17
8/18/2019 Anatomia Si Fiziologia Apratului Respirator http://slidepdf.com/reader/full/anatomia-si-fiziologia-apratului-respirator 1/17 CURS 1 ANATOMIA SI FIZIOLOGIA APARATULUI RESPIRATOR OCTOMBRIE 2015

Anatomia Si Fiziologia Apratului Respirator

Embed Size (px)

Citation preview

Page 1: Anatomia Si Fiziologia Apratului Respirator

8/18/2019 Anatomia Si Fiziologia Apratului Respirator

http://slidepdf.com/reader/full/anatomia-si-fiziologia-apratului-respirator 1/17

CURS 1ANATOMIA SI FIZIOLOGIA

APARATULUI RESPIRATOROCTOMBRIE 2015

Page 2: Anatomia Si Fiziologia Apratului Respirator

8/18/2019 Anatomia Si Fiziologia Apratului Respirator

http://slidepdf.com/reader/full/anatomia-si-fiziologia-apratului-respirator 2/17

Page 3: Anatomia Si Fiziologia Apratului Respirator

8/18/2019 Anatomia Si Fiziologia Apratului Respirator

http://slidepdf.com/reader/full/anatomia-si-fiziologia-apratului-respirator 3/17

Page 4: Anatomia Si Fiziologia Apratului Respirator

8/18/2019 Anatomia Si Fiziologia Apratului Respirator

http://slidepdf.com/reader/full/anatomia-si-fiziologia-apratului-respirator 4/17

TRAHEE BRONHIA PRIMITIVA BRONHIA PRIMITIVADREAPTA STANGA

↓ ↓ B. LOBARA SUPERIOARA (LSD) B.LOBARA SUPERIOARA↗ CULMEN

B. LOBARA MEDIE (LM) (L SS )↘ LINGULA

B. LOBARA INFERIOARA (LIS) B. LOBARA INFERIOARA

(LIS) ↓ ↓ B. SEGMENTARE (10) B. SEGMENTARE ( ) ↓ BRONHIOLE LOBULARE (TERMINALE) ↓

BRONHIOLE RESPIRATORII ↓ DUCTE ALVEOLARE LOBULII TERMINALI ↓ SACULETI ALVEOLARI (ALVEOLE)

Page 5: Anatomia Si Fiziologia Apratului Respirator

8/18/2019 Anatomia Si Fiziologia Apratului Respirator

http://slidepdf.com/reader/full/anatomia-si-fiziologia-apratului-respirator 5/17

Page 6: Anatomia Si Fiziologia Apratului Respirator

8/18/2019 Anatomia Si Fiziologia Apratului Respirator

http://slidepdf.com/reader/full/anatomia-si-fiziologia-apratului-respirator 6/17

Page 7: Anatomia Si Fiziologia Apratului Respirator

8/18/2019 Anatomia Si Fiziologia Apratului Respirator

http://slidepdf.com/reader/full/anatomia-si-fiziologia-apratului-respirator 7/17

TAP

CROSA AORTA

TBC DREPT

TBC STANG

VCS

VV PULMONARE

Page 8: Anatomia Si Fiziologia Apratului Respirator

8/18/2019 Anatomia Si Fiziologia Apratului Respirator

http://slidepdf.com/reader/full/anatomia-si-fiziologia-apratului-respirator 8/17

Page 9: Anatomia Si Fiziologia Apratului Respirator

8/18/2019 Anatomia Si Fiziologia Apratului Respirator

http://slidepdf.com/reader/full/anatomia-si-fiziologia-apratului-respirator 9/17

SEMIOLOGIA APARATULUI RESPIRATORI. ANAMNEZA !

• V"#$%"& '# *$+" (*,'- *#* '# *$+ "/" /" ,*

#*$'+#"% #++)&• AHC! '"#+ %+ #- * - "$%3 " *# &• S%"%-$ -3"% # (PA)&• APP! '"% / 4*+ ( * 6+3*7 4#" +%"%*7 %#"%"3* %)

II. ISTORICUL BOLII:S+3'% 3* (3",+3 89)& * # +

4* *#"/ / "/

SIMPTOME LOCALE!

