1. Chest Surface and Pleura Cavity
Advanced Anatomy & Physiology
Tony Serino, Ph.D.
Biology Department
Misericordia Univ.

2. Thoracic Vertebrae

3. Vertebrae and Ribs

4. Rib Types and Sternum

5. Rib Anomalies Cervical ribs Bicipital rib (rib fusion)
Bifid rib (two heads)

6. Ribs 1st rib 2nd rib 11th rib 12th rib Crest of head Head Neck
Tubercle
11th rib
12th rib

7. Clavicle

8. Scapula

9. Scapular Fossa

10. Superficial Muscles
Deltopectoral triangle (contains Cephalic vein)

11. Thoracic Apertures
Superior
Inferior

12. Breast
Male nipple at T4 Dermatome

13. Female Breast Retromammary space Suspensory ligaments Tail of breast
Glandular tissue and stroma

14. Female Breast
Retromammary space

15. Blood supply to the Breast
Lateral thoracic (from axillary a.)
Internal thoracic a. (from subclavian)
Anterior intercostals
Post. Intercostals (from thoracic aorta)
(Venous drainage mostly to axillary v. and internal thoracic v.)

16. Lymphatic Drainage of Breast
Axillary nodes
Parasternal nodes
Pectoral nodes
Subareolar plexus
Inferior phrenic nodes

17. Untreated Breast Cancer

18. Muscles of Thorax

19. Primary muscles of respiration

20. Only used during rapid breathing.

21. Chest Plate

22. Pressures affecting Breathing

24. Inspiration

25. Expiration

26. Pressure changes around lung

27. Lung Volumes

28. Normal Lung Volumes

29. Nerves of thoracic wall

30. Intercostal arteries and nerves

31. Pleura
Cardiac notch
Costodiaphragmatic recess
Costomediastinal recess

32. Surface to Deep Structure Alignment
Bare Pericardium

33. Respiration External Respiration Internal Respiration
The exchange of gas between the blood and external environment (usually includes ventilation)
Internal Respiration
The exchange of gas between the blood and the tissues
Cellular Respiration
Burning of fuel to produce energy within cells
Ventilation (Breathing)
Movement of air in and out of the lungs

34. Respiratory Organs Divided into:
Upper Respiratory Tract
Includes: nostrils (nares), nasal cavity, and nasopharynx
Lower Respiratory Tract
Includes: larynx, trachea, bronchi, and lungs
Conducting Air passages include: nares to terminal bronchioles
Move air to respiratory membrane
Condition the air
Moisten, Warm, Clean

35. Trachea

36. Trachea (x.s.)

37. Mucous Membrane (pseudostratified columnar epithelium)

38. Bronchi Primary bronchi lead to to each lung (left and right)
Secondary (lobar) bronchi lead to each lung lobe (3 on right and 2 on left)

39. Cadaver Lungs

40. Lobes of Right Lung

41. Lobes of Left Lung

42. Bronchi Branches Tertiary Bronchi Primary Bronchi Secondary Bronchi
Tertiary (segmental) bronchi lead to each lung broncho-pulmonary segment
Bronchi continue to divide at least 20 more times.

43. Broncho-pulmonary Segments

44. Lung Blood Supply PA PV
Note: blood supply to respiratory surface; airway blood supplied by bronchial a. (branch of aorta)

45. Blood pathways
Bronchi PA PV

46. Bronchioles Air passages less than 1 mm in diameter are bronchioles.
The terminal bronchioles are the last of the purely conducting air passages.

47. Alveoli highly specialized for Gas Exchange
Lots of Surface Area
Highly vascular
Thin walls

48. Lung Tissue

49. Alveolus

50. P = pressure to collapse
T = surface tension
r = radius
Role of surfactant is to decrease surface tension in alveoli.

51. Partial Pressure Favors Resp. Gas Movement

52. Time to Complete O2 Saturation in Pulmonary Capillaries

53. Oxygen Content of Blood
PO2 = 100 mmHg
Whole Blood
Plasma
Oxygen
Oxyhemoglobin
Total Volume of Oxygen = 0.3ml Plasma + 20 ml whole blood

54. Hemoglobin

55. Oxyhemoglobin Dissociation Curve

56. Hemoglobin Affinity for Oxygen: Effect of Temperature
Affinity decreases with increasing Temperature

57. Hemoglobin Affinity for Oxygen: Effect of pH
Affinity decreases with increasing acidity (i pH)

58. Gas Exchange in Lungs

59. Gas Exchange in Tissues
10%
70%
20%

60. Neural Control of Breathing

61. Neural Control of Breathing
Voluntary control located in cerebral cortex and acts through the corticospinal tract. Involuntary located in pons and medulla acting through the spinal cord in the roots of the phrenic nerve (C3-C5) and thoracic cord roots of the external (inspriation(I)) and internal (expiration(E)) intercostal nerves
PRG –pontine resp. group (formerly the apneustic and pneumotaxic centers) –play role in smoothing between insp. and exp., especially during sleep, vocalization and exercise. VRG and DRG – ventral and dorsal resp. group of the medulla. DRG primarily responsible for inspiration; VRG mixture of I and E neurons contains Pre-Botzinger complex which may be pacemaker cells for respiration

62. Neural control of Breathing
PRG
Red is inhibitory
Black is excitatory
DRG
VRG
Hering-Breuer Reflex
I neurons
E neurons
Ext. Intercostals & diaphragm
Int. Intercostals
Lung Stretch
Chemoreceptors

66. Factors Effecting Respiratory Centers

67. CO2 Drive

68. COPD