respi.pdf

(thq;fp) clypy; Rh- ,w;Fupa gpwnghUs; vjpupfs; KjYUtpy; cUthf;fk; eilngWk;. ,uz;lhtJ Foe;ijAk; Rh+ ,w;F vjpuhf jhapdJ KjYUtpy; cUthfpAs;s gpwnghUs; vjpupfs; #y;tpj;jfj;jpw;F FWf;fhf flj;jg;gl;L Kjpu;%yTUtpDs; nrd;W RBC I mopf;Fk;. tpyq;Ffspy; thAg;gupkhw;wk; (Gas Exchange In Animal) tpyq;Ffspy; Rth...

(thq;fp) clypy; Rh- ,w;Fupa gpwnghUs; vjpupfs; KjYUtpy; cUthf;fk; eilngWk;. ,uz;lhtJ Foe;ijAk; Rh+ ,w;F vjpuhf jhapdJ KjYUtpy; cUthfpAs;s gpwnghUs; vjpupfs; #y;tpj;jfj;jpw;F FWf;fhf flj;jg;gl;L Kjpu;%yTUtpDs; nrd;W RBC I mopf;Fk;. tpyq;Ffspy; thAg;gupkhw;wk; (Gas Exchange In Animal) tpyq;Ffspy; Rthrf; fl;likg;Gfspd; NjitAk; ntt;NtW tpyq;Ff; $l;lq;fspd; Rthrf; fl;likg;Gf;fspd; rpf;fw; jd;ikfspd; $u;g;Gk; Rthr thAg; gupkhw;wk; (clypDs; xl;rprd; cs;nsLf;fg;gLjy; kw;Wk; ntspg;Gwr; #oYf;F fhgdPnuhl;irl;L thA tpLtpf;fg;gLjy; / ntspNaWjy;) guty; %yk; eilngWk;. vspa tpyq;Ffshd ieNlupad;fs;> jl;ilg; GOf;fs; Nghd;wtw;wpy; clypYs;s xt;nthU fyKk; Gwr;#oYf;F mUfhikapy; ,Ug;gjdhy; thAg;gupkhw;wk; NeubahfNt #oYf;Fk; fyq;fSf;Fkpilapy; eilngWfpd;wJ. vspa cly; mikg;Gk; Fiwe;jstpyhd rj;jpj; NjitAk; fhzg;gLtjdhy; ,t;tifahd tpyq;FfSf;F cly; Nkw;gug;gpy; eilngWk; guty; NghJkhdJ. ngupa tpyq;Ffspy; cly; rpf;fyhdJ kw;Wk; rf;jpj; Njit cau;thFk;. cau; clw;jpzpT nfhz;l mq;fpfspy; fyq;fs; Gwr;#oYld; Fiwe;jstpNyNa njhlu;GWk;. vdNt ,tw;wpd; rf;jpj; Njitia epiwT nra;tjw;F cly; Nkw;gug;gpd; %yk; eilngWk; thAg;gupkhw;wk; NghJkhdjy;y. ,jd; tpisthf thAg;gupkhw;wj;jpw;fhf rpwj;jyile;j Nkw;gug;G mjhtJ Rthr Nkw;gug;Gf;fs; $u;g;gile;Js;sd. tpyq;Ffspy; clw; gUkd; mjpfupg;Gld; rpf;fw;jd;ik mjpfupg;G kw;Wk; Nkw;gug;G fdtsT tpfpjk; (A/V) Fiwtilfpd;wJ. vt;thwhapDk; tpidj;jpwdhd thAg;gupkhw;wj;jpw;F ngupa Nkw;gug;G NjitahFk;. ,jdhy; tpidj;jpwdhd thAg;gupkhw;wj;jpw;fhf gy;tifikahd Rthrf; fl;likg;Gf;fs; ngupa cly; Nkw;gug;G