RESPIRATORY

SYSTEM
ANNISA WARDA IRVANI
1610211053
 “
RESPIRASI

Pertukaran oksigen dan karbon dioksida antara atmosfer dan

sel tubuh, meliputi ventilasi (inspirasi dan ekspirasi); difusi
oksigen dari alveolus ke darah dan karbon dioksida dari darah
ke alveolus; serta transport oksigen ke sel tubuh dan karbon
dioksida dari sel tubuh (Dorland)
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Pertukaran gas Pengaturan

antara homoestasis
FUNGSI UTAMA atmosfer dan pH tubuh
darah
SISTEM
RESPIRASI
Perlindungan
terhadap
substansi
Vokalisasi
patogen dan
iritan yang
terhirup
 4

RESPIRASI

INTERNAL
EKSTERNAL
(CELULLAR
(VENTILATION)
RESPIRATION)
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RESPIRASI
INTERNAL
(CELULLAR RESPIRATION)
 “
“Reaksi intraselular oksigen dengan molekul
organik untuk menghasilnya karbon dioksida, air,
energi dlm bentuk ATP”
SILVERTHRON
 ○ Melibatkan pertukaran gas antara kapiler dan sel
jaringan tubuh
RESPIRASI  sel jaringan terus menggunakan O2 dan menghasilkan
INTERNAL CO2 selama metabolisme
• Partial Pressure (p)
 PO2  darah arteri > jaringan
 PCO2  darah arteri < jaringan
• O2 dan CO2 bergerak menurunkan gradien parsial
 O2: kapiler  jaringan
 CO2: jaringan kapiler
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RESPIRASI
EKSTERNAL
(VENTILATION)
 “
“Pergerakan gas antara lingkungan dan sel
tubuh”
SILVERTHRON
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RESPIRASI EKSTERNAL
Dibagi menjadi 4 proses terintegritas:
1. Ventilasi
2. Difusi: Pertukaran O2 dan CO2 antara paru dan darah
3. Transportasi: Transpor O2 dan CO2 oleh darah
4. Perfusi: Pertukaran gas O2 dan CO2 antara darah dan sel
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SILVERTHRON EDISI 6 HAL. 591

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SISTEM RESPIRASI
Terdiri dari struktur yg terlibat dalam ventilasi
dan pertukaran gas:
1. Sistem konduksi
2. Alveoli
3. Tulang dan otot toraks dan abdomen
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SISTEM RESPIRASI
Dibagi menjadi 2 bagian:
1. Traktus respirasi atas
c/ mulut, rongga hidung, faring, laring
2. Traktus respirasi bawah
c/ trakea, 2 dua bronkus utama
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SILVERTHRON EDISI 6
HAL 593
 MEKANISME
PERNAPASAN
 “
16

VENTILASI

“PERTUKARAN ALIRAN UDARA MASAL

ANTARA ATMOSFER DAN ALVEOLI”
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○ Tekanan Atmosfer (Barometrik)

3 TEKANAN YG
BERPERAN ○ Tekanan Intra-Alveolus
PENTING DALAM
VENTILASI ○ Tekanan Intrapleura
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SHERWOOD EDISI 8 HAL. 493

 LUNG VENTILATION 19

Udara
Rongga Volume >> mengalis dari Udara
Paru-paru
thoraks mengembang Tekanan <<
tekanan masuk ke
mengembang tinggi ke paru-paru
rendah
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LAPLACE’S POISEUILLE’S
HUKUM BOYLE’S LAW
LAW LAW
 ○ Law of Laplace –
states that pressure in
alveolus is directly
SURFACE proportional to ST; and
inversely to radius of
TENSION alveoli
◦ Thus, pressure in
smaller alveoli
would be greater
than in larger
alveoli, if ST were
same in both
◦ Greater pressure
of smaller alveolus
would cause it to
 ○ Akhir Trimester ke-3
○ Mengandung phospolipid yg disekresi
oleh alveolar tipe II
SURFACTANT
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INSPIRASI / INHALASI
“pergerakan udara ke dalam paru“
 24

You can also

split your
content

SILVERTHRON
EDISI 6 HAL. 602
 25

You can also

split your
content

SILVERTHRON EDISI 6 HAL. 592

 29

EKSPIRASI / EKSHALASI
“pergerakan udara ke luar dari paru“
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Quiet Breathing
WHEN?
REST, SLEEP
Muscles of Breathing – Inspiration:
• External intercostals
• Diaphragm
 34

Forced or Deep Inspiration

WHEN?
FALSAFA, SNEEZING, COUGH, TALK, SCREAM, SING
Muscles include:
• Sternocleidomastoid
• Scalenes (neck muscles)
 Muscles of Breathing - Inspiration
Quiet Breathing

• Contract to expand the rib cage and stretch the lungs = ↑

volume of the thoracic cavity
• ↑ intrapulmonary volume
• ↓ intrapulmonary pressure (relative to atmospheric
pressure)
• Decreased pressure inside the lungs pulls air into the
lungs down its pressure gradient until intrapulmonary
pressure equals atmospheric pressure
 Muscles of Breathing - Inspiration
Forced or Deep Inspiration

• Involves several accessory muscles:

• Sternocleidomastoid
• Pectoralis minor
• Scalenes (neck muscles)
• Maximal ↑ in thoracic volume
• Greater ↓ in intrapulmonary pressure
• More air moves into the lungs
• At the end of inspiration, the intrapulmonary pressure
equals atmospheric pressure
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Forced Expiration
WHEN?
blowing up a balloon, exercising, or yelling
Forced Expiration
○ Active process

