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Module 103: The Heart, Lungs and Blood > Theme 1: Lecture 5 - Applied Anatomical Concepts > Flashcards

Theme 1: Lecture 5 - Applied Anatomical Concepts Flashcards

1
Q

What are the areas of breathing?

A

Thoracic and Abdominal

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2
Q

What are the types of breathing?

A

Quiet and forced

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3
Q

Boyles law

A
  • Decrease in volume leads to an increase in pressure

- Increase in volume leads to a decrease in pressure

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4
Q

What are the pressure changes in inspiration?

A

Increase in intrathoracic volume and decrease in intrathoracic pressure

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5
Q

What happens in inspiration?

A
  • 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
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6
Q

What are the pressure changes in expiration?

A

Decreased intrathoracic volume and higher intrathoracic pressure

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7
Q

What happens in expiration?

A
  • 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 the lungs towards lower pressure
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8
Q

What are the dimension changes in thoracic breathing?

A
  • Transverse/lateral diameter

- Anteroposterior diameter

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9
Q

What are the dimension changes in abdominal breathing?

A
  • Transverse/lateral diameter
  • Anteroposterior diameter
  • Vertical diameter
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10
Q

How does the lateral diameter of the thorax change in breathing?

A
  • 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
  • AKA bucket handle movement
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11
Q

How does the anteroposterior diameter of the thorax change in breathing?

A
  • Anterior ends of ribs are raised in inspiration
  • Elevation causes sternum to also be raised
  • Movement is facilitated by costal cartilages
  • Results in an increase in anteroposterior diameter of chest cavity
  • AKA pump handle movement
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12
Q

Origin of diaphragm

A
  • Sternal (xiphoid process)
  • Costal (costal cartilages of ribs 7-10, ribs 11 and 12)
  • Lumbar (medial and lateral arcuate ligaments and lumbar vertebral bodies)
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13
Q

Insertion of diaphragm

A

Central tendon

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14
Q

How does the vertical diameter of the thorax change in abdominal breathing?

A
  • Via diaphragm which forms the floor of the thoracic cavity
  • Resting position of diaphragm is domed
  • Upon contraction the diaphragm descends 5 -10 cm compressing abdominal organs
  • Increases vertical diameter of thorax
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15
Q

Which muscles are involved in quiet inspiration?

A
  • External intercostals
  • Scalene muscles
  • Diaphragm
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16
Q

Which muscles are involved in quiet expiration?

A

Normally a passive process. Elastic recoil of lungs expels air and chest wall falls back into resting position

17
Q

What are the scalene muscles?

A
  • They are 3 pairs of muscles, anterior, middle and posterior
  • They come from the cervical spine
  • Anterior and middle scalenes insert into the first rib whereas the posterior inserts into the second
18
Q

Which muscles are involved in forced inspiration?

A
  • The muscles used in quiet inspiration plus:
  • Pectoral muscles
  • Sternocleidomastoid (SCM)
  • Latissimus dorsi
19
Q

Origin and insertion of sternocleidomastoid

A

Origin: Sternum and clavicle
Insertion: Mastoid process (prominence behind the ear)

20
Q

Latissimus dorsi

A

A large muscle of the back that wraps up and around and inserts into the upper limb

21
Q

Which muscles are involved in forced expiration?

A
  • Internal intercostals
  • Oblique and transverse abdominal muscles
  • Quadratus lumborum
22
Q

Describe the diaphragm

A
  • 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
23
Q

What are the openings of the diaphragm and what levels are they at?

A

-Opening for Inferior Vena Cava (T8)
-Oesophageal hiatus (T10)
-Aortic hiatus (T12)
The thoracic duct and azygos vein also pass through the aortic hiatus

24
Q

What is the blood supply to the diaphragm?

A

Superior and inferior phrenic arteries

25
Q

Actions of the diaphragm when altering the volume of the thorax

A
  • Quiet inspiration (descends approx. 2cm)
  • Forced inspiration (descends 7-10cm) e.g. coughing
  • Aids venous return
  • Hiccups
26
Q

Actions of the diaphragm when altering the volume of the abdomen

A
  • Urinating and defecation
  • Lifting heavy objects (braces vertebral column)
  • Child birth
27
Q

Where does the phrenic nerve arise from?

A

Ventral rami of C3,4 and 5

28
Q

Where does the phrenic nerve travel?

A
  • Enters superior mediastinum lateral to the Vagus nerve

- Passes anterior to main bronchi/root of lung

29
Q

What does the phrenic nerve innovate (motor supply)

A

Diaphragm (sole supply)

30
Q

What does the phrenic nerve innovate (sensory supply)

A
  • pericardium
  • parietal pleura (mediastinal and central part of diaphragmatic)
  • parietal peritoneum
  • central region of diaphragm
31
Q

What does the lumbar part of the diaphragm arise from?

A

medial and lateral arcuate ligaments and from the lumbar vertebral bodies via right and left crura

32
Q

How is the aortic hiatus formed?

A

The right at left crura meet to form the median arcuate ligament to form aortic hiatus

33
Q

How is the oesophageal hiatus formed?

A

Fibres of the right crus pass around the oesophagus forming the oesophageal hiatus

34
Q

Crus/Crura

A

The crus of diaphragm (pl. crura), refers to one of two tendinous structures that extends below the diaphragm to the vertebral column

35
Q

Pancoast tumour

A
  • A cancer located at the apex of the lung
  • If it’s on the left side, it can cause recurrent larengeal nerve compression
  • Vocal cord paralysis = hoarsness
36
Q

What imaging technique is used to determine coronary artery dominance

A

Angiogram

Module 103: The Heart, Lungs and Blood (51 decks)

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