haryn'At the junction o the mouth !ith the oral #art othe #haryn', and the nose !ith the nasal #art othe #haryn', are collections o lym#hoid tissue
&he #alatine tonsils and the naso#haryn"ealtonsils are the most im#ortant
&he dee# cervical lym#h node situated belo! andbehind the an"le o the mandible, !hich drainslym#h rom this or"an, is usually enlar"ed and
tender$ecurrent attac+s o tonsillitis are best treated by
tonsillectomy, the e'ternal #alatine vein, !hichlies lateral to the tonsil, may be the source otroublesome #osto#erative bleedin"
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4alatine &onsils &he tonsil is covered on its lateral surace bya
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Tonsila 8alatina:Se#asan" 1 #ada dindin" lateral oroarin'8/9 inva"inasi dalam -+ri#ta. C eba+microba,enca#sulasi
Tonsila faringea +1adenoids4: &un""al1 #ada ata# nasoarin'ta+ ber+ri#ta, +a#sula ti#is
Tonsila -ingualis:
(ebih +ecil, jumlah banya+, #ada basis lidahri#ta tun""al, +a#sula ti#is
Tonsil
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Su##ly o the 4haryn"eal
Mucous Membranennervation : -Sensori+.
Nasal #haryn': &he ma'illary nerve
Oral #haryn': &he "losso#haryn"eal nerve
(aryn"eal #haryn': &he internal laryn"eal brancho the va"us nerve
6asc : Ascendin" #haryn"eal, tonsillarbranches o acial arteries, and branches o
ma'illary and lin"ual arteries(ym#h : Directly into the dee# cervical lym#h
nodes or indirectly via the retro#haryn"eal or#aratracheal nodes into the dee# cervical
nodes
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Blood Su##ly &he tonsillar branch o the acial artery
&he veins #ierce the su#erior constrictor
muscle and join the e'ternal #alatine, the#haryn"eal, or the acial veins
(ym#h drains into the u##er dee# cervicallym#h nodes, just belo! and behind the an"leo the mandible
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(aryn'
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(aryn'S#eciali%ed or"an at
the inlet o air
#assa"e)
)unction:
8/ 4rotective s#hincter
at the air #assa"e)9/ 4honation)
0/ $e"ulates #assa"eo air in ins#iration
and e'#iration)=/ O#ens closes
durin" s!allo!in",cou"hin" snee%in")
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3artila"es o the (aryn'=npaired cartilages
E#i"lottis &hyroid cartila"e
3ricoid
8aired cartilagesArytenoid
3orniculate
3uneiormAll cartila"es are
hyaline e'ce#t thee#i"lottis -elastic.
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&he rame!or+ o the laryn' is made u# o cartila"es)
&hese cartila"es are connected by joints, membranes li"aments)
Moved by muscles)
(ined by mucous membranes)
The -aryngeal
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The -aryngealcartilage are Nine
$ sin"le $ 4aired
ingle:
&hyroid
3ricoid
E#i"lottis)
8aired:Arytenoids
3orniculate
3uneiorm)
Thyroid %artilage
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Thyroid %artilaget is the lar"est o the
laryn"eal cartila"e)
Formed o 9 laminae,each has su#erior inerior horn)
&he an"le bet!een 9laminae is G in male 89 in emale)
t has 9 notches su#erior inerior at the meetin"
o its 9 laminae)
%onnection of
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%onnection ofthe thyroidcartilage:
Su#erior: &ohyoid bone bythyrohyoid
membrane) nerior: &o cricoid
cartila"e by the
cricothyroid joint cricothyroidmembrane
;piglottis:
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p g
(ea/sha#ed elasticcartila"e)
(ies behind the root o theton"ue)
3onnected by its stal+ tothe bac+ o the thyroidcartila"e)
ts sides are connected tothe arytenoid cartila"e byarye#i"lottic old)
ts u##er end is ree) But
its mucous membrane isconnected to the bac+ oton"ue by 0"lossoe#i"lottic olds onemedian 9 lateral)
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%ricoid cartilage:5yaline)
$in" sha#ed, havin" a narro! anterior arch and !ide #osteriorlamina)
3onnected su#eriorly to thyroid cartila"e by cricothyroid joint and
cricothyroid membrane)
/rytenoid cartilage:4 i d h li il
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4aired hyaline cartila"e)
Sha#ed li+e a 0/ sided#yramid)
ts base sits on the su#eriorsurace o the cricoid lamina)
A#e': directed su#eriorly,su##orts the corniculate
cartila"e)Muscular #rocess directed
laterally, "ives attachment to0 muscles:
4osterior lateralcricoarytenoid)
And &hyroarytenoid)
6ocal #rocess: directedor!ard and "ives attachment
to the vocal li"ament)
M l th (
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Muscles o the (aryn'9 Major "rou#s
;xtrinsic *uscles: - move the !hole laryn'.;levators: Di"astric, stylohyoid, mylohyoid,
"eniohyoid, stylo#haryn"eus,sal#in"o#haryn"eus #alato#haryn"eus)
Depressors: Sternothyroid, sternohyoid omohyoid)
(ntrinsic *uscles - movement !ithin laryn'.
