Diagnosticul și evoluția astmului bronsic

Astmul bronsic este o entitate clinica cunoscuta cu aproximativ 1000 de ani i. e. n, el deriva de la un cuvant gracesc care inseamna greutate respiratorie, si este considerat un brevet de viata lunga. Indienii vechi socoteau ca astmul este produs de un principiu activ al toracelui, care impiedicat in trecere, cauzeaza greutatea respiratorie.

Ei au introdus tratamentul cu Datura Strammonium in tigari astmatice.

Se intalnesc referiri despre astm in Exod, Homer si Herodot. Hipocrate mentioneaza astmul in patru din aforismele lui. Este primul autor care ii recunoaste natura spasmodica (il compara cu epilepsia) si include intre cauze: frigul si excitantii de mediu. S-a crezut multa vreme ca astmul este o boala exclusiv alergica; mai tarziu s-a revenit la idea ca astmul reprezinta un sindrom de etiopatogenie complexa.

Se pare ca atat in antichitate, cat si in evul mediu, sub numele de astm au fost clasate tulburarile cu cause diferite si fara rezultate terapeutice satisfacatoare. Hipocrate recunoaste totusi rolul mediului. Astmul bronsic este una dintre cele mai importante si raspandite afectiuni respiratorii cu o prevalenta de 3-6% din populatie.

Lucrurile vor continua sa se inrautateasca, pana cand lumea va folosi mai bine mijloacele de care dispune, pentru a putea lupta in prevenirea acestei afectiuni.

O parte din organele aparatului respirator indeplinesc si alte functii decat respiratia: - fosele nazale servesc la respiratie, dar si pentru miros; - naso-faringele sau rino-faringele lasa sa treaca aerul spre plamani, dar ventileaza si urechea medie prin trompa lui Eustachio sau faringotimpaniera.

- orofaringele sau bucofaringele: la nivelul lui se incruciseaza calea respiratorie cu cea digestiva; - laringele este un organ respirator, dar si un organ al fonatiei.

Incepand cu traheea, organele aparatului respirator au functii pur respiratorii.

Componentele aparatului respirator: caile respiratorii superioare: - nas; - cavitati nazale; - laringe; - trahee.

- organele de schimb respirator, plamanul, cu arborele bronsic.

TRAHEEA Traheea este segmentul aparatului respirator, care continua laringele, fiind asezata inaintea esofagului, si are forma unui conduct cilindric. Este situate pe linia mediana a corpului si se intinde la de extremitatea inferioara a laringelui (C6) pana la mediastin, unde in dreptul vertebrei a 4 a toracale (T4) se bifurca in cele doua bronhii principale sau pulmonare.

Raporturile traheei: Traheei i se descriu doua portiuni: cervicala si toracala.

Traheea cervicala vine in raport anterior cu glanda tiroida, posterior cu esofagul si lateral cu pachetul vasculo-nervos al gatului (artera carotida comuna, vena jugulara externa, nervul vag) si cu nervii recurenti.

Traheea toracala vine in raport anterior cu vasele mari de la baza inimii si timusul, posterior cu esofagul si lateral cu pleura mediastinala dreapta si stanga, vena cava superioara, crosa venei azygos si arcul aortei. STRUCTURA ANATOMICA A TRAHEEI Este formata ...

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