Pulmonary Anatomy And Physiology Flashcards
Pulmonary Anatomy and Physiology
Ventilation ≠ Respiration
- Ventilation: movement of AIR into and outside the body.
- Respiration: process by which we take in O2 and throw off CO2.
Pulmonary Anatomy and Physiology
Functional movement of the thorax:
- Pump handle: anterior and superior motion of the sternum and upper rib cage.
- Bucket handle: lateral and superior motion of the ribs.
Pulmonary Anatomy and Physiology
Principal muscles of inspiration:
- DIAPHRAGM: primary muscle of inspiration.
- INTERCOSTALS: ext & int
Pulmonary Anatomy and Physiology
What are the 2 main purposes of the thorax?
- Attachment for mm of ventilation.
- Houses lungs and mediastinum
Pulmonary Anatomy and Physiology
the thorax is made up of:
- 12 thoracic Vertebrae: provide stability
-
Sternum:
- Manubrium: ribs 1 and 2
- Body: ribs 3-7
- Sternal angle: leveled with the carina and about the 5th thoracic vertebrae.
- 12 Ribs: Attachment for muscles, protection of organs.
Pulmonary Anatomy and Physiology
Movement of the thorax increases where?
Inferiorly and anteriorly, so it is more stable posteriorly and superiorly
Pulmonary Anatomy and Physiology
What is the sequence of normal breathing?
- Diaphragm: rises the abdomen.
- Abdominals: allow lateral costal expansion of the lower chest.
- Intercostals: gentle rise of the of the upper rib cage sup and ant.
Pulmonary Anatomy and Physiology
Principal muscles of INSPIRATION:
- Diaphragm: flattens over the abd cavity. Causes chest to expand laterally and lower ribs to elevate. Depends on abdominal and intercostals for optimal diaphragmatic breathing.
-
Intercostals:
- Internal: lower the ribs, decrease pressure.
- External: elevate the ribs, increase pressure.
Pulmonary Anatomy and Physiology
When internal and external intercostals contract:
Elevate the ribs
Pulmonary Anatomy and Physiology
Upward movement of upper ribs increases _________________ diameter of chest.
anterior and posterior
Pulmonary Anatomy and Physiology
Elevation of lower ribs increases ________ diameter of the chest.
longitudinal (transverse)
Pulmonary Anatomy and Physiology
This principal muscle of inspiration flattens over abd contents, and decreases intrathoracic cavity pressure:
DIAPHRAGM
Pulmonary Anatomy and Physiology
What is the amount percentage of the diaphragm’s work in breathing?
How much of the tidal volume does it provide?
60 - 70% Of the work providing 2/3 - 3/4 of the tidal volume
Pulmonary Anatomy and Physiology
3 origins of the diaphragm:
- Posterior xiphoid.
- Ant lumbar vertebrae & arcuate ligaments.
- Inner surface of costal cartilage 6 to 12.
Pulmonary Anatomy and Physiology
How does the diaphragm level changes in relation to positioning?
- Supine: higher in thorax, larger inspiratory excursion, but harder to get a deep breath.
- Sitting: lower, easier to get a deep breath.
- Sidelying: lower side is higher.
Pulmonary Anatomy and Physiology
Muscles of exhalation:
- Exhalation is passive.
- Forceful exhalation uses abdominal muscles to depress the ribs and compress abdominal contents,
Pulmonary Anatomy and Physiology
Innervation of the diaphragm:
Phrenic nerve C3 to C5
Pulmonary Anatomy and Physiology
What happens during a concentric diaphragmatic contraction?
Quiet forceful inhalation.
Pulmonary Anatomy and Physiology
What happens during a eccentric diaphragmatic contraction?
Controlled exhalation and speech.
Pulmonary Anatomy and Physiology
Function of the intercostal muscles:
Stabilize rib cage during inhalation and prevent chest wall from moving inward toward the negative pressure.
Pulmonary Anatomy and Physiology
Innervation of the intercostals muscles:
T1 to T12
Pulmonary Anatomy and Physiology
Upper chest intercostals expand the chest in which direction?
Superior and anterior
Pulmonary Anatomy and Physiology
Lower chest intercostals expand the chest in which direction?
