Week 1 Resp Flashcards
3 internal compartments of the thoracic cavity?
Central mediastinum, left and right pleural cavities
What defines the area of the thorax?
The area between the superior thoracic aperture and the diaphragm.
Function of the diaphragm?
Increase and decrease volume of the thoracic cavity in order to allow intake and expiration of air
What are the muscles directly involved in respiration?
Diaphragm, intercostals (external,internal and innermost)
What important structures pass through the mediastinum?
Oesophagus, trachea, major vessels and nerves
What is the orientation of external intercostals?
Inferiorly and anteriorly (like hands in pockets)
What is function of external intercostals?
Elevates ribs and moves sternum forward. Increases thoracic cavity volume for more air intake.
What is the orientation of internal and innermost intercostals?
Posteriorly and inferiorly (hands backwards on hips)
What is the function of the internal and innermost intercostals?
Depression of the ribs, decreasing space in thoracic cavity and causing expiration.
Where does the intercostal neuromuscular bundle run between?
The internal and innermost intercostals muscles
What is it he intercostal groove?
Shelf of bone the protects that vein and artery but leaves the intercostal nerve slightly vulnerable
What are the layers of the thoracic wall?
Skin, superficial fascia, intercostal muscles, endothoracic fascia, parietal pleura, pleural cavity, visceral pleura and the lungs
How many sets of ribs?
12
What is a true rib?
Ribs that articulate directly with the sternum (ribs 1-7)
What is a false rib?
Ribs that only articulate with the sternum joining the costal cartilages of he ribs above them
What ribs are floating ribs?
11 and 12. Only articulate with the vertebral column and end anteriorly in a cartilaginous tip
What is the costal margin?
The line formed by the most inferior aspect of the costal cartilages
3 parts of the sternum?
Manubrium, body and xiphoid process
What is the sternal angle?
Joint between the manubrium and the body of the sternum. Articulate facets on lateral aspect of the sternal angle for attachment of rib II
How can you palpated the 2nd rib?
First palpate the jugular notch on top of the manubrium, find the first bumpy landmark inferior to that, and then walk fingers across laterally to feel the 2nd rib. 1st rib cannot be palpated underneath The clavicle
What types of joints are the rib articulations with the sternum and vertebral column?
Synovial
Where is the plane of St. Louis?
Articulation of rib 2 with the sternum
What important structures lie behind the plane of St. Louis?
Aorta begins and ends, trachea bifurcates into the two bronchi, superior vena cava penetrates the right atrium, loop of left recurrent laryngeal nerve around aortic arch
What are the 3 articulations of a typical rib with the vertebral column?
Articulating at the transverse process ( costotransverse joint) and articulating with an inferior and superior vertebral body (costovertebral joint)
What part of the rib articulates with the vertebral body?
The head
What part of the rib articulates with the transverse process
.
Which ribs articulate only with 1 vertebral body?
.
What are the distinguishing features of thoracic vertebra?
Costal demifacets on the vertebral body and transverse processes
Inferiorly projecting spinous processes (movement)
Heart shaped vertebral body (weight bearing)
Larger transverse processes (support rib articulation)
Origin and insertion of the diaphragm?
Xiphoid process, Costal margin, lateral aspects of ribs and lumbar vertebral bodies (essentially an upside down bowl at rest)
Inserted into a central tendon which has a hiatus allowing for communication through the diaphragm
What dimensions can the thoracic cage increase its diameter?
Vertically, transversely and anteroposteriorly
What is the pump handle movement?
Movement at the costovertebral joints which raises the ribs and pushes the sternum up and forward (first 6 ribs)
What is the pump handle movement?
.
How does the diaphragm help with breathing in and out?
When it contracts, it flattens out and increased the volume of the cavity. This causes a decrease in pressure and air rushes in. When it relaxes, it decreases the volume and increases the pressure, forcing air out
What are the accessory muscles of inspiration?
External intercostals, SCM and scalenes (pretty much anything that attaches to the ribs from above). Pec major, minor and serratus anterior and posterior superior to lesser extent.
What muscles aid in forced expiration?
Internal and innermost intercostals. Also abdominal muscles, rictus abdominus, internal and external obliques.
Abdominal muscles force abdominal contents upwards and decrease the volume of the thoracic cavity
What are the veins that follow the course of the ribs?
.
Where do these veins empty?
Internal thoracic vein or azygous.
Where do the internal thoracic and azygous veins empty?
Brachiocephalic vein ( which drains into the superior vena cava)
What major arteries supply the intercostal arteries?
They branch off the aorta posteriorly and the internal thoracic arteries anteriorly.
The anterior and posterior intercostal arteries anastomoses laterally.
Where do the intercostal nerves branch from, and what muscles do they supply?
Branches from the anterior rami of the thoracic spinal nerves (t1- T12) and innervate the intercostal muscles
What are the structures of the upper airway?
Nose to the trachea, which includes the oral cavity, the pharynx and larynx
What is the lower airway?
The bronchi to the alveoli…
What is the respiratory zone?
Area of the bronchioles meeting the alveoli (where gas exchange can take place)
What is the conducting zone?
Where air enters and travels towards the respiratory zone, including nasal cavity, oral cavity, trachea, bronchi etc
What are conchae?
Flaps of mucosal membrane which protrude medically from the nasal cavity walls
Meatuses are the flat grooves underneath the conchae
What is the function of the nasal conchae?
Create greater turbulence in the nasal cavity and trap and non gaseous particles in the mucus membrane
What are the paranasal sinuses and where are they found?
