ANATOMI Thorak, Pulmonal, Laring, Trakea

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Transcript of ANATOMI Thorak, Pulmonal, Laring, Trakea

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    1. Thorax/pulmonal

    2. Laring

    3. Trakea

    4. Pulmonal-bronkus bronkiolus - alveoli

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    Thorax :

    Terletak antara regio olli et ab!omen

    "avum thorais !ikelilingi oleh dinding thorax!an isin#a

    antar lain:

    Pulmo$ %antung$ th#mus$ trahea$ !an oesophagus&emegang peranan penting :

    'alam perna(asan/ respiratie

    pemeriksaan ph#si thorax untuk mengetahui letak !an

    struktur !ari organ vital !i avum thorais.

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    ).Dinding thorax:

    12 psg "ostae $artilago

    ostalis.

    *ternum

    12 +ertebrae thoraales!an !isus intervert.$

    ,. Cavum thoraciset visera

    thorais

    avum pleura et avumme!iastinum

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    aris bantu untuk

    menentukan lokalisasi

    !i!aerah thorax:

    Linea mi!sternalanterior$

    mi!laviular$xillaris

    ant.$ me!ia.$ post.$

    mi!verteb.$parasternal

    .$ sapularis

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    "linial :

    Pigeon breast /petus arinatum :sternumpro#eksi ke!epan !an baah

    unnel hest petus exavatum : sternumter!orong ke belakang oleh pertumbuhan

    berlebihan !ari ostae.

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    l. &ammae

    Lokalisasi : Latreral :garis

    parasternalis sampai garismi!axxilaris

    *uperior : ostae ke 00 bisostae ke +0.

    *truktur : 1-2 lobusmen%a!i lobulus !anainus !ipisahkan olehsepta

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    batas ranial : a!itus lar#ngis

    atas au!al : artilago rioi!ea

    !ibentuk oleh : - epiglottis

    - artilago th#roi!ea

    - artilago rioi!ea

    - artilago ar#tenoi!ea 2 5

    artiulatio : - rioth#roi!ea - rioar#tenoi!ea

    ligamentum - eratorioi!eum ant / lat / post

    - rioth#roi!eum me!

    - rioar#t post

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    ligamentum : - orniulophar#ngium

    - h#oth#roi!eum lat / me!

    - h#oepiglottium

    - ventriulare

    - voale

    - th#reoepiglottium

    musulus : - extrinsi : m.rioth#roi!eus pars reta / obli6ua

    ----N.laryngicus sup N.vagi 7.externus 5

    - intrinsi : m.rioar#tenoi!eus post / lat

    m.th#roar#tenoi!eus m.th#reoepiglottius

    m.voalis - ar#tenoi!eus transv / obli6uus

    -----N.recurrens

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    ")+8& L)790* :

    batas

    ranial : - a!itus lar#ngis

    au!al : - bi!ang #g mel tepi au!al .rioi!ea

    ventral : - permukaan !orsal epiglottis

    - tuberulum epiglottium

    - lig.th#roepiglottium

    - lig.rioth#roi!eum me!

    - arus artilago rioi!ea

    lateral : - membrana 6ua!rangularis .ar#tenoi!ea

    - onus elastius - arus artilago rioi!ea

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    Pulmo ). )pex : ke!uan#a sama 2$ m !iatas akhir me!ial !ari

    laviula

    ,. 3 (aies: ostalis$ !iaphragmatia$ me!iastinalis " .3 pinggir/ margo

    )nterior$ posterior$ in(erior

    7a!ix pulmonum

    Lig.$ pulmonum Lobus pulmonum

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    7a!ix pulmonum

    ;ilus pulmonum

    issura hori

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    Pulmo sinistrae :

    Lobus superior

    Lobus in(erior issura obli6ua

    Lobus !an (issura !i pulmo:Lobus !an (issura !i pulmo:

    Pulmo !ext.$ 3 lobusPulmo !ext.$ 3 lobus

    )nterior :lobus superior$ me!ia et)nterior :lobus superior$ me!ia et

    in(erior ter!apat (issura hori

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    ,ronhopulmonar segment !ari pulmo:,ronhopulmonar segment !ari pulmo:

    Pulmo !extrae pulmo sinistraePulmo !extrae pulmo sinistrae

    Lobus superior 35 lobus superiorLobus superior 35 lobus superior

    4545

    1.1. )pial 1-2 apioposterior)pial 1-2 apioposterior

    2.2. Posterior 3. )nteriorPosterior 3. )nterior

    Lobus me!ia 25Lobus me!ia 25

    4. &e!ia 4. *uperior lingular4. &e!ia 4. *uperior lingular

    .lateral . 0n(erior lingular.lateral . 0n(erior lingular

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    Lobus in(erior !ext.5 Lobus in(erior sinist.4-5Lobus in(erior !ext.5 Lobus in(erior sinist.4-5

    >. *uperior >. *uperior>. *uperior >. *uperior

    ? basal me!ial ?.-=. ,asal anterome!ial? basal me!ial ?.-=. ,asal anterome!ial

    =. ,asal anterior @. ,asal lateral=. ,asal anterior @. ,asal lateral

    @. ,asal lateal 1 basal posterior@. ,asal lateal 1 basal posterior1 basal posterior.1 basal posterior.

