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Clinical physiology of the larynx, trachea and bronchi
Resume function. The larynx is part of the airway; when inhaling, it conducts air to the lower sections - the trachea, bronchi and lungs, when exhaling, the air passes in the opposite direction. The act of breathing is provided by the respiratory muscles, and in the larynx by the contraction of the posterior cricoid muscles, which expand the glottis. When breathing, the glottis is always open, and its size and shape depend on the depth of inspiration. So, with calm breathing, the glottis takes the shape of a triangle, with a deep breath, its lumen becomes like a rhombus. Such a change in size and shape is regulated reflexively due to irritation of the nerve air
Larynx, trachea and bronchi
a is a diagram; b - tracheobronchoscopic picture: 1 - right main bronchus; 2 - the left main bronchus; 3 - Karina.
endings located in the mucous membrane, when inhaling and exhaling. A sharp irritation of the mucous membrane of the larynx does not cause spasm of the glottis and respiratory arrest. The resulting impulse along the nerves reaches the respiratory center located in the bottom of the IV ventricle, then the response is transmitted to the muscles involved in the expansion or contraction of the glottis. A similar reaction is observed with irritation of the nerve endings embedded in the mucous membrane of the trachea; this reaction also affects the rhythm and depth of breathing.
Zashch and t n and I funkcion and I. The larynx and trachea, being part of the respiratory tract, perform, on the one hand, the role of a barrier preventing the entry of foreign bodies into the underlying respiratory tract, and on the other, organs that help moisturize, warm and purify the inhaled air. The mechanism of protective function is associated with the presence of three reflexogenic zones of the mucous membrane of the larynx. The first of them is located around the entrance to the larynx (the laryngeal surface of the epiglottis, the mucous membrane of the arytenopharyngeal folds), the second occupies the anterior surface of the arytenoid cartilage (from their apex to the base) and continues to the vocal folds, the third is located in the sub-voice space on the inner surface of the cricoid cartilage (rice . 3.7).
Reflexogenic zones (1-3) of the larynx
In reflexogenic zones there is a nervous network of nerve fibers, the filaments of which penetrate into the intercellular spaces of the epithelium of the mucous membrane, where they end freely or in cells in the form of buttons and loops. As a result of irritation of the mucous membrane of these zones with food and other particles or chemicals, spasm of the glottis occurs. The reflex is transmitted to the muscles that provide exhalation. In such cases, a reflex cough occurs, sputum is expectorated, and breathing quickens. An example is the accidental ingestion of food particles in the larynx. In a normal state, these particles cannot get into, because when swallowing it is covered tightly. The larynx rises up and back to front, the entrance to it is covered by the epiglottis, which is lowered by the root of the tongue, with the top of the epiglottis adjacent to the posterior pharyngeal wall. Food masses flow around the epiglottis from two sides and enter the “mouth” of the esophagus, opened at the time of the pharynx. The closure of the vestibular folds and the forward inclination of the arytenoid cartilage during swallowing are of some importance in protecting the respiratory tract from the penetration of foreign bodies. However, if a foreign body slips into the larynx or goes deeper, a spasm of the glottis occurs and it closes, which prevents the ejection of a foreign body during coughing. Often, in persons who are even in a state of slight anxiety, with laryngoscopy there is a paradoxical convulsive closure of the vocal folds on inspiration (laryngoscopic spasm as a protective reflex) of varying severity.
Atrial cleansing of dust is facilitated by the ciliated epithelium of the mucous membrane and the mucus produced by it.
GLOBAL PARTICIPATION (OPPORTUNITY) FUNCTIONS. In humans, the voice-forming function of the larynx is an integral part of the formation of speech, psyche, and social life. It should be noted that animals have only a voice-forming function.
Three main sections of the respiratory apparatus take part in reproducing sounds: 1) the vocal apparatus of the larynx; 2) forming and resonating sound of the oral cavity, nose, pharynx, the shape of which changes with the movements of the tongue, lower jaw, lips, palate and cheeks (upper resonator); 3) chest - lungs, bronchi, trachea (lower resonator). At the moment of pronouncing the sound, the glottis is initially closed, i.e. vocal folds are tense and closed. Then, under the pressure of the air located in the lungs, trachea and bronchi, the glottis opens for a very short time, and at this moment part of the air breaks through it, after which the vocal folds close again, which creates airborne sound waves; the frequency of these vibrational movements corresponds to the height of the sound being emitted. Thus, during voice formation, the current of air leaving the lower resonator is interrupted with a certain frequency, i.e. is in a state of oscillatory motion. These air vibrations create sound.
Oscillations of the free edges of the vocal folds, which are represented by elastic fibers in the form of a thin narrow strip, also participate in the formation of sound. The pitch depends on the number of such vibrations or breaks between them per second; the pitch and timbre of the voice are affected by the magnitude of the vocal folds, their tension and the characteristics of the resonators. As a result, wanting to make a sound of a certain height, a person, contracting the laryngeal muscles with a certain force, gives the vocal folds the necessary length and tension, and the upper resonators - a certain shape. All this refers to the normal formation of sound, or the chest register. When whispering, the vocal folds close only in the front sections. Air passing through the glottis in the back makes a noise called a whisper. Due to the large size of the larynx and vocal folds in men, the voice is usually an octave lower than in children and women.
