Sistema Respiratorium

dr. Dodik Nursanto, M.Biomed

 THORACIC CAGE

SUSUNAN TULANG YG TERDIRI

COSTAE
DINDING ARCUS COSTAE
THORAX STERNUM
VETEBRA THORAXIS

MUSCULI

DIAPHRAGMA
MUSCULUS RESPIRATORIUS
 MUSCULUS RESPIRATORIUS
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Inspiration

Sternocleidomastoid
(elevates sternum)

Scalenes
(fix or elevate ribs 1–2)

External intercostals
(elevate ribs 2–12,
widen thoracic cavity)

Pectoralis minor (cut)

(elevates ribs 3–5) Forced expiration

Internal intercostals,
interosseous part
Internal intercostals, (depress ribs 1–11,
intercartilaginous part narrow thoracic cavity)
(aid in elevating ribs) Diaphragm
(ascends and
reduces depth
Diaphragm of thoracic cavity)
(descends and
increases depth Rectus abdominis
(depresses lower ribs,
of thoracic cavity) pushes diaphragm upward
by compressing
abdominal organs)

External abdominal oblique

(same effects as
rectus abdominis)

22-4
 PLEURAL CAVITY

(content: pleural fluid – thin mucus)

PARIETAL PLEURA
(inner surface)
THORACIC
VISCERAL PLEURA
CAVITY (outer surface)
Lubrication

Lungs to slide freely inside the pleural cavities

MEDIASTINUM
Cavitas Thoracis
 Intercostal muscle
Rib
Parietal pleura
Lung Pleural cavity
Trachea Visceral pleura
Thymus

Apex of lung
Left
superior lobe
Right superior lobe Oblique
Horizontal fissure fissure
Right middle lobe Left inferior
lobe
Oblique fissure
Right inferior lobe
Heart
(in pericardial cavity
of mediastinum)
Diaphragm
Base of lung
(a) Anterior view. The lungs flank mediastinal structures laterally.
 Posterior
Vertebra Esophagus
(in posterior mediastinum)
Root of lung
at hilum
Right lung • Left main bronchus
• Left pulmonary artery
Parietal pleura
• Left pulmonary vein
Visceral pleura
Left lung
Pleural cavity
Thoracic wall
Pulmonary trunk
Pericardial
membranes Heart (in mediastinum)
Anterior mediastinum
Sternum
Anterior
(b) Transverse section through the thorax, viewed from above. Lungs, pleural
membranes, and major organs in the mediastinum are shown.
Cross Section Cavitas Thoracis
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Anterior
Breast

Sternum
Ribs
Pericardial
cavity
Heart
Left lung Right lung
Visceral
pleura Aorta
Pleural cavity Vertebra
Parietal Spinal cord
pleura

Posterior
Ralph Hutchings/Visuals Unlimited

Figure 22.10

22-10
Komponen Systema Respiratorium
 NASAL CAVITTY "Air conditioning"
Precipitate particles
 PHARYNX Nasopharynx
Oropharynx
Laryngopharynx
 LARYNX Epiglottis
Plica Vocal
Musculus
 TRACHEA Cartilages (bentuk C)

Menjaga tdk kolap

Komponen Systema Respiratorium

 LUNGS (PULMO) dextra (3 lobulus)

sinistra (2 lobulus)
n BRONCHI (cartilages)
n BRONCHIOLI (smooth muscles)
n RESPIRATORY LOBULES
 RESPIRATORY BRONCHIOLES O2 CO2
 ALVEOLARY DUCTS
 ATRIA
 ALVEOLARY SACS
 ALVEOLI CAPILLARIES
 PULMONARY VASCULAR SYSTEM
 RESPIRATORY MUSCLES Inspiratory
Expiratory
Chapter 22, Respiratory System
 NASAL CAVITIES FUNCTIONS
· The air is conditioned before it entering the lungs
· Particles are precipitated

I."AIR-CONDITIONING"
Warm air Extensive vasculature NASAL
Moisten air Mucous glands MUCOUS
MEMBRANE
(Conchae & Septum)
Filtration
II. PRECIPITATION OF PARTICLES Nasal hairs
Air turbulence
Conchae
(superior, middle, inferior)

III. SMELLING ODOURS Olfactory bulb <- Olfactory nerves (Sensory)

 Nasus

 Bag internal & eksternal

 Bag internal : rongga berlorong yg dipisah mjd rongga
hidung ka & ki o/pembagi vertikal yg sempit
SEPTUM
 Lendir disekresi o/sel2 goblet
 Hidung olfaktorius
Nasus externus

