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Respiración para Psicólogos

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A 2-day lecture on breathing training focused on emotional disorders, such as generalised anxiety and panic. Includes slides on respiratory physiology, hyperventilation syndrome, respiratory muscles and breathing modification.

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  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
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Respiración para Psicólogos

  1. 1. La Respiración como Herramienta Clínica en Psicología Dr. Pandelis Perakakis This work is licensed under a Creative Commons Attribution 4.0 International License. email: peraka@ugr.es website: https://pandelisperakakis.wordpress.com twitter: @ppandelis
  2. 2. Parte I: Fisiología Respiratoria
  3. 3. La respiración como un mecanismo de intercambio de gases aire cargado de O2 aire cargado de CO2 Respiración Externa Respiración Interna Aorta Arteria Pulmonar Vena Pulmonar Arteria Pulmonar Vena Pulmonar Vena Cava Superior Vena Cava Inferior
  4. 4. El intercambio de gases entre los alveolos y la sangre venosa se consigue por difusión gracias a las diferencias de presión parcial de cada gas O2 =100 CO2 =40 CO2 =45 O2 =40 O2 =100 CO2 =40 O2 =150 mm Hg CO2 =0.3 mmHg
  5. 5. El oxigeno se transporta en la sangre ligado a la molécula de hemoglobina O2 O2 +Hb HbO2 Globulo Rojo Pared Alveolar
  6. 6. Curva de disociación de hemoglobina Un aumento de pH (alcalosis) desplaza la curva hacía la izquierda. Una saturación de 100% significa poca disponibilidad de oxigeno para los tejidos. 0 10 20 30 40 50 60 70 80 90 100 100908070605040302010 PO2 (mm Hg) HbO2 (%saturación) pH pH pH=log10 (1/H+ )
  7. 7. CO2 Pared Capilar Globulo Rojo CO2 + H2 O H2 CO3 HCO3 - H+ HCO3 - H+ + HbO2 HHb + O2 O2 O2O2 El dióxido de carbono diminuye el pH (aumenta el H+ intracelular) y facilita la disociación del oxigeno de la hemoglobina (efecto Bohr) respiración = CO2 = pH = oxigeno
  8. 8. Parte II: Hiperventilación
  9. 9. Regulación respiratoria del pH El diagrama de Davenport que ilustra las relaciones entre HCO3-, pH, y PCO2 explica el proceso de la hiperventilación crónica como una alcalosis respiratoria compensada Hiperventilación crónica
  10. 10. Efectos de la hiperventilación CO2 pH O2 Más efectos de la alcalosis diametro de arterias cerebrales calcio intracelular broncoespasmo arritmias cardiacas catecolaminas tono arterial resistencia periférica potasio y calcio extracelular excitabilidad neuronal
  11. 11. Trastornos que se han asociado con la hiperventilación Ansiedad Pánico Dolor crónico Síndrome de fatiga Asma Hipertensión Tensión muscular crónica Trastornos gastrointestinales Migrañas Insomnio Epilepsia Apnea de sueño …
  12. 12. Diagnostico de hiperventilación Hiperventilación: respirar por encima de tus necesidades metabólicas. En otra palabras, mantener una alcalosis respiratoria. Hiperventilación crónica: hiperventilación compensada. No existe desequilibrio de pH o síntomas agudos. Existe, sin embargo, un equilibrio precario con niveles bajos de CO2 y HCO3-. El diagnóstico requiere una gasometría. Una manera alternativa pero menos informativa es la capnografía o capnometría. En la mayoría de las veces la observación clínica no es suficiente ya que la hiperventilación se puede mantener con suspiros frecuentes o con un volumen respiratorio un poco aumentado que puede perfectamente pasar desapercibido.
  13. 13. Capnografía o Capnometría
  14. 14. Hiperventilación y trastorno de pánico La hiperventilación provoca el ataque de pánico (Lum, 1987) Teoría de la falsa alarma de sofocación (Klein, 1992) Factores a tener en cuenta: tiempo de recuperación suspiros interpretación inestabilidad respiratoria Wilhelm et al, 2001
  15. 15. Causas de hiperventilación Estrés Falta de ejercicio Educación Alimentación Control de temperatura Hábitos respiratorios al hablar, cantar, tocar música, etc. Exposición a químicos tóxicos …
  16. 16. Parte III: Modificación de la Respiración
  17. 17. Músculos Respiratorios
  18. 18. Los músculos respiratorios Rectomayor OblicuointernoIntercostalinterno Esternocleidomastoideo Pectoral menor Intercostal externo Serratoanterior Diafrágma Músculos Inspiratorios Músculos Espiratorios Se utilizan diferentes grupos musculares para la inhalación y la exhalación. En reposo la exhalación no requiere ninguna activación muscular.
  19. 19. Músculos Inspiratorios
