肺科国外教材2.docx

肺科国外教材2.docx

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肺科国外教材2

PHYSIOLOGYOFADULT HOMOSAPIENS -RESPIRATORYAPPARATUS,PULMONARYBLOODANDLYMPHCIRCULATION,RESPIRATION,ANDMEDIASTINUM 

（seealso heart

 blood

 circulation

 and sportsmedicine

）

Tableofcontents:

respiratoryapparatus

∙conductionsystem

oupperrespiratorytract（URT）

▪nose

▪paranasalsinuses

▪rhinopharynx

olarynx

olowerrespiratorytract（LRT）

▪trachea

▪bronchi

∙exchangesystem:

lungs

∙pleura

∙pressures

∙workofbreathing（WOB）

∙compliances

∙respiratorymovements

∙pulmonaryfunctiontests（PFT）

orespiratoryvolumes

orespiratorycapacities

oflowrates

∙pulmonarybloodcirculation

∙assessmentofrespiratorymusclesstrength

mediastinum

∙respiratoryapparatus

Organogenesis :

 laryngotrachealgroove :

afurrowatthecaudalendoftheflooroftheembryonicpharynxthatdevelopsintotherespiratorytract 

Celltypes:

 simplecylindricepithelium（aimedtocreatetheso-named"mucociliaryelevator"）exceptthanovervocalcords

▪mucociliaryapparatus :

ontheinnersurfaceoftherespiratorytract,alayerofcolumnarepithelialcellscoveredbyathinmucouslayerandmanyprojectingciliathatbeatinarhythmicmannertobringaboutmucociliaryclearance

▪ciliatedcell

▪unciliatedsecretorycells

▪goblet,beaker,caliciform,chaliceormuciparouscells :

aunicellularmucousglandfoundintheepitheliumofURT.Dropletsofmucigencollectintheupperpartofthecellanddistendit,whilethebasalendremainsslender,andthecellassumestheshapeofagoblet.

▪Clara'scells :

unciliatedcellsfoundintheepitheliumoftherespiratoryandterminalbronchioles.Theyproducelittlemucustopreventobstructionofbronchiolesduringbronchospasmofsmallairwaysandundergogobletmetaplasiainsmallairwaydisease

▪basalorreservecells （precursorcells）:

cellsofthebasalorgerminallayerofthebronchialepithelium.

▪pulmonaryneuroendocrinecells（PNECs）

▪Kultchitskycells （APUDcells

 whosenumberdecreaseswithage）

oconductionsystem（massflowventilation） warmairfromroomtemperatureto35°C（patientwithtracheostomydevelopsquamousmetaplasiaoftheURT）,humidifiesair（PH2O 3.7=>47mmHg）,filtersair（particleswithØ>1μmareentrappedintomucusandswallowed）.Evenifairwaydiameterreducesmovingdownward,Rtot decreasesasresistancesareplacedinparallel.

▪upperrespiratorytract（URT）/upperairways

▪nose（rhinology） （seealso diseasesofthenose

）

▪bonyskeleton:

▪nasalbones

▪maxillarybones

▪externalnose/nasusexternus :

thepartofthenosethatprotrudesontheface;madeupofanosteocartilaginousframework,coveredexternallybymusclesandskinandlinedinternallybymucousmembrane;ithastwoaperturesthatopenintothenasalcavityandisseparatedinto2halvesbythenasalseptum.

▪nasalcartilages/cartilaginesnasi

▪（upper）lateralcartilageofnose/cartilagonasilateralis/quadrilateralcartilage/triangularcartilageofnose

▪greateralarcartilage/cartilagoalarismajor/inferiorcartilageofnose/lowerorinferior（lateral）nasalcartilage/tipcartilage

▪crusmedialecartilaginisalarismajoris/internalcrusofgreateralarcartilage/ medialcrusofgreateralarcartilage :

thepartofthegreateralarcartilage,looselyattachedtoitsfellowoftheoppositeside,andhelpingtoformthemobileseptumofthenose

▪cruslateralecartilaginisalarismajoris/lateralcrusofgreateralarcartilage :

thepartofthegreateralarcartilagethatcurveslaterallyaroundthenarisandhelpsmaintainitscontour

▪accessoryorsesamoidcartilagesofnose/cartilaginesnasalesaccessoriae

▪lesseralarcartilage/cartilaginesalaresminores/sesamoidcartilage

▪Jacobson'ssubvomerineorvomeronasalcartilage/cartilagovomeronasalis[Jacobsoni] :

eitherofthetwonarrow,longitudinalstripsofcartilage,onelyingoneithersideoftheanteriorportionofthelowermarginoftheseptalcartilage

▪nasalseptum:

▪（quadrangular）cartilageofnasalseptum/cartilagoseptinasi/septalcartilageofnose

▪perpendicularlaminaofethmoid

▪vomer

▪organumvomeronasale/Jacobson'svomeronasalorgan :

ashortrudimentarycanaljustabovethevomeronasalcartilage,openinginthesideofthenasalseptumandpassingfromthereblindlyupwardandbackward

▪noseshape

▪leptorrhine :

havinganasalindexbelow48

▪platyrrhine :

havingabroadnose;havinganasalindexexceeding53

▪catarrhine :

characterizedbynostrilsthatareclosetogetheranddirecteddownward

▪vestibulumnasaleornasi/vestibuleofnose/nasalvestibule :

theanteriorpartofthenasalcavitysituatedjustinferiortothenaresandlimitedposteriorlybythelimennasi.Itislinedwithstratifiedsquamousepitheliumandcontainshairs （vibrissae）andsebaceousglands

▪nasalcavity

▪tunicamucosanasi/Schneide