3ontrol o laryn"eal inlet3ontrol o rima "lottidis
3ontrol o len"th tension o vocal cords
!ll intrinsic muscles lie inside the lar"n cricoth"roid !ll intrinsic muscles lie inside the lar"n cricoth"roid
3ricothyroid Muscle
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3ricothyroid Muscle
Ori"in: Anterior #art o arch o cricoid
nsertion: nerior border in) 5orn o thyroid
3auses 7e'ion at cricothyroid joint(en"thens ti"htens the vocal li"ament
Nerve su##ly: E'ternal laryn"eal nerve o su#eriorlaryn"eal o va"us)
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4osterior cricoarytenoid is the onlyabductor o the vocal cords)
Muscles actin" on the
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Muscles actin" on thearytenoids4osteriorcricoarytenoids
(ateral cricoarytenoid
nterarytenoid
muscles: &ransverse
ObliHue
&hyroarytenoidmuscle
Arye#i"lottic muscles
&hyroarytenoid 6ocalis
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&hyroarytenoid 6ocalisMuscles
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i
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nnervation o (aryn'
*7T7& !ll muscles o the laryn' are su##liedthe recurrent laryn"eal nerve EI3E4&
3ricothyroid C su##lied by e'ternal laryn"ealbranch o su#erior laryn"eal nerve)
;N7&> ? ;%&;T7*7T7&
Above 6ocal 3ords: nternal laryn"eal
Belo! 6ocal 3ords: $ecurrentlaryn"eal
The interior of the
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The interior of thelarynx
t is divided into 0 #arts:
8/ vestibule: bet!eenlaryn"eal inlet vestibular old)
9/ 6entricle: a de#ression
e'tendin" laterallybet!een vestibular vocal olds)
0/ nra"lottic cavity: lies
bet!een the vocal old lo!er border o cricoidcartila"e)
t is continuous !ith the
trachea ineriorly)
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Blood Su##ly o (aryn'Su#erior laryn"eal artery Cbranch o su#erior thyroid artery
nerior laryn"eal artery C brancho inerior thyroid artery
0eins accom#any the arteries
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&rachea
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&rachea &he trachea is a mobile cartila"inous and membranous
tube
t be"ins in the nec+ as a continuation o the laryn' at thelo!er border o the cricoid cartila"e at the level o thesi'th cervical vertebra
t descends in the midline o the nec+
n the thora' the trachea ends belo! at the carina by
dividin" into ri"ht and let #rinci#al -main. bronchi Durin" e'#iration the biurcation rises by about one
vertebral level
Durin" dee# ins#iration may be lo!ered as ar as thesi'th thoracic vertebra
n adults the trachea is about =J in) -88)9> cm. lon" and8 in) -9)> cm. in diameter
&he
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5ubun"an
/nterior: sternum, thymus, venabrachioce#halica sinistra, arteri carotis communissinistra dan ar+us aorta
8osterior: Eso#ha"us dan n) (arin"eus re+urens
sinistra &ight side: v)a%y"os vein, n) I destra dan #leura
-eft side: Arcus aorta, a) 3arotis communissinistra, a) Subclavia sinistra, n I sinistra dan n)
4hreni+us sinistra, dan #leura
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Chapter 22, Respiratory ystem !"
