Thorax and Breathing Flashcards

1
Q

work of respiration

A
  • requires muscular effort
  • lungs do not contain muscles and therefore cannot move on their own - therefore require assistance
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2
Q

mechanisms of respiration

A
  1. the thoracic rib cage acts as a mechanical pump for the lungs
  2. lungs must stick to the walls of the thoracic cavity
  3. muscles acting on the ribs and bony thorax drive the pump
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3
Q

breathing apparatus

A
  1. pulmonary apparatus - lungs and airways
  2. chest wall - rib cage wall, abdominal wall, diaphragm and abdominal content
  3. pulmonary - chest wall unit
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4
Q

the rib cage

A
  • rib cage is connected to thoracic vertebrae - T1 -12 which is important bc twelve ribs attach from those vertebrae
  • also costal cartillages, sternum (manubrium, body of the sternum, xiphoid process/ xiphisternum), two clavicles
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5
Q

structures of the rib cage - superior thoracic apeture

A
  • space connecting thoracic cavity to head, neck, and upper limb
  • made by border of T1, rib 1 and the manubrium of the sternum
  • passes through the space of - carotid arteries, jugular veins, phrenic nerve, vagus nerve, trachea and oesaphagus
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6
Q

structure of rib cage - inferior thoracic opening

A
  • space connecting thoracic cavity to abdominopelvic cavity
  • made by costal margin - 12th rib and T12
    passes through - oesophagus, descending aorta, vena cava, phrenic nerves
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7
Q

structure of the rib

A
  • twelves pairs of ribs
  • ribs elevate and depress - hinged on the posterior vertebral column at costovertebral joints
  • 1-10 attatch to the the sternum anteriorly via a costal cartillage
  • a typical rib articulates posteriorly w a costal facet on the transverse process of its own thoracic vertebra and the body of the vertebra above
  • rib bones articular wuth costal cartilages
  • costal cartillages articulate with the sternum (rins 1-10) - directly (1-7) and indirectly (8-10)
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8
Q

costosternal joints

A

cartiliginous joints, slightly mobile but allow twisting and bending

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9
Q

difference bw costosternal joints and costovertebral joints

A
  • costosternal joints - cartiliginous joints, slightly mobile but allow twisting and bending
    different to
  • costovertebral joints - these are synovial joints which - highly flexible and allow for greater hinging to take place on that posterior side
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10
Q

types of ribs

A
  • ribs 1-7 = -these ribs directly attach from rib to our costal cartillage then to the sternum
  • false ribs - connect to sternum hw they join up together
  • floating ribs still attach posteriorly to our vertebrae but do not attach to the sternum
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11
Q

rib movements

A
  • costovertebral joints - elevation and depression of ribs occur
  • bine shape will remain firm and strong - extends anterior posterior dimension
    > true ribs lift up (pump handle movements) - sternum moves anteriorly and increases the anteroposterior volume
    > false rib lift upwards ( bucket handle movements) - ribs move superiorly and laterally - increases lateral volume
  • elevation and depression of all ribs act to expand and depress the rib
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12
Q

muscles of the the thorax: thoracic diaphragm

A
  • lie bw thoracic + abdominal cavities -primary muscle of inspiration
  • attaches to the inferior border of the rib cage, xiphoid process, vertebral column and central tendon
  • thoracic cavity is an upwardly domed shape = contraction of the muscular diaphragm causes diaphragm to flatten / lower > pulled down within the thoracic cavity
  • upward shape to flatten - flattening is for inspiration and increase size of thoracic cavity
    innervated by general somatic efferent neurons in phrenic nerve - fron CN 3-5- needed for inspiration to keep us alive
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13
Q

muscles of thorax: intercostal muscle

A

lie between pairs of adjacent ribs - two main sets of muscles which have been supplied by the intercostal nerves

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14
Q

what are external intercostal muscles used for

A

inspiration

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15
Q

external intercostal muscles- explain inspiration

A
  • attach from rib below to rib above - R12-1 = 11 pairs
  • fibers run in a hand in pocket orientation
  • fibers begin near vertebral column and end at angle of rib - fascia
    towards sternal aspects
  • elevate ribs - increase size of thoracic cavity
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16
Q

what are internal intercostal muscles used for?

