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Samenvatting ademhalingsstelsel, spijsverteringsstelsel en urinewegstelsel
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AdemhalingsstelselInleiding................................................................................................................................... 9
Functies van het ademhalingsstelsel...................................................................................9
Luchtwegen......................................................................................................................... 9
Deel voor geleiding van lucht...........................................................................................9
................................................................................................................................. 9
Deel voor de gasuitwisseling............................................................................................9
................................................................................................................................. 9
Functie............................................................................................................................. 9
................................................................................................................................. 9
Respiratoir slijmvlies........................................................................................................ 9
Bouw ademhalingsstelsel......................................................................................................10
Neus.................................................................................................................................. 10
Neusholte.......................................................................................................................... 11
Drie paar neusschelpen (concha)...................................................................................11
............................................................................................................................... 11
Bekleed met respiratoire mucosa...................................................................................11
Functies respiratoire mucosa.........................................................................................11
Neusbijholten (sinus paranasales).................................................................................11
............................................................................................................................... 12
Functie:.......................................................................................................................... 12
Farynx=keelholte............................................................................................................... 12
Bestaat uit:..................................................................................................................... 12
Nasofarynx............................................................................................................................ 12
Orofarynx.............................................................................................................................. 12
Laryngofarynx....................................................................................................................... 12
Larynx= strottenhoofd........................................................................................................12
Opgebouwd uit kraakbeendelen.....................................................................................13
Strottenklepje (epiglottis).......................................................................................................13
Schildkraakbeen (cartilago thyroidea)...................................................................................13
Functie.................................................................................................................................. 13
Bouw..................................................................................................................................... 13
Stembanden en vorming van geluid......................................................................................13
Trachea............................................................................................................................. 14
Versteviging wanden door 15 – 20 kraakbeenstukken...................................................14
Bronchiën.......................................................................................................................... 15
Vertakking trachea in rechter en linker primaire bronchus..............................................15
,Bouw primaire bronchiën.......................................................................................................15
Bronchusboom...............................................................................................................16
Bouw wand bronchiolen.................................................................................................16
Bronchiolen ....................................................................................................................... 16
Gasuitwisseling luchtwegen...........................................................................................16
Alveoli en ductuli alveolares...............................................................................................17
Longtrechtertjes.............................................................................................................17
alveoli............................................................................................................................. 17
Alveolaire macrofagen........................................................................................................... 17
Pneumonocyten.................................................................................................................... 17
Type 1................................................................................................................................... 17
Type 2................................................................................................................................... 17
De respiratoire membraan.................................................................................................18
Bestaat uit:..................................................................................................................... 18
Longen.............................................................................................................................. 18
Longkwabben.................................................................................................................18
Bouw..................................................................................................................................... 18
Extra...................................................................................................................................... 19
Pleuraholten................................................................................................................... 19
Vliezen.................................................................................................................................. 19
Aandoeningen....................................................................................................................... 19
Pneumothorax (=klaplong)....................................................................................................19
Hemothorax........................................................................................................................... 19
Gaswisseling: respiratie= ademhaling...................................................................................19
Twee soorten respiratie:....................................................................................................19
Externe respiratie:.......................................................................................................... 19
Doel:...................................................................................................................................... 19
Verloop.................................................................................................................................. 19
Afwijkingen in deze processen..............................................................................................20
Interne respiratie:...........................................................................................................20
Longventilatie........................................................................................................................ 20
Longventilatie.................................................................................................................... 20
Ademhalingscyclus........................................................................................................ 20
Ademhalingsfrequentie..................................................................................................20
Functie ademhaling........................................................................................................20
Druk en luchtstroom naar de longen.................................................................................20
Volumeverandering ter hoogte van de borstholte...........................................................21
,Het diafragma........................................................................................................................ 21
