Week 4
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| Muscle respiration | Breathing requires the use of muscles
Diaphragm and external intercostal muscles
internal intercostal muscles
Contraction of first 2 produces inspiration
Contraction of last produces forced expiration
Normal expiration requires little muscular activi
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| Muscle respiration-diaphram | Muscular dome between thoracic and abdominal cavities
Muscle fascicles extend to a fibrous central tendon
Contraction flattens it
increases the vertical dimension of the thorax drawing air into the lungs
raises the abdominal pressure to help expel
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| Muscles of respiration | External intercostals
extend downward and anteriorly from rib to rib
pull ribcage up and outward during inspiration
Internal intercostals
extend upward and anteriorly from rib to rib
pull ribcage downward during forced expiration
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| Surface Anatomy Thorax | Sternocleidomastoid
Thyroid cartilage
Trapezius
Supraclavicular fossa
Clavicle
Suprasternal notch
Acromion
Deltoid
Manubrium
Pectoralis major
Body
Nipple
Xiphoid process
Rectus abdominis
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| Organs of respiratory | Nose, pharynx, larynx, trachea, bronchi, lungs
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| Nose | Functions
warms, cleanses, humidifies inhaled air
detects odors
resonating chamber that amplifies the voice
Bony and cartilaginous supports
superior half: nasal bones medially and maxillae laterally
inferior half: lateral and alar cartilages
ala na
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| Nasal cavity | Extends from nostrils to posterior nares
Vestibule: dilated chamber inside ala nasi
stratified squamous epithelium, vibrissae (guard hairs)
Nasal septum divides cavity into right and left chambers called nasal fossae
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| Conchae and Meatuses | Superior, middle and inferior nasal conchae
3 folds of tissue on lateral wall of nasal fossa
mucous membranes supported by thin scroll-like turbinate bones
Meatuses
narrow air passage beneath each conchae
narrowness and turbulence ensures air contact
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| Nasal cavity mucosa | Olfactory mucosa
lines roof of nasal fossa
Respiratory mucosa
lines rest of nasal cavity with ciliated pseudostratified epithelium
Defensive role of mucosa
mucus (from goblet cells) traps inhaled particles
bacteria destroyed by lysozyme
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| Nasal cavity cilia | Function of cilia of respiratory epithelium
sweep debris-laden mucus into pharynx to be swallowed
Erectile tissue of inferior concha
venous plexus that rhythmically engorges with blood and shifts flow of air from one side of fossa to the other
Epista
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| Regions of pharynx | Nasopharynx
Oropharynx
Laryngopharynx
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| Nasopharynx | (pseudostratified epithelium)
posterior to choanae, dorsal to soft palate
receives auditory tubes and contains pharyngeal tonsil
90 downward turn traps large particles (>10m)
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| Oropharynx | (stratified squamous epithelium)
space between soft palate and root of tongue, inferiorly as far as hyoid bone, contains palatine and lingual tonsils
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| Laryngopharynx | (stratified squamous)
hyoid bone to level of cricoid cartilage
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| Larynx | Glottis – vocal cords and opening between
Epiglottis
flap of tissue that guards glottis, directs food and drink to esophagus
Infant larynx
higher in throat, forms a continuous airway from nasal cavity that allows breathing while swallowing
by age 2
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| 9 Cartilages of Larynx | Epiglottic cartilage most superior
Thyroid cartilage – largest
Cricoid cartilage (circ)
Arytenoid cartilages (2)
Corniculate cartilages (2) lil horns
Cuneiform cartilages (2)
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| Interior wall of larynx | Interior wall has 2 folds on each side, from thyroid to arytenoid cartilages
vestibular folds: superior pair, close glottis during swallowing
vocal cords: produce sound
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| Intrinsic muscles of larynx | Intrinsic muscles - rotate corniculate and arytenoid cartilages
adducts (tightens: high pitch sound) or abducts (loosens: low pitch sound) vocal cords
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| Extrinsic muscles of larynx | Extrinsic muscles - connect larynx to hyoid bone, elevate larynx during swallowing
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| Trachea | Rigid tube
Supported by c-shaped rings
opening in rings faces posteriorly towards esophagus
trachealis spans opening in rings, adjusts airflow by expanding or contracting
Larynx/trachea lined w/ ciliated pseudostrat epithelium which functions as escal
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| Lung surface anatomy | Apex
Primary bronchi
Superior lobe
Coastal surface
Middle lobe
Fissures
Mediastinal surfaces
R. Cardiac impression
Inferrior lobe
Base
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| Primary bronchi | from trachea; after 2-3 cm enter hilum of lungs
right bronchus slightly wider and more vertical (aspiration)
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| Secondary bronchi | (lobar) bronchi (overlapping plates)
one secondary bronchus for each lobe of lung
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| Tertiary bronchi | (segmental) bronchi (overlapping plates)
10 right, 8 left
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| Bronchioles | (lack cartilage)
layer of smooth muscle
pulmonary lobule
portion ventilated by one bronchiole
divides into 50 - 80 terminal bronchioles
ciliated; end of conducting division
respiratory bronchioles
divide into 2-10 alveolar ducts; end in alveolar s
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| Alveoli | bud from respiratory bronchioles, alveolar ducts and alveolar sacs
main site for gas exchange
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| Pleurae and Pleural Fluid | Visceral (on lungs) and parietal (lines rib cage) pleurae
Pleural cavity - space between pleurae, lubricated with fluid
Functions
reduce friction
create pressure gradient
lower pressure assists lung inflation
compartmentalization
prevents spread of
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| Pulmonary ventilation | Breathing (pulmonary ventilation) – one cycle of inspiration and expiration
quiet respiration – at rest
forced respiration – during exercise
Flow of air in and out of lung requires a pressure difference between air pressure within lungs and outside bod
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| Diahram | (dome shaped)
contraction flattens diaphragm
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| Scalenes | hold first pair of ribs stationary
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| Ext./Int intercoastals | stiffen thoracic cage; increases diameter
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| Pectoralis minor, strnocleidomastoid, and errector spinae muscles | used in forced inspiration