16
Struktur kerangka nasus

17
 Pharynx

 Tuba yg menghub nares & rongga mulut ke laring

 Nasofaring : disebelah posterior hidung & atas
palatum mole
 Orofaring : fausial/palatin, tonsil
 Laringofaring : memanjang dr tulang hioid ke kartilago
krikoid
 Fungsi faring u/ menyedikan sal pd traktus respiratori
& digestif
Pharynx
• Nasopharynx
• Oropharynx
• Laryngopharynx

(a) Regions of the pharynx

Figure 13.2a
Cribriform plate
of ethmoid bone
Sphenoidal sinus Frontal sinus
Posterior nasal Nasal cavity
aperture
• Nasal conchae (superior,
middle and inferior)
Nasopharynx
• Pharyngeal tonsil • Nasal meatuses (superior,
• Opening of middle, and inferior)
pharyngotympanic
tube • Nasal vestibule
• Uvula • Nostril

Oropharynx Hard palate

• Palatine tonsil Soft palate

• Lingual tonsil Tongue

Laryngopharynx Hyoid bone

Larynx
Esophagus • Epiglottis
• Thyroid cartilage
Trachea • Vocal fold
• Cricoid cartilage

(b) Detailed anatomy of the upper respiratory tract

Figure 13.2b
THE PHARYNX (Throat)
SEPARATION OF AIR FROM FOOD

 NASOPHARYNX (closing nasopharynx from oropharynx)

(Surrounds the larynx)
1. SOFT PALATE
 LARYNGOPHARYNX (preventing food fromentering the
(Upward projection Posterior of trachea)
nasal cavity)
2. EPIGLOTTIS
 OROPHARYNX Activated by nerve reflexes from the
mouth and pharyngeal wall
(Posterior of oral cavity)
(whenever food is propelled backward
into the pharyns from the mouth)
(closing the opening/blocking entry to
the trachea)

3. VOCAL CORDS
(the muscular folds on the inside lateral
wall of the larynx)

Powerful reflex spasm of the muscles

controlling the vocal cords
THE LARYNX &
VOCALIZATION (PHONATION)
THE LARYNX

I. THE SKELETON & WALL

1. SKELETAL CARTILAGES major THYROID
STRUCTURES CRICOID
ARYTENOID
minor TRITICEA
CORNICULATE
CUNEIFORM
LIGAMENTS
2. MUSCLES

EXTRINSIC INTRINSIC
(move the larynx as a whole (-alter the positions of laryngeal cartilages
relative to other structyres) relative to each other or control directly the
aryapiglottic and vocal folds)
II. CAVITIES
VESTIBULE VENTRICLE INFRAGLOTTIC
(of the larynx) (of the larynx) LARYNX
 INSPIRATION
THE VOLUME OF THE THORACIC 1. DIAPHRAGM CONTRACTION (Downward movement)
CAVITY CAN BE EXPANDED
Lengthen the cavity
( superior-inferior diameter)

 INTRATHORACIC 2. ENTIRE ANTERIOR THORACIC WALL

PRESSURE (Upward movement)
Elevates the ribs

 the anteroposterior diameter of the thoracic cavity

MUSCLES OF INSP.
A. External intercostal muscles
MOVE THE ENTIRE
ANTERIOR CHEST WALL
Pull the upper rib anteriorly and
ANTERIORLY AND SUPERIORLY the lower rib superiorly

B. All the muscles of the neck that elevate

the rib cage
(-Sternocleidomastoid: elevates the sternum
- Anterior serrati: elevate the upper ribs
- Scaleni: elevate the first two ribs)
Inspiration

24 Chapter 22, Respiratory System Figure 22.13.1

EXPIRATION CHEST HAS BEEN FLATTENED

 ANTEROPOST. DIAMETER EXP. MUSC.

1. Pulling the rib cage inferiorly

 anteropost. Diameter Rectus abd.

2. Upward excursion of the diaphragm

Abdominal contents to be pushed upward

(against the inferior surface of the diaphragm)

Contraction of the External oblique

muscles encircle Internal oblique
the abdomen Transverse abdominal
Expiration

26 Chapter 22, Respiratory System

Figure 22.13.2
 THE LARYNX & VOCALIZATION
(PHONATION)
VOCALIZATION

 RESPIRATORY SYSTEM
 LARYNX
SPEECH  CORTEX CEREBRI ( speech control center)
 CEREBRAL TRUNK (respiratory control center)
 NASAL & ORAL CAVITIES Articulation
Resonance
(Mechanical function) (Resonators:
- Nasal cavity
- Oral cavity
- Paranasal sinuses
- Pharynx
VOCALIZATION ARTICULATION - Thoracic cavity)

LARYNX MOUTH Lips, tongue, softy palate (movement during speech

NOSE and other vocalization)
IN THE RETICULAR FORMATION (RF):
MEDULLA OBLONGATA
PONS