Borstkas................................................................................................................................ 21
Ademhaling.................................................................................................................... 21
Compliantie (compliance)..................................................................................................21
Mechanisme van ademhaling............................................................................................22
Rustige ademhaling.......................................................................................................22
Geforceerde ademhaling................................................................................................22
Longvolume en capaciteit..................................................................................................22
Ademhalingscyclus........................................................................................................ 22
Ademvolume (= tidal volume=TV)..................................................................................23
Expiratoir reservevolume (ERV)............................................................................................23
Inspiratoir reservevolume (IRV).............................................................................................23
Vitale capaciteit (VC).............................................................................................................23
Residuvolume....................................................................................................................... 23
Minimumvolume.................................................................................................................... 23
Partiële gasdrukken en diffusie..........................................................................................23
Snelheid gaswissel tussen bloed en alveolaire lucht (thv respiratoir membraan) bepaald
door:............................................................................................................................... 23
Partiële druk betrokken gassen.............................................................................................23
Diffusie van moleculen tussen gas en vloeistof.....................................................................23
Alveolaire lucht vs atmosferische lucht...........................................................................23
Partiële drukken (P) in bloedsomloop.............................................................................24
............................................................................................................................................. 24
Binding van zuurstof en koolstofdioxide................................................................................25
Zuurstoftransport............................................................................................................... 25
Transport van CO2 en O2..................................................................................................25
Zuurstoftransport............................................................................................................ 25
Koolstofdioxidetransport.................................................................................................26
Transport in bloedplasma......................................................................................................26
Binding aan hemoglobine......................................................................................................26
Koolzuurvorming................................................................................................................... 26
Betekenis van de ademhaling............................................................................................26
Regulering van de ademhaling..............................................................................................27
Besluit................................................................................................................................... 27
Inleiding................................................................................................................................. 28
voedingsstoffen uit hun omgeving nodig voor....................................................................28
Spijsverteringskanaal= Gastro-intestinaal kanaal..............................................................28
Functies GI kanaal.............................................................................................................29
, Ingestie.......................................................................................................................... 29
Mechanische verwerking................................................................................................29
Vertering........................................................................................................................ 29
Secretie.......................................................................................................................... 29
Opname......................................................................................................................... 29
Uitscheiding................................................................................................................... 29
afweer............................................................................................................................ 29
Over volledige lengte zelfde bouw.....................................................................................30
Overzicht van binnen naar buiten...................................................................................30
Mucosa (slijmvlies)................................................................................................................30
Submucosa........................................................................................................................... 31
Muscularis externa................................................................................................................31
Serosa= Sereuze membraan................................................................................................32
Verplaatsing van de spijsbrij..................................................................................................32
Mondholte= cavitas oris.........................................................................................................33
Functies:............................................................................................................................ 33
Begrenzing mondholte.......................................................................................................33
De tong.............................................................................................................................. 33
Speekselklieren................................................................................................................. 34
Samenstelling speeksel..................................................................................................34
Productie speeksel.........................................................................................................34
Keelholte= farynx..................................................................................................................34
Bouw................................................................................................................................. 34
Nasofarynx..................................................................................................................... 34
Orofarynx....................................................................................................................... 35
Laryngofarynx................................................................................................................35
Bouw farynxwand..............................................................................................................35
Oesophagus= slokdarm........................................................................................................35
Topografie......................................................................................................................... 35
Bouw wand........................................................................................................................ 35
Functie:.............................................................................................................................. 35
Slikken= deglutitie................................................................................................................. 36
Bewuste / onbewuste regulatie:.........................................................................................36
Fasen................................................................................................................................ 36
Orale= buccale fase:......................................................................................................36
Faryngale fase:..............................................................................................................36
Oesophagale fase:......................................................................................................... 36
, Bolus komt binnen in de maag.......................................................................................36
Maag..................................................................................................................................... 37
