Anatomy #5 (Respitory) Flashcards
Number of breaths
20,000 breaths per day –> 7.3 Million breaths per year –> 550 Million per life
2.5 X 10^22 molecules of O2 taken in per breath
Human body vs. Single cell
Single cell - everything goes in or out through osmosis or transproters on membrae
Human body = trillions of cells –> have many areas that need oxygen/need to remove CO2 BUT these areas are deep in the tissue
Solution: Respitory/circulatory system tea up tp create a signle cell scenerio
- Oxygen is taken in through the respitory system –> goes to a situation where have a single cell that you transoprt the O2 into
- Air goes to the lungs –> Air goes to aveoli (in lungs) –> Averoli are n contact with blood = creates a single cell scenrio when O2 goes inot the blood –> O2 goes to the blood –> O2 goes to the tissue - have a SECOND single cell scenerio
Overall movment of O2
Air –> Aveoli –> blood –> Capilary beds –> tissues
What is respiration
Respiration is really ventilation
Pulmniary ventilation
Movement of air in and out of body from the outside evirnment (Breathing)
Air - 80% Nitrigen ; 20% Oxygen with other trace gases
- Amount of Nitorgen and Oxygen varies depending on location on earth (Ex. mount everst has less O2)
Mount everst story
Issue on mount everest - collection of O2 tanks on mountain (Nepal sent people up to Everest to clean O2 tanks)
Story #1 - Rini’s roomate (jim) –> worked at a national park when he was a med student
- He clibed everst twice (one time without supplemental air –> hard to do because the hypoxia plays with your head)
- He is now a high altitude physican
Story #2 - Rini and his wife were dirving –> weree reading a book –> Jimmy was mentioned in the book (jimmy was running a clinic on everst during wave of people dying)
- Author of the book went on a rescue trip when here was a wave of people dying on everst
Types of Respiration
- External (pulminary)
- Internal (Tissue)
- Cellular
External (pulimniary) respiration
Gas exchnage within the lungs in the blood between the capilaries and alveoli
- Aveoli Level (air comes in)
Internal (tissue) respiration
Gas exchnage between the blood and tissues of the body
- Blood carries Oygen to the tissues in the body
- Exchange occuring at the capilaries in the tissue
Cellular respiration
Energy production within the cell
Example - Glycolysis + Oxidative phosphorylation
Lungs (blue circle) - external respiration (occurs in lungs)
- Caused by Pulminary artery and pulminary vein
Red circles - Internal respiration at all capilary beds
- ONLY exception is the lIver (because the liver capilary beds is not for O2 its designed for nutrients + drug metabolsim + clear fat ; hepatocytes ONLY take some O2)
Story (about cellular respiration)
Young Cho - young reseraher at hopkins working for pete peterson
Since 1930s - people knew about the Warberg effect (cancer is glycoitic ; basis for pet scan)
- Pet scans work because they add a radio marker in the blood –> if have glycolitic acitivity –> have more glucose uptake in that area - means that tosses using sugar are tagged –> when scan you can see that radio material
- Brain = always red because it is very glyoclitic (not necesari;ly cancer)
2000s - Pete was looking at the Warberg effect with Young cho
- They thought that if the Warberg effect works to bring glucose to the tumor then you should be able to use sugar to target the tumor
- Started by looking at markers (used 10broo- florate - anology for glucose) –> put in rates –> molecule goe sto tumor –> causes apoptosis + necrosis –> good results
- They staryed doing a liver cancer model –> rini got involoved - drew images for them –> presented image sto presenident (Rini became part of their team)
End - people were contacting pete –> one person had a son with liver cancer asking for the drg but the drug was not approved by the FDA –> guy (was a chemist) –> said he would give it to son himself –> young and pete were able to get emergencey use for son –> son had a big reduction in tumor sze
After pete - eeryone started to work on Warberg again (there was a german physican who got in toruble because patinets died)
