respiratory anatomy Flashcards
1
Q
anatomy must meet these requirements
A
- must be able to alter volume of a chamber linked to atmosphere, to create airflow in and out
- must be able to alter the rate and amount of volume change to meet differing bodily needs
- must have some way for oxygen in the inhaled air to be absorbed into body and C02 expelled
2
Q
lungs are composed of three main tissue componants
A
- alveoli: tissue involved in air exchange
- type I and II
- bronchi: tubes that carry gases to and away from alveoli
- vascular tissue: carrying blood to and from alveoli
3
Q
lungs are composed of
A
lobes and lobules
4
Q
right lung lobes
A
superior, middle, inferior
R upper R middle R lower
5
Q
left lung lobes
A
superior, inferior
6
Q
alveoli
A
- tiny sacs involved in air exchange
- 300 million alveoli in healthy lungs
- each covered in about 2000 capillaries
- capillary walls are thin promoting rapid gas exchange
7
Q
alveoli
A
the branching and tiny alveoli allow large surface area that improves efficiency of gas exchange
8
Q
trachea-bronchial tree
A
- trachea is in wind pipe below larynx
- stretches down neck into chest
- within chest, trachea branches into right and left bronchi
- first division of bronchi - lobar bronchi - enter each lung
- these bronchi then divide into two branches which is repeated over and over again until the smallest divisions are reached
9
Q
branching of bronchi
A
- 14 divisions on left
- 28 divisions on right
- trachea and first 9 divisions have catilage smaller ones dont
- final 7 divisions are respiratory zones
- terminal bronchi are called bronchioles that end in alveolar ducts and lead to alveoli
10
Q
pneumocytes
A
- lung cells
- line alveoli and do work
- type I: membranous - primary job is gas exchange - max surface area to volume ratio
- type II: cubodial - has more mass/volume to produce something - job is to produce surfactant
- surfactant - reduces surface tension dramatically
11
Q
trachea structure
A
- combines stiffness for structure with flexibility for movement and adaptation
- cartilaginois C - rings
12
Q
internal lung structure
A
- trachea
- to bronchi
- to bronchioles
- to alveolar ducts and sacs
- to alveoli
- 70 sq. m surface area
- GOAL maxamize surface area for gas exchange by dividing
13
Q
internal lung structure: filtration
A
- nasal hairs
- goblet cells make mucous to trap pollutants
- cilia - beat more than 1000 times per minute
- lymphatic system = final defense
14
Q
surfactant
A
- secreted by type II pneumocytes
- makes pleural linings adhere
- why spongy tissue of lungs expands when thoracic cavity expands
- allows negative pressure to be maintained
- creates “suction” that allows thorax and lungs to move as unit
15
Q
spine
A
- combo of rigidity and flexibility
- rigid structures support the ribs
- muscles connecting to vertabrae also rigid
- four main sections - 33 total
- cervical (C1-C7)
- thoracic ( T1-T12)
- lumbar (L1-L5)
- sacral (S1-S5)
16
Q
cervical vertebra
A
- transverse foramen conduct vertebral arteries
- the superior and inferior articular facets link vertebra together connecting spine mechanically
- necessary for support
- uppermost vertebra is ATLAS that supports head
- atlas and C2 comminucate
- C3-C7 larger transverse and spinois processes
17
Q
thoracic vertebra
A
- 12 thoracic provide connections for the ribs and costal muscles
- larger spinous and transverse processes
- superior and inferior facts provide attachments for ribs
- rib attachments EXCEPT 1 10 11 12
18
Q
lumbar vertebra
A
- larger structures to support ambulation and lifting
- posterior fibers of the diaphragm attach to lumbar vertebra
19
Q
muscles spanning ____ ____ and ____ can change dimension of lungs
A
- scapula
- clavicle
- thorax
20
Q
ribs
A
defining and protecting a changing volume
- true 1-7
- false 8-10
- floating 11 12
- upper ribs move as unit with sternum
- lower ribs have more freedom
- arthrodial joints with vertebrae
- allow ribs to glide up and down but dont permit movement in any direction
- terminate in cartilage that attaches to sternum
- flexible cartilage allows twisting at front
21
Q
rib cage or thorax is an ________ structure
mobility can
A
interconnected
overall expansion that increase volume and decrease pressure
compress the lungs resulting in decrease in presure
22