Sound varies in pitch, timbre, and strength. The pitch of the sound depends on the frequency of oscillation of the vocal folds, and the frequency on their length and voltage. In the process of human growth and development, the size of the vocal folds changes, which leads to a change in voice. Change, or fracture (mutation), of the voice occurs during puberty (between 12 and 16 years). In boys, treble or viola turns into tenor, baritone or bass, in girls - into soprano or contralto. The mouth and nose, where the sound coming out of the larynx gets, can no longer change its height. Being the upper resonator, they form only some overtones of the laryngeal sound, as a result of which it acquires a certain timbre. In addition, by changing the position of the cheeks, tongue, palate and lips, we can arbitrarily change the timbre of sounds, but only within certain limits. The voice timbre of each person is individual, so we recognize the voices of familiar people. The nature of the sounds of colloquial speech does not depend on the larynx, but on the shape of the mouth, pharynx and the relative position of the organs located in them. The strength and pitch of sound are determined by the force of closing of the vocal folds and the force of exhalation, which depends on the contractility of not only the striated respiratory muscles, but to a certain extent and the smooth muscles of the bronchi.
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Clinical physiology of the larynx, trachea and bronchi
- CLINICAL ANATOMY AND PHYSIOLOGY OF THE Larynx, Trachea, and BRONCH
CLINICAL ANATOMY AND PHYSIOLOGY OF THE LARYNX, TRAJA AND
- Physiology of the trachea and bronchi
The main function of the trachea and bronchi is respiratory. During breathing, in connection with excursions of the chest, the trachea and bronchi make a number of movements, while the bifurcation of the trachea during inspiration moves down and anterior to 2 cm (Lepnev P.G., 1956). The volume of air in the tracheobronchial tree, the so-called "harmful space" is equal to 120 - 180 ml. Due to the presence, in the annular ligaments and
- Physiology of the esophagus, trachea and bronchus
Physiology of the Esophagus, Trachea and
- Clinical anatomy of the trachea and bronchi
The respiratory throat or trachea is a direct continuation of the larynx and refers to the initial section of the lower respiratory tract. The trachea is a hollow elastic tube, somewhat compressed in the anteroposterior direction. Above, through the cricoid-tracheal ligament, it connects to the larynx, below, in the bifurcation area, it is divided into two main bronchi. Distinguish in the trachea
- Clinical anatomy of the trachea and bronchi
The respiratory throat (trachea) is a continuation of the larynx, with which it is connected through the cricotracheal ligament (lig. Cricotracheale). Trachea - a long cylindrical tube (length 11-13 cm); it begins at the body level of Suz. and at the level of ThiV — Thv is divided into two main bronchi (bronchus principalis dexter et sinister). The beginning of the septum dividing the trachea is called the spur (carina;
- Clinical anatomy of the esophagus, trachea and bronchus
Clinical anatomy of the esophagus, trachea and
- Examination of the larynx and trachea.
Carry out external and internal studies of the larynx and trachea. Outdoor research. It consists of examination, palpation and auscultation. With an external examination, you can notice the lowering of the head, stretching of the neck and shortness of breath, sometimes swelling is established in the larynx and trachea due to inflammation and swelling of the surrounding tissues. When examining the trachea determine the change in its shape,
- Malformations of the wall of the trachea and bronchi.
Malformations of the structural elements of the wall of the trachea, bronchi and bronchioles are morphologically associated with the absence, deficiency or disorganization of cartilage or elastic and muscle tissue. Malformations of the wall of the bronchi can be divided into limited and common. Limited defects of tracheobronchial structures usually lead to local narrowing of a particular segment
- Research methods of the trachea and bronchi
The study of the lower respiratory tract, which include the trachea and bronchi, is carried out by endoscopic and radiological methods. With indirect laryngoscopy, you can see not only the sub-fold space of the larynx, but also the first rings of the trachea. With a deep breath, in individual patients it is possible to examine the trachea throughout the bifurcation area and even the beginning of the main bronchi. But,
- Foreign bodies of the trachea and bronchi
Most often, foreign bodies of the respiratory tract are found in young children. This is because children, learning the world around them, take various objects into their mouths, and their protective reflexes are not sufficiently developed. The frequency of predominant localization of foreign bodies in the respiratory tract is as follows: in the larynx - 13%, in the trachea - 22%, in the bronchi - 65% (Rokitsky M.R., 1978). Other authors
- Damage to the bronchi and trachea
Fractures of the first two ribs, sternum and collarbone are the most characteristic bone injuries that cause airway injuries. Hemoptysis, atelectasis, subcutaneous emphysema, pneumomediastinum or pneumothorax, which cannot be corrected by pleural drainage, are signs of possible damage to the main respiratory tract. (The presence of bilateral pneumothorax after blunt injury
- Injuries, foreign bodies of the esophagus, trachea and bronchus
Injuries, foreign bodies of the esophagus, trachea and
- Larynx Physiology
The larynx has the functions of breathing, voice formation and protection. The mechanism of these functions is fused together and is provided mainly by the muscles of the larynx, as well as lymphoid congestion in the larynx, pharyngeal vestibule (Voyachek tonsil) and the morgan sinus. Breathing and voice formation is provided by the vocal folds, or rather their muscles. The only muscle that extends the glottis is
- Clinical anatomy of the larynx
The larynx (larynx) enters the initial part of the respiratory tract, the upper section of which opens into the pharynx, the lower part passes into the trachea. The larynx is located under the hyoid bone, on the front of the neck. In thin men, the contours of the larynx are well outlined. In adult men, the upper edge of the larynx is located on the border of CIV and Cv, and the lower one corresponds to Cvi (Fig. 3.1). In newborns,