&rachea
#igure 22.$a
&racheind#i#e
Divides to
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&rachea
Divides toorm
4rimarybronchi
3arina:3ou"hre7e'
%nsert #ig 2." all but b
•Dense 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 muscle
•The lining of the trachea is pseudostratified
ciliated columnar epithelium with goblet cels
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$elation /nteriorly: &he sternum, the thymus, the letbrachioce#halic vein, the ori"ins o thebrachioce#halic and let common carotid arteries,
and the arch o the aorta 8osteriorly: &he eso#ha"us and the let
recurrent laryn"eal nerve
&ight side: &he a%y"os vein, the ri"ht va"us
nerve, and the #leura -eft side: &he arch o the aorta, the let common
carotid and let subclavian arteries, the let va"usand let #hrenic nerves, and the #leura
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Blood and nerve Su##ly &he sensory nerve su##ly is rom the va"i and the
recurrent laryn"eal nerves Sym#athetic nerves su##ly the trachealis muscle
&he u##er t!o thirds are su##lied by the ineriorthyroid arteries
&he lo!er third is su##lied by the bronchial arteries
(ym#h Draina"e &he lym#h drains into the #retracheal and#aratracheal lym#h nodes and the dee#cervical nodes
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Bronchi &he trachea biurcates behind the arch o theaorta into the ri"ht and let #rinci#al -#rimary,or main. bronchi
&he bronchi divide into several millionterminal bronchioles that terminate in one ormore res#iratory bronchioles
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Bronchi Each res#iratory bronchiole divides into 9 to88 alveolar ducts that enter the alveolar sacs
&he alveoli arise rom the !alls o the sacs asdiverticula
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(et 4rinci#al Bronchus s narro!er, lon"er, and more hori%ontal thanthe ri"ht and is about 9 in) -> cm. lon"
t #asses to the let belo! the arch o the
aorta and in ront o the eso#ha"us On enterin" the hilum o the let lun", the
#rinci#al bronchus divides into a su#erior andan inerior lobar bronchus
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Broncho#ulmonary
Se"ment &he broncho#ulmonary se"ments are theanatomic, unctional, and sur"ical units o thelun"s
Each lobar -secondary. bronchus "ives oKbranches called se"mental -tertiary. bronchi
Each se"mental bronchus #asses to astructurally and unctionally inde#endent unito a lun" lobe called a broncho#ulmonaryse"ment, surrounded by connective tissue
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Broncho#ulmonary
Se"ment &he se"mental bronchus is accom#anied by abranch o the #ulmonary artery
Each se"ment has its o!n lym#hatic vesselsand autonomic nerve su##ly
On enterin" a broncho#ulmonary se"ment,each se"mental bronchus divides re#eatedly
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Broncho#ulmonary
Se"ment As the bronchi become smaller, the U/sha#edbars o cartila"e ound in the trachea are"radually re#laced by irre"ular #lates o
cartila"e
&he smallest bronchi divide and "ive rise tobronchioles, !hich are less than 8 mm in
diameter
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Broncho#ulmonary
Se"ment Bronchioles #ossess no cartila"e in their !alls andare lined !ith columnar ciliated e#ithelium
&he submucosa #ossesses a com#lete layer ocircularly arran"ed smooth muscle
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Broncho#ulmonary
Se"ment &he diameter o a res#iratory bronchiole is about )>mm
&he res#iratory bronchioles end by branchin" into
alveolar ducts, !hich lead into tubular #assa"es !ithnumerous thin/!alled out#ouchin"s called alveolar sacs
&he alveolar sacs consist o several alveoli o#enin" intoa sin"le chamber
Each alveolus is surrounded by a rich net!or+ o blood
ca#illaries ;aseous e'chan"e ta+es #lace bet!een the air in the
alveolar lumen throu"h the alveolar !all into the blood!ithin the surroundin" ca#illaries
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3haracteristics o
Broncho#ulmonary Se"ment t is a subdivision o a lun" lobe t is #yramid sha#ed, !ith its a#e' to!ard the
lun" root
t is surrounded by connective tissue t has a se"mental bronchus, a se"mental
artery, lym#h vessels, and autonomic nerves
&he se"mental vein lies in the connective tissuebet!een adjacent broncho#ulmonary se"ments
Because it is a structural unit, a diseasedse"ment can be removed sur"ically
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(OAS 4A$U/4A$U D
$ON;;A DADA
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(un"s &!o lun"s are sot, s#on"y and elasticn the child, they are #in+, but !ith a"e, they
become dar+ and mottled because o theinhalation o dust #articles
&hese #articles are tra##ed in the #ha"ocyteso the lun"
&he lun"s are situated so that one lies on
each side o the mediastinum
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(un"s &!o lun"s are se#arated rom each other bythe heart and "reat vessels and otherstructures in the mediastinum
Each lun" is conical, covered !ith visceral#leura and sus#ended ree in its o!n #leuralcavity
Attached to the mediastinum only by its root
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(un"sA blunt a#e' #rojects u#!ard into the nec+ orabout 8 in) -9)> cm. above the clavicle
A concave base that sits on the dia#hra"m
A conve' costal surace, !hich corres#onds tothe concave chest !all
A concave mediastinal surace, !hich is moldedto the #ericardium and other mediastinalstructures
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( b d Fi $
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(obes and Fissures o $t)
(un" &he ri"ht lun" is sli"htly lar"er than the let
Divided by the obliHue and hori%ontal cm. belo!
