Applied Anatomy and Physiology Exam #1

Transverse Planes

divides body into upper/lower parts

Rectus Abdominis

large, flat, ribbon-like muscle.

between the front of pelvis > sternum and 5th-7th ribs

assist other abdominal muscles with compression of the abdominal cavity

External Oblique

large flat muscle

between external surface of lower 8 ribs and hip bone > abdominal aponeurosis(sheet of connective tissue white)

contraction compresses the abdominal cavity

Internal Oblique

Located just deep to external oblique.

between crest of pelvic bone > lower 4 ribs

contraction compresses the abdominal cavity

Transversus Abdominis

between thoracolumbar vertebrae > abdominal aponeurosis

contraction provides strong compression of the abdomen (corset-like)

sagittal plane

divides body into right/left part

coronal plane

divides body into front/back parts

Superior position

headward

inferior position

toward the bottom

anterior position

ventral, front

Posterior position

dorsal, back

medial position

toward the middle

lateral position

toward the side

distal position

away from point of origin or attachment

proximal position

near point of origin or attachment

Rib Cage

12 pairs

True or False: Ribs attach to the sternum anteriorly

true

True or False: lowest ribs are free floating anteriorly

true

True or False: the ribs attach to the vertebrae posteriorly

True

"Bucket handle effect"

cartilage attaching the lower ribs is slanted

pulmonary system

Trachea, bronchi, lungs(lobes/alveolar air sacs)

Chest Wall Structures

rib cage, rib cage muscles, diaphragm, abdominal wall, abdominal content

Diaphragm

sheet of muscle, has the shape of an inverted bowl when relaxed, flattens when contracted, contraction increases the vertical space in the thoracic cavity

Location of Diaphragm

between internal margin of ribs and vertebrae > control tendon of the diaphragm

Rib cage Muscles of Inhalation

External Intercostals, Leratores Costarum, Serratus Posterior Superior

contraction for all muscles above raises the rib cage

External Intercostals location

between lower border of a rib > upper border of rib below.

Location of Leratores Costarum

between vertebra > rib below

Location of Serratus Posterior Superior

between lower cervical and upper thoracic vertebrae > 2nd - 5th ribs

Neck Muscles of Inhalation

Sternocleidomastoid, Scalenus Group

contraction of the above muscles helps raise the rib cage

Location of Sternocleidomastoid

between sternum and clavicle > mastoid process of skull

Scalenus Group location

between cervical vertebrae > 1st - 2nd ribs

Front Muscles of Inhalation

Pectoralis Major, Pectoralis Minor, Serratus Anterior

contraction of all above muscles raises the rib cage

Pectoralis Major location

between sternum and clavicle > humerus

Pectoralis Minor location

between 2nd - 5th ribs > scapula

Serratus Anterior location

between upper 8 ribs > scapula

Rib Cage muscles of active exhalation

Internal intercostals, transversus thoracis, subcostals, Serratus posterior inferior, Quadratus Lumborum

contraction of all the above muscles helps lower the rib cage

internal intercostals location

located deep to external intercostals

between superior border of a rib > inferior border of the rib above

Transversus Thoracis location

between lower part of the sternum > ribs 2nd - 6th

subcostals location

between lower ribs near vertebrae > inner surface of 2nd - 3rd rib above

Serratus Posterior inferior location

between lower thoracic and upper lumbar vertebrae > lower border of lowest 4 ribs

contraction lowers the ribs

Quadratus Lumborum location

between upper border of hip bone > lowest rib and lumbar vertebrae

contraction supports abdominal compression (during active exhalation)

Abdominal Muscles of Active Exhalation

Rectus Abdominis, External oblique, internal oblique, Transversus Abdominis

Metabolic Aspects

blood runs around alveolar air sacs

venous blood contains CO2

the sacs contain oxygen

membrane exists between the sacs and blood

Total Lung Capacity (TLC)

volume in pulmonary systems after max inspiration

Vital Capacity (VC)

Max volume expired after max inspiration

Tidal Volume (TV)

volume exchanged during a breath cycle

can vary depending on activity level

Inspiratory Reserve Volume (IRV)

max volume inspired from end of tidal inspiration

Expiratory Reserve Volume (ERV)

max volume expired from end of tidal expiration

Residual Volume (RV)

volume remaining after max exhalation

Vital Capacity

dependent on amount of lung tissue

increases the age until 20s, then decreases

Breathing rate

higher and irregular with infants

Residual Volume

increases with age

Quiet Respiration

must be efficient

involves diaphragm and external intercostals

Quiet inspiration

initiated at functional residual capacity; it is the volume in the lungs at the end of passive expiration

Quiet expiration

passive process

elastic recoil of lung tissue recoil of abdomen

Forced Respiration

Used when energy requirements of muscles increases or we need more aerodynamic (singing, loud speech, exercise, wind instruments)

additional muscles of inspiration are activated to assist the diaphragm and external intercostals