Q
sternum
A
- ribs curve around to join sternum in front closing ribcage
- manubrium, corpus and xiphoid process
- clavicle attaches superiorly to manubrium
- 1st rib attaches to lateral edges
- 2nd rib attaches at juncture between manubrium and corpis
- 3-7 attach directly to corpus through cartilage
- 8-10 attach indirectly through chrondal attachments
23
Q
muscles of inspiration
A
- diaphragm
- rib cage elevators
24
Q
diaphragm
A
- contraction pulls tendons downwards and forwards
- enlarges thorax vertically and circumerentially (elevates 6 lower ribs)
- increases pressure on abdominal content
- thick sheet of muscle that forms floor of thorax
- separates abdoman and thorax
- bowl shape, slightly lower on left
- in center is central tendon
- lateral muscles attach all around lower ribcage and circumference
- MAJOR inhalation muscles
25
Q
diaphragm
origins and insertions
A
- origins
- sternal part: xiphoid process: posterior surface
- costal part: ribs 6-12 and their costal cartilages
- lumbar part: 1. medial and lateral arcuate ligaments 2. vertebrae L1-L3
- insertion
- central tendon
26
Q
diaphragm apertures
aortic aperture
A
most inferoposteroir opening located at the inferior border of T12 and slightly to the left of the midline
allows passing of descending aorta, thoracic duct, azygos and hemiazygous veins
27
Q
diaphragm apertures
esophageal aperture
A
oval shaped middle opening of the diaphragm located in the right crus, at level of T10
-muscle fibers surround esophagus in vertical tube
**when diaphragm moves during inspiration, esophagus is contricted preventing reflux of gastric contents
-allows passage of esophagus, esophageal vessels, vagal trunks
28
Q
diaphragm apertures
vena caval aperture
A
square shaped most superior opening located in the anterior edge of the diaphragm at the level of the intervertebral disc between T8 and T9
- the vena cava adgeres to the opening so as the diaphragm contracts in inspiration the aperture widens, stretching the vena cava to facilitate blood flow
- allows the passage of the inferior vena cava and right phrenic nerve
29
Q
diaphragm structure
A
high tensile strength
oriented vertically
attached to spine
-mostly muscular
30
Q
torque
A
- force that leads to turning, rotating or twisting about an axis
- ribs arent horizontal - not pulled straight up and down for respiration
- ribs rotate about points of articulation with the spine and sternum/cartilage
- contraction creates force
- force along rib and force perpendicular to rib
- forces equal in magnitude opposite in direction
- force x distance
- distance is greater on lower ribs to torque greater on lower ribs
- lower rib rotates up
31
Q
mechanical advantage
A
- a muscle can only make itself shorter or more tense
- but it can produce (or resist) motion in a direction other than along its length by creating torque to produce (or resist) rotation
- tension, and torque resisting tension, are how muscles contribute to stability
32
Q
muscles of inspiration
acting on ribs
A
- serratus posterior superior
- serratus anterior
- levator costarum longis & brevis
- scalenes anterior, posterior and middle
33
Q
muscles on inspiration
acting on sternum
A
- sternocleidomastoid
- pectoralis major and minor
- subclavius
- lateral iliocostal cervicis
34
Q
rib cage elevators
A
- serratus anterior
- serratus posterior superior
- scalenus anterior
- scalenus medius
- scalenus posterior
- sternocleidomastoid
- pectoralis major and minor
35
Q
ribcage depressors
A
- internal intercostals
- transversus thoracis
- serratus posterior inferior
- lateral iliocostals
- subcostals
- innermost intercostals
- quadratus lumborum
- latissimus dorsi
- lateral iliocostal thoracis
36
Q
muscles of expiration
A
- must generate positive air pressure
- must reduce thoracic volume by reducing radius or height
- contained by
- spine dorsally
- pelvis caudally
- iliac crest laterally
- nowhere to go but UP against diaphragm
37
Q
muscles of expiration
reducing radius
A
- innermost intercostals
- subcostals
- transversus thoracis
- serratus posterior inferior
38
Q
abdominal muscles
A
- rectus abdominus
- pulls lower ribs and sternum downward and compresses abdominal wall
- transversus abdominus
- contraction forces front and side of abdominal wall inward
- external oblique