the a#e'
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( b d Fi $t
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(obes and Fissures o $t)
(un" &he let lun" is divided by a similar obliHue
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$i"ht lun" uperior lobe: A#ical, #osterior, anterior
*iddle lobe: (ateral, medial
(nferior lobe: Su#erior -a#ical., medial basal,anterior basal, lateral basal, #osterior basal
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(et lun" uperior lobe: A#ical, #osterior, anterior,su#erior lin"ular, inerior lin"ular
(nferior lobe: Su#erior -a#ical., medial basal,anterior basal, lateral basal, #osterior basal
Bl d S l
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Blood Su##ly
&he bronchi and the connective tissue o the lun"receive their blood su##ly rom the bronchial arteries,!hich are branches o the descendin" aorta
&he bronchial veins communicate !ith the #ulmonary
veins and drain into the a%y"os and hemia%y"os veins &he alveoli receive deo'y"enated blood rom theterminal branches o the #ulmonary arteries
&he o'y"enated blood leavin" the alveolar ca#illaries
drains into the tributaries o the #ulmonary veins
&!o #ulmonary veins leave each lun" root to em#tyinto the let atrium o the heart
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(ym#h Draina"e &he lym#h vessels ori"inate in su#er
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(ym#h Draina"e &he dee# #le'us travels to the hilum o thelun" and enters the broncho#ulmonary nodes
All the lym#h rom the lun" leaves the hilumand drains into the tracheobronchial nodesand then into the bronchomediastinal lym#htrun+s
Nerve Su##ly
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Nerve Su##ly At the root o each lun" is a #ulmonary
#le'us com#osed o eKerent and aKerentautonomic nerve
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(ocation &he #leurae and lun"s lie on either side o themediastinum !ithin the chest cavity
Each #leura has t!o #arts:
4arietal layer
6isceral layer
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4arietal (ayert lines the thoracic !all
3overs the thoracic surace o the dia#hra"m
and the lateral as#ect o the mediastinum
E'tends into the root o the nec+ to line theundersurace o the su#ra#leural membrane
at the thoracic outlet
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6isceral (ayert com#letely covers the outer suraces o the
lun"s
E'tends into the de#ths o the interlobar
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4leural 3uK &he t!o layers continuous !ith one another
by means o a cuK o #leura
&his cuK surrounds the structures enterin"and leavin" the lun" at the hilum o each lun"
4leural cuK han"s do!n as a loose old calledthe #ulmonary li"ament
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4leural 3avity &he #arietal and visceral layers are
se#arated rom one another by a slitli+es#ace called #leural cavity
3linicians use the term #leural s#ace insteado the anatomic term #leural cavity
4leural cavity contains thin
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3ervical 4leura4arietal #leura is divided into the re"ion in
!hich it lies or the surace that it covers
&he cervical #leura e'tends u# into the nec+
t lines the undersurace o the su#ra#leuralmembrane
t reaches a level 8 to 8)> in) -9)> to = cm.above the medial third o the clavicle
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3ostal 4leura t lines the inner suraces o:
&he ribs
&he costal cartila"es &he intercostal s#aces
&he sides o the vertebral bodies
&he bac+ o the sternum
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Dia#hra"matic 4leurat covers the thoracic surace o the
dia#hra"m
n Huiet res#iration, the costal anddia#hra"matic #leurae are in a##osition toeach other belo! the lo!er border o the lun"
3ostal and dia#hra"matic #leurae se#arate indee# ins#iration
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3ostodia#hra"matic
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3ostodia#hra"matic