I. DUREREAII. DISPNEEAIII. TUSEA

Page 10: Anatomia Si Fiziologia Apratului Respirator

8/18/2019 Anatomia Si Fiziologia Apratului Respirator

http://slidepdf.com/reader/full/anatomia-si-fiziologia-apratului-respirator 10/17

1.DUREREA TORACICA :1) :- 46+-/ % #" + ! ;" -%"7 + %* $+%"%* 3"#* 7 </ +%-#" * '-3 "/=&2) ; ' *-3 +" / >"#" TEP ' *-3 % #",

$' %" *3'+*3&

8) D-#*#*" + %#"6* ># $+%"! ;"#$-#" #*%# $%*# "/"?) D-#*#*" + -@"7 $-# "! '/*-#*@++ ( +$'"#* " $* " -3-/*"@" /+ 6+ )&5) D* '*#*%* ! Z " Z $%*#&

) N* #"/4+" + %*# $%"/"! " -%"7 * /" $"%" * + $'+# '# - %-$* #+4) D-#*#*" $ "$" 3+"/4+" -#*#*" 3"3"#" &

2 . DUREREA DIAFRGMATICA :* #"/4+*( <$*3+ * %-#"=/" + */-/ -/%+3*/ # $'"%++ + %*# $%"/*)&

3. DURERI ALE ORGANELORINTRATORACICE:

1) C"# +" "! + "# %7 " 4+ "7 '*#+ "# +%" (+#" +"@" - -3"#-/ $%" 4 4"% ",+/"

$%" 4")&2) A #%+ "! " * #+$3&3) D +4*$%+ "! - +$ "4+*& *$ "4+%" 6*# +* 6+"%"/" (" * %-"%" + /+ $%"%+$3&

"3*/+ #"%" + ' @+%+" $*@" ")&?) C /* +$%+%" " -%"! 4#*"%" "#$"%-#+& - * #+ +#" +"@" + -3"#-/ #*'%&5) M* +"$%+ "/"! -#*#* #*%# $%*# "/" "#%* + %* $"7 + "/+ " %"7 #*& *3 @*3

3* +"$%+ "/ #-'*#*" - *+ >-/* * *3 @*3 ( #*'+%"%++ $-> -%" "%*) + * %++&

Page 11: Anatomia Si Fiziologia Apratului Respirator

8/18/2019 Anatomia Si Fiziologia Apratului Respirator

http://slidepdf.com/reader/full/anatomia-si-fiziologia-apratului-respirator 11/17

DISPNEEAo DEFINITIE! % %"/+%"%*" 3 + "#+/ # #*$'+#"%+*+ " #+%37 #* * %"7 + %* $+%"% ;$->+* %+ "! #*$'+#"%+* 4#*" 4#*-%"%* ="'"$"#*=&

; >+* %+ "! 3 + "#+ "/* #+%3-/-+7 #* * %*+ 7 "3'/+%- + ++&FR #3"/" 1 ;1 3+ (*-' *+ )• FR #*$ -%" ' /+' ** 6+' ,*3+* 6+'*# "' +* * #

@+ 6TA * 3'* $"#*" "# +" " #*"'%"& #*$'+#"%+* $-'*# +"/" -"3'/+%- + * 3+ "&

• FR $ "@-%" >#" +' ** " * %+- + "/* 33 #*$'+#"% #+ -%+* % #" + "&'#*/- 4+%"7 #%"%"7 + $ %+%" * @4 3 % + $'+#"% # $-+*#"% ( # " )&

V /-3-/ * "*# + $'+#"% $+ *,'+#"% + /- #*$'+#"% # VC ( /-3 -#* %)500-600mL

MECANISMUL RESPIRATIEI! ;#* *,&• C* %#++ *# $+! >-/> $+ '# %->*#" %" ' %+ "&• C"+ " *#* %*! ; >#* #%+ "/* ( #*$'+#"%+" %# /"%") ; >#* >-/>"#*( J N. VAG) (#*$'+#"%+* #* *,") ; >#* $+ "# %+ +* * ( 6*3 #* *'% #+ $*$+@*"@"

$ " *#*" * %#"%+*+ ,+4* -/-+ + $4. "#%*#+"/)•

C"+ * *#* %*! ; "/* '#+ +'"/"! N. FRENIC ; "/* " *$ #+* ! *# + + %*# $%"/+ (T2;T ).

Page 12: Anatomia Si Fiziologia Apratului Respirator

8/18/2019 Anatomia Si Fiziologia Apratului Respirator

http://slidepdf.com/reader/full/anatomia-si-fiziologia-apratului-respirator 12/17

• CAUZELE DISPNEEI!1) Aport !"#$t %& o'( &* !