Image (ADD when updates slides) - Shows PET scan of metastatic cancer –> red is the metastisized cancer
What does Pulminary ventilation include
Overall: Movement of air in and out of body
An open and clear passageay for air from ecterior to interior (get air to lungs)
Mechanism to move air through the system (need to push air)
Sufficient sirface area and apparatus for gas exchnage to occur
- At this stage you are getting to external respiration
Why is nasal cavity important
- Air is conditioned (cooled or heated)
- If you bretah in hot air –> the air going to the lungs will be condistioned –> have systems taht will take the air through the nasal cancity and cool it/heat it
- Cool/heat through blood or muscosa (Ex. cold sink of blood and muscosa to warm the ar)
- Moisture is added before going to lungs
- Initial filtration of the air
- Completes the first filatration throigh nasal hairs (Ex. see leaves in snot after raking because hairs trapped it)
Function of Nose
Overall - nose is a passage way
Midsagotal section of nose
What to see:
1. See nasal pasageway
2. Ethroid bone –> creates the roof of the nasal cavity
3. Septum
4. Citrulus –> goes to the foraman magnum
4. Basal artery –> Sits on the citrulas bones
Where does ventilation occur
Ventilation = through nose + mouth
Anterior portion of the nose
Made of cartiledge
Important for:
1. When get hit the nose doesn’t brak because the external cartilege is flaxible
2. For nasal strips - strips will pull on the catilegde of the nose (pulls on the skin -> pul on cartiledge -> pull on nose)
- Strip is spring loaded –> when put on nose –> strip tried to striaghted –> pulls on skin –> opens nasal passage
- Used for snoring + sleep apnea
Nose structures
Overall - Nose is made of catilegde and bose
- Vestibule - external flaps (contain course hairs)
- Immediatly inside the nares (flaps of nose) are widneings of the cavicty - widenings = vestibules
- Septum divides the cavity
- Anetior third of the septum has os catilegde that is covered by stratified epithliim (skin) - skin then tranistions to muscosa (2 and 3rd have muscosa)
- Concha - Have 3 shelves of bone
- When covered with mucosa = concha
- When not covered withmuscosa = terbines
Function of muscosa
Muscosa in 2nds and 3rd area of septum = mosturizes and fiters
- Is able to captire smaller particles ; hair gets bigger particles)
Turbinates
Function: Increases Surface Area
As air goe sinto the nose –> turbinates slows down the air (makes a mini vortex of air) = good thing because the air stops and buffest –> makes more hemodynamics –> air has more contact with muscosal surfae –> get more conditioning
Image - Top of nose = superior turminates ; bottom has inferior turbinates
- In back of nose hole = see anterior edge of septum
Image of external nose
Overall see external nose –> mostly made of cartilege
Top part of nose (near eyes) = bone
Down from bone = cartiledge (deteroirtes = skulls often lack cartiledge after people die)
Bottom under tip of nose = nasal spine (comes off the maxilla)
Medical recunstration STORY
Rini was at Michagen –> worked with a facial reconstructions artists (betty)
- They teamed up with Clyde who was looking at the thicknes of skin (looked at the aveage skin thickness i the skull)
- Betty measured the avergae thickness and put where data from Clyde was taken –> she would use artistic and anatomical knowldge/connected the dots (thinknig about shaoe and bulk of the muscle) –> led to the idea of forensic resuctructve scultures
End - betty was succesfu in making reconstructive scultires (her scutures were used for investigations_
Issues in being able to reconstruct the skull
- If the old skull is in nature
- Espically if there is no hair = hard to know
- If has clothes = could help know socioeconomic status
- Lips - no tissues indication for lip
- Sometimes there are teeth which help to know lips
- If have no eyes - can’t know color of eyes or shape of eye or shape of eyelids
- Nose - slope of nasal bone and nasal spine = dictates the shape of nose
- Issue in image = based on nasal bone the nose would be huge (psosible they had huge nose or might not be accurate)