kw;Wk; fpisfSk; kbg;GfSk; nfhz;litahf $u;g;gile;Js;sJ. mt;tifahd Rthrf; fl;likg;Gf;fSf;F cjhuzq;fshf g+f;fs;> thjdhsp kw;Wk; EiuaPuy; vd;gtw;iwf; Fwpg;gplyhk;. ePu;tho; tpyq;Ffspy; ePupy; fiue;Js;s xl;rprid tpidj;jpwdhf cs;nsLg;gjw;fhf cly; ntspePl;lq;fs; mjhtJ g+f;fs; Nghd;wit $u;g;gile;Js;sd. ,d;ndhU tifapy; jiutho; tpyq;Ffspy; tspkz;ly xl;rprid tpidj;jpwdhf cs;nsLg;gjw;fhf thjdhsp kw;Wk; EiuaPuy; Nghd;w Nkw;gug;G cs;kbTfs; $u;g;gile;Js;sd. 241 Rthr Nkw;gug;Gfspd; ,ay;Gfs; tpidj;jpwdhd Rthr Nkw;gug;gpd; ,ay;Gfshtd : ²² thAf;fSf;fhd CLGftpLk; jd;ikAilajhfTk; kz;GOf;fs; ²² g+f;fs; : ²² ntspg;g+f;fs; : fly;tho; mdyplhf;fs; ²² cl;g+f;fs; : kPd;> ,why;> fztha; ²² thjdhspj; njhFjpfs; : g+r;rpfs; ²² EiuaPuy;fs; : ghY}l;bfs; (kdpjd;)> nug;uPypahf;fs;> gwitfs; ²² Njhy; : mk;gpgpahf;fs; ²² Vl;L EiuaPuy;fs; : rpye;jpfs;> Njs;fs; kdpj Rthrj; njhFjp kdpj Rthrj; njhFjpapd; nkhj;jf; fl;likg;G kw;Wk; njhopy;fs; kdpj Rthrj;njhFjpahdJ gpd;tUk; gpujhd fl;likg;Gf;fisf; nfhz;lJ. mitahtd: %f;Fj;Jthuk;> %f;Ff;Fop> njhz;il> Fuy;tis thjdhspapypUe;J tUk; njhluhd fpisfs; ,uz;L Rthrg;igf; Foha;> Rthrg;igf; Foha;fs; ePz;L fpisj;J Rthrg;igapDs; Rthrg;igr; rpWFoha;fs;> ,Wjpapy; rpw;wiwj; njhFjpfshf mjhtJ rpw;wiwfisf; nfhz;lit. neQ;riwf; FopapDs; mike;j $k;G tbthd Nrhbahd Rthrg;igapDs; Rthrg;igr; rpWFoha;fSk; rpw;wiwfSk; fhzg;gLk;. ,U Rthrg;igfSk; mjd; gUkd; kw;Wk; tbtj;jpy; rpwpjsT NtWgLk;. tyJ Rthrg;igia tpl ,lJRthrg;ig rw;Wr; rpwpaJ. Vnddpy; ,jacr;rpahdJ eLf;Nfhl;Lg;Gwj;jpypUe;J rw;W ,lJ Gwkhf cs;sJ. ,lJ Rthrg;igahdJ 2 Nrhizfisf; nfhz;lJ. Mdhy; tyJ Rthrg;igahdJ 3 Nrhizfisf; nfhz;lJ. xt;nthU Rthrg;igAk; 2 nkd;rt;Tfspdhy; 242 #og;gl;lit. cs;EiuaPuy; ciw (Gilr;rt;T) vd;wiof;fg;gLk; cs; nkd;rt;T EiuaPuy;fis xl;bf;fhzg;gLk; mNjNtis ntspEiuaPuy; ciw vd;wiof;fg;gLk; ntspnkd;rt;T neQ;riwf; Fopapd; Rtiu xl;bf; fhzg;gLk;. ,t;tpU