- pulls lower ribs down and abdomen inward
- internal oblique
- pulls lower ribs down and abdomen inward
39
Q
cervical plexus
A
C1-C4
40
Q
ansa cervicalis
A
C1-C3
41
Q
actions of pulmonary-chest wall unit account for
A
pressure changes during respiration
42
Q
pulmonary apparatus
A
- lungs
- bronchi
- trachea up to VF
43
Q
chest wall
A
- encases pulmonary unit
- diaphragm
- rib cage wall
- abdominal wall
- abdominal content
- upper wall is thorax
- lower wall is abdomen
44
Q
diaphragm movements
A
- origin (lower 6 ribs) and central tendon of diaphragm are moveable
- movements do not displace luung as readily as ribcage
45
Q
diaphragm forces
A
- diaphragm can exert active inhalation force and passive inhalation forces only
- active force flattens diaphragm expanding volume of pulmonary unit
- when pulmonary unit is compressed diaphragm can recoil footward passively
46
Q
rib cage wall movements
A
- a relatively flexible structure composed of costosternal joints and costovertebral joints
- in front ribs move up
- on sides ribs rotate up and outward
- rotates around costovertebral joint
- typically move as a unit or with a single degree of freedom
47
Q
rib cage wall forces
A
- rib cage muscles can exert active inhalation or exhalation forces
- degree and direction resulting from forces applied to rib cage depends on prevailing size
- when rib cage is expanded there is less potential for expansion
- when rib cage is compressed there is less potential for compression
- increasing expansion increases potential for compression
- rib cage muscles can adjust more rapidly and precisely for respiration than other muscle groups
48
Q
diaphragm + rib cage
A
- contribute passively and actively
- recoils inward at large chest sizes
- recoils outward at small sizes
- all rib cage muscles can inspire or expire at ANY rib cage volume
- upper rib cage muscles and diaphragm inspire
- lower rib cage and abdominal muscles expire
- ability to expire or inspire is related to position of muscle along length-tnesion characteristic
49
Q
movements of abdominal wall and content
A
- moves as unit
- movements: bulge outward or pushed inward
- bulging outward is PASSIVE
- caused by flattening of diaphragm and contraction of ribcage wall
- inward pushing is active AND passive
- expansion of rib cage and elevation of diaphragm pulls abdomen inward
- contraction of abdominal muscles
50
Q
abdominal wall forces
A
- pushed outward passively by inspiration
- recoil force developed by stretching
- active forces due to abdominal muscles are a central force developing mechanism for exhalation
- abdominal contents are not compressible so contents maintain a constant volume
51
Q
pulmonary - chest wall unit
A
- actions of ribcage wall can cause adjustments in diaphragm and abdominal wall
- expanding rib cage can pull on diaphragm and pulls abdominal contents inward
- compression of rib cage flattens diaphragm and causes it to be forced outward
- compression of abdominal contents during exhalation can force lower ribs outward
52
Q
controlled pressures
A
- pressure can change during respiration
- volitional movements of breathing can manipulate these forces
- alveolar pressure
- pleural pressure
- abdominal pressure
- transdiaphragmatic pressure
53
Q
external intercostals
A
- origin: inferior surface of ribs 1-11
- insertion: upper surface of rib immediately below
- innervation: intercostal nerves-thoracic intercostal nerves arising from T1-T6 and thoracoabdominal intercostal nerves from T7-T11
- function: elevates ribs 1-11
54
Q
internal intercostals
inhalation
A
- origin: inferior margin of ribs 1-11
- insertion: superior surface of rib below
- innervation: intercostal nerves- thoracic intercostal nerves arising from T2-T6 and thoracoabdominal intercostal nerves T7-T11
- function: elevates ribs 1-11
55
Q
sternocleidomastoid
A
- origin: mastoid process of the temporal bone
- insertion: superior manubrium sterni; clavicle
- innervation: XI accessory, spinal branch arising from spinal cord in the regions of C2-C4/C5
- function: elevates sternum and by association rib cage
56
Q
pectoralis minor
A
- origin: anterior surface of ribs 2-5 near chondral margins
- insertion: coracoid process of scapula
- innervation: superior branch of the brachial plexus
- function: increases transverse dimension of the rib cage