King Philip of spane
He was a hapersburg –> they are known for having a lot of cranial facial issues
- There is an old skull people think could be his (has a big nose)
- Cranial facila issues = because of inbreeding
- There was a painting by valsquez that shoed face
Richard Nixon
Structure of his nose = sattle nose
Nasal bones = flattened and cartiledge comes out verticle
Nixon = bpxer –> possibole his nose shape is because he broke his nose many times
Shows view of septim
See skin –> tranistions to muscosal AND see cartilage –> transitions to bone
- 1st third of septum = cartaledge = adds to flexibility
Bones folding in - turbinates –> shelves of bone
Deviated septum
Septim = in the midsagital BUt often deviated a little
Image - see that vecause of the inflamed mucosa + deviated spetum = the nasal cavity is not wide open
- Nasal cavity is not always wide open
Inflamed muscoa
Rhynitus
Septoplasy
Done to sraighten the septum
Cut the mucosa –> expose he septum –> break the septum –> have peices of the septum in mucousa –> pack peices in –> over time the bone fragments and cartiledge heal = breath better
Lego story
There was a lego stuck in persons nose for 30 years –> after 30 years they were able t remove the lego
When young they put a dot lego up nose –> they trired to remove the lego with a lego head but then the lego head got stuck –> used tweezers to get the lego head out —> 26 years later they blew nose in shoer and the lego came put
Rini sinus issues
Rini has sinus issues –> doctor said to use slaine –> saline breaks up the muscosa
- Don’t use water because water iritates nose
Netti pot
Used for stuffed nose
Make solution –> goes in one nostril –> comes out the other (goes behind the septum)
- Issue = need to use DI water or boiled water –> IF not you can get infection (Ex. if use pond water –> pond water has pathogen –> pathogen goes to cryptaphorm plates –> have perferations in the bone where nerves can go through –> pathogen goes up to the brain –> get memgitus
- Need to add saline to water –> if just add water it throws off osmotic balance
Openings in nose
Overall - openings are very thin
Purpose:
1. Have siumues because it keeps the weight of the sjull low (not solid bone)
2. Important for talking (Photon) –> noise produced by vocal cords echos in openings
Lateral view of nose
See concha covered with mucosa + See opening to nasal lacromol duct
Upper part of each shelf = important
- Above the 1st concha = sphenpid bone sinus
- Under the mddle concha = open to the fromtal and maxilary sinus (doctor feels when sick)
- Under inferior = openings of nasal lacromeal ducts
Lacromol Gland + Nasaolactromoe duct
Gives the fluid in eye for blinkning
Fluid then goes to the lactromole duct on medial side of eye –> then fluid goes to the nasolactromol duct –> goes to opening under inferior tube –> as you breath the fluid evaporates
- Can be evaported in air that is breathed in and then the fluid is reabsorbed
Pharyncx
Pharynx - goes from behind nasal cavity to the larynx (to hyloid bone)
Dividied into:
1. Nasal pharyx (lined with ciliated mucosa)
- By the soft pallete
- Continuation of nasal cavity - only used for respiration = cilaited
2. Orro pharynx - Non-cilaited because have air coming from breathing and food from mouth
3. Laryngl Pharynx (lined with mucosa because shared with food and air)
Doll maker movie
Have GIs making fun of this girl –> girl was a welder 00> one guy choked and no one knew what to do –> she took a knife and made a hole in the cricothrypid ligament –> put pen in hole –> make sift trace
Image - see cricothrypid ligament
False vocal cords + true vocal cords
True = tuogh cartliagnous ligaments in memebrane of trachea - as talk they because taught or relaxted based on phonoation
False vocal cords = soft tissue - not involoved in sound production but involoved in veselvas menuver (plug nose and close mouth)
- When biold pressure during veselvas menuver - prevents us from blowing out lungs
True vs. False in image
Vocal cords = part of larynx
- Vocal cords = not ciliated because would interfere with cords coming together