nkd;rt;TfSf;fpilapy; nky;ypa ghap epiwe;j ntsp fhzg;gLk;. Rthrj;jpd;NghJ %f;Fj;Jthuj;jpD}lhf tsp Rthrj; njhFjpapDs; cl;nry;Yk;. %f;Ff; FopapDs; tspahdJ flj;jg;gLk;NghJ kapu;fspd; cjtpapdhy; tbf;fg;gl;L cly; ntg;gepiyf;F caur; nra;J jfuk; kw;Wk; epyf;fup mfo;T yy ntbnghUl;fisg; gad;gLj;jp fw;Ftpay; kw;Wk; kzy; vLj;jy; yy fz;zhb kw;Wk; kl;ghz;l Ntiy cl;Rthrj;jpD}L cs;nsLf;fg;gLk; rpypf;fhj; Jzpf;iffs; rpw;wiw fspy; gbAk;. ,tw;wpy; ngUk;ghyhdit ngUe;jpd;Fopaq;fs; %yk; mfw;wg;gl;lhYk; rpy rpw;wiwfspy; kPe;jpUf;Fk; gpd;du; EiuaPuy; ntspciwapYs;s FUjpf;fyd;fs; kw;Wk; Rthrg;igiar; nrd;wilAk;. ,jdhy; ,tw;wpy; tsUk; fl;bfs; J}z;lg;gLk;. gbg;gbahf EiuaPuy; ,ioaq;fs; mopf;fg;gl;L cau;FUjp mOj;jk; Vw;gl;L ,Wjpahf ,ja nraypog;G Vw;gLk;. 251 m];g];Nuhrp]; - m];guRld; njhlu;Gila Neha;fs; (Asbestosis) m];g];u]; jahupg;G kw;Wk; ,J rk;ge;jkhd njhopYld; njhlu;Gila tu;fSf;F mr;;RWj;jyhFk;. m];ng];Nlh]; ehu;fs; J}RfSld; cs;nsLf;fg;gLk; NghJ m];ng];Nlhrp]; (asbestosis) Vw;gLk; tha;g;Gfs; mjpfk; ngupa Jzpf;iffs; rpw;wiwfs; kw;Wk; Rthrg;igr;; rpWFoha;fis CLUTk; NghJ rpwpa Jzpf;iffs; ngUe;jpd; Fopaq;fspdhy; cs;nsLf;fg;gLk;. ngupa Jzpf;ifs; ngUe;jpd; Fopaq;fisr; #of; fhzg;gLk;. ,jpy; GujKk; ,Uk;Gk; gbAk;. ,j; jpd;Fopaq;fs; mire;J Rthrg;igr; rpWFoha;fs; kw;Wk; FUjpf; fyd;fspy; gbtilAk;. ,r; nrad;Kiw ehupioak; cUthFtijj; J}z;Lk;. ,J njhlu;r;rpahd EiuaPuy; ,ioa mopit Vw;gLj;JtJld; Rthrf;FUjp cau; mKf;fj;ij Vw;gLj;Jk;. Rthrg;igg;Gw;WNeha; Vwj;jho 90 % tPjkhd Rthrg;igg;Gw;WNeha; Gijj;jypdhy; Vw;gLfpd;wJ. Gifj;jypdhy; %f;fpYs;s gprpu;fs;> rPjk; kw;Wk; kapu;fspd; nraw;ghLfs; ghjpf;fg;gLtjdhy; ,urhad kw;Wk; capupay; cWj;jy;fs; gbg;gbahf Vida Rthrr; nraw;ghLfisAk; ghjpf;Fk;. ,jd; tpisthf cWj;Jk; gjhu;j;jq;fs;> RahjPd %ypfq;fs;> Gw;WNehahf;fpfs; kw;Wk; Nehahf;fpfs; gbfpd;wd. ,itfs; Rthrg;igg;Gw;WNeha; Vw;gl VJthfpd;wd. fhrk; (TB) ,J