1. Chapter 16 Respiratory System
Function – supply oxygen to & eliminate carbon dioxide from lungs

2. Thoracic Cage Ribs Sternum Costal cartilages Thoracic vertebra
Top – clavicle
Bottom – diaphragm
Sternum – manubrium, body, xyphoid
12 pairs of ribs – 7 true, 3 false – costal cartilage to rib 7, 2 floating

3. Joints and Articulations – Costovertebral Joints
Facet
Demifacet
Costovertebral & Costotransverse Joints – nonaxial, diarthrodial, gliding joints (costocartilage joints also this type)
- Ribs attachment to thoracic spine

4. Movements of the Thorax
Elevation
Depression
Elevation – inspiration; up & out; increase medial/lateral diameter; bucket handle
Depression - - expiration; down & in; decrease medial/lateral diameter;
Pump handle – change in anterior/posterior diameter

5. Structures of Respiration
Nose
Nasal cavity
Oral cavity
Pharynx
Larynx
Trachea
Main stem bronchi
Lobar bronchi
Bronchioles
Alveolus
All made of cartilage material
Upper respiratory tract – nose to larynx; pharynx = throat; larynx = voice box; larynx = anterior to C4-C6
Lower Respiratory tract – trachea to alveoli;
- trachea- C6-T4
- R & L main stem bronchi
- Lobar bronchi – 3 R & 2 L
- Bronchioles
- Alveolus

6. Mechanics of Respiration
Inspiration
Expiration
Pressure Change – air will flow from areas of higher pressure to areas of lower pressure
Inspiration – thoracic cavity increases which decreases pressure, causing air to flow in
Expiration – thoracic cavity decreases in size, causing pressure to increase, causing air to flow out

7. Phases of Respiration/Breathing
Quiet inspiration
Deep inspiration
Forced inspiration
Quiet expiration
Forced expiration
Quiet inspiration – resting; diaphragm & external intercostals
Deep inspiration – breathing harder; may recruit some accessory muscles
Forced inspiration – air hunger; use of accessory muscles
Quiet expiration – relaxing diaphragm; passive; no muscle action
Forced expiration – use of accessory muscles

8. Muscles of Quiet Respiration
Diaphragm
External intercostals
Internal intercostals
2 ways to change thoracic volume:
Move ribs
Lower diaphragm
Diaphragm – descends when it contracts; lowers 4”
External Intercostals – elevate ribs by pulling up on inferior one; V shaped anteriorly; inverted V shape posteriorly
Internal Intercostals – depress ribs by pulling down on superior one; inverted V shape anteriorly; V shaped posteriorly
- Orientation of muscles same as obliques anteriorly

9. Accessory Inspiratory Muscles
Sternocleidomastoid
Scalenes
Pectoralis Major
- Accessory muscles work in a reversal of muscle action – hands on hips – CKC breathing; allows pectoralis major to pull sternum to humerus

10. Accessory Expiratory Muscles
Rectus abdominus
Quadratus lumborum
Pull down on rib cage; reversal of muscle action;
Rectus abdominus – sternum to pelvis
Quadratus Lumborum – ribs to iliac crest;
Transverse Abdominus – forces air out by compression (coughing)
Tables 16.1 & 16.2 page 243

11. Respiratory System Anatomical relationships
Diaphragmatic versus chest breathing
Summary of innervation of the muscles of respiration
Valsalva’s maneuver
Diaphragmatic breathing – most efficient; least energy expenditure; easiest in standing or sitting with gravity assisted
Chest Breathing – requires more effort and more energy; smaller volume of air is produced with more rapid breathing
Innervation – diaphragm = phrenic nerve C3-C5
Valsalva – increases BP & HR with a reflexive decrease in HR; may lead to cardiac arrest

12. Common Respiratory Conditions or Pathologies
Upper respiratory infection
Pneumonia
Bronchitis
Emphysema
Asthma
Pleurisy
Pneumothorax
URI – nose, throat, larynx; cold, flu
Pneumonia – LRI; inflammation of alveoli caused by bacterial or viral infection
Bronchitis – LRI
Emphysema – LRI – chronic bronchial obstruction; lose elasticity of alveoli
Asthma – LRI – spasm of bronchial walls; difficult exhalation
Pleurisy – inflammation of pleura
Pneumothorax – collapsed lung
Stitch – cramp of diaphragm
Hiccups – spasm of diaphragm
Rib Pathology
Separation – between ribs & cartilage
Dislocation – cartilage from sternum
Flail chest – 4+ ribs fractured – collapsed chest wall