57
Q
pectoralis major
A
- origin: sternal head; clavicular head; anterior clavicle
- insertion: greater tubercle of humerus
- innervation: superior branch brachial plexus
- function: elevates sternum and subsequently increases transverse dimension of rib cage
58
Q
scalenus anterior
A
- origin: transverse process of vertebrae C3-C6
- insertion: superior surface of rib 1
- innervation: C4-C6
- function: elevates rib 1
59
Q
scalenus medius
A
- origin: transverse process of vertebrae C2-C7
- insertion: superior surface of first rib
- innervation: cervical plexus derived from C3 and C4 and spinal nerves C5-C8
- function: elevates rib 1
60
Q
scalenus posterior
A
- origin: transverse process of C5-C7
- insertion: second rib
- innervation: spinal nerves C5-C8
- function: elevates rib 2
61
Q
subclavius
A
- origin: inferior surface of the clavicle
- insertion: superior surface of rib 1 at chondral margin
- innervation: brachial plexus, lateral branch, from fifth and sixth spinal nerves
- function: elevates rib 1
62
Q
serratus anterior
A
- origin: ribs 1-9, lateral surface of the thorax
- insertion: inner vertebral border of scapula
- innervation: brachial plexus, long thoracic nerve from C5-C7
- function: elevates ribs 1-9
63
Q
serratus posterior superior
A
- origin: spinous processes of C7 and T1-T3
- insertion: just beyond angles of ribs 2-5
- innervation: ventral intercostal portion of spinal nerves T1 - T4/T5
- function: elevates ribs 2-5
64
Q
internal intercostals
depressor
A
- origin: inferior margin of ribs 1-11
- insertion: superior surface of ribs below
- innervation: intercostal nerves arising from T2-T6 and thoracoabdominal intercostal nerves from T7-T11
- function: depresses ribs 1-11
65
Q
innermost intercostal
A
- origin: superior margin of ribs 1-11
- insertion: superior surface of rib below
- innervation: intercostal nerves-thoracic nerves arising from T2-T6 and thoracoabdominal intercostal nerves T7-T11
- function: depresses ribs 1-11
66
Q
quadratus lumborum
A
- origin: Iliac crest
- insertion: transverse processes of the lumbar vertebrae and inferior border of rib 12
- innervation: thoracic nerve T12 and L1-L4 lumbar nerves
- function: bilateral contraction fixes the abdominal wall in support of abdominal compression
67
Q
latissimus dorsi
A
- origin: lumbar, sacral and lower thoracic vertebrae
- insertion: humerus
- innervation: brachial plexus, posterior branch; fibers from the regions of C6-C8 form the long subscapular nerve
- function: for respiration, stabilizes posterior abdominal wall for expiration
68
Q
transversus abdominis
A
- origin: posterior abdominal wall at the vertebral column via the thoracolumbar fascia of the abdominal aponeurosis
- insertion: inner surface of ribs 6-12, fibers of diaphragm, inferior attachment at pubis
- innervation: thoracic and lumbar nerves from lower spinal intercostal nerves and first lumbar nerves, iliohypogastric and ilioinguinl branches
- function: compresses abdomen
69
Q
rectus abdominis
A
- origin: originates as 4 or 5 segments at pubis inferiorly
- insertion: xiphoid process of sternim and cartilage of ribs 5-7, lower ribs
- innervation: T7-T11 intercostal nerves, subcostal nerve from T12
- function: flexion of vertebral column
70
Q
rectus abdominis
A
- origin: originates as 4 or 5 segments at pubis inferiorly
- insertion: xiphoid process of sternum and cartilage of ribs 5-7, lower ribs
- innervation: T7-T11 intercostal nerves, subcostal nerve from T12
- function: flexion of vertebral column
71
Q
external oblique abdominis
A
- origin: osseous portion of the lower 7 ribs
- insertion: Iliac crest, inguinal ligament and abdominal aponeurosis lateral to rectus abdominis
- innervation: thoracoabdominal nerve arising from T7-T11 and subcostal nerve from T12
- function: bilateral contraction flexes vertebral column and compresses abdomen, unilateral contraction results in trunk rotation
72
Q
internal oblique abdominis
A
- origin: inguinal ligament and iliac crest
- insertion: cartilaginous portion of lower ribs and portion of the abdominal aponeurosis lateral to rectus abdominis
- innervation: thoracic and lumbar nerves from lower spinal intercostal nerves and first lumber nerves, iliohypogastric and ilioinguinal branches
- function: rotates trunk, flexes trunk, compresses abdomen
