Module 4 - Thorax Flashcards by Rose Hsieh

Respiration requires

Muscular effort

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Do lungs contain muscles? Can they move on their own?

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Respiration:
How do lungs move? (3)

1 - thoracic rib cage = mechanical pump for lungs

2 - lungs stick to the thoracic cavity walls

3 - Muscles on ribs + bony thorax drive the pump

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Breathing apparatus:

3 subdivisions

Pulmonary apparatus: (2)
Chest Wall (4)
Pulmonary-chest wall unit

1 - Pulmonary (lungs) apparatus
lungs
airways

2 - Chest Wall
Rib cage
Abdominal wall
Diaphragm
Abdominal context

3 - Pulmonary Chest Wall Unit
Pulmonary apparatus
Chest Wall

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Rib Cage: Structures (5)

Thoracic Vertebrae (T1-T12)

Clavicles 2x

Ribs (12 pairs)
True / Direct: 1-7
False / Indirect: 8-10
Floating: 11-12

Costal Cartilage

Sternum
Manubrium (handle)
Body of Sternum
Xiphoid Process

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Rib Cage:

Cavities (2)

Superior Thoracic Aperture
T1 + Rib 1 + Manubrium (sternum)

Inferior Throracic Aperture
T12 + Rib 12 + Costal Margin

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Rib Cage: Cavities

Superior Thoracic Aperture:

Components

What passes through?
Vessels, Nerves, Organs

Components:
T1
Rib 1
Sternum (Manubrium)

Vessels
Jugular Veins
Carotid Arteries

Nerves
Phrenic Nerves
Vagus Nerve

Organs
Esophagus
Trachea

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Rib Cage: Cavities

Inferior Thoracic Aperture:
What passes through?
Vessels, Nerves, Organs

Vessels
Vena Cava (Vein)
Aorta artery

Nerves
Phrenic Nerve

Organ
Esophagus

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Individual rib structure:

Posterior -> anterior
(8)

Posterior -> Anterior

Thoracic vertebrae->
Costovertebral joint
Articulator facets
Head
Neck
Costal angle
Shaft
Costal groove
Costochondral joint
Costal cartilage

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Rib Cage: Joints (3)

Costovertebral joint: connects rib to vertebrae

Costochondral joint: connects rib to costal cartilage

Costosternal joint: connects costal cartilage to sternum

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Ribs (1-12)

True Ribs
False Ribs
Floating ribs

True Ribs
1-7

False Ribs
8-10

Floating Ribs
11-12

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Rib Movement Origin:

Elevation & depression of ribs occur at____

Facets: (3)

Costovertebral joints

Facets
Transverse costal facet
Superior costal facet
Inferior costal facet

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True Ribs

Movement
Volume increase

Rib 1-7

Pump handle movement
Sternum moves anteriorly

Volume increase
Anteroposterior volume

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False Rib

Movement
Volume

Rib 8-10

Bucket handle movement
Ribs move superiorly
Laterally

Volume
Increase in lateral volume

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Muscles of the thorax:

Main muscles (3)
Accessory muscles (2)

Main Muscles
Diaphragm
External Intercostal Muscles
Internal Intercostal Muscles

Accessory Muscles
Accessory Inspiratory Muscles
Accessory Expiratory Muscles

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Thoracic Diaphragm

Location
Function
Innervation

Location
Between thoracic & Abdominal cavities

Function
Primary muscle for inspiration

Attachments
Inferior border of rib cage
Xiphoid process
Vertebral Column

Innervation
Phrenic Nerve (General somatic efferent neurons)
From Cervical Nerves 3,4,5 keeps you alive

Thoracic Diaphragm

Movement
Inspiration ->volume
Expiration -> volume

Resting position: domed

Inspiration
Flattens (contracted)
Increase thoracic cavity volume

Expiration
Diaphragm snap back to domed position
Decrease thoracic cavity volume

Intercostal Muscles (2)

Innervation
Attachments

Intercostal Muscles
External intercostal muscle
Internal Intercostal muscle

Innervation
Intercostal Nerves

Attachments
Between ribs

External Intercostal Muscles

Function
Attachment
Fibre running direction
Movement -> Volume

Function
Inspirate

Attachment
Rib below -> Rib above
R1-R12 (11 pairs)

Fibre Running direction
Hand in pocket orientation
Runs from vertebral column to end of rib towards sternum