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    Lobus pulmo

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    Trahea : bentuk "$ arina

    !an bronhus

    ,ronhus primer :Ain(erolateral !aribi(uratie trahea.

    ,onhus prinipalis / main bronhus/

    bronhus primer ,.P5 post. !i hilustrh!p art.$ pulmonalis$ vena pul.$ ant.

    ,.P. !ext.$pen!ek$ lebar$ lebihvertikal !ari #ang kiri masuk !irekke hilus pulmonalis.$

    ,.P kiri$ber%alan in(ero-lateral$in(erior terha!ap arus aortae$ ant.$th!p oesophagus !an aortaethoraalis

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    ,.P masuk ke pulmo !anakan membentuk pohonbronhi / bronhial tree

    ,ronhus seun!er /lobaris kanan 3$ #ang kiri

    2. &asing2 bronhus lobaris

    !ibagi men%a!i bronhussegmentalis /pulmonal/tertier mengurus segment

    brohopulmonal

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    *egmen pulmonal t!!:

    pulmo dext.,

    1.Lobus superior: apial$ posterior$ !ananterior.

    2.Lobus medial: segmen lateral !an me!ial

    3.Lobus inferior: seg. superior.$ me!ial$ anterior$

    lateral$ !an posterobasal.$

    pulmo sinist.,

    lobus superior: pars/bagian superior t!!: seg.$

    apial-superior !an anterior.Pars in(erior : seg.$superior !an lingular/in(erior.

    Lobus inferior: seg.$superior$ anterior$ me!ial$

    lateral !an posterobasal

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    )spiratio ben!a asing :

    ke pulmo !extrae :karena bronhus lebar$

    pen!ek$ber%alan lebih vertikal : !entist : gigi

    sebagai ben!a asing.

    7esetio pulmo :

    bronhopulmonal segmen sangat penting untukresetio segmen akibat aner bronhus$ absess

    !i bronhopulmonal segmen

    .aner !apat pneumonetom#$ lobetom#$segmentetom#.

    ,ronhosop# : arina.

    & ! l !

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    &en!elson s#n!rome :

    segmen bronhopulmonal5 superior lobus in(erior

    ke!ua pulmo terletak posterior sehingga sering

    ter%a!i aspirasi pneumonia $akibat vomitus.

    Panoast tumor : tumor !i lobus superio ke!ua paru-

    paru sehingga !apat men#ebabkan :

    a. o!ema pa!a muka !an lengan sisi#ang samaben!ungan v. brahiephalia 5.

    b. pulas berkuang/menghilang karena art.$ sublavia

    tertekan.paral#sis hemi!iaphragma

    ganguan pita suara

    !. Turner s#n!rome miosis$ pseu!optosis

    anh !rosis

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    +asularisasi !an inervasi pulmo et pleura

    )rt. pulmonalis !an vena pulmonalis

    art. pulmonar# !extr.$ et sinistr.$ !iabangkan !ari:trunus pulmonalis setinggi : angulus sterni..

    )rt. pumonalis berabang men%a!i : art.$ lobaris$

    segmentalisart. bronhialis$

    B art.$ bronhialis sinistrae berasal !ari : aorta

    thoraia$

    Bse!angkan #ang !extrae berasal !ari :

    Bart. inter.$. posterior superior.

    BTrunus ommunis !ari aortae thoraalis !engan

    art.$ interostalis ke 3 posterior !extrae.

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    +ena pulmonalis bermuara ke atrium sinistrae

    vena bronhialis !extrae ke vena a

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    Plexus l#mphatius super(iialis:terletak pro(un!a !ari pleura viseralis

    menerima l#mph !ari parenh#m pulmo !an

    pleura viseralis !ialirkan ke bronhopulmonar#l.$n.$

    plexus l#mphatius pro(un!a

    : submoosa bronhus !an %aringan

    peribronhial !ialirkan ke n.$ l.$ pulmonal

    sepan%ang bronhi lobaris !an akhirn#a !ialirkan

    ke bronhopulmonar l.$n.$ke traheopulmonar

    n.$ l.$ #ang akan masuk ke trunus

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    0nervasi :

    1. .vagus P. * 5$ bronhoonstritor$

    vaso!ilator$!an seretomotoris

    2. *#mphatis :segment me!ulla spinalisTh 1- Th4/ membentuk plexus pulmonalis

    anterior et posterior terha!ap ra!ix pulmonum.

    *#mphatis :bronho!ilator an! vasoonstritor!an menghambat seresi gl.$ alveolus.$

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    ungsi pulmo :

    B !asarn#a pertukaran oksigen !an arbon!ioksi!a

    !i alveolus1. +entilasi

    a. %alan u!ara :BPars on!uksi : trahea$ bronhi 0$

    00$ 000 sampai bronhiole terminalB pars respirasi :bronhiole respiratio$ !utus

    alveolaris$ atria$saus alv.$ !an alveoli

    2.7espirasi.

    7espirasi !i alveolus bloo! air barrier.$ antara

    epithel kapiller !an epithel alveolus

    'i((usi gas $perbe!aan tekanan !arah venous !an

    alveoli

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