$ecess &he lo!er area o the #leural cavity into !hichthe lun" e'#ands on ins#iration is reerred toas the costodia#hra"matic recess
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Mediastinal 4leura t covers and orms the lateral boundary o the
mediastinum
t is re7ected as a cuK around the vessels and
bronchi at the hilum o the lun"
&hen continuous !ith the visceral #leura
Each lun" lies ree e'ce#t at the hilum
it is attached to the blood vessels and bronchi thatconstitute the lun" root
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3ostodia#hra"matic
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recesses Are slitli+e s#aces bet!een the costal and dia#hra"matic #arietal#leurae
Se#arated only by a ca#illary layer o #leural 7uid
Durin" ins#iration, the lo!er mar"ins o the lun"s descend into therecesses
Durin" e'#iration, the lo!er mar"ins o the lun"s ascend so thatthe costal and dia#hra"matic #leurae come to"ether a"ain
Are situated alon" the anterior mar"ins o the #leura
&hey are slitli+e s#aces bet!een the costal and the mediastinal#arietal #leurae
Se#arated by a ca#illary layer o #leural 7uid
Durin" ins#iration and e'#iration, the anterior borders o the lun"sslide in and out o the recesses
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3ostomediastinal
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3ostomediastinal
$ecessesAre situated alon" the anterior mar"ins o the#leura
&hey are slitli+e s#aces bet!een the costal andthe mediastinal #arietal #leurae
Se#arated by a ca#illary layer o #leural 7uid
Durin" ins#iration and e'#iration, the anteriorborders o the lun"s slide in and out o therecesses
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Nerve Su##ly &he #arietal #leura is sensitive to #ain, tem#erature,
touch and #ressure, and is su##lied as ollo!s:
&he costal #leura is se"mentally su##lied by the
intercostal nerves
&he mediastinal #leura is su##lied by the #hrenicnerve
&he dia#hra"matic #leura is su##lied over the domesby the #hrenic nerve and around the #eri#hery by thelo!er si' intercostal nerves
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Nerve Su##ly &he visceral #leura coverin" the lun"s is
sensitive to stretch
t is insensitive to common sensations such as#ain and touch
t receives an autonomic nerve su##ly romthe #ulmonary #le'us
l l l id
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4leural Fluid &he #leural s#ace normally contains > to 8 ml o
clear 7uid
t lubricates the o##osin" suraces o the visceral
and #arietal #leurae durin" res#iration
&he ormation o the 7uid results rom hydrostaticand osmotic #ressures bet!een the ca#illaries
&he #leural 7uid is normally absorbed into theca#illaries o the visceral #leura
The uscles of
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Breathing
%nspiratory muscles• 'iaphragm
• (xternal%ntercostalis
• ternocleido)mastodeus
• calenus
(xpiratory muscles
• %nternal%ntercostalis
• *bdominal+uscles
NS4$AS7tot utama:
!" Diafragma n phrenicus
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!" Diafragma n phrenicus+%ervical $,6,@
#" m" intercotalis externus nintercosta
7tot tambahan
Aika inspirasi dalam
!" m" ternocleido mastoideusmengangkat sternum ke atas
#" m" calenus mengangkatcosta !,#
$" *"serratus anterior;28(&/(
7tot.otot di abdomen : a"l m
rectus abdominis menarikke arah bawah pd costa bagbawah
*" (ntercostalis internus
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Modi
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Memulai a!al rata/rata na#as &erleta+ #d ormasio reti+ularis
medulla oblon"ata -MO. 2emoreseptor
Lat #en"atur utama : 3O94erubahan #5 menstimulasiarea +emo/sensiti +ece#atan dan dalamnya#erna#asan
adar O9 darah beree+ #adares#irasi ji+a jumlah menurun> dari normal)
2emoreseptor pusatterletak di *7
2emoreseptor tepi terletak
di badan aorta dan badancarotis Sistem 3erebral dan limbi+
$es#irasi da#at di+ontrolsecara volunter dandimodi
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Chapter 22, Respiratory ystem "
Medullary $es#iratory
3enters
#igure 22.2"
S l t B l j
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