cvp 1: anatomy of the pulmonary and cardiovascular systems

pulmonary/respiratory system anatomy includes

bony thorax, muscles of ventilation,upper and lower airways, pulmonary circulation

pulmonary/respiratory system anatomy functions

gas exchange, fluid exchange, maintains a low volume blood reservoir, filtration and metabolism

thorax houses

2 lungs and heart (mediastinum)

Bony thorax covers and protects the

major organs of the cardiopulmonary system (heart and lungs)

Boundarie of thorax

front: sternum, cartilage, ribs

lateral: ribs

back: 12 vertebrae

what are the sections of the sternum

manubrium, body, xiphoid process

Manubrium (top of sternum) - articulates with

clavicles and 1st and 2nd ribs

jugular or suprasternal notch at the superior border of the manubrium has what behind it

trachea

body of the sternum articulates with what

ribs 3-7

what is the xiphisternal joint

point where sternal body and xiphoid process fuse

Angle of Louis/Sternal angle between manubrium and body significance

place to find 2nd ribs laterally (costal cartilage), T4 and T5 posteriorly, bifurcationof trachea into L and R mainstem bronchi

where is the 1st rib

under the clavicle

different kind of ribs

true ribs

false ribs

free ribs

what are true ribs and which rib numbers are they

ribs that attach to the sternum directly via their costal cartilages

ribs 1-7

what are false ribs and which rib numbers are they

Attach to cartilage of the rib above, not to the sternum directly, via their costal cartilage

ribs 8-10

What are floating ribs? Which rib numbers are they?

ribs that end freely

ribs 11-12

what does the costal groove house?

intercostal nerve and vessels

Pulmonary ventilation

Air moved in and out of the lungs - 'breathing'

how does inspiration occur

The diaphragm moves down, the external intercostal muscles contract, and the chest cavity expands, which allows air to move into the lungs.

muscles change volume of thorax - more negative compared to the atmosphere (intrathoracic pressure)

Bucket and pump handle mechanisms increase intrathoracic volume

muscles of inspiration

-Primary muscles of inspiration: diaphragm, EXTERNAL intercostals

-Accessory muscles of inspiration: sternocleidomastoid, scalenes, levator costarum, serratus, trapezius, and pectorals

when are the accessory muscles for inspiration:

used when a more rapid or deeper inhalation is required or in disease

inspiration is what kind of process

ACTIVE

describe the diaphragm

a dome sheet of muscle separating the thoracic cavity from the abdominal cavity

innervated by the phrenic nerve

right dome: 5th rib

left dome: 6th rib

openings in the diaphragm allow IVC, esophagus, aorta..

describe the external intercostals

11 on each side of the sternum

oblique, forward, and downward fibers allow the ribcage to elevate and cause lateral and anterior expansion

actions of the accessory muscles of inspiration

expiration is what kind of process at rest

PASSIVE

Recoil of lungs and relaxation of ext. intercostals and diaphragm

when does active expiration occur? what muscles are at play?

cough, huff

rectus and transverse abdominis, int and ext obliques; increase abd pressure and Interosseous portion depress ribs

pleura types

visceral and parietal

describe the pleura

visceral: Covers outer surface of the lung, attached to lung tissue

parietal: Covers inner surface of the chest wall, diaphragm,mediastinum

what is the pleural space/pleural cavity? what does it do?

Potential space between the two pleurae

pleurae are in intimate contact with each other - thin serous fluid

Constant negative pressure within this space maintains lung inflation

what is the lung made of?

parenchyma--substance of lung, porous, and spongy filled with alveoli

how is the lung shaped?

apex, base, three borders, and surfaces

3 borders: ant, post, inf

3 surfaces: costal, medial, diaphragmatic

what is the hilus

point at which nerves, vessels (pulmonary artery and vein), primary bronchi enter the lung parenchyma at 5-7th thoracic vertebrae

difference between right and left lobes of the lung

Right: upper, middle (CANNOT FEEL IN THE BACK), lower lobes

Left: upper (lingula - where middle would be) and lower

what is the horizontal fissure?

separates the superior and middle lobes of the right lung

from the level of the right fourth costal cartilage horizontally to a junction with the oblique fissure at approximately the midaxillary line at the 4th rib

ONLY ON RIGHT LOBE

what is the oblique fissure

the line that divides each lung roughly in half

extends from the level of 4th thoracic vertebra posteriorly to the diaphragm anteriorly and inferiorly. 6th ribanteriorly to 5th rib in axilla

where is the middle lobe of the (right) lung

Ribs 4 - 6 in the front

where is the lingula of the left lobe

Xiphoid process ~ rib 6

What is the cardiac notch?

indentation in the left lung where the heart lies

where is the lower lobe of the lung

From 1 inch below the spine of the scapula to T10

what is the upper respiratory tract

nose, pharynx, larynx

what is the lower respiratory tract

trachea

mainstem bronchi

segmental bronchi respiratory/terminal bronchioles

alveolar ducts

alveolar sacs

Respiratory bronchioles, alveolar ducts, and alveolar sacs are

gas exchange airways

trachea, primary bronchus, bronchus, bronchi and terminal bronchioles are

conducting airways: conduct, warm, humidify, filter

peripheral nervous system types

Autonomic nervous system: (Parasympathetic (PSNS) and sympathetic(SNS))

peripheral nervous system innervates

bronchial and vascular smooth muscles, glands

PSNS Vagus nerve functions

bronchial constriction, pulmonary arterialsmooth muscle dilation and increased glandular secretions