A

expiration

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17
Q

internal intercostal muscles - explain expiration

A
  • attach from rib above to rib below - from R1-R12 =11 pairs
  • fibers run opposite to external muscles - begin near sternal aspect and end at vertebral column
  • depress ribs - decrease size and volume of thoracic cavity
18
Q

what are the accessory inspiratory muscles

A
  • thoracic volume can further increased by use of accessory
    muscles
  • anterior cervical group - scalene group and sternocleidomastoid -
    elevate top and anterior rib cage
  • posterior and lateral thoracic group - extend vertebral column and expend rib cage - deep extensor back muscles/ superficial back muscles, serratus posterior and latissimus dorsi
19
Q

accesory EXPIRATORY muscles

A
  • thoracic volume can be quickly decreased by use of large abdominal muscles
  • rectus abdominus, internal and external obliques, transversus abdominus - pulls down on lower ribs and causes expiration
  • squeezes abdomen, transferring upward pressure on diaphragm
20
Q

BREATHING FOR SPEECH > pulmonary - chest wall unit

A
  • for the lungs to expands they need the rib cage to also expand ( lungs are not attached to ribs) - musculature must contract in order to have movement of the ribs
  • pleural membranes and fluid act to link rib cage movements to lung movements
21
Q

pleural cavities and membranes

A
  • function is to link movement of the rib cage walls to lung movement via interpleural pressure
  • negative pressure created between the visceral and parietal pleural membranes - due to fluid link
22
Q

ventillation - breathing

A
  • movement of air into and out of the lungs
  • continue the cycle of inspired air and expired air
  • respiration cycle - one complete inhalation and exhalation - about four seconds when at rest
  • respiration rate - number of breaths per minutes - roughly 15 cycles per minute
23
Q

tidal volume

A

amount of air that moves in or out of the lungs within each respiratory cycle

24
Q
  • inspiraratory reserve volume
A
  • amount of air that you can force that can be forcibly inhaled after and above the normal tidal volume - normally kept in reserved but is used in deep breathing
    > amount of extra air (> tidal volume) during forceful breaths in
25
Q

inspiratory capacity

A

total airs in inspiration, including TV and insipratory reserve volume

26
Q

expiratory reserve volume

A

expiratory reserve volume - amount of air abouve TV that is exhaled during a breath

27
Q

how is air moved - clue = diffusion

A
  • air is driven by a pressure gradient - diffusion
  • air moves from high pressures in atmosphere to low pressure in intra-alveolar space
28
Q

Boyles law

A

increase volume decrease pressure - vice versa

29
Q

mechanism of breathing - inhalation

A
  • increase thoracic cavity size
  • decrease in pressure as more space for same amout of gas
  • pressure outside is greater than pressure inside
  • air rushes in - high to low diaphragm is flattened
30
Q

mechanism of breathing - exhalation

A
  • decrease in thoracic cavity size
  • increase pressure - less space for same amount of gas
  • pressure inside is greater than pressure outside
  • air rushes out - high to low diaphragm is domed
31
Q

normal respiration cycle

A
  • adults completere between 12 and 18 cycles per minutes
  • normal respiratory cycle = inspiration takes up to 40% of th cycle while expiration takes up 60% of the cycle
32
Q

breathing in conversational speaking

A
  • inspiration takes up 10% and expiration takes up 90% of the cycle
  • speech is produced on exhaled air - slower exhalation
33
Q

active forces and their relationship to movement of breathing

A
  • forces brought about by muscle movement
  • dependant on air volumes in the system
  • greater volume requires greater forces - usually recruit more muscular contractions
    eg. diaphragm, external intercostal muscles etc. contract and they allow respiratory to take place
34
Q

passive forces and their relationship to movement of breathing

A
  • nautral recoil forces of stretched or twisted structures - ribs, muscles and lungs
  • gravity
35
Q

types of respiration - focus on inspiration for this one

A
  • driven by negative pressures

quiet inspiration
- thoracic diaphragm increases vertical dimension of thorax

forced inspiration
- external intercostals elevate ribs
- muscles act to increase 3D dimensions of the thorax - accessory muscles (scale, back muscles)
- more air is getting pulled into the lungs

36
Q

types of respiration - especially focus on expiration

A
  • driven by positive pressures

quiet expiration
- system is restored to a resting position after respiration
- driven by forces of torque, elasticity and gravity (helping return muscles to resting position)
- diaphragm will recoil back to its naturally domed positions and internal intercostals that inferiorly move that depress the ribs)

forced expiration
- internal intercostals depress ribs and reduce size of the thorax
- abdomen is compressed by abdominal muscles
- more air is pushed out of the lungs

37
Q

neural control of tidal breathing

A
  • “automatic” breathing controlled
    by the brainstem breathing centers (medulla)
  • tidal breathing is under strong afferent
    influence from chemoreceptors and
    mechanoreceptors
38
Q

control of special acts of breathing

A
  • voluntary acts of breathing (breath- holding, glass blowing, speaking, singing) are controlled by higher brain centers
  • commands from higher brain centers can integrate with and override brainstem breathing centers, they can also be sent directly to spinal nerves
39
Q

spinal nerves important for breathing

A
  • rib cage wall - cervical through lumbar (L) 2
  • diaphragm - C3-C5
  • abdominal wall - thoracic (T) 7 through L 1
40
Q

chronic obstructive pulmonary disease (COPD)

A
  • an umbrella term for a number of lung diseases that prevent proper breathing - three of the most common COPD conditions are emphysema, chronic bronchitis and chronic asthma
  • no cure for COPD - management can slow disease progression and relieve symptoms