Functies maag:..................................................................................................................37
Uitwendige anatomie.........................................................................................................37
Inwendige anatomie........................................................................................................... 37
Maagwand......................................................................................................................... 38
Bekleedt met enkelvoudig cilinderepitheel.....................................................................38
Maaggroefjes................................................................................................................. 38
Maagwandklieren...........................................................................................................39
Bestanddelen maagsap gevormd door:.................................................................................39
Pariëtale cellen...................................................................................................................... 39
Zymogene cellen................................................................................................................... 39
Regulering van de maagactiviteit.......................................................................................39
Vorming zuur en enzymen gereguleerd door.................................................................39
Afgifte producten maagwandklieren in drie overlappende fasen....................................39
Cefalische fase:..................................................................................................................... 39
Gastrische fase:.................................................................................................................... 39
Intestinale fase:..................................................................................................................... 39
Maagactiviteit remmende reflexen door:........................................................................39
Maaglediging.................................................................................................................. 40
Vertering in de maag.........................................................................................................40
Pepsine.......................................................................................................................... 40
Amylase (uit speeksel)...................................................................................................40
Geen opname in de maag zelf doordat..........................................................................40
Dunne darm= intestinum tenue.............................................................................................40
Uitwendige anatomie.........................................................................................................40
Drie delen:...................................................................................................................... 41
Twaalfvingerige darm (duodenum)........................................................................................41
C- vormig.............................................................................................................................. 41
Ontvangt:.............................................................................................................................. 41
Nuchtere darm (jejunum).......................................................................................................41
Kronkeldarm (ileum).............................................................................................................. 41
Darmwand......................................................................................................................... 41
Darmvlok........................................................................................................................... 42
Darmsapklieren................................................................................................................. 42
Darmbewegingen...............................................................................................................42
Darmsap............................................................................................................................ 43
, Hormonen spijsverteringsstelsel........................................................................................43
Gastrine......................................................................................................................... 43
Werking:................................................................................................................................ 43
Secretine........................................................................................................................ 43
Werking:................................................................................................................................ 43
Vertering in de dunne darm...............................................................................................43
Pancreas............................................................................................................................... 44
Uitwendige anatomie.........................................................................................................44
Exocriene klieren............................................................................................................ 44
Gereguleerd door hormonen duodenum...............................................................................44
Secretine............................................................................................................................... 44
Pancreasamylase.................................................................................................................. 44
Pancreaslipase...................................................................................................................... 44
Endocriene klieren.........................................................................................................44
Liggen in groepen Eilandjes van Langerhans.......................................................................44
Twee typen cellen:................................................................................................................45
α-cellen (alfacellen) glucagon...............................................................................................45
β-cellen (bètacellen) insuline................................................................................................45
Fysiologie.......................................................................................................................... 45
Lever= hepar......................................................................................................................... 46
Anatomie - topografie........................................................................................................46
Anatomie........................................................................................................................ 47
Omgeven door taai vezelig kapsel........................................................................................47
Verdeeld in vier ongelijke kwabben door taai ligament (bindweefselplooi)............................47
Onderzijde = leverpoort of hilus.............................................................................................47
Galblaas................................................................................................................................ 47
Uitwendige anatomie.............................................................................................................47
Leverbuis (ductus hepaticus).................................................................................................47
Inwendige anatomie.............................................................................................................. 47
Leverparenchym................................................................................................................... 47
Fysiologie....................................................................................................................... 48
Productie van gal..................................................................................................................48
Samenstelling gal:.................................................................................................................48
Rol in de suikerstofwisseling:................................................................................................48
Belang constant houden glycemie.........................................................................................48
Rol in de eiwitstofwisseling....................................................................................................48
Eiwitsynthese........................................................................................................................ 48
,Transaminering..................................................................................................................... 48
Deaminering.......................................................................................................................... 49
Ontgiften............................................................................................................................... 49
Depotfunctie.......................................................................................................................... 49
