Presentation is loading. Please wait.

Presentation is loading. Please wait.

The Lungs and Chest Wall Chapter 2. The Lungs as Organs Apex: upper rounded part of lung – apices extend above clavicles Base: lower concave part of lung.

Similar presentations


Presentation on theme: "The Lungs and Chest Wall Chapter 2. The Lungs as Organs Apex: upper rounded part of lung – apices extend above clavicles Base: lower concave part of lung."— Presentation transcript:

1 The Lungs and Chest Wall Chapter 2

2 The Lungs as Organs Apex: upper rounded part of lung – apices extend above clavicles Base: lower concave part of lung – Rests on the diaphragm – Major muscle of ventilation – Separates the thoracic and abdominal cavity Mediastinum contains heart, aorta, esophagus, great veins, trachea, mainstem bronchi

3 Lung Topography

4 Lung Features Diaphragm ≈ 9 th -11 th rib COPD = Lower Rt Lung = 3 lobes Lt Lung = 2 lobes Which one has less volume?

5 Lungs as Organs (cont’d) Cardiac notch—left lung’s anterior border Diaphragm—major muscle of ventilation – Separates thorax from abdomen – Dome-shaped Lower margin at T10 Highest margin T8-T9 – Right hemi-diaphragm is higher than left Liver pushes it up; heart pushes left side down

6 Hilum – where arteries, veins, and bronchi enter and leave lungs Pulmonary ligament – connects lung’s surface membrane with diaphragm Lingula: tongue-like anterior portion of left upper lobe that overlaps heart – Lingula = counterpart of right middle lobe

7 Pleural Membranes Form sealed envelope around each lung Visceral pleura – attached to lung’s surface Parietal pleura – attached to inner chest wall surface Pleural space – potential space between visceral and parietal pleura

8 Pleural Membranes Visceral pleura attached to lung’s surface Parietal pleura inner chest wall surface Pleural space potential space between visceral and parietal pleura

9 Costophrenic Angles Where lowest margin of diaphragm meets chest wall Pleural effusion – fluid in pleural space – fluid settles into costophrenic angles, blunting their points on chest x-ray images – thoracentesis — surgical removal of excess pleural fluid via tube insertion into pleural cavity

10

11 Blood Supply to the Lungs Mr. Cosa’s Drawing

12 Rough Schematic

13 Pulmonary Blood Flow

14 Regulation of fluid in the lung: Lymphatic System Lymph: clear, protein-containing fluid in interstitial spaces (Pleura) Normal fluid filtration – 30 L plasma/day filters into interstitium – 27 L plasma/day gets reabsorbed – 3 L in lung interstitium returns to the systemic circulation via the lymphatic system If Lymphatic System does not filter the 3 L out, it can accumulate in the alveoli and cause pulmonary edema

15 The Nervous System Central nervous system (CNS) – Brain & Spinal cord Peripheral nervous system (portion of nervous system laying outside brain and spinal cord) – Sensory (afferent) neurons – Carry signals that are transmitted to the brain and spinal cord – Motor (efferent) neurons – carry signals away from CNS – Autonomic nervous system Non voluntary Parasympathetic branch Sympathetic branch Somatic nervous system

16 Afferent Neurons Somatic Neurons Autonomic

17 Phrenic nerves – Stimulation of Diaphragm – If injury from surgery, disease, or trauma may paralyze diaphragm breathing is possible if accessory nerves are intact Intercostal nerves – spinal nerves that stimulate/innervate intercostal muscles

18 Autonomic Innervation Controls Involuntary Movements Example: Heart Rate… Pupil Dilation… Salivation… Two branches arise: Sympathetic Parasympathetic

19 Sympathetic (Adrenergic) Innervates – adrenal medulla Neurotransmitter = Noradrenaline – Aka norepinephrine Alpha, Beta 1, Beta 2 Stimulation of ß 2 receptors in the airway causes bronchodilation

20 Which would you recommend? Alpha vs. Beta 2 Upper airway swelling s/p extubation Lower airway wheezing/asthma clinical Focus 2-4 pg. 36

21 Parasympathetic (Cholinergic) Innervates – smooth airway muscle – mucous glands – pulmonary vasculature Neurotransmitter = Acetylcholine Overstimulation – bronchospasm – increased mucous production & thickness

22 Thoracic Anatomy Thorax is formed by

23 Thoracic Cage 12 ribs – 7 attach directly to sternum anteriorly – 3 (ribs 8-10) connect to sternum – 2 do not attach anteriorly floating ribs Puncture – Pneumothorax Fracture – Flail Chest

24 Ventilatory Muscles Primary muscles used for quiet breathing – Diaphragm (major effect) – Scalenes (minor effect) Accessory muscles used for increased work of breathing (WOB) – scalenes (inspiration) – sternomastoids (inspiration) – pectoralis major (inspiration) – abdominals (expiration)

25 Muscles of Ventilation Fig. 2-13


Download ppt "The Lungs and Chest Wall Chapter 2. The Lungs as Organs Apex: upper rounded part of lung – apices extend above clavicles Base: lower concave part of lung."

Similar presentations


Ads by Google