management（气道管理） ppt课件

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1、AirwayManagementImportanceThemajorresponsibilityoftheanesthesiologististoprovideadequaterespirationforthepatient.Themostvitalelementinprovidingfunctionalrespirationistheairway.Noanestheticissafeunlessdiligenteffortsaredevotedtomaintaininganintactfunctionala

2、irway.Thesameprinciplesofairwaymanagementoutlinedinthischapterareapplicabletoallclinicalsituationsinwhichrespiratoryinadequacymaydevelop.TheFirstSectionMaintenanceofAirwaySmooth1.StuctureAndFunctionOfTheAirwaysUpperAirways:Mouth,nose,pharynx,larynxLowerAi

3、rway:Trachea,Bronchus,LungNoseThenoseistheprimarypathwayfornormalbreathingunlessobstructionbypolypsorupperrespiratoryinfectionispresent.Duringquietbreathing,theresistancetoairflowthroughthenasalpassagesaccountsforalmosttwothirdsofthetotalairwayresistance.Th

4、eresistancethroughthenoseisalmosttwicethatassociatedwithmouthbreathing.PharynxThepharyngealairwayextendsfromtheposterioraspectofthenosedowntothecricoidcartilage,wherethepassagecontinuesastheesophagus.OropharynxNasopharynxLaryngopharynxEpiglottisGlottissoftp

5、alatelarynxThelarynx,whichliesatthelevelofthethirdthroughsixthcervicalvertebraeThelaryngealcavityextendsfromtheepiglottistothelowerlevelofthecricoidcartilage.Theglottisrepresentsthenarrowestpointintheadultairway(morethan8yearsofage),whereasthecricoidcartila

6、gerepresentsthenarrowestpointintheinfantairway(birthto1yearofage).TracheaThetracheaisafibromusculartubethatis10to15cmlongwithadiameterofapproximately20mminadults.Itextendsfromthecricoidcartilagetothecarina.Thetracheabifurcatesintotherightandleftmainstembron

7、chiatthecarina.Therightmainstembronchusisapproximately2.5cmlongwithatake-offangleofapproximately25°.Theleftmainstembronchusisapproximately5cmlongwithatake-offangleofapproximately45°.2.ReasonandTreatmentofAirwayObstructionReasonofAirwayObstruction:Secretions

8、,blood,foreignbodyblockairway.GlossocomaLaryngospasmBronchospasmNeuromusculardiseaseGlossocomaGlossocomaisthemostcommonreasonofupperairwayobstruction.SymptomsandSignsInlessseverecases:Snore,thethroatwa