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Samenvatting module 2.1: oxygenatie
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samenvatting module 2.1: oxygenatie
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Module 2.1: oxygenatie:Ademhaling:
Bronchiëctasieën:
= permanente abnormale dilatatie van bronchi door destructie van bronchiale wand
<-> verstoorde mucociliaire klaring
➔ Ophoesten van grote hoeveelheden purulent sputum
Ademhaling teweeggebracht door ademhalingsspieren:
• M. sternocleidomastoideus
• M. scalenus
• M. intercostales externi
• Diafragma
• M. intercostales interni
• M. rectus abdominis
• M. obliquus externus abdominis
Drukveranderingen leiden tot luchttransport:
• Ppl altijd negatief
• Inspiratie:
▪ Contractie AH spieren
▪ Ppl meer negatief
▪ Instroming van lucht
▪ Elastische retractiekracht van de long neemt toe
▪ + expansiekracht van thorax
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, • Expiratie:
▪ Relaxatie AH spieren
▪ Passief uitstromen van lucht tot FRC
▪ Positieve Ppl bij geforceerde expiratie
Ventilatie:
• Ademvolume= ademteugvolume
500-800 ml lucht per ademhaling
• Ademhalingsfrequentie
10-15 keer per minuut
• Ademminuutvolume
Ademvolume x frequentie= 5-7.5 L/minuut
• De dode ruimte beperkt de effectiviteit van de ventilatie = gang tussen buiten en longen
• Alveolair ademminuutvolume
3,5-5.25 minuut
Alveolo-capilaire membraan:
Enorm groot oppervlak:
▪ 250 miljoen alveolen per long
▪ Totale oppervlak: 70-80 m^2
▪ 70% van oppervlakte alveolus bekleed met capillairen
▪ Diameter alveolus 200-500µm met enorm dun oppervlak
▪ Surfactant
• Gasuitwisseling gebeurt via passieve diffusie
• Op basis van diffusiewet van FICK
Ventilatie-perfusie evenwicht:
• ventilatie-perfusie verhouding (V/Q)= hoeveelheid lucht die alveolen binnengaat in relatie tot
de capillaire diffusie
▪ lage V/Q leidt tot shunt-effect ➔ verminderde oxygenatie
▪ hypoxemische pulmonaire vasocontrictie ➔ afname shunt
▪ hoge V/Q leidt tot dode ruimte ventilatie ➔ verminderde oxygenatie,
bronchoconstrictie
samenstelling bloed:
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