fisiologi hidung smt5

8/13/2019 fisiologi hidung smt5

1/22


2/22

. Physiology of nose

respiratory function: physiological turbinal cycle

protective function: clearing, filtration, warming,humidifying

olfactory function

resonant function

6. Physiology of accessory nasal sinuses


3/22

Nose Function

Heat, Humidify and Filter the incoming gas

Smell

nasal blood vessels,

nasal glands, and

the mucociliarysystem


4/22

Anatomy of the Nose

Bone and Cartilage

Partition in the nose is called the nasal septum

Air enters through the nostrils or nares Two nasal passages are called choanae

Vibrissaefilter the incoming gas

First 1/3 is stratified squamous epithelium (PROTECTION)

Posterior 2/3 is pseudostratified ciliated columnarepithelium (MUCUS SECRETION)


5/22

Anatomy of the Nose Mucous secreting glands are found in the posterior 2/3

of nose

Bony Protrusions on the lateral wall are called nasalturbinates or conchae

Separate incoming gas into turbulentairstreams morecontact

Extensive capillary network Constrict or dilate to

change blood flow


6/22

Sympathetic Vasomotor Control -- vasoconstrictor tone

Norepinephrine, pancreatic polypeptide and neuropeptide Y

Parasympathetic Vasomotor Control-- controllingsecretion, vasodilation

vasoactive intestinal polypeptide and peptide histamineisoleucine


7/22


8/22

Conditioning of the

Inspired AirHumidification

Temperature regulation


9/22

Respiration Modification of Inspired Air

Nasal Airway Resistance

1. nasal vestibule,2. nasal valve

3. nasal cavum


10/22

Nasal Airflow

superiorly into the nares, determined by its positionand the anterior nasal valve

the anterior nasal valve is located 1.5-2 cm posterior tothe anterior nares and is the narrowest portion of theupper airway.

Humidification occurs by evaporation of moisture

from the mucosal blanketWarming of inspired air to 36C


11/22

Nasal vestibule activation of the dilator nares muscles during

inspiration

Nasal Cavum

degree of engorgement of the erectile tissues of the turbinates and theseptum


12/22

The NV a tridimensional structure, anteriorly outlined by the

ostium internum

a pear-shaped orifice, inferior border of the SLC as lateral border,

the nasal septum as the medial one and

the nasal cavity floor inferiorly, located at 1 to 1.5 cm

from the nostril


13/22

Physical Principles

of Nasal Airflow

Nasal Air FlowLaminar vs Turbulent

Control of Nasal Resistance

Action of Dilator Nares

Vascular Control of Resistance

Nasal Cycle

Regulate by autonomic nervous system

80% of human each 2 hours

Positional Effect

Nasal Vascular Reflexes


14/22

Protective

Functions of the

Nasal MucosaNonspecific DefenseMechanisms1. Mechanical defenses

(mucociliary apparatus)

2. Nonspecific protectivefactors (Interferon,

Proteases, Proteaseinhibitors , LysozymeAntioxidants)

3. Cellular defenses(phagocytic cells)

Specific Immune

Responses1. Humoral immuneresponse

2. Cellular immuneresponse

3. The endothelial cells

4. The epithelial cells


15/22

an immunological function.

IgA and IgE, which are involved in local mucosal defense

mechanisms, andenzymes like lysozymes, lactoferrin, and complementand C reactive proteins.

Sensory nerve endings present in the nose can mediate

various reflexes


16/22

Speech ProductionVarious organ systems are involved in the production of voice and speech: Glottis, Supraglottic vocal tract, Central nervous system

must be coordinated in order to produce a normal voice sound

Hyponasal speech (rhinophonia clausa) : occurs when these segmentscontribute less to sound production as a result of partial or complete nasal

obstruction or mass lesions in the nasopharynx

Hypernasal speech (rhinophonia aperta):develops when the nasopharynxand nasal cavities over contribute to sound production.cleft palate, velar palsy due to various causes


17/22

Physiology of the Nose Nose can filter particles down to 5 m (microns)in

diameter

Two factors which decrease the humidification andfiltering ability of the nose is:

Mouth Breathing

Placement of an ET (endotracheal) tube


18/22

Paranasal Sinuses Empty air spaces found in the bones of the skull;

Paired Frontal

Ethmoid Sphenoid

Maxillary

They contain mucous secreting goblet cells which

drain into the nasal cavity


19/22

The physiological functions of the

paranasal sinuses are controversial

play a role in conditioning of the inspired air, pressuredamping, heat insulation and voice resonance

however are of the opinion that the sinuses mayindeed have no function at all and may merely bevestigeal structures assuming a significant role when

diseased.


20/22


21/22

Nose and Nasal Cavities


22/22

Abnormal Nasal Physiology

Environmental allergies

Nonallergic or vasomotor rhinitis

nasal cavities and paranasal sinuses are the mainsources of nitric oxide (NO)

fisiologi hidung smt5

Documents