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Respiratory and breathing
respiratory and breathing
70
Anatomy
Graduate
10/16/2016

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Term
What is the air conduction potion or upper respiratory tract consist of?
Definition
-Nasal cavity
-Pharynx
-Larynx
-Trachea
-Bronchi & Bronchioles (lined by epithelial goblet cells)
-Contraction of bronchi/bronchioles=asthma
Term
What does the respiratory portion or lower respiratory tract consist of?
Definition
- respiratory bronchioles
- alveolar ducts
-alveolar sacs
-alveoli
AIR XCHANGE OCCURS IN ALVEOLI OR EAR SACS
Term
Nasopharynx
Definition
-Lies above the soft palate
-Pharyngeal tonsil- may enlarge to become adenoids in which it prevents breathing and blocks auditory tubes
-openings of pharyngotympanic tubes
Term
What connects the tympanic cavity to the nasopharynx?
Definition
Pharyngotympanic/auditory tube
Term
What is the purpose of the pharyngotympanic/ auditory tube?
Definition
Allows equalization of pressure between middle ear cavity and nasopharynx (think when flying)
Term
What's the pharyngotympanic/auditory tube of children ?
Definition
It's shorter and more horizontal in children predisposing it to infections (OTITIS MEDIA)
Term
Oropharynx
Definition
-Extends from soft palate to upper border of epiglottis
-Behind oral cavity & dorsum of tongue
-Bounded superiorly by soft palate
-Inferiorly by base of tongue
-Laterally by palatoglossal and palatopharyngeal arches
Term
Laryngopharynx
Definition
Upper border of epiglottis to lower border of cricoid cartilage-> continues with esophagus
-Has depression on each side of laryngeal inlet (piriform recess)
Term
Retropharyngeal space
Definition
Space between posterior wall of pharynx and muscles covering vertebral column
-Pathway for spread of infection from skull base to mediastinum (MEDIASTINHTIS)
-Site of abscess formation-> Dysphagia-> ruptures-> aspiration pneumonia
Term
respiratory layer of cervical layer
Definition
Larynx+ Trachea
-Routes air and food
-Provides airway
-Produces tone for mouth to modify voice
Term
Larynx
Definition
-Between pharynx and trachea
-C3-C6 Vertebrae
Term
Larynx functions
Definition
-Connects oropharynx with trachea
-Voice production
-Guards air passages during swallowing; acts as a sphincter or valve for LRT
-Maintains patent airway
Term
Skeleton of larynx (9 cartilages- 3 unpaired and 3 paired)
Definition
Thyroid cartilage(paired)
Cricoid cartilage (paired)
Epiglottis cartilage (unpaired)
Arytenoid cartilages (unpaired)
Corniculate cartilages (unpaired)
Cuneiform cartilages (paired)
Term
Thyroid cartilage
Definition
-Forms laryngeal prominence/ Adam's apple in males
-Has 2 laminae fused in midline anteriorly
-Forms bilateral cricothyroid joints
Term
Cricoid cartilage
Definition
-Signet ring that is broad lamina posteriorly
-Articulates with thyroid cartilage above at cricothyroid joints
-Attached to it on the anterior midline, Cricothyroid ligament
Term
Where is an emergency airway made?
Definition
Cricothyrotomy- on the cricothyroid ligament
Term
Cricoid cartilage pt. 2
Definition
-Landmark for C6
-Carotid tubercle (the enlarged anterior tubercle) is a compression site to control bleeding from carotid arteries and their branches
Term
Arytenoid cartilages
Definition
-Posterior
-Pyramidal shaped that articulate with superior border of cricoid cartilage lamina
-Vocal ligaments attach to vocal processes
Term
Arytenoid cartilages movements
Definition
-Sliding toward or away from each other
-Tilting anteriorly or posteriorly
-Rotating around a vertical axis
Term
Epiglottic cartilage
Definition
Covers laryngeal inlet during swallowing
Term
Extrinsic ligaments of the larynx
Definition
1) Thyrohyoid membrane
-Lateral thyrohyoid ligaments
-Median thyrohyoid ligament
2) Hyo-epiglottic ligament
3) Cricotracheal ligament
Term
Intrinsic ligaments of the larynx #1
Definition
1) Cricothyroid ligament- thickened to form the vocal ligament which is under the vocal fold or true vocal cords of the larynx
-thickened anteriorly in the midline to form median cricothyroid ligament
-Cricothyrotomy occurs on the median cricothyroid ligament
Term
Intrinsic ligaments of the larynx #2
Definition
2) Quadrangular membrane- lower margin forms vestibular ligament (false vocal cords)
Term
2 joints of the larynx
Definition
Cricithyroid joints
Cricoarytenoid joints
Term
Laryngeal cavity consists of
Definition
1) two pairs of mucosal folds: divide into 3 regions -the vestibule -upper part of the chamber -Middle part- very tin and is between vestibular folds and vocal folds -Infraglottic space-Lower most chamber and is between vocal folds and inferior opening of larynx
Term
Rima vestibuli
Definition
When viewed from above, there is a triangular opening between 2 vestibular folds
Term
Rima glottidis
Definition
Vocal folds and adjacent mucosa (covered by arytenoid cartilage) form lateral walls of the narrow triangular opening
Term
What moves rims vestibule and gottidis
Definition
Arytenoid cartilages and associated fibroblastic membranes
Term
What is the glottis?