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| Abdominalis and latissimus dorsi | forced expiration (to sing, cough, sneeze)
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| Neural control of breathing | Breathing depends on repetitive stimuli from brain
Neurons in medulla oblongata and pons control unconscious breathing
Voluntary control provided by motor cortex
Inspiratory neurons: fire during inspiration
Expiratory neurons: fire during forced expir
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| Respiratory nuclei in medulla | inspiratory center (dorsal respiratory group)
frequent signals, you inhale deeply
signals of longer duration, breath is prolonged
expiratory center (ventral respiratory group)
involved in forced expiration
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| Pons | pneumotaxic center
sends continual inhibitory impulses to inspiratory center, as impulse frequency rises, breathe faster and shallower
apneustic center
prolongs inspiration, breathe slower and deeper
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| From limbic system and hypothalamus | respiratory effects of pain and emotion
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| From airways and lungs | irritant receptors in respiratory mucosa
stimulate vagal afferents to medulla, results in bronchoconstriction or coughing
stretch receptors in airways - inflation reflex
excessive inflation triggers reflex
stops inspiration
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| From chemoreceptors | monitor blood pH, CO2 and O2 levels
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| Peripheral chemoreceptors | found in major blood vessels
aortic bodies
signals medulla by vagus nerves
carotid bodies
signals medulla by glossopharyngeal nerves
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| Central chemoreceptors | in medulla
primarily monitor pH of CSF
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| Voluntary control | Neural pathways
motor cortex of frontal lobe of cerebrum sends impulses down corticospinal tracts to respiratory neurons in spinal cord, bypassing brainstem
Limitations on voluntary control
blood CO2 and O2 limits cause automatic respiration
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| Atmospheric pressure | 1 atmosphere (atm) = 760 mmHg
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| Intrapulmonary pressure and lung volume | pressure is inversely proportional to volume
for a given amount of gas, as volume inc, pressure inc and as volume inc, pressure inc
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| Pressure gradients | difference between atmospheric and intrapulmonary pressure
created by changes in volume thoracic cavity
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| Inspiration pressure changes | inc intrapleural atm: as vol of thoracic cavity inc,visceral pleura clings to parietal pleura
dec intrapulmonary atm: lungs expand with visceral pleura
Transpulmonary atm: intrapleural minus intrapulmonary atm
Inflation aided by warming of inhaled ai
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| Passive expiration | Expiration achieved by elasticity of lungs and thoracic cage
As volume of thoracic cavity , intrapulmonary pressure and air is expelled
After inspiration, phrenic nerves continue to stimulate diaphragm to produce a braking action to elastic recoil
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| Forced expiration | Internal intercostal muscles
depress the ribs
Contract abdominal muscles
Inc intra-abdominal pressure forces diaphragm upward
Inc pressure on thoracic cavity
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| Pneumothoax | Presence of air in pleural cavity
loss of negative intrapleural pressure allows lungs to recoil and collapse
Collapse of lung (or part of lung) is called atelectasis
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| Resistance to airflow | Pulmonary compliance
distensibility of lungs; change in lung volume
Bronchiolar diameter
primary control over resistance to airflow
bronchoconstriction
bronchodilation
sympathetic nerves, epinephrine
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| Aveolar surface tension | Thin film of water needed for gas exchange
creates surface tension that acts to collapse alveoli and distal bronchioles
Pulmonary surfactant (great alveolar cells)
decreases surface tension
Premature infants that lack surfactant suffer from respirator
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| Dead air | fills conducting division of airway, cannot exchange gases
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| Anatomic dead space | conducting division of airway
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| Physiologic dead space | sum of anatomic dead space and any pathological alveolar dead space
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| Aveolar ventilation rate | air that ventilates alveoli X respiratory rate
directly relevant to ability to exchange gases
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| Spirometer | measures ventilation
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| Tidal volume | volume of air in one quiet breath
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| inspiratory reserve volume | air in excess of tidal inspiration that can be inhaled with maximum effort
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| expiratory reserve volume | air in excess of tidal expiration that can be exhaled with maximum effort
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| residual volume | (keeps alveoli inflated)
air remaining in lungs after maximum expiration
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| Vital capacity | total amount of air that can be exhaled with effort after maximum inspiration
assesses strength of thoracic muscles and pulmonary function
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| Inspiratory capacity | maximum amount of air that can be inhaled after a normal tidal expiration
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| Functional residual capacity | amount of air in lungs after a normal tidal expiration
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| Total lung capacities | maximum amount of air lungs can hold
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| Forced expiratory volume FEV | % of vital capacity exhaled/ time
healthy adult - 75 to 85% in 1 sec
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| Peak flow | maximum speed of exhalation
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| Minute respiratory volume | TV x respiratory rate, at rest 500 x 12 = 6 L/min
maximum: 125 to 170 L/min
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| Challenges to respiratory volumes and capacities | Age:dec lung compliance, respiratory m. weaken
Exercise:maintains strength of respiratory m.
Body size:proportional, big body/large lungs
Restrictive disorders: dec compliance and vital capacity
Obstruct DOs: itfr airflow, expir more effort/less compl
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| Surface Anatomy Thorax | Serratus anterior
Lianea semilunaris
Tedinous insertion of rectus abdominus
Linea alba
Umbilicus
Anterior superior spine of ilium
External abdominal oblique
Iliac crest
Inguinal ligament
Sternal Angle of Loui
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