Samenvatting – BIAZ-toets 2 – Respiratie
,Inhoudsopgave
1. Longfysiologie............................................................................................................................................ 4
Gaswisseling.........................................................................................................................................................4
Compliantie..........................................................................................................................................................5
Resistance (Weerstand).......................................................................................................................................5
Surfacant..........................................................................................................................................................5
Anatomie hoofd/hals...........................................................................................................................................5
De farynx (keelholte).......................................................................................................................................5
De larynx (strottenhoofd)................................................................................................................................6
De stembanden................................................................................................................................................6
De trachea (luchtpijp)......................................................................................................................................6
Anatomie vertakkingen luchtwegen....................................................................................................................6
Hoofdbronchus................................................................................................................................................6
Bronchi.............................................................................................................................................................7
Bronchiolen......................................................................................................................................................7
Alveoli..............................................................................................................................................................7
Longkwabben en pleuraholte...............................................................................................................................7
Longen.............................................................................................................................................................7
Pleuraholten....................................................................................................................................................8
Longvolumia.........................................................................................................................................................8
Soorten longvolumes:......................................................................................................................................9
Druk in en buiten de longen.................................................................................................................................9
Atmosferische druk (1)....................................................................................................................................9
Intra pleurale druk (2)....................................................................................................................................10
Intra pulmonale druk (3)................................................................................................................................10
Intra-alveolaire druk (4).................................................................................................................................10
Intra-abdominale druk (5).............................................................................................................................10
Transairway....................................................................................................................................................10
Transpulmonale druk.....................................................................................................................................10
Transthoracale druk.......................................................................................................................................10
Transdiafragmatische druk............................................................................................................................10
Druk en luchtstroom naar de longen.................................................................................................................10
In rust.............................................................................................................................................................11
Inademing......................................................................................................................................................11
Uitademing....................................................................................................................................................11
Ademhalingsspieren...........................................................................................................................................11
Ademhalingspatronen........................................................................................................................................11
Normale ademhaling.....................................................................................................................................11
Hyperventilatie..............................................................................................................................................12
Cheyne-stokes ademhaling............................................................................................................................12
Kussmaul ademhaling....................................................................................................................................13
Atactische ademhaling...................................................................................................................................13
BIOT-ademhaling...........................................................................................................................................13
Regulatie van de ademhaling.............................................................................................................................13
Ademprikkel...................................................................................................................................................13
Ademcentrum................................................................................................................................................14
Prikkelgeleiding..................................................................................................................................................14
Bewakingsmogelijkheden voor de ademprikkel en prikkelgeleiding............................................................15
Ademarbeid........................................................................................................................................................15
, Spieren...........................................................................................................................................................16
Gaswisseling.......................................................................................................................................................16
Ventilatie........................................................................................................................................................17
Perfusie..........................................................................................................................................................17
Zuurstofaanbod.............................................................................................................................................17
Diffusieweg....................................................................................................................................................17
Longoppervlak...............................................................................................................................................17
Normaalwaarden...............................................................................................................................................18
2. Zuurstoftherapieën.................................................................................................................................. 19
Neusbril..............................................................................................................................................................19
Venturimasker....................................................................................................................................................19
Non rebreathing masker....................................................................................................................................19
3. Zuur-base evenwicht................................................................................................................................ 21
Normaalwaarden...............................................................................................................................................21
Bloedgas beoordeling.........................................................................................................................................21
Stappen bij beoordeling bloedgas......................................................................................................................21
Compensatie.......................................................................................................................................................22
Buffersysteem.....................................................................................................................................................23
Aandoeningen....................................................................................................................................................23
Regulatie via de longen en de nieren............................................................................................................ 24
Acidose (verzuring).............................................................................................................................................24
Oorzaken van Metabole Acidose:..................................................................................................................25
Oorzaken van Respiratoire Acidose:..............................................................................................................25
Alkalose (Basisch)...............................................................................................................................................25
Oorzaken van Metabole Alkalose:.................................................................................................................26
Oorzaken van Respiratoire Alkalose:.............................................................................................................26
Symptomen van Metabole Alkalose..............................................................................................................26
Symptomen respiratoire alkalose..................................................................................................................26
4. Respiratoire insufficiëntie...............................................................................................................................28
Dode ruimte ventilatie...................................................................................................................................28
Shunting.........................................................................................................................................................28