○ Abdominal wall muscles are involved in forced expiration

◦ Function to ↑ the pressure in the abdominal cavity forcing the
abdominal organs upward against the diaphragm
○ ↓ volume of the thoracic cavity

○ ↑ pressure in the thoracic cavity

○ Air is forced out of the lungs

Quiet Breathing
○ Passive process
◦ Depends on the elasticity of the lungs
○ Muscles of inspiration relax
◦ The rib cage descends
◦ The lungs recoil
○ ↓ intrapulmonary volume
○ ↑ intrapulmonary pressure
○ Alveoli are compressed, thus forcing air out of the lungs
 Contraction of the
Diaphragm contracts down, diaphragm, Diaphragm and
increasing the vertical dimension Brain (medulla intercostals and rib-cage relax
of the thorax. and higher interchondral decreasing the
centers) sends muscles stop and vertical, lateral and
Intercostals and impulse to elastic recoil brings anterior-posterior
interchondral muscles inspire. them to released dimensions of the
contract expanding lateral position. thorax.Abdominal and
and anterior-posterior intercostals
dimensions of the thorax. Pressure is muscles contract
equalized decreasing
in the thoracic volume.
lungs. EXPIRATION
INSPIRATION

Gas is Positive air

Negative air expelled pressure is
pressure is Air is
from the created in the
created in the drawn
lungs. lungs.
lungs into the
lungs.
 Factors Affecting Pulmonary
Ventilation
Lung compliance
○ The ease with which the lungs may be expanded, stretched,
or inflated
○ Depends primarily on the elasticity of the lung tissue
◦ Elasticity refers to the ability of the lung to recoil after it
has been inflated
Factors Affecting Pulmonary
Ventilation
○ Lung and thoracic cavity tissue has a natural
tendency to recoil, or become smaller
○ Lung recoil is essential for normal expiration and
depends on the fibroelastic qualities of lung tissue
○ In normal lungs there is a balance between
compliance and elasticity
 Factors Affecting Pulmonary Ventilation
○ Recoil pressure is inversely proportional to compliance

○ Increased compliance results in decreased recoil

Example: Emphysema

◦ Results in difficulty resuming the shape of the lung during exhalation

○ Decreased compliance results in increased recoil

Example: Cysitc fibrosis

◦ Results in difficulty expanding the lung because of increased fibrous

tissue and mucous
 Factors Affecting Pulmonary Ventilation
Airway Resistance (Poiseuille’s Law)
○ Opposition to air flow in the respiratory passageways
○ Resistance and air flow are inversely related
◦ ↑ airway resistance = ↓ air flow (and vice versa)
○ Airway resistance is most affected by changes in the diameter of the bronchioles
◦ ↓ diameter of the bronchioles = ↑ airway resistance
○ Examples:

- Asthma

- Bronchiospasm during an allergic reaction

○ A high resistance to air flow produces a greater energy cost of breathing
 “
46

DIFUSI

“Proses perpindahan O2 dari alveoli ke

dalam darah, serta keluarnya CO2 dari
darah ke alveoli”
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• Keadaan beristirahat normal  difusi

keseimbangan O2 (di kapiler darah paru dan
alveolus berlangsung 0.25 detik dari total waktu
kontak 0.75 detik
• Paru normal  Cadangan waktu difusi cukup
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HUKUM DALTON’S
LAW

HENRY’S LAW
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VOLUME PARU
VOLUME TIDAL (VT)

VOLUME CADANGAN
INSPIRASI (VCI)

VOLUME CADANGAN
EKSPIRASI (VCE)

VOLUME RESIDU
(VR)
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VOLUME TIDAL VOLUME CADANGAN

VOLUME PARU INSPIRASI
(udara yg bergerak ○ Volume udara yg
selama bernapas) bergerak selama ○ Napas tambahan pada
satu inspirasi dan akhir ekspirasi
satu ekspirasi
○ 6x lipat dari volume
○ Napas tenang tidal
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VOLUME VOLUME RESIDU

VOLUME PARU CADANGAN
(udara yg bergerak ○ Volume udara di
EKSPIRASI
selama bernapas) dalam sistem respirasi
○ Ekspirasi tambahan setelah ekspirasi
pada akhir ekspirasi maksimal
normal
○ Tidak dapat diukur
○ Rerata 1100 mL langsung
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KAPASITAS
PARU

KAPASITAS
KAPASITAS KAPASITAS KAPASITAS
RESIDU
VITAL PARU TOTAL INSPIRASI
FUNGSIONAL
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SILVERTHRON EDISI 6 HAL. 600

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KAPASITAS KAPASITAS VITAL KAPASITAS PARU

PARU TOTAL (KPT)
○ KV = VCI + VCE +
(penjumlahan dua VT ○ KPT = KV + VR
atau lebih volume)
○ Mempresentasikan
jumlah udara
maksimum yg secara
sadar dpt
dipindahkan ke
dalam/luar paru
selama satu napas
○ << seiring dgn usia
 otot melemah 
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KAPASITAS KAPASITAS INSPIRASI KAPASITAS RESIDU

PARU FUNGSIONAL
○ KI = VT + VCI
(penjumlahan dua ○ KRF = VCE + VR
atau lebih volume)
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SHERWOOD EDISI 8 HAL. 504-505