  20. 20. El diafragma El músculo respiratorio principal. Cuando se contrae se aplana aumentando el volumen de la cavidad torácica.
  21. 21. Pectoral menor Se origina en el omóplato y se inserta a las costillas 3 y 5. Cuando se contrae, levanta la parte superior del pecho (“respirar en las clavículas”).
  22. 22. Pectoral mayor Se origina en la parte superior del brazo, cubre el pectoral menor y se inserta en la clavicula, las primeras ocho costillas, y el esternón. Cuando se contrae levanta el esternón abriendo el angulo inferior de las costillas.
  23. 23. Serrato anterior Se origina en la escápula y se inserta en las costillas de1 a 10. Cuando se contrae, intenta “abrir” las costillas lo que causa que se eleven en un largo movimiento lateral.
  24. 24. Serrato posterior superior Se origina en los procesos espinosos de las vertebras C7 y T1 hasta T4 y se inserta en las primeras cuatro costillas. Cuando se contrae, eleva las costillas desde la columna vertebral (“inhalar en la espalda”).
  25. 25. Esternocleidomastoideo Se origina en el esternón y las clavículas y se inserta en los procesos mastoides en la base del cráneo. Cuando se contrae, eleva la caja toracica.
  26. 26. Escalenos Se origina en la columna cervical y se insertan a las primeras dos costillas. Cuando se contraen, elevan las primeras dos costillas y contribuyen a una respiración costal superior.
  27. 27. Músculos Espiratorios
  28. 28. Recto abdominal Contribuye al movimiento espiratorio ejerciendo, mediante su contracción, presión sobre las vísceras del abdomen. A nivel óseo, puede mover la columna, la pelvis, y las costillas lo que puede contribuir aun más a la exhalación.
  29. 29. Transverso abdominal Es un músculo fibroso que rodea el abdomen como un “cinturón”. Su contracción reduce el diámetro del abdomen contribuyendo al movimiento espiratorio.
  30. 30. Obliquo interno Aparte de reducir el diámetro del abdomen, su contracción contribuye al movimiento espiratorio bajando las costillas inferiores.
  31. 31. Obliquo externo Contribuye a la espiración bajando las costillas y reduciendo el diámetro del abdomen (en colaboración con el transverso abdominal).
  32. 32. Transverso toracico Localizado dentro de la caja torácica, se origina en la parte posterior del esternón y se inserta en los cartílagos de las costillas 2 a 7. Su contracción baja los cartílagos, los mueve hacía atrás cerrando la zona alrededor del esternón.
  33. 33. Serrato posterior inferior Se origina en las vertebras lumbares L1 y L2 y las vertebras torácicas T10 y T12 y se inserta a las costillas de 9 a 12. Su contracción baja esas costillas contribuyendo en la exhalación.
  34. 34. Patrones Respiratorios
  35. 35. El control automático de la respiración Los quimiorreceptores se activan cuando detectan un aumento de H+ (bajada de pH) debido al aumento de CO2. Entonces estimulan la respiración para eliminar el exceso de CO2 y restablecer el pH. ¡Respiramos para eliminar CO2, no para obtener O2! Quimiorreceptor Cerebro Vaso sanguineo Craneo Fluido Extracelular (ECF) Fluido Cerebroespinal (CSF) HCO3 - H+ CO2 pH
  36. 36. Otras funciones de la respiración Acompaña otros movimientos Acompaña y modifica emociones Modifica el nivel de tensión Acompaña y modifica sensaciones de dolor Facilita el habla, el canto, etc. Moviliza los organos Regula la postura
  37. 37. Volumenes respiratorios 500 mL 6,000 mL 2,400 mL1,200 mL 1,200 mL 4,800 mL3,100 mL 3,600 mL
  38. 38. Patrones respiratorios 12 x 500 ml=6 lt/min PCO2=40 mmHg 15 x 800 ml=12 lt/min PCO2=35 mmHg Inhalación Exhalación Apnea
  39. 39. El objetivo de la educación respiratoria • Comprender las funciones de la respiración • Tomar consciencia de los músculos respiratorios • Comprender el mecanismo de la hiperventilación • Entender los factores que conducen a la hiperventilación • Investigar la relación de la respiración con la postura, la alimentación y el pensamiento • Ajustar en todo momento la respiración a las necesidades metabólicas • Respirar menos para tener mas
  40. 40. Reducir el volumen de aire respirado mediante la relajación profunda de todos los músculos respiratorios durante la fase de exhalación Regla de oro de la reeducación respiratoria
  41. 41. Para mas información: Dr. Pandelis Perakakis Centro de Investigación Mente, Cerebro y Comportamiento Universidad de Granada España ! email: peraka@ugr.es website: https://pandelisperakakis.wordpress.com twitter: @ppandelis

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