Lateral and superior
Pulmonary Anatomy and Physiology
Eccentric contraction of the intercostals is needed for what?
-
Controlled exhalation and speech:
- Vocal folds control exhalation speed.
Pulmonary Anatomy and Physiology
What structure controls the speed of exhalation?
- Vocal folds
- Eccentric contraction of intercostals and diaphragm
Pulmonary Anatomy and Physiology
What are the functions of the abdominal muscles from a pulmonary perspective?
- Stabilize rib cage and provide visceral support.
- Provide positive pressure to help stabilize diaphragm. Prevent abdominal cavity from pushing out when diaphragm is pressing down.
- Allow for effective cough, venous return, bowel movement.
Pulmonary Anatomy and Physiology
Innervation of the abdominal muscles:
- T6 - L1
- T4 injury? Can get a breath in, but what if they need to cough?
Pulmonary Anatomy and Physiology
Paradoxical breathing:
- Inward abdominal or chest wall movement with inspiration and outward movement with exhalation.
- Weakness of diaphragm.
Pulmonary Anatomy and Physiology
ACCESSORY INSPIRATORY MUSCLES:
- Erector Spinae (T1 - S3): stabilize thorax posteriorly.
- Pectoralis (C5 - C7): stabilize ribs; assists with ant and lat chest expansion; forced exhalation when chest moves into flx.
- Serratus Anterior (C5 - C7): only inspiration muscle paired with trunk flexion; posterior expansion with fixed UE.
- Scalenes (C3 -C8): sup and ant expansion; elevate and fix upper ribs.
- SCM (C2, C3, CN XI): sup and ant expansion; elevates the sternum.
- Trapezius (C2 - C4, CN XI): superior expansion; least energy efficient accessory muscle.
Pulmonary Anatomy and Physiology
Only inspiration muscle paired with trunk flexion; posterior expansion with fixed UE.
Serratus Anterior (C5 - C7)
Pulmonary Anatomy and Physiology
Most significant stage of normal chest development:
6-12 MO, all breathing mm available
Pulmonary Anatomy and Physiology
What is the shape of the chest wall in a newborn baby?
Triangular
Pulmonary Anatomy and Physiology
How does a newborn breathes?
Diaphragmatic breather
Pulmonary Anatomy and Physiology
According to the the body’s “aluminum can” concept, the diaphragm…
is a major pressure regulator
Pulmonary Anatomy and Physiology
According to the body’s “aluminum soda can” concept, intra-abdominal pressure always
positive
flluctuates w/breathing:
- Increase w/inhalatioN
- Decrease w/exhalation
Pulmonary Anatomy and Physiology
According to the body’s “aluminum soda can” concept, intra-thoracic pressure is…
Lower to draw air in (inhalation) and higher with exhalation
Pulmonary Anatomy and Physiology
Function of the conducting airways:
filter, warm, and conduct air to the respiratory units
Pulmonary Anatomy and Physiology
Upper airways pathway:
- From nasal and oral orificies to the false vocal cords in the larynx:
- Nose
- Nasal cavity
- Pharynx
- Nasoparynx
- Oropharynx
- Laryngopharynx
- Larynx: acts as a valve and has pronating mechanism for voice production.
Pulmonary Anatomy and Physiology
acts as a valve and has pronating mechanism for voice production
Larynx
Pulmonary Anatomy and Physiology
Lower airways go from…
True vocal folds to the alveoli:
- Trachea (ciliated)
- Bronchi (ciliated)
- Bronchioles (ciliated)
- Terminal bronchioles (non-ciliated)
- Terminal respiratory units
Pulmonary Anatomy and Physiology
Right main stem bronchus is more _____________,
_____________, and _______________ than left→clinical significance?
Vertical, shorter, and wider:
aspiration (food particles more to the right).
Pulmonary Anatomy and Physiology
Where O2 gets from lung to the capillary
Alveolar capillary septum (membrane)
Pulmonary Anatomy and Physiology
Carina:
- Located in in the trachea, where it divides into right and left main stem bronchi
- right main stem bronchi is shorter, wider, and more vertical than left
Pulmonary Anatomy and Physiology
Number of orders of branching from trachea to alveolar duct
23-25