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解剖学,气道

Anatomy, Airway

作者信息

Nata Steffi C., Launico Marjorie V.

机构信息

De La Salle Medical and Health Sciences Institute

Abstract

The airway comprises the passages of the respiratory tract that conduct air from the external environment to the alveoli. This conduit extends from the nares and oral opening to the terminal bronchioles, where gas exchange occurs within the alveolar respiratory units. The airway is divided into upper and lower portions, each with distinct anatomical structures and specialized functions. In addition to conducting airflow, the airway filters, humidifies, and warms inspired air, provides defense against pathogens through mucosal and lymphoid tissues, and contributes to phonation and olfaction. Airway anatomy underpins clinical practice in anesthesia, emergency care, trauma, and respiratory disease, where patency is fundamental to oxygenation and survival. Anatomical detail also frames surgical practice, shaping approaches to endotracheal intubation, cricothyrotomy, and tracheostomy, and influencing outcomes in procedures involving the thyroid or tonsils, where adjacent structures or tissue hypertrophy may compromise the passage of air. Thorough knowledge of airway structure and function enables accurate assessment, supports safe device placement, guides management of developmental and acquired variations, and allows rapid, effective intervention in urgent situations.

摘要

气道,即呼吸道,指的是在通气过程中允许气流通过的呼吸道器官。它们从鼻孔和口腔开口一直延伸到肺泡囊的盲端。气道被细分为不同区域,包含各种器官和组织以执行特定功能。气道可细分为上气道和下气道,每个气道又有众多细分部分,具体如下。咽部是颅骨底部与食管之间气道内衬黏膜的部分,又可细分为:鼻咽部,也称为鼻咽喉、鼻后间隙,是从鼻孔起的肌性管道,包括后鼻腔,由腭与口咽分隔,向上衬于颅底;口咽部连接鼻咽部和下咽,是腭与舌骨之间的区域,前方由扁桃体弓与口腔分隔;下咽连接口咽部与食管和喉部,是舌骨下方的咽部区域。喉部是咽部与气管之间的气道部分,包含发声器官,由九块软骨构成的软骨骨架组成,包括重要的会厌和声襞(声带),声襞是声门的开口。气管是由纤毛假复层柱状上皮内衬的管状结构,由透明软骨的C形环支撑。这些C形环的扁平开放面与食管相对,以便在吞咽时食管能够扩张。气管在胸骨角水平处、心脏上方分叉并因此终止。支气管是气管的主要分支,结构相似,但有完整的环形软骨环。主支气管:有两条,分别为每个肺提供通气。右主支气管直径较大,比左主支气管更垂直。叶支气管:左肺有两条,右肺有三条,分别为肺的各个主叶提供通气。段支气管为肺的各个支气管肺段提供通气。细支气管缺乏支撑软骨骨架,直径约为1毫米。它们最初有纤毛,逐渐变为单层柱状上皮,其衬里细胞不再含有产生黏液的细胞。传导性细支气管传导气流,但不含任何黏液腺或浆液黏液腺。终末细支气管是气道中最后一个没有呼吸表面的分支。呼吸性细支气管偶尔含有肺泡,并有产生表面活性物质的细胞,每个呼吸性细支气管会分出两到11个肺泡管。肺泡是气道的最后部分,内衬单层肺细胞,靠近毛细血管。它们含有产生表面活性物质的II型肺细胞和克拉拉细胞。肺泡管是有呼吸表面的管状部分,肺泡囊从这里分支出来。肺泡囊是盲端空间,肺泡簇从这里形成并与之相连。它们通过小孔相连,使它们之间的气压能够平衡。它们与毛细血管一起形成气血屏障。

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