Movement
Elevate ribs -> increase thoracic cavity

Internal Intercostal Muscles

Function
Attachment
Fibre running direction
Movement -> Volume

Function
Expirate

Attachment
From Rib above to rib below
Rib 1-12 (11 pairs)

Fibre running direction
Opposite direction to external fibres
Fibre begin near sternal aspect and end at vertebral column

Movement
Depress ribs -> decrease in thoracic cavity volume

Accessory Inspiratory Group:

Anterior Cervical group: (2)

Function

Accessory Inspiratory Muscles

Anterior Cervical Group:
Scalenes
Sternocleidomastoid

Function
Elevates top and anterior rib cage -> increase Thoracic Cavity volue

Accessory Inspiratory Group:

Anterior Thorax group: (4)

Function

Accessory Inspiratory Muscles

Anterior Thorax group:
Pectoralis major & minor
Subclavius
Transversus thoracis
Serratus anterior

Function:
Elevates upper ribs

Accessory Inspiratory Group:

Posterior & Lateral thoracic group (2)

Function

Accessory Inspiratory Muscles

Posterior & lateral thoracic group
Deep extensor back muscles
Superficial back muscles
Serratus posterior
Latissimus dorsi

Function:
Extend vertebral column (extend rib cage)

Accessory Expiratory Muscles

Abdominal Muscles (4)
Function

Accessory Expiratory Muscles

Abdominal Muscles
Rectus Abdominis
External Obliques
Internal Obliques
Transversus Abdominis

Function
Pulls down lower ribs ->causing expiration
Squeezes abdomen -> Transfers upward pressure on diaphragm

Respiration cycle: seconds

One inspiration and one expiration at rest 4 seconds at rest

Respiration rate:

Approximately 15 cycles / minute

Normal respiratory Cycle Inspiration: % Expiration: %

Normal Respiratory cycle: Inspiration: 40% Expiration: 60%

Conversation respiratory Cycle Inspiration: % Expiration: %

Conversation Respiratory cycle: Inspiration: 10% Expiration: 90% Speech is produced during exhaled air

Lung Volume (4) Tidal Volume (TV) Inspiratory Reserve Volume (IRV) Expiratory Reserve Volume Vital Capacity

Tidal Volume: Amount of air that moves in and out of the lungs during quiet breathing Inspiratory Reserve Volume (IRV) Amount of extra air inhaled, after tidal volume, during forced inspiration Expiratory Reserve Volume (ERV) Amount of extra air exhaled, after tidal volume, during forced expiration Vital Capacity Total usable volume of the lungs that you can control. Not the total lung capacity it is impossible to breathe out all of the air in your lungs

Intrapleural pressure Function Structures (3)

Function Links rib cage movements to lung movements via intrapleural pressure (negative pressure) created between visceral and parietal pleural membranes Structures Parietal pleural membrane (thoracic rib cage) Visceral Pleural membrane (lungs) Pleural fluid

Boyles Law (3)

Air moves from high pressure -> low pressure When volume increases -> pressure decreases When volume decreases -> pressure increases

Mechanism of ventilation Inhalation (4)

Increase in thoracic cavity Decrease in pressure Pressure outside > than pressure inside Air rushes in (high -> low)

Mechanism of ventilation Exhalation (4)

Decrease in thoracic cavity Increase in pressure Pressure inside > pressure outside Air rushes out (high -> low)

Forces for breathing Active forces Passive forces

Active forces Muscles Dependent on air volume Greater volume -> greater forces Passive forces Natural recoil forces of Ribs Muscles Lungs gravity

Types of Inspiration

Air moves to lungs driven by low pressures Quiet inspiration Thoracic diaphragm flattens to increase volume of thoracic cavity External intercostal muscles Forced inspiration External intercostal muscles Accessory Inspiratory Muscles

Types of expiration

Air moves out of lungs due to high pressures Quiet expiration Recoil of thoracic diaphragm and rib and muscles Forced expiration Internal intercostal muscles Abdominal muscles

Automatic/ Tidal Breathing: Neural control:

Neural Control: Medulla (Brainstem)

Voluntary acts of breathing (speaking, singing, breath holding) Neural control:

Neural control: Cerebrum Overrides brainstem

Dysfunctions: Chronic Obstructive Pulmonary Disease (COPD) Characteristics Treatment

Lung disease Emphysema Chronic bronchitis Chronic asthma Treatment: No treatment, but can slow progression and relieve symptoms