Galblaas = vesica fellea........................................................................................................49
Functie............................................................................................................................... 49
Afvoer gal.......................................................................................................................... 49
Dikke darm= intestinum crassum..........................................................................................50
Functies............................................................................................................................. 50
Terugresorptie van water......................................................................................................50
Absorptie van vitaminen gevormd door bacteriën..................................................................50
Opslag van ontlasting voorafgaand aan de defecatie............................................................50
Opname in de dikke darm.....................................................................................................50
Bewegingen van de dikke darm............................................................................................50
Anatomie........................................................................................................................... 50
....................................................................................................................................... 51
....................................................................................................................................... 51
Drie delen:...................................................................................................................... 51
Blindedarm= caecum............................................................................................................ 51
Colon:.................................................................................................................................... 51
Endeldarm (rectum)...............................................................................................................51
Defecatie........................................................................................................................... 51
Uitrekking rectumwand activering defecatiereflex.................................................................52
Uitrekking rectumwand veroorzaakt......................................................................................52
Vooraleer feces het anale kanaal kan passeren moet de interne anale sfincter zich
ontspannen........................................................................................................................... 52
Bewuste inspanning nodig om externe anale sfincter te openen o.i.v. de wil........................52
Besluit................................................................................................................................... 52
Inleiding................................................................................................................................. 52
Functies............................................................................................................................. 53
Organisatie............................................................................................................................ 53
Functies worden vervuld door:...........................................................................................53
Homeostatische functies:...............................................................................................53
Nieren................................................................................................................................... 53
Uitwendige anatomie.........................................................................................................54
Het nefron ........................................................................................................................ 55
Basale functionele eenheid van de nier.............................................................................55
Overzicht........................................................................................................................ 55
,Nierlichaam........................................................................................................................... 55
nierbuis................................................................................................................................. 56
Functies......................................................................................................................... 56
Nierlichaam.................................................................................................................... 56
Proximale tubulus contortus (PCT).................................................................................57
Lis van Henle................................................................................................................. 57
Distale tubulus contortus (DCT).....................................................................................57
Het verzamelsysteem.....................................................................................................57
Urinevorming..................................................................................................................... 58
Doel urinevorming:.........................................................................................................58
Fundamentele processen...............................................................................................58
Filtratie.................................................................................................................................. 58
Terugresorptie....................................................................................................................... 58
Actieve afgifte........................................................................................................................ 58
Filtratie in glomerulus............................................................................................................ 59
Glomerulaire filtratiesnelheid.................................................................................................59
Terugresorptie en afgifte in nierbuisje...................................................................................59
Proximale tubulus contortus:.................................................................................................59
Lis van Henle........................................................................................................................ 59
Distale tubulus contortus en verzamelsysteem.....................................................................59
Normale nierfunctie............................................................................................................60
Afhankelijk van stabiel GFS...........................................................................................60
Vervoer urine door urinewegen..........................................................................................61
Ureters (urineleiders).....................................................................................................61
Urineblaas (vesica urinaria)............................................................................................61
Urethra........................................................................................................................... 62
,Inleiding
Functies van het ademhalingsstelsel
Vorming van het oppervlak voor gaswisseling tussen lucht en bloed
Verplaatsing van lucht naar oppervlak waar gaswissel zal plaatsvinden in de longen
Bescherming alveolaire oppervlakken tegen:
o Uitdroging
o Temperatuurveranderingen
o Verdediging pathogene
Vorming van geluid waardoor spreken, zingen en andere vormen van communicatie
mogelijk zijn.
Bevorderen reukzin
Luchtwegen
Buizen die lucht van en naar de gasuitwisselings-oppervlakken van de longen
vervoeren
Deel voor geleiding van lucht
Ingang neusholte
Farynx (=keelholte) – larynx – trachea
Bronchiën en grote bronchiolen
Deel voor de gasuitwisseling
Kleine, kwetsbare bronchiolen
Alveoli in de longen
Functie
Transport van lucht naar de longen
Filteren van lucht
Verwarmen van lucht
Bevochtigen van lucht
Resultaat: pathogenen verwijderd, vochtigheid en temperatuur binnen nodige
grenzen
Respiratoir slijmvlies
Slijmvlies= dekweefsel van slijmcellen (=bekercellen)
Bestaat uit een respiratoir epitheel dat bestaat uit:
, o Een cilindrisch epitheel met trilharen en slijmcellen
o Ondergelegen losmazig bindweefsel (=lamina propria) dat slijmklieren bevat
die hun klierproduct afgeven op het oppervlak van het dekweefsel
Slijmlaag door slijmcellen en slijmklieren het slijmt vangt cel resten en micro-
organismen via de trolharen gaat het slijm door de farynx naar de maag hier
word het slijm blootgesteld aan de zuren en enzymen van de maag
Bouw ademhalingsstelsel
Neus
De lucht verplaatst zich van de buitenwereld uitwendige neusopening
(=neusgaten=nares) neusholte
Vestibulum nasi (opening nares): de vibrissae (= ruwe haren) steken uit de nares
naar buiten en beschermen de neusholte tegen grote deeltjes die met de lucht
meekomen zoals zand, stof, insecten
Neustussenschot (septum nasale)
o Verdeelt de neusholte in twee helften
o Voorste deel bestaat uit hyalien kraakbeen
o Bodem bestaat uit benig hard gehemelte. Het scheidt de neusholte van de
mondholte
De bodem van de nasofarynx bestaat uitvlezig zacht gehemelte
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