Definition
The vocal apparatus of the larynx
-consists of vocal folds and processes, together with rims glottidis
-Shape depends on position of vocal folds
Term
Function of larynx during QUIET RESPIRATION
Definition
-Laryngeal inlet, vestibule, rima vestibule and rima glottides are open. Arytenoid cartilages are abducted and rims glottides is triangular
Term
Function of larynx during FORCED INSPIRATION
Definition
Arytenoid cartilages are rotated laterally mainly by cricoarytenoid muscles; vocal folds are abducted, rims glottides widens into a rhomboid shape; diameter of laryngeal airway increases
Term
Function of larynx during PHONATION
Definition
-Vocal folds are adducted and air is forced through the close rims glottidis
-Vocal folds vibrate against each other and produce sounds which are modified by upper parts of the airway and oral cavity
-Tension is controlled by vocals and cricothyroid muscles
Term
Function of larynx during EFFORT CLOSURE
Definition
-occurs when air is retained in thoracic cavity (i.e. heavy lifting)
-Rima glottidis is completely closed, as is rima vestibule and lower parts of the vestibule
-Airway is completely and forcefully shut
Term
Function of larynx during SWALLOWING
Definition
-Rima glottidis and rima vestibule and vestibule are closed and laryngeal inlet is narrowed
-Larynx moves up and forward thus causing the epiglottis to swing downward toward the arytenoidd cartilages
-Up and forward movement also opens up the esophagus, which is attached to the posterior aspect of the lamina of the cricoid cartilage
Term
Extrinsic laryngeal muscles
Definition
1) Infrahyoid muscles- depress hyoid bone and larynx
2) Suprahyoid and stylopharyngeus- elevate hyoid bone and larynx
Term
Intrinsic laryngeal muscles
Definition
1) Cricothyroid
2) Thyroarytenoid
3) Posterior cricoarytenoid
4) lateral cricoarytenoid
5) transverse and oblique arytenoids
6) Vocalis
Term
Actions of intrinsic laryngeal muscles
Definition
1) Posterior cricoarytenoid muscles- abduct vocal cords
2) Lateral cricoarytenoid muscles- adduct vocal cords
3) Cicothyroid muscles- lengthen and tense vocal cords
4) Vocalis- adjusts the thickness and tension of vocal ligaments
Term
What innervates the intrinsic laryngeal muscles?
Definition
Vagus nerve's recurrent laryngeal muscles to all except CRICOTHYROID MUSCLES, which is innervated by external laryngeal branches
Term
SENSORY innervation for larynx
Definition
Also vagus nerves:
Inferior to vocal folds-> Recurrent laryngeal branches
Superior to vocal folds-> Internal laryngeal branches
Term
What are the only muscles that abduct the vocal folds?
Definition
Posterior cricoarytenoid- these can be paralyzed by damage to the recurrent laryngeal nerves
Term
What happens if the internal laryngeal nerves are damaged?
Definition
The cough reflex is lost
Term
When does the trachea divide into right and left primary bronchi?
Definition
at the level if IV disc t4/t5
Term
Where is an inhaled foreign object more likely to end up and why?
Definition
The right primary bronchus because it is wider and more vertically oriented
Term
What are the involuntary muscles that feel the posterior gap of the trachea called?
Definition
Trachealis
Term
Where is an opening made in the trachea during an emergency?