Forced Inspiration muscles

accessory muscles: back, neck, front muscles

Forced Expiration muscles

Accessory muscles: rib cage muscles, abdominal muscles

Speech Breathing

used to create and maintain enough air pressure to drive the vocal folds and force air past obstructions and through constrictions

efficient speech breathing

speaking requires 8cm H20 pressure

Speech Breathing Prosody

Loudness changes, changes for stressed words in speech

thyroid cartilage

House/protects the vocal folds and other structures

wing-shaped

Cricoid Cartilage

located at the top of the trachea

signet-shaped

base of larynx

other laryngeal structures attach to it

Arytenoid Cartilage

paired, small & pyramidal in shape

located on posterior rim of cricoid

vocal process; projects anteriorly, VF muscle attach here

muscle process: projects laterally/pivots arytenoids

rocking and gliding motions

Epiglottis

flap of cartilage

attached to interior wall of thyroid cartilage

stalk-like attachment

inverts over airway during swallowing

protects against aspiration

Thyroarytenoid (External/Vocalis)

between internal surface of thyroid cartilage and vocal process of the arytenoid

this is the “body” of the vocal fold

Three contractions of the Thyroarytenoid

shortens the vocal fold

tenses the vocal fold

helps with adduction

Cricothyroid

between cricoid and inferior margin of thyroid cartilage

contraction pulls thyroid and cricoid together

stretches vocal folds lengthwise

increase rate of vibration

pitch rises because of tension from stretching

Posterior Cricoarytenoid

Between posterior surface of cricoid and muscular process of the arytenoids

contraction pivots the arytenoid/vocal folds to abducted position (main abductor muscle)

lateral Cricoarytenoid

between lateral surface of cricoid and muscular process of arytenoid

contraction pivots the arytenoid/vocal folds to adducted position (main adductor muscle)

Transverse Arytenoids

between the backs of the arytenoids (transverse arrangement)

contraction pulls the lower portions of the arytenoids medially (likely helps hold posterior glottis closed during phonation)

Oblique Arytenoid

between muscular process of one arytenoid and the apex of the opposite arytenoid

contraction pulls the upper portions of the arytenoids medially (also helps hold posterior glottis closed during phonation)

Ventricular (false) folds

Located superior to the true vocal folds

thick membranous folds

ventricle of Morgagni separates true and false vocal folds (contains mucous glands)

provides a layer of protection during swallowing

Anatomy of Vocal Folds

Epithelium, Superficial layer of Lamina Propria, Intermediate layer of Lamina Propria, Deep layer of LP

Thyroarytenoid/vocalis muscle fibers, cover--transition-body concept

Superficial Layer of Lamina Propria (a.k.a. Reinke's Space)

contains loosely packed elastic fibers

“gelatin-like”

Intermediate Layer of Lamina Propria

Contains densely packed elastic fibers

“rubber bands” / “vocal ligament”

Deep Layer of Lamina Propria

Redish fiber

contains collagen fibers

“thread-like”

Thyroarytenoid/vocalis muscle fibers

striated muscle - stiffest layer

Cover-Transition-Body Concept

A simplification of the multilayered structure according to mechanical properties

The Cover

• composed of epithelium and the superficial layer of LP

• loose, pliable, and it can move somewhat independently from the deep layers

• Air is able to "grip" the soft cover & push the vocal folds laterally (aeromechanical coupling)

• mucosal wave is evidence of this

Transition

• composed of the intermediate and deep layers of Lamina Propria

• allows stretching of vocal folds

• body (vocal muscles)

• allows changes in shape and mechanical properties of vocal folds

Body

• composed of the vocalis muscle

• allows changes in shape of vocal folds (shortens/thickens)

• also allows changes in mechanical characteristics

Biological Functions of Larynx

Normal Breathing, forced breathing, swallowing, Coughing & sneezing

Larynx Normal Breathing

vocal folds in intermediate postion

Larynx Forced Breathing

vocal folds are fulling abducted

Larynx Swallowing

• airway protection - larynx elevates

• constriction of supraglottic cavity

• reflexive valving if aspiration occurs

Coughing & Sneezing

impound large amount of air with sudden release

vibratory cycle

tracheal pressure builds below the vocal folds

vibratory cycle step 1

pressure begins to separate the vocal folds from bottom up

vibratory cycle step 2

folds separate & a convergent glottis forms (helps with vocal fold separation)

Vibratory cycle step 3

vocal folds reach full lateral excursion

vibratory cycle step 4

vocal folds return toward midline & encounter the Bernoulli Effect/ low pressure

vibratory cycle step 5

vocal folds close at the bottom first

Vibratory Cycle open phase

• has an opening portion where the vocal folds are separating

• has a closing portion where the vocal folds are moving medially

vibratory cycle closed phase

the portion of the cycle where the vocal folds are closed

Fundamental Frequency (F0)

• Defined as # of cycles per second

• determined by age & sex

increase fundamental frequency

• vocal folds are stretched & made thinner

• vocalis muscle contracts (to further stiffen the vocal folds)

• all parts of cycle have shorter duration (more cycles per second)

Loudness

increased tracheal pressure: displaces vocal folds farther & faster

large puff of air is released with each cycle

restoring forces are greater due to increased movement & stretch of vocal folds

vocal folds return to midline faster

airflow is shut off more quickly

Above events result in ___ voice