1、Physiotherapy Diagnosis & Management of Cardiopulmonary DysfunctionLecture 1Functional Anatomy and Monitoring of the Function of the Respiratory SystemRespiratory SystemRespiratory Tract Lungs Alveoli Pleura胸膜 Ultimate Function allow adequate/efficient gas exchange Respiratory AnatomyPosition of the

2、 Airwayposture of the Head & NeckSurface AnatomyLung & PleuraMuscles of Respiration Intercostals, DiaphramFunction of the Upper Respiratory TractFilters(過濾) inspired air Humidifies inspired air Warms inspired air Smell, articulation(發音), resonance(回聲) Produce mucus (goblet cells)Mobilise mucus (cili

3、ated纖毛 cells) Epithelial Lining上皮層Resting Position of the Head and NeckAirway Patency & Sleep Disordersa problem common in subjects with:Obesity Chronic respiratory diseases Obstructive Sleep ApnoeaHypoventilation during SleepCO2 and SaO2 Sleepiness / Non-refreshed Sleep Headache Fatigue Lack of Con

4、centrationroad traffic accident Management of Obstructive Sleep ApnoeaPositive Airway Pressureto keep the airway open during sleep and allow optimal ventilationSurgical ManagementBronchial TreeCinical RelevancePostural / Gravitational Drainagepositioning of the “bronchial tree” to facilitate drainin

5、g of pulmonary secretions by gravityparticipate in gas exchangeCollateral Ventilationpores of KohnAlveolar Cells alveolar lining (prevent protein leak) for storage of surfactantImmune function巨噬細胞Clinical Relevance oxygen diffusion capacity alveolar membrane thickness fluid balance in the lungs Capi

6、llary毛細血管 (hydrostatic pressure靜水壓) /alveolar pressure/osmotic pressure滲透壓alveolar expansion effect of surfactant on surface tensionRespiratory MusclesRespiratory MusclesDiaphragmInternal and External intercostals Abdominal Muscles Forced expiration Coughing If Abdominal Muscles is weakDiaphragm Mus

7、cle Ventilation Lung Volume Stablization of Back Muscles Providing Support like a CorsetWork of Breathing is Affected byefficiency of the respiratory muscles weakness/fatigue Compliance順應性 of the chest wall (obesity, pleural restriction) position of the diaphragm obesity postural changes Function of

8、 the Respiratory SystemGas exchange oxygenation efficient removal of CO2 Affected by airway diameter lung volume Monitoring of the Function of the RSlung volume expiratory flow rates oxygen level (PaO2, SaO2) expired CO2 level chest radiographs lung sounds functional capacity Summarysurface anatomy position