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            呼吸系統(1)-2019年專升本醫學綜合復習資料-福建函授

            福建成人高考信息網www.laiwobuy.com 發布時間: 2018年12月19日



                    第一節 總論


              呼吸系統由呼吸道和肺兩部分組成。臨床上通常把鼻、咽、喉稱為上呼吸道,氣管和各級支氣管稱為下呼吸道。肺由實質組織和間質組成,實質組織包括支氣管樹和肺泡;間質包括結締組織、血管、淋巴管、淋巴結和神經等。呼吸系統的主要功能是進行氣體交換,另外,肺還具有內分泌功能,鼻有嗅覺功能,喉有發音功能。


              第二節 呼吸道


              呼吸道包括鼻、咽、喉、氣管和各級支氣管,它們的壁內有骨或軟骨作為支架、以保障氣體的暢通。


              一、鼻

              鼻是呼吸道的起始部分,又是嗅覺器官。它可分為外鼻、鼻腔和鼻旁竇三部分。


              (一)外鼻

              外鼻位于面部中央,以骨和軟骨作支架,外覆皮膚。其下端突起部分為鼻尖。鼻尖兩側略呈弧形的隆突部分的鼻翼,圍成一對鼻孔。


              (二)鼻腔

              鼻腔被鼻中隔分為左、右二腔。每側鼻腔均可分為前下份的鼻前庭和后份的固有鼻腔。鼻前庭內面襯有皮膚,生有鼻毛,可過濾、清潔吸入的空氣。固有鼻腔由骨性鼻腔內襯黏膜而成。鼻黏膜分兩部分,上鼻甲及鼻中隔上部的黏膜呈淡黃色,內含嗅細胞,具有嗅覺功能,稱為嗅區。其余部分的黏膜呈粉紅色稱為呼吸區,內含豐富的血管和腺體,具有溫暖、濕潤和凈化空氣的功能。在鼻中隔前下部的黏膜、血管特別豐富是鼻出血的常見部位,稱為易出血區。外側壁上自上而下有上、中、下三個鼻甲及上、中、下三個鼻道,固有鼻腔向后為一對鼻后孔。下鼻道的前部有鼻淚管的開口。

              鼻腔前借鼻孔通外界,后借鼻后孔通咽。


              (三)鼻旁竇的位置、開口及臨床意義

              鼻旁竇是鼻腔周圍顱骨內的含氣空腔,共有四對,即蝶竇、篩竇、額竇和上頜竇。其中篩竇義分為前、中、后三群。各竇均位于同名的顱骨內,能溫暖與濕潤空氣,對發音產生共鳴。旁竇均開口于鼻腔,蝶竇開口于上鼻甲后上方的蝶篩隱窩,篩竇后群開口于上鼻道,上頜竇、額竇和篩竇前、中群均開口于中鼻道。鼻旁竇內襯覆黏膜與鼻黏膜相延續,故鼻腔炎癥時常引發鼻旁竇炎一七頜竇因開口位置較高,分泌物不易排除,竇腔積液時,體位引流是很重要的。


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