SNS nerve functions

bronchial relaxation, pulmonary arterial smooth muscleconstriction, decreased glandular secretions (bronchodilators)

circulation of the heart

RA-> Tricupsid Valve-> RV -> Pulmonic Valve-> Lungs-> Back into pulmonary veins-> LA-> Mitral Valve (bicupsid)-> LV-> Aorta-> Body

Pulmonary arteries function

carry oxygen-poor blood from the right side of your heart to your lungs

pulmonary veins function

blood vessels that transfer freshly oxygenated blood from the lungs to the left atria of the heart

Cardiovascular System Anatomy

what is the mediastinum

structure separating the right and left thoracic cavities/pleura

contains all thoracic viscera except lungs

Contains the heart, great vessels of the heart, esophagus, trachea, phrenic nerve, thymus.

what is a mediastinal shift

Shift of thoracic structures to one side of the body

what is a tension pneumothorax

air stuck in the pleural space

describe the heart

Pumps blood thru the entirevascular system

Lies obliquely in the mediastinum

key ways to find the heart

Base: superior portion - made up of two atria - level of 2nd intercostal space

Apex: tip of left ventricle, 5th intercostal - midclavicular line

heart tissue layers

endocardium-innermost layer

myocardium-middle layer

epicardium-outermost layer

what does the myocardium do?

Performs pumping action of the heart

what does the pericardium do?

Protects and anchors the heart

Prevents overfilling of the heart with blood

Allows for the heart to work in a relatively friction-free environment

what does the endocardium do?

lines the inside of the heart

what is pericarditis?

inflammation of the pericardium

what is endocarditis?

inflammation of the inner lining of the heart

what is serous pericardium?

thinner, more delicate membrane, double layer (parietal layer fused to fibrous pericardium and visceral layer called epicardium)

heart pressures

Central venous pressure: 0-8 mmHg - normal diastolic pressure to enable filling

Right ventricle: diastolic pressure: 0-8 mmHg, systolic: 15-30 mmHg

Left atria: diastolic pressure: 4-12 mmHg

Left ventricle: diastolic: 4-12 mmHg, systolic: 80-120 mmHg

heart valves

atrioventricular valves and semilunar valves

chambers of the heart

right atrium, right ventricle, left atrium, left ventricle

atrioventricular valves include

tricuspid and bicuspid (mitral)

semilunar valves include

pulmonary valve and aortic valve

right-sided valves

tricuspid and pulmonic

Left sided valves:

mitral and aortic

AV valves function

prevent backflow of blood into the atria during ventricular contraction or systole

semilunar valves function

prevent backflow of blood from the aorta and pulmonary artery into the ventricles during diastole

diastolic pressure

occurs when the ventricles are relaxed; the lowest pressure against the walls of an artery (lower number)

systole

contraction phase of the heartbeat/ contracting of the ventricle

conduction system of the heart

SA node, AV node, Bundle of His, Purkinje fibers

the autonomic nervous system influences...

the rate of impulse generation, and strength of contraction

parasympathetic relationship to HR

vagus nerves realeases acetylcholine and decreases HR on SA and AV nodes (NO MUSCLE CONTRACTILITY)

sympathetic relationship to HR

cardiac plexus releases norepinephrine, increase HR and muscle contractility, Beta receptors

the SA node is the...

junction of the SVC and right atrium

the SA to AV node is

internodal tracts

describe the aorta

largest artery in the body and carries oxygenated blood at high pressure

receives ejected blood from the left ventricle

3 parts: ascending aorta, aortic arch, descending aorta

describe the ascending aorta

originates at the base of the left ventricle

contains the opening to coronary arteries

describe the aortic arch

originates at level of R 2nd costal cartilage

courses upward backward and leftward

ends at level of L 2nd costal cartilage

what comes off the aorta

brachiocephalic trunk

left common artery

left subclavian

right and left coronary arteries

coronary arteries

receives blood during diastole

the right coronary artery supplies

-right atrium right ventricle

-posterior and inferior surface of the left ventricles

-the SA and AV nodes (80% of population)

right coronary artery divides

posterior descending artery

• supplies posterior walls of both ventricles and L inf ventricles(sometimes L or co-dominant)

left coronary artery supplies

Left atrium left ventricle

SA node in 40% of people

The anterior septum

left coronary artery divides

left anterior descending branch

70% of L ventricle

left cricumflex artery

diagonal branch

cardiac veins drain

into common sinus which empties into RA

thebesian veins drain

directly into the myocardium and into all four chambers

describe pulmonary veins

transport oxygenated blood to the left atrium of the heart

2 veins from each lung: superior and inferior

originate in capillary beds

drains into the left atrium

describe the pulmonary arteries

carry deoxygenated blood to the lungs

originate at pulmonary trunk from base of RA

runs anterior to Left of ascending aorta

becomes right and left at the level of T5

describe arteries and arterioles

composed of elasic and fibrous connective tissue

aorta and pulmonary artery is more elastic and has more strethc with heart pumping

smooth muscles receives autonomic stimulation from alpha receptors (smaller arteries and arterioles)

describe endothelium functions

functions: filtration, permeability, vasomotor, clotting, and inflammation

Atherosclerosis is initiated through

endothelial dysfunction

evidenced by endothelial cells that are extensively permeable to fat cells and white blood cells.

describe venules and veins

thinner walls. larger diameter, less elastic tissue

valves create unidirectional flow

blood transferred back to the heart through the muscle pump and by negative pressure during inspiration

venules and veins functions

to act as conduit vessels, transporting blood back to the heart from the body's organs and tissues (i.e., the venous return); and

to act as capacitance vessels, accommodating large volumes of blood

Very distensible - expand easily