 1. PNEUMOTAXIC AREA
RESPIRATORY
CENTERS  2. INSPIRATORY AREA
 3. EXPIRATORY AREA

Midbrain
1

Inhibition
2
Pons
N X (Inhibition)
Medulla obl.
3
Insp. muscles Exp. muscles
THE BASIC RHYTHM OF
RESPIRATION
INSPIRATORY AREA Exited every several seconds
(signals)

Contraction: - Diaphragm
- Inspiratory muscles

The signals stop suddenly Relaxation suddenly

Elastic recoil
(the lungs, thoracic cage)

EXPIRATION Lungs deflate (2-3 seconds)

( 1 CYCLE OF RESPIRATION: 5 SECONDS

INSPIRATION (2 SEC.)
EXPIRATION (3 SEC.)
 PNEUMOTAXIC
CENTER
FUNCTION: TO CONTROL RESPIRATION
(Depth & Rate)

PNEUMOTAXIC CENTER

STIMULATION RESP. RATE  Total volume of respiratory

RESP. DEPTH  air/minute changes a little

EXPIRATORY
AREA

* EXPIRATORY NEURONS: practically “dormant” when normal quiet respiration

(Quiet respiration Contraction of inspiratory
muscles)

* WHEN RESPIRATORY DRIVE INCREASES (> normal/heavy exercise)

The signals spill out to the expiratory area

Increase expiratory muscles contraction

During heavy respiration: the air does not just enter the lungs
THE VOCAL CORDS
(See: vocalization/phonation)

THE VOCAL CORDS (FOLDS): the vibrating elements of the larynx

 On the lateral walls of the interior larynx

 The medial border encloses a strong band of elastic

tissue: vocal ligament
 (vocal process arytenoid cartilage
post. surface of thyroid cartilage)

 Thyroarytenoid muscle
(- lateral to the vocal lig.
- helps to control the shape and tension of the vocal fold)
Movements of Vocal Cords
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Adduction of vocal cords Abduction of vocal cords

Thyroid cartilage

Cricoid cartilage
Anterior
Vocal cord

Lateral
cricoarytenoid muscle

Arytenoid cartilage Posterior

Corniculate cartilage

Posterior
cricoarytenoid muscle
(a) (c)

Base of tongue

Epiglottis

Vestibular fold

Vocal cord

Glottis

Corniculate
cartilage

(b) (d)
22-32
T H E LARYNX
MUSCLES

EXTRINSIC INTRINSIC
(Move the larynx as (Alter the positions of
a whole relative to laryngeal cartilages relative
other structures) to each other
- Sternohyoid Control directly aryepiglottic
- Thyrohyoid and vocal cords)
- Inferior constrictor - Cricothyroid Cricothyroid
of the pharynx - Thyroarytenoid joints
- Transverse arytenoid
- Oblique arytenoid Cricoarytenoid
- Lat. cricoarytenoid joints
- Post. cricoarytenoid
Larynx

34
 LARYNX
 Pria: 5 cm, wanita lebih kecil, bayi
letaknya tinggi.
 Cartilago:
 Cartilago thyroidea (Adam’s apple)
 Cricoidea
 Arytenoidea
 Epiglotis
 Cavitas laryngis:
 2 plica vestibuli → rima vestibuli
 2 plica vocalis → rima glotidis →
menghasilkan suara
 TRACHEA

 Diantara Larynx dan

Bifurcatio trachea
 Terdapat 16-20 cincin
cartilago
 Panjang: 9-11cm
Trachea

37
Anatomy of the Lower Respiratory Tract
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Mucus
Thyroid Mucociliary
cartilage escalator
Larynx
Cricoid Particles
cartilage of debris
Epithelium:
Goblet cell
Ciliated cell

Mucous gland
Trachea Cartilage

Chondrocytes

(b)

Carina Trachealis
muscle

Lobar Hyaline
bronchi Main cartilage ring
bronchi Lumen
Segmental Mucosa
bronchi
Mucous gland

Perichondrium 22-38
(a)
Figure 22.7a–c (c)
Bronchus
Embriology Pulmo
 THE LUNGS
II. TRACHEA
Tertiary bronchus
Secondary
Right bronchus Left bronchus bronchus Terminal bronchus

Primary Bronchial tree:

bronchus TERMINAL BRONCHIOLE

RESPIRATORY LOBULE

Respiratory Alveolar Alveolar

Atrium Alveoli
CARTILAGES bronchioles ducts saccs

TRACHEA
C-shaped partial cartilaginous ring
Prevent tracheal collapse

BRONCHI Cartilaginous plates

Bronchi: - semirigid Prevent bronchial collapse
- pliable Bend and stretch to accommodate the
 T H E L U N G S (cont.)
III. THE BRONCHIOLES

< 1-2 mm Cartilage: -

Smooth muscles
 (normally remain relax bronchioles stay open)*
The wall
Connective tissues

Branch several times

Respiratory bronchioles (have little smooth muscle)

(entryways to the resp. lobules: the final airspace of the lungs)

(* Bronchiolar spasm – local!