Definition
Between first and second tracheal rings or through 2nd-4th rings
-BEWARE of jugular veins, carotid arteries, thyroid veins, and thyroid glands
Term
What does each alveolar duct terminate into?
Definition
2 to 3 alveolar sacs formed from the confluence of the openings of several alveoli
Term
What are alveoli?
Definition
air sacs which are the main site of gas exchange
-150-400 million in each lung providing enormous surface area
Term
What are alveoli pt.2?
Definition
-Squamous epithelium that contain 2 cell types:
1) Type 1 pneumocytes-squamous cells that cover 90% of the surface lining
2) Type 2 pneumocytes- located on corners of alveoli; they secrete surfactant to reduce alveolar surface tension and keep alveoli from collapsing
Term
What separates adjacent alveoli?
Definition
Interalveolar septa- consist mainly of lining of adjacent alveoli, abundant capillaries, elastic fibers, and collagen
Term
What passes between inter alveolar septa?
Definition
Dust cells that remove/phaocytose inhaled debris and bacteria
Term
What happens during emphysema?
Definition
Walls of the alveolar ducts, sacs, and alveoli are destroyed creating large air sacs and reduce surface area available for gas exchange
Term
Diaphragm
Definition
-Convexes towards thoracic cavity
-musculature is peripheral and radiates from xiphoid process (sternal)
Term
Diaphragm contents
Definition
-Costal cartilages and lower 6 ribs
-2 aponeurotic arches; the medial and lateral arcuate ligaments; and upper 3 lumbar vertebrae
-central tendon- underlies the heart and medial portions of lungs
Term
Canal opening of Diaphragmatic apertures
Definition
-Caval opening in the central tendon at the level of IV disc between T8 and T9
-IVC and terminal branches of phrenic nerve transmit through here
Term
Esophageal hiatus of diaphragmatic apertures
Definition
-For esophagus at the level of T10
-A/P vagal trunks, esophageal branches of left historic vessels and lympathics also pass through here
Term
Aortic hiatus of diaphragmatic apertures
Definition
-Posterior to diaphragm at kevek of T12 vertebra
-transmists aorta, azygous vein, and thoracic duct
Term
Arterial supply of diaphragm
Definition
Superior-Musculophrewnic and pericardiophernin and superior phrenic artery branch of aorta
Inferior- inferior phrenic arteries (abdominal aorta)
Term
Venous drainage of diaphragm
Definition
IVC and companion veins
Term
Motor supply of diaphragm
Definition
Phrenic nerves C3 4 5
Term
Sensory supply of diaphragm
Definition
Centrally- Phrenic nerve
Peripherally- intercostal nerves T5-T11 and subcostal nerves T12
Term
Referred pain of diaphragm
Definition
Ipsilateral Shoulder region C3-C5; same side as phrenic nerve
Skin of costal margins T5-T12
Term
Phrenic nerves
Definition
Each innervates 1/2 of the diaphragm (hemidiaphragm)
Term
Injury of phrenic nerve
Definition
Left phrenic nerve is injured, left hemidiaphragm is injured, left hemidiaphragm will rise during inspiration called paradoxical movement
Term
Diaphragm movements
Definition
Depression- muscle fibers of diaphragm contract
elevation- Diaphragm relaxes
Elevation and depression of ribs change anterior/posterior
Term
Pump handle movement
Definition
Ribs move upward and forward during inhalation
Ribs move downward and backward during exhalation
Because anterior ends are inferior to posterior ends
Term
Bucket Handle Movements
Definition
Anterior and posterior ends are lower than the middle ends.
When elevated, middle shafts move laterally and increase lateral dimensions of the thorax.
Term
INSPIRATION
Definition
-Diaphragm is the primary muscle of inspiration
-Diaphragm contracts
-Volume increases
-Intrathoracic pressure decreases
-Draws air in
Term
FORCED INSPIRATION
Definition
- External intercostal muscles contract elevating ribs upward and forward
- A-P and transverse diameters of thorax increase
Term
FORCED EXPIRATION
Definition
- volume decreases
- Air pressure increase
-Air is forced out
-Quiet expiration involves elastic recoil of lungs/relaxation of diaphragm
-Internal intercostal muscles are involved
Term
Respiration and breathing
Definition
-Normal is 12-20 per minute
-Dyspnea- shortness of breath
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