gw;wPupahthd Mycobacterium tuberculosis vd;Dk; Nehahf;fpapdhy; Vw;gLk; njhw;WNehahFk;. NehahspfspypUe;J Jk;ky;> ,Ukypd; NghJ ,e;;Nehahf;fp guTk;. ,jdhy; cl;Rthr tsp %yk; Nehaw;w kdpjdpd; Rthrg;igia ,e;Nehahf;fp nrd;wilAk;. kpfTk; nghJthd Rthrj; njhFjp Nehahf frk; fhzg;gLfpd;wJ. ,J gpujhdkhf EiuaPuypDs; njhw;iw Vw;gLj;Jk;. ,Ug;gpDk; Vida mq;fq;fSk; ghjpg;gilAk;. ,e;j gw;wPupahthdJ tsp kw;Wk; tPl;Lj; J}Rfs; Nghd;wtw;wpy; kpf ePz;l fhykhf jg;gp thOk;. Nghrizf; FiwghL kw;Wk; Vida njhw;Wf;fs; Neha; Vw;gLtjw;F re;ju;g;gq;fis mjpfupf;Fk;. Neha; mwpFwpfs; : grpapd;ik mjpfkhf tpau;j;jy; epiwf;FiwT fha;r;ry; njhlu; ,Uky; FUjpAld; Nru;e;j Jk;ky; 252 njha;T (Asthma) ,jd;NghJ kpFe;j rpukj;Jld; %r;RtpLjy; kw;Wk; neQ;riwapDs; ,Wf;fk; Nghd;w czu;T Nghd;wit fhuzkhf %r;RtpLjy; fbdkhFk;. Rthrg;igf;;Fohapd; Rtu;fspy; fhzg;gLk; kokog;ghd jirfs; rLjpahfr; RUq;Ftjdhy; ,jd; cs;splk; xLf;fkhff; fhzg;gLk; my;yJ %btpLk;. ,jdhy; %r;RtpLjypd; NghJ xyp xd;W cUthFk;. Mj;Jkh kpifahf ntspg;glf; fhuzkhtJ kfue;jkzp> J}R> tpj;jpfs;> rpy czTfs;> Fspuhd tsp> clw;gapw;rp> GifapYs;s thAf;fs; vd;gtw;Wf;fhd J} z;lypd; epu;g;gPld Jyq;fyhfNt ,J Vw;gLk;. mow;rpiaf; fl;Lg;gLj;j cjTk; khj;jpiu> kUe;Jfs; %yk; fl;Lg;gLj;jyhk;. Rthr tl;lk; kw;Wk; Rthrf; nfhs;ssTfs;> Rthrf; fdtsTfs;; xU Rthrr; nrad;Kiwapd; NghJ eilngWk; cl;rthrk; kw;Wk; ntspr;Rthrk; vd;gd xUq;Nf Rthrtl;lk; vdg;gLk;. EiuaPuypDs; cs;nsLf;fg;gLk; kw;Wk; ntspNaw;wg;gLk; tspapd; msthdJ cl;Rthrk; kw;Wk; ntspr;Rthr epge;jidfspy; jq;fpAs;sJ. ,jdbg;gilapy; 4 Rhtrf; fdtsTfs; tpgupf;fg;gl;Ls;sd. yy tw;Wg;ngUf;Ff; fdtsT : rhjhuz Rthrj;jpd; NghJ xU Rthrj;jpy; cl;Rthrk; kw;Wk; ntspr;Rthrj;jpy; gq;Fnfhs;Sk; tspapd; fdtsthFk;. Xa;T epiyapYs;s ,J Kjpu;Tlyp kdpjDf;F ruhrupahf 500 ml (TV) MFk;. yy cl;Rthr xJf;ff; fdtsT (RV) : cl;Rthr xJf;f fdtsT Mo;e;j cl;Rthrj;jpd; NghJ tw;Wg;ngUf;Ff;fdtsit