; * %#"%+* $ "@-%" " O2 + "*#-/ *,'+#"% ("/%+%- + *);$%* @" CARS (/"#+ 4*7 %#"6**) '#+ %-3 #+ *-#-/ 4+ * "/*#4+* + * %++

%#"-3"%+$3 $'"$3 /"#+ 4+";" * %"#* "/ * /"#"! ' *-3 ++ * *3 #*@* %++ ' *-3 % #",;'"#"/+@+" 33. + %*# $%"/+ (3+"$%* +*) 7 " +" #"43-/-+; A * %+- + '*#*%* % #" + ! + $ /+ @* >*@+%"%* (3 #>+ ")

2) +&,!(t (* pr& $"r&" o'( &*$ $( !;" * %"#*" +# -/"%+*+ '-/3 "#* (CV)! HTAP *3> /++ '-/3 "#*; * +% * 6*3 4/ >+ "! " *3+* + % ,+ "%++ - CO2

8) St(m$ ( *&r o ( "*orm" (:

;%-3 #+ AVC * * "/+%*;+ % ,+ "%++; *-# #* *,! *3 %++ '-%*# + * +$%*#+* (9999 A%" -/ * '" + ")

Page 13: Anatomia Si Fiziologia Apratului Respirator

8/18/2019 Anatomia Si Fiziologia Apratului Respirator

http://slidepdf.com/reader/full/anatomia-si-fiziologia-apratului-respirator 13/17

• CLASIFICAREA DISPNEEI !I. M -/ * "'"#+%+*!

ACUTA : ; >$%#- %+* ># $+ " ( #' $%#"+ ) ; $'"$3 /"#+ 4+" (/"#+ 4+%* *'+4/ %+%* '++)

;'"# ,+$%+ " ("$%3 *," *#>"#* BPOC)& NBP ; - +" @" $+ - 46+ (' *-3 % #", $' %" TEP)

CRONICA ! BPOC "$%3 * 6+ ># @* '-/3 "#* NBP "# +" "

PARTICULARITATI:

" ) r& p(r"t(" t&rtoro" " ! "4 +*7 + $- . #* "/* # + *7 3"*#*>#"/"

>) C/& *&-Sto & ! ' /+' ** >#" +' ** "' **& '" +* %$ 3 /* % 3"% $& "-@*; IVS " . *-# / 4+ * 3 # "

) /(po &*t( "t(" " &o "r" 2P(! 3(! ): >*@+%"%* 3 #>+ " ) 4$ m"$ ! 3" +">*%+ " - *% " + @"

II. C +%++/* * "'"#+%+*!+E E ORT+E REPAUS+E +ECUBIT 2ORTOPNEE)

Page 14: Anatomia Si Fiziologia Apratului Respirator

8/18/2019 Anatomia Si Fiziologia Apratului Respirator

http://slidepdf.com/reader/full/anatomia-si-fiziologia-apratului-respirator 14/17

*

Page 15: Anatomia Si Fiziologia Apratului Respirator

8/18/2019 Anatomia Si Fiziologia Apratului Respirator

http://slidepdf.com/reader/full/anatomia-si-fiziologia-apratului-respirator 15/17

E J P

E C T O R A T I A

( S P U T A )

D E F I N I T I E ! " % -

/ ' # + . " # * $ - . % *

/ + 3 + . "

% * 7

+ . - # 3

" % - $ *

+ 7

' #

- $ *

/ * ' "

% / 4

+ * + . " # >

T B

$ + ' " # * . 6

+ 3 -

/ ' -

/ 3 . " # & $ *

* / + 3 + . " ! 3 - - $ 7

* , -

"

% + . " 3 "

% # 7 # '

+ $ % # " + .

+ 7 $ " . 4 * 7

' " # * . 6

+ 3 7

$ " / + " 7

$ * # *

% + + . " @ "

/ * " # + . 4

+ * . *

C A R A C T E R I S T I C I !

1 .

C " *

t ( t " t & : " > $ * .

% " # *

- $ "

( K

2 0 0 3

L @ + ) # * $ -

% " ( ? 0 0

;

5 0 0 3

L @ + ) 3

+ " ( " > * $ ' -

/ 3 . " # # - '

% )

6 . C o *

( t & *

t " 9 " p & !

t :

S * # " $ "

3 - " $ " !

% # " . $ ' " # * .