Frontal sinus, above the eyes.
Sphenoid sinus, posteriorly behind the eyes
Ethmoid, collection of pockets behind eye but more anteriorly than the sphenoid
Maxillary Sinus, either side of the nose
What is the classification of respiratory epithelium?
Pseudostratified, ciliated columnar
What is the function of respiratory epithelium?
Goblet cells secret mucus, trap particles. Seromucous glands secrete antibacterial enzymes. Cilia create current by pushing mucus towards the throat.
What are the muscles of the soft palate?
Tensor Veli Palatini Levator Veli Palatini Palatoglossus Palatopharyngeus Musculus Uvulae
What happens to the soft palate during swallowing?
Muscles tense together and the tongue presses up against it, squeezing food to the back of the oral cavity.
Soft palate then elevates, blocking off nasal passage and preventing food entering nasal cavity
What are the three parts of the pharynx?
Nasopharynx, Oropharynx and laryngopharynx
What is function of Nasopharynx?
Acts as an air passageway only, warming and humidifying the air
What is the function of the Oropharynx?
Area which receives food from the oral cavity. Stratified squamous epithelia for dealing with the extra friction of food.
What is the bucket handle movement?
The movement of the lower 6 ribs laterally to expand the thoracic cavity
What is the function of the laryngopharynx?
Directing food and air towards their specific passageways. Epiglottis moves inferiorly to block the trachea and ensure food travels into the oesophagus.
What structures make up the larynx?
3 paired and 3 unpaired cartilages
Thyroid, cricoid and epiglottis cartilage
Arytenoid, Corniculate and cuneiform
What are the two types of muscle in the pharynx?
Longitudinal and constrictor muscles
What are the 3 longitudinal muscles of the pharynx?
Palatopharyngeus
Salpingopharyngeus
Stylopharyngeus
What are the 3 constrictor muscles of the pharynx?
Superior, middle and inferior constrictors. Contract sequentially to force food down from top to bottom
What is significant about the salpingopharyngeus muscle?
It is attached to the Eustachian tube that enters the ear, and opens when swallowing to equilibrate pressure.
How does the thyroid articulate with the cricoid cartilage?
Via facets on the superior, lateral aspects of the cricoid. The inferior horns attach here, and the two cartilages are connected via the cricothyroid ligament
What ligament forms the vocal cords?
Cricothyroid.
Free margin of this ligament attaches to the arytenoid cartilage and the membrane formed is what is moved, tensed and relaxed to form vocal sounds with air moving through them.
What is the importance of the quadrangular membrane?
It forms the vestibular folds, with the ligament attaching to the arytenoid cartilage superior to the vocal cords.
Where are the vocal ligaments attached to?
The midline of the thyroid cartilage.
How are different pitches generated in the voice?
Via abduction and adduction, tensing and relaxation of the vocal ligaments
How can these membranes aid in coughing up material from the throat/lungs?
Can act as a sphincter to close off the larynx and allow increase in intra abdominal and thoracic pressure to then force air out quickly, coughing up any material back into the throat.
What is the abductor muscle of the vocal cords?
Posterior cricoarytenoid
What muscles increase tension of the vocal cords?
Cricothyroid and vocalis
Adductor of the vocal cords?
Lateral cricoarytenoid, transverse arytenoid, oblique arytenoid
What muscle decreases tension of the vocal cords?
Thyroarytenoid
At what spinal level does the trachea begin and end?
C6 and T4 (where it bifurcates)
What is the role of the cartilaginous rings of the trachea?
Structurally keeping the airways open
Why is the cartilage C shaped, and not continuous the whole way around?
It must accommodate the oesophagus posteriorly, which expands when large chunks of food are swallowed and distends in the space of the trachea.
Trachealis smooth muscles stretch and allow the food to pass.
What is the carina?
Point at which the trachea divides into the two bronchi
What is the epithelium of the trachea?
Pseudostratified ciliated columanr
What structures are between the tracheal cartilages?
Angular ligaments
When is a branch of a bronchi defined as a bronchiole?
When it has a diameter of less than 1mm
What is an alveolar duct?
The terminal end of a bronchiole, which then is surrounded by alveoli
What is the role of Type 1 pneumocytes?
Simple squamous epithelia which line the alveoli and are in contact with the capillaries. Site of gas exchange due to high surface area and thin space to diffuse through
What is the role of type 2 pneumocytes?
More rounded epithelia which secrete surfactant, reducing surface tension required to inflate the alveoli
Where are macrophages found in the lungs?
The alveoli
How is oxygen transferred from the alveoli to to red blood cell?
The basement membrane of the capillary endothelium fuses with the type 1 cell and allows oxygen and carbon dioxide to pass between them.
How many loves do each of the lungs have?
Right lung has 3 lobes
Left lung has 2 lobes
What is the costodiaphragmatic recess?
Out pocketing of the pleural membrane resting on the diaphragm underneath the lungs
How can you distinguish the lungs based upon their fissures?
The right lung has both a horizontal and oblique fissure, whereas the left lung only has an oblique fissure.
What is the hilum?
Where the lung connects to the mediastinum (via the different vessels)
What artery supplies blood to the lung tissue itself?
Bronchial artery
What does metaplasia refer to in a smokers respiratory epithelia?
Changing of the epithelia to stratified squamous
Which muscle of the larynx is not innervated by the recurrent branch of the laryngeal nerve?
Cricothyroid muscle (innervated by the superior external branch of the laryngeal nerve - which also comes off the vagus nerve)