- Vocal cords = pulled taght to create pitch
Image - see true vs. false vocal cords
- left image - flaps coming out of sides = true vocal cords
Anterior to posterior view of larynx
White space between thrypids cartilge + Cricoid cartilege = cricothrypod ligament (plave where put trach tube)
First pic - Anterior to posterio
Second pic - Posterior to anterior
Image - shows larynx is made up of a lot of cariledge ; yellow at the top line is the Hyland bone ; see epiglotus (has cratlige and soft tosise) ; see thyrpoid cartldge ; see crycoid cartidlge
Trachea
Made up of 16-20 cartilegenous rings
- Front and the Posterior = soft tissue –> gives way for bolus food (food can’t block airway = tissues give way for asophogas in back)
- Trangle point where branch comes togterh = where heart is
- Upper right branch - primary branch
- Goes to the lungs
- Top of branch - cincentraic around
- Bottom right - ice bergs of cartilege
- Top left - Right primary
- Becomes circumfrational
- More verticle
- If inhale things = often goes to right bronchi (Ex. guy salloed spoon = living in right bronchi)
Rings of the trache
Cartegalous rings of trache = c shaped not entire rings in intial portion - sift tissue in back is deisgned to take flex - behind trachea is the asophas = when have a big bite of food = the stretching point allow trachea to give without callapsing the trachea –> go down into primary bronchia the cratagunous rings become complete because there is nothing behind them that needs some give
- Flexible part = posterior side
At bottom in secondary and tertiary bronch - cartileg becomes lakecurum (lakes of cartiledge) - floating icebergs of cartildge
Labeled trachea
Always named for the section of lung that they go to
Example - right lobe = goes to right lobes
Lobes of the lung
Right lung = 3 lobes (upper, middle, lower)
Left lung = 2 lobes (upper and lower)
On right side (left lobe) = have chunk missing –> this is area where the heart sits
- becuause of heart = chnages capcity/shape of the lung
Lobes of lung can be removed – vesels can be ligated - airway can be taken and crymed shut - lobe can be romved ; remianing lung tissue fills the space - people can do wee
Fissures in lobe
Right lung - Has horinzontal + oblique fissure
- Horizonal fissure - only on the right lung
Left lung - only has oblique fissure
Depressions in lungs
Sulcus:
1. Suclus of Sueprior vena cava
2. Sulcus of subclavian artery
- Depression where subclavian artery sits
3. Diaphragmatic surface
4. cardiac impression
Aveoli and Capilaries
When squeeze lung –> feels spongy –> calapsy aveleio
Top part of capilaries = spent blood coming in –> capilaries start around area sacs –> then retrun (at the side of capilary image) –> collect into vein to go to heart
- capilaries go around averolo
- Aveoli have surface area = have effective gas exchnage in lungs
- Aveoli in people with emphizema = cells bud together (two sacs become one) –> in pateint see large single aveoli –> area will take place many aveoli = less urface area –> bad shape because don’t get gas exchange
Picture with right ad left lung + arteries
Issue in image left pulminary artyer is red –> should be blue because carrying deoxinoginated blood to the lung
Blue veins coming back = should be red
Hylum
left image - pulinary veins - see that the oxygen comes back more anterior
Bronchi = cary
Covering of the lungs - Hyla???
Image-
- Airway (white circle) = cartlegnous
- Veins coming back from lungs (going to heart) (red circles) - more anterior ; arteries are posterior to them (Blue circles)
lateral view of right chest
See root of ling by pruple (group of 4 = root of lung)
- Yellow = brinchia - have first division = in secindary brinchia
- red and purple = veins and arteries
See azavgus veins (blue line above bundle of 4) - ties in the intercostal veins –> drains to suprior vena cava
Bottom = diaphram
Image of the coverings of the lungs
Red - pareital plura
- Red = really should fold in and go up and around the heart and then down and back to the diaphram
Blue = puminary (visceral) plura
See blue and red are continous with one another at the lungs