% " 7

-

+ " &

+ . > # . $ + % * " -

% *

( " > - .

* .

% " ) E P A ( # @ "

% " 7 <

" "

/ > - $ -

/ * -

= )

M - ' - # - / * .

% " ! ' # * $ * # .

+ * ( B P O C

7 " $ % 3

7

> # . $ + * % " @

+ + 7 T B C )

P - # -

/ * .

% " ! $ - ' - # "

% + * ' -

/ 3 . " # "

S " . 4

+ .

/ * . % " ( $ " . 4 * # $ - )

6 * 3 '

% + " ! T

B C N B P

T E P $ % * . @ "

3 + % # " / " >

/ + " -

% + 3 - . *

7 .

C $

- o " r & : "

/ > G

* # @ -

+ *

8 .

M ( r o :

+ .

# "

* % + "

• .

V O M I C A ! * , ' -

/ @ + " > # - $ " " - . *

+ " .

% + % " % + 3 " $

+ *

* $ ' -

% "

' - # -

/ * .

% " &

• .

H E M O P T I Z I A ! ;

* / + 3 + . " # * " ' # + .

% - $ * " - . *

+ " .

% + % " % + * $ " . 4 *

# $ - G . * 4 # +

+ $

( < "

"

< )

; ' #

# 3 ! "

/ - # "

# * % # $ % * # . "

/ " = 4 "

+ / + % - # "

= " . ,

+ * % " % * - # * # *

% # " + "

; ' " + * .

% ' "

/ + 7

" . ,

+ $ 7 ' / + ' . *

+ 7

% " 6 + " #

+ 7 6 T A

; 3

+ " ( K 1 0 0 3

L ) 3 " # +

( K 5 0 0 3

L ) " % "

/ + $ 3 + * ( * * $ )

; + " 4 . $ % +

+ * # * .

% + " / !

* '

+ $ % " % + , 6 * 3 "

% * 3 * @ "

( * '

+ 4 " $ % # " / 4 + + 7 4 # * "

% " )

Page 16: Anatomia Si Fiziologia Apratului Respirator

8/18/2019 Anatomia Si Fiziologia Apratului Respirator

http://slidepdf.com/reader/full/anatomia-si-fiziologia-apratului-respirator 16/17

• EJAMENUL DE LABORATOR AL SPUTEIA. CLASIC! "$ %#" $'"#* %& $'-%" 2? #*& $'-%" 3"%+ "/" (>" +/ 6; 8

*$" %+ " * #" >" %*#+" " "*# >" 1 *$" %+ )-. +% / 4+*! */-/* %-3 #"/*

-. #" >" "/"! >" %*#++ "*# >*! 4#"3 ' @+%+ ( + /" %-#+) $"- 4#"3*4"%+ + A*"&ro (( *$ !$ t( " ;;;;-. 3+ / 4+*! - 4+ (C" + ")-. BAAR

S* $+>+/+"%* $ "@-%" 80B. ASPIRAT BRONSIC7 LBA

C"3*#" * #* /%"#*9999 P" +* %-/ + $'+#" '# - * "%* " #+ '" " *$%* * /" $"% #* *,-/

* %-$* 99999

Page 17: Anatomia Si Fiziologia Apratului Respirator

8/18/2019 Anatomia Si Fiziologia Apratului Respirator

http://slidepdf.com/reader/full/anatomia-si-fiziologia-apratului-respirator 17/17

• EJAMEN CLINIC APARAT RESPIRATORA. INSPECTIE: ; % #" *! #3"7 $+3*%#+*7 "3'/+%- + *& $*

$-'#" /" + -/"#* &; IR! %+#" + %*# $%"/ $-'#" /" + -/"# ( #*%#" %+" $'"%++/ #

+ . I + $'+#) <$*3 * < * /-'%"& ; / " " #*%*>#"/" ! #* %+%- + * -#>-#+ @+ / 4+ * ; +3+ -"#*" "3'/+%- + ++ - +/"%*#"/ >+/%*#"/ !

'/*-#*@++ ' *-3 % #", '"#"/+@++3-$ -/"#*&

B. PALPARE: ; "3'/+"%++& +>#"%++ "/* (<88=) " * %-"%* + ' *-3 +++3+ -"%* + *3 @*3 $"- '/*-#*@++ "> /+%* + ' *-3 % #", 3"$+ &

C. PERCUTIA: $ # 3"%&

+. AUSCULTATIA: MV #"/-#+&