Applied Anatomical Concepts Flashcards
What is the definition of breathing and what is the definition of respiration?
- Breathing: inspiration and expiration
- Respiration: oxygen conveyed to tissues and cells, and the oxidation products, carbon dioxide and water, are given off (gaseous exchange)
What are the -
2 phases of breathing
2 places of breathing
2 types of breathing
Phases:
- Inspiration (inhalation)
- Expiration (exhalation)
Areas:
- Thoracic
- Abdominal
Types:
- Quiet
- Forced
What is Boyle’s Law?
- Decrease in volume = increase in pressure
- Increase in volume = decrease in pressure
What happens to the intrathoracic volume and pressure during inspiration and expiration?
Inspiration - Increase in intrathoracic volume = Decreased intrathoracic pressure
Expiration - Decreased intrathoracic volume = Increased intrathoracic pressure
How does inspiration occur?
- Parietal pleura is pulled with the movement of the ribs and diaphragm
- Visceral pleura moves with parietal pleura (surface tension)
- Lung volume increases
- Air moves into lungs towards lower pressure
How does expiration occur?
- Visceral pleura moves with elastic recoil of lungs
- Parietal pleura moves with the ribs and diaphragm as they return to rest
- Surface tension between parietal and visceral pleura prevents lung from collapsing
- Lung volume decreases
- Air moves out of lungs towards lower pressure
Label the type of dimension changes and whether they would change in thoracic or abdominal breathing.
Thoracic breathing
- Lateral/Transverse diameter
- Anteroposterior diameter
Abdominal breathing
- Vertical diameter
What type of diameter change does this show?
Lateral Diameter of Thorax
How does lateral diameter change assist in breathing?
- Lateral edges of ribs are elevated supero-laterally during inspiration and the lateral diameter of thoracic cavity increases
- Results in an increase in the transverse or lateral diameter of chest cavity
What is the lateral diameter change also known as?
Bucket handle movement
What type of diameter change does this show?
Anteroposterior Diameter of Thorax
How does the anteroposterior diameter change assist breathing?
- Anterior ends of ribs are raised during inspiration
- Elevation causes sternum to also be raised
- Movement is facilitated by costal cartilages
- Results in an increase in antero-posterior diameter of chest cavity
What is the anteroposterior diameter change also known as?
Pump handle movement
How does the vertical diameter change assist with breathing?
- Via diaphragm which forms floor of thoracic cavity
- Resting position of diaphragm is domed
- Upon contraction the diaphragm descends 5 -10 cm compressing abdominal organs
- Increases vertical diameter of thorax
What muscles are used in quiet inspiration and quiet expiration?
Quiet Inspiration
- External intercostals
- Scalene muscles
- Diaphragm
Quiet Expiration
Normally a passive process. Elastic recoil of lungs expels air and chest wall falls back into resting position
What muscles is this?
Scalenes
What muscles are used in forced inspiration?
Muscles used in quiet inspiration,
- External intercostals
- Scalene muscles
- Diaphragm
plus: Pectoral muscles, Sternocleidomastoid (SCM) and Latissimus dorsi
What muscles are used in forced expiration?
Internal intercostals, Oblique and transverse abdominal muscles, Quadratus lumborum
Name an example of when forced inspiration and forced expiration would occur
Forced inspiration - during excersise
Forced expiration - coughing, playing wind instrument
Complete the diagram
Complete the diagram
What tissue is the diaghpragm made up of?
Sheet of skeletal muscle with a central tendon
Where does the pericardium and the parietal pleura attach to the diaphragm?
- Pericardium attached to middle of tendon on its superior surface
- Diaphragmatic (parietal) pleura lines its superior surface
Complete the diagram of the diaphragm
What is the origin and insertion of the diaphram?
Origin has 3 parts
1) Sternal (xiphoid process),
2) Costal (costal cartilages of ribs 7-10, ribs 11 and 12),
3) Lumbar (medial and lateral arcuate ligaments and lumbar vertebral bodies)
Insertion: Central tendon
Complete the diagram of the origin and insertion of the diaphragm
Where does the lumbar part of the diaphragm arise from?
Lumbar part of diaphragm arises from the medial and lateral arcuate ligaments and from the lumbar vertebral bodies via right and left crura.
How is the aortic hiatus formed?
The right and left crura meet to form the median arcuate ligament to form aortic hiatus
How is the oesophageal hiatus formed?
Fibres of the right crus pass around the oesophagus forming the oesophageal hiatus
Complete the diagram on the lumbar attachements of the diaphragm
What are the 3 openings of the diaphragm?
- Opening for Inferior Vena Cava (T8)
- Oesophageal hiatus (T10)
- Aortic hiatus (T12) - the thoracic duct and azygos vein also pass through the aortic hiatus
What is the purpose of the diaphragm altering the volume of the thorax?
- Quiet inspiration (descends approx. 2cm)
- Forced inspiration (descends 7-10cm) e.g. coughing
- Aids venous return
- Hiccups
What is the blood supply to the diaphragm?
Superior & Inferior phrenic arteries
Complete the diagram of the openings of the diaphragm
What is the purpose of the diaphragm altering the volume of the abdomen?
Urinating and defecation
Lifting heavy objects (braces vertebral column)
Child birth
Complete the diagram on the nerves
Where does the phrenic nerve arrise from?
From ventral rami of C3, C4, C5
Which nerve does the phrenic nerve enter the superior mediastinum lateral to?
Vagus nerve
What structures does the phrenic nerve supply motor and sensory innervation to?
Motor: diaphragm (sole supply)
Sensory:
- pericardium
- parietal pleura (mediastinal and central part of diaphragmatic)
- parietal peritoneum
- central region of diaphragm
Does the phrenic nerve pass anterior or posterior to the main bronchi?
Anterior
What is a pancoast tumour?
Pancoast Tumour is cancer located at apex of the lung
How can a pancoast tumour cause hoarseness?
What pathology does this x-ray show?
Pancoast tumour
Name 2 situations that have different outcomes depending on coronary artery dominance
Blockage of the main right or left coronary artery will have different outcomes depending on coronary artery dominance
Coronary artery dominance is also important when planning for a coronary artery bypass graft
What is this imaging technique?
Label the image
Is this a left or right dominant heart?
This is a coronary angiogram, 3D CT image
Right dominant heart
How can coronary dominance be determined?
Arteriograms are used to determine coronary artery dominance