Ventilatie perfusie verhouding (V/P-verhouding).........................................................................................29
Respiratoire insufficiëntie..............................................................................................................................30
Beinvloeden van de ademhaling........................................................................................................................32
Belangrijke termen........................................................................................................................................33
Ventilatoire insufficiëntie...................................................................................................................................33
Cyanose....................................................................................................................................................... 34
Centrale cyanose................................................................................................................................................34
Perifere cyanose.................................................................................................................................................34
Acute dyspnoe............................................................................................................................................. 34
Astma.......................................................................................................................................................... 35
Anatomie en fysiologie.......................................................................................................................................35
, Symptomen........................................................................................................................................................36
Ontstaan.............................................................................................................................................................36
Diagnose.............................................................................................................................................................36
Behandeling........................................................................................................................................................37
COPD........................................................................................................................................................... 37
Anatomie en fysiologie.......................................................................................................................................37
Chronische bronchitis.........................................................................................................................................38
Longemfyseem...................................................................................................................................................38
............................................................................................................................................................................38
Hypercapnie................................................................................................................................................ 39
Pneumonie.........................................................................................................................................................40
Longembolie.......................................................................................................................................................40
5. Thoraxdrainage........................................................................................................................................ 41
Diagnosestelling.................................................................................................................................................41
Thoraxdrainage..................................................................................................................................................42
Inbrengen thoraxdrain.......................................................................................................................................42
Drainagesystemen..............................................................................................................................................42
Één-fles-drainage systeem.............................................................................................................................43
Twee-fles-drainage systeem..........................................................................................................................43
Drie-fles-drainage systeem............................................................................................................................43
één compartiment systeem (disposable)......................................................................................................44
Aandachtspunten thoraxdrainage.....................................................................................................................44
Verwijderen thoraxdrain....................................................................................................................................44
Procedure......................................................................................................................................................45
Transport.......................................................................................................................................................45
Intubatie...................................................................................................................................................... 46
Indicaties............................................................................................................................................................46
1. Longfysiologie
Gaswisseling
Respiratie bestaat uit ventilatie en diffusie. Het belangrijkste doel van de respiratie is
zuurstof naar de cellen voeren en koolstofdioxide uit de cellen af te voeren.
,Inhoudsopgave
1. Longfysiologie............................................................................................................................................ 4
Gaswisseling.........................................................................................................................................................4
Compliantie..........................................................................................................................................................5
Resistance (Weerstand).......................................................................................................................................5
Surfacant..........................................................................................................................................................5
Anatomie hoofd/hals...........................................................................................................................................5
De farynx (keelholte).......................................................................................................................................5
De larynx (strottenhoofd)................................................................................................................................6
De stembanden................................................................................................................................................6
De trachea (luchtpijp)......................................................................................................................................6
Anatomie vertakkingen luchtwegen....................................................................................................................6
Hoofdbronchus................................................................................................................................................6
Bronchi.............................................................................................................................................................7
Bronchiolen......................................................................................................................................................7
Alveoli..............................................................................................................................................................7
Longkwabben en pleuraholte...............................................................................................................................7
Longen.............................................................................................................................................................7
Pleuraholten....................................................................................................................................................8
Longvolumia.........................................................................................................................................................8
Soorten longvolumes:......................................................................................................................................9
Druk in en buiten de longen.................................................................................................................................9
Atmosferische druk (1)....................................................................................................................................9
Intra pleurale druk (2)....................................................................................................................................10
Intra pulmonale druk (3)................................................................................................................................10
Intra-alveolaire druk (4).................................................................................................................................10
Intra-abdominale druk (5).............................................................................................................................10
Transairway....................................................................................................................................................10
Transpulmonale druk.....................................................................................................................................10
Transthoracale druk.......................................................................................................................................10
Transdiafragmatische druk............................................................................................................................10
Druk en luchtstroom naar de longen.................................................................................................................10
In rust.............................................................................................................................................................11
Inademing......................................................................................................................................................11
Uitademing....................................................................................................................................................11
Ademhalingsspieren...........................................................................................................................................11
Ademhalingspatronen........................................................................................................................................11
Normale ademhaling.....................................................................................................................................11
Hyperventilatie..............................................................................................................................................12
Cheyne-stokes ademhaling............................................................................................................................12