tpl Nkyjpfkhf cs;nsLf;fg;gLk; tspapd; fdtsT cl;rthr xJf;ff; fdtsT MFk;. yy ntspr;Rthr xJf;ff; fdtsT (ERV) : Mo;e;j ntspr;Rthrj;jpd; NghJ tw;Wg;ngUf;Ff; fdtsittpl Nkyjpfkhf ntspNaWk; tspapd; fdtsT ntspr;Rthr xJf;ff; fdtsT MFk;. yy kPjpf;fdtsT (RV) : type;j / Mo;e;j ntspr;Rthrj;jpd; gpd;dUk; fzprkhd msT tsp Rthrg;igfspDs; vQ;rpf; fhzg;gLk;. ,t;tspapd; fdtsT kPjpf; fdtsT vdg;gLk;. ,J ruhrupahf 1200 ml MFk;. Rthrf; fdtsTfspd; jdpj;Jtkhd njhlu;Gfs; Rthrf; nfhs;ssTfs; vd miof;fg;gLk;. vg;nghOJk; Rthrf; nfhs;ssTfs; 2 my;yJ mjw;F Nkyjpfkhd Rthrf; fdtsTfisf; nfhz;lit. xU jdpegupd; Rthr epiyiaj; jPu;khdpg;gjpy; Rthrf; nfhs;ssT Kf;fpaj;Jtk; ngWfpd;wJ. 253 yy cl;Rthrf; nfhs;ssT (IC) : ,ay;ghd ntspr;Rthrj;jpd; gpd;du; cs;nsLf;fg;gLk; tspapd; nkhj;jf; fdtsT vdyhk;. / IC = TV + IRV yy njhopw;ghl;bw;Fupa kPjpf;nfhs;ssT (FRC) : tw;Wg; ngUf;F ntspr;Rthrj;jpd; Kbtpy; EiuaPuypDs; vQ;rp ,Uf;Fk; tspapd; fdtsthFk;. FRC = RV + ERV ,f;fdtstpd; Kf;fpaj;Jtk; ahnjdpy;> fhw;wiwfspDs; njhlu;r;rpahd thAg;gupkhw;wk; epfo;tjw;Fk; ntspr;Rthrj;jpd;NghJ rpw;wiwfs; jfu;tiltJ jLf;fg;gLk;. yy capu;f;nfhs;ssT (VC) : cl;Rthr kw;Wk; ntspr;Rthr nrad;Kiwapd;NghJ Mff; $Ljyhf cs;nsLf;fg;gLtJk; ntsptplg; gLtJkhd tspapd; fdtsT. rhjhuz ngz;fspy; VC 3100 ml ck; Mz;fspy; 4800 ml ck; MFk;. VC + TV + IRV + ERV yy EiuaPuypd; nkhj;jf; nfhs;ssT Total lung Capacity (TLC) : EiuaPuy; fspDs; fhzg;gLk; cr;r tspapd; fdtsT my;yJ EiuaPuy;fspDs; fhzg;gLk; vy;yhf; fdtsTfspdJk; $l;Lj;njhif vdyhk;. rhjhuzkhf ,jd; msT 6000 ml MFk;. ,jw;F Nkyjpfkhf Rthrg;ghijapd; Rthrf; FohapDs; fhzg;gLk; rpy cl;Rthr tspapd; fdtsTfs; (thjdhsp> rthrf;Foha;> Rthrr; rpWFoha;fs;) xUNghJk; rpw;wiwj; njhFjpfspd; thAg;gupkhw;wj;jpy; gq;fspg;G nra;tjpy;iy. ,e;jf; fdtsT clw;$w;wpaYf;Fupa ,we;jntsp (anatomical dead space) vd miof;fg;gLk;. ,jd; Fwpg;gplj;jf;f msT 150 ml MFk;. 254