Particles/irritating substances/
Allergens e.g., patients who have asthma)
 T H E L U N G S (cont.)
THE CILIA & MUCOUS GLANDS
Inner surface of the trachea & bronchial tree: REMOVE MOST
Are lined with ciliated respiratory epithelial cells
DUST PARTICLES,
- (Cilia beat in the opposite direction to
those in the nose: upward toward the pharynx) BACTERIA, OTHER
- Mucous glands: secrete mucus DEBRIS THAT ENTER
THE LUNGS

IV. RESPIRATORY LOBULE

- Respiratory exchange unit of the lung

RESPIRATORY - Portion of the lung that branches from
BRONCHIOLES each terminal bronchiole
- The walls of all parts: respiratory membrane (extremely thin)
ALVEOLAR DUCTS O2 and CO2 can pass freely through
the pulmonary capillaries
ATRIA
(< 1 u; 1/8 of red blood cell diameter)
ALVEOLAR SACS

ALVEOLI
PULMO
Pulmo
Pulmo
Anatomy Pulmo
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Larynx:
Thyroid cartilage
Cricoid cartilage

Trachea
Apex of lung Main bronchi

Superior lobe

Superior lobar
bronchus
Costal
Horizontal fissure surface
Middle lobar
bronchus Superior
lobe
Middle lobe
Inferior lobar Cardiac
bronchus impression
Mediastinal
Oblique fissure
surfaces
Inferior lobe
Inferior lobe Oblique
Base of lung fissure
(a) Anterior view

Apex

Superior lobe

Pulmonary Lobar bronchi

arteries
Pulmonary
veins

Hilum
Middle lobe Pulmonary
ligament
Inferior lobe

Diaphragmatic
surface
(b) Mediastinal surface, right lung
 Pulmo Dextra

 Fissura obliqua dan

horizontalis
 Lobus superior, medius
dan inferior
Pulmo Sinistra

 Fissura obliqua
 Lobus superior dan
inferior
 Pleura

 Pleura parietale
 Pleura viscerale
Zona Respirasi

52
Zona Respirasi

53 Chapter 22, Respiratory System Figure 22.9.c,

d
THE PULMONARY CIRCULATION

THE
RIGHT VENTRIC. LEFT ATRIUM
O2 BODY
CO2
PULMONARY AA. PULMON. VV

PULMON. ARTERIOLES PULMON. VENULES

O2
PULMON. CAPILLARIES
O2 CO2
Right pulmonary artery Left pulmonary
artery
Pulmonary
Right lung trunc
Left lung
Right ventricle
Left atrium + CO2
+ O2
ABNORMALITIES OF
PULMONARY CIRCULATION
I PULMONARY EDEMA PULMONARY HIGH PRESSURE IN
(Excess fluid in the lungs CONGESTION THE PULMONARY
(too much fluid CIRCULATION
and blood in the lungs)

DEATH FAILURE OF THE LEFT

(30 min. – 2 hrs.) HEART TO PUMP
(From the lungs to
systemic circulation)
II ATELECTASIS BLOCK OF ONE OR
(collapse of the lungs) MORE OF THE BRONCHI
Blood Unblocked area
Cutting off airflow

Air (in the alveoli) is absorbed into the blood (few hours)
THIS AREA OF THE LUNG COLLAPSES
Lack of oxygen Muscular contraction
Compression and kinking of the vessels
DECREASES BLOOD FLOW THROUGH THE COLLAPSED LUNG
(about 1/5 of its previous value)
ABNORMALITIES OF
PULMONARY CIRCULATION
III SURGICAL REMOVAL EXESSIVE BLOOD FLOW
OF LARGE PORTIONS OF (Normal situation)
THE LUNGS
THROUGH THE REMAINING
LUNG TISSUE
(Heavy exercise) (Increase blood flow)
RAPIDLY REACHES AN
UPPER LIMIT TO THE RATE
OF PULMONARY BLOOD FLOW NO SERIOUS DISABILITY

PULMONARY HYPERTENSION

FAILURE OF THE RIGHT HEART

IV EMPHYSEMA
(a disease of the lungs in which a large portions of the lung are destroyed
e.g., SMOKING)
SINUS PARANASALIS
Cavitas disekitar cavum nasi
 Sinus maxillaris
 Sinus ethmoidalis
 Sinus sphenoidalis
 Sinus frontalis

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