Kussmaul ademhaling....................................................................................................................................13
Atactische ademhaling...................................................................................................................................13
BIOT-ademhaling...........................................................................................................................................13
Regulatie van de ademhaling.............................................................................................................................13
Ademprikkel...................................................................................................................................................13
Ademcentrum................................................................................................................................................14
Prikkelgeleiding..................................................................................................................................................14
Bewakingsmogelijkheden voor de ademprikkel en prikkelgeleiding............................................................15
Ademarbeid........................................................................................................................................................15
, Spieren...........................................................................................................................................................16
Gaswisseling.......................................................................................................................................................16
Ventilatie........................................................................................................................................................17
Perfusie..........................................................................................................................................................17
Zuurstofaanbod.............................................................................................................................................17
Diffusieweg....................................................................................................................................................17
Longoppervlak...............................................................................................................................................17
Normaalwaarden...............................................................................................................................................18
2. Zuurstoftherapieën.................................................................................................................................. 19
Neusbril..............................................................................................................................................................19
Venturimasker....................................................................................................................................................19
Non rebreathing masker....................................................................................................................................19
3. Zuur-base evenwicht................................................................................................................................ 21
Normaalwaarden...............................................................................................................................................21
Bloedgas beoordeling.........................................................................................................................................21
Stappen bij beoordeling bloedgas......................................................................................................................21
Compensatie.......................................................................................................................................................22
Buffersysteem.....................................................................................................................................................23
Aandoeningen....................................................................................................................................................23
Regulatie via de longen en de nieren............................................................................................................ 24
Acidose (verzuring).............................................................................................................................................24
Oorzaken van Metabole Acidose:..................................................................................................................25
Oorzaken van Respiratoire Acidose:..............................................................................................................25
Alkalose (Basisch)...............................................................................................................................................25
Oorzaken van Metabole Alkalose:.................................................................................................................26
Oorzaken van Respiratoire Alkalose:.............................................................................................................26
Symptomen van Metabole Alkalose..............................................................................................................26
Symptomen respiratoire alkalose..................................................................................................................26
4. Respiratoire insufficiëntie...............................................................................................................................28
Dode ruimte ventilatie...................................................................................................................................28
Shunting.........................................................................................................................................................28
Ventilatie perfusie verhouding (V/P-verhouding).........................................................................................29
Respiratoire insufficiëntie..............................................................................................................................30
Beinvloeden van de ademhaling........................................................................................................................32
Belangrijke termen........................................................................................................................................33
Ventilatoire insufficiëntie...................................................................................................................................33
Cyanose....................................................................................................................................................... 34
Centrale cyanose................................................................................................................................................34
Perifere cyanose.................................................................................................................................................34
Acute dyspnoe............................................................................................................................................. 34
Astma.......................................................................................................................................................... 35
Anatomie en fysiologie.......................................................................................................................................35
, Symptomen........................................................................................................................................................36
Ontstaan.............................................................................................................................................................36
Diagnose.............................................................................................................................................................36
Behandeling........................................................................................................................................................37
COPD........................................................................................................................................................... 37
Anatomie en fysiologie.......................................................................................................................................37
Chronische bronchitis.........................................................................................................................................38
Longemfyseem...................................................................................................................................................38
............................................................................................................................................................................38
Hypercapnie................................................................................................................................................ 39
Pneumonie.........................................................................................................................................................40
Longembolie.......................................................................................................................................................40
5. Thoraxdrainage........................................................................................................................................ 41
Diagnosestelling.................................................................................................................................................41
Thoraxdrainage..................................................................................................................................................42
Inbrengen thoraxdrain.......................................................................................................................................42
Drainagesystemen..............................................................................................................................................42
Één-fles-drainage systeem.............................................................................................................................43
Twee-fles-drainage systeem..........................................................................................................................43
Drie-fles-drainage systeem............................................................................................................................43
één compartiment systeem (disposable)......................................................................................................44
Aandachtspunten thoraxdrainage.....................................................................................................................44
Verwijderen thoraxdrain....................................................................................................................................44
Procedure......................................................................................................................................................45
Transport.......................................................................................................................................................45
Intubatie...................................................................................................................................................... 46
Indicaties............................................................................................................................................................46
1. Longfysiologie
Gaswisseling
Respiratie bestaat uit ventilatie en diffusie. Het belangrijkste doel van de respiratie is
zuurstof naar de cellen voeren en koolstofdioxide uit de cellen af te voeren.
