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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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