applied anatomical concepts Flashcards
what is respiration?
- oxygen conveyed to tissues and cells and the oxidation products, carbon dioxide and water are given off (gaseous exchange)
what are the phases of breathing? 2
inspiration
expiration
what are the areas of breathing? 2
thoracic
abdominal
what are the types of breathing? 2
quiet
forced
describe inspiration? 5
- increase in intrathoracic volume= decrease in intrathoracic pressure
- parietal pleura is pulled with the movement of the ribs and diaphragm
- visceral pleura moves with parietal pleura
- lung volume increases
- air moves into the lungs towards lower pressure
describe expiration? 5
- decreased intrathoracic volume= increased intrathoracic pressure
- visceral pleura moves with elastic recoil of the lungs
- parietal pleura moves with the ribs and diaphragm as they return to rest
- surface tension between the parietal and visceral pleura prevents the lung from collapsing
- lung volume decreases
- air moves out of the lungs towards lower pressure
explain dimension changes of thoracic breathing? 2
- lateral/transverse diameter
- anteroposterior diameter (between anterior and posterior)
explain the dimension changes of abdominal breathing?
vertical diameter
describe the lateral diameter of the thorax? 4
- Lateral edges of ribs are elevated supero-laterally during inspiration and the lateral diameter of the thoracic cavity increases
- Results in an increase in the transverse or lateral diameter of chest cavity
- Also known as the bucket handle movement
- We use this during thoracic breathing
describe the anteroposterior diameter of the thorax? 6
- 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 anteroposterior diameter of the chest cavity
- Also known as pump handle movement
- We use this in thoracic breathing
describe the vertical diameter of the thorax? 4
- Via diaphragm which forms floor of the thoracic cavity
- Upon contraction the diaphragm descends 5-10cm compressing abdominal organs
- Increases the vertical diameter of the thorax
- We use this in abdominal breathing
what muscles are used in quiet inspiration? 3
- external intercostals
- scalene muscles
- diaphragm
what muscles are used in quiet expiration?
- normally a passive process. elastic recoil of the lungs expels air and chest wall falls back into resting position
what muscles are used in forced inspiration? 6
- external intercostals
- scalene muscles
- diaphragm
- pectoral muscles
- sternocleidomastoid (SCM)
- latissimus dorsi
what are the muscles used in forced expiration? 3
- internal intercostals
- oblique and transverse abdominal muscles
- quadratus lumborum
what is the diaphragm? 3
- sheet of skeletal muscle with a central tendon
- pericardium attached to middle of tendon on its superior surface
- diaphragmatic (parietal) pleura lines its superior surface
what are the origins of the diaphragm? 3
- sternal- xiphoid process
- costal- costal cartilages of ribs 7-10 and ribs 11-12
- lumbar- medial and lateral arcuate ligaments and lumber vertebral bodies
what is the insertion of the diaphragm?
central tendon
what are the lumbar attachments of the diaphragm? 3
- lumbar part of diaphragm arises from the medial and lateral arcuate ligaments and from the lumbar vertebral bodies via right and left crura
- the right and left crura meet to form the median acruate ligament to form the aortic hiatus
- fibres of the right crus pass around the oesophagus forming the oesophageal hiatus
what are the openings of the diaphragm? 4
- opening for inferior vena cava t8
- oesophageal hiatus T10
- aortic hiatus t12
- the thoracic duct and azygous vein also pass through the aortic hiatus
what is the blood supply of the diaphragm?
superior and inferior phrenic arteries
what are the actions of the diaphragm? 9
- Alters the volume of the thorax:
- Quiet inspiration (descends 2cm)
- Forced inspiration (descends 7-10cm)
- Aids venous return
- Hiccups
- .
- Alters the volume of the abdomen:
- Urinating and defecation
- Lifting heavy objects (braces vertebral column)
- Childbirth
describe the phrenic nerve? 4
- Arises from C3,4,5
- Enters superior mediastinum lateral to the vagus nerve
- Motor: diaphragm (sole supply)
- Sensory: pericardium, parietal pleura (mediastinal and central part of the diaphragmatic), parietal peritoneum, central region of the diaphragm
describe a pan coast tumour? 3
- Pancoast tumour is cancer located at the apex of the lung
- If on the left side can cause recurrent nerve compression
- Vocal cord paralysis= hoarseness
