1. Cardiorespiratory system Lisa Leong July 2009

2. Respiratory system Breath is Spirit. The act of breathing is Living. ~Author Unknown

3. Functions Gas exchange Airway defences –Warm and humidify the air –Trap particles – nasal turbinates –Epiglottis –Mucociliary escalator (small particles) –Macrophages/lymphocytes Synthesis, degradation, removal

4. Thoracic cage

5. Thorax

7. Pneumothorax

9. The nose is for breathing, the mouth is for eating. ~Proverb

10. Alveoli

11. How gases move Gas to the alveoli –Flow –Muscles of respiration –Lung volumes –Minute volumes, Anatomic dead space Diffusion Transport to periphery Control of breathing

12. Flow Ventilatory flow is due to pressure differences between alveoli and atmosphere Inspiration - generated by active contraction of skeletal muscles Passive expiration – elastic recoil

13. Muscles of respiration Inspiration - diaphragm

14. Muscles of respiration Inspiration Diaphragm External intercostal muscles Accessory muscles –Scalene (Ribs 1 and 2) –Sternocleidomastoids (sternum) –Minor : alae nasi, small muscles head and neck

15. Muscles of respiration Exhalation Passive during quiet breathing –(elastic recoil) Active –Abdominal muscles (rectus abdominus, ext and int obliques, transversus abdominus) –Internal intercostal muscles

16. Lung volumes 500 1100 1200 3000 5800

17. Diffusion CO 2 O2O2 O2O2 Blood to lungs alveoli

18. Transport to periphery Dissolved in blood Attached to haemoglobin –Dissociation curve (temp, CO 2, H +, DPG)

19. Control of breathing Central controller (brain) Sensors (chemoreceptors) Effectors (resp muscles) -Brainstem -Cortex (voluntary control) Central (H + ) Peripheral ( dec O 2, pH, inc pCO 2 )

20. CO 2 vs O 2 Hypoventilation Hyperventilation –Exercise –Altitude –Fatigue, irritability, lightheadedness, panic attacks –Fainting

21. Restrictions to breathing Postural : –supine, prone, sitting Body habitus: –obesity, pregnancy, kyphoscoliosis Clothing: –corsets, tight belts Physiological: –nerve damage (paradoxical), age, disease, training

22. Kyphoscoliosis

23. Pregnancy and obesity

24. THE NEW YORK MEDICAL JOURNAL, NOVEMBER 5, 1887. The Corset: Questions of Pressure and Displacement by Robert L. DickinsonRobert L. Dickinson

25. Yoga breathing Diaphragmatic / Thoracic The complete breath

26. Inhale, and God approaches you. Hold the inhalation, and God remains with you. Exhale, and you approach God. Hold the exhalation, and surrender to God. ~Krishnamacharya

27. Cardiovascular system Wheresoever you go, go with all your heart. Confucius

28. The heart Pump 4 chambers Atria –Priming pumps –Conduits Ventricles Deoxygenated blood to lungs Oxygenated blood to body

29. Unidirectional flow Valves separate chambers Close at differing times in cardiac cycle Heart sounds CO = VR steady state

30. The vascular system Tubes to carry blood around Arteries - oxygenated blood away from heart Veins – deoxygenated blood to heart (note pulmonary vessels opposite)

31. Arteries Arterioles Capillaries (low pressures system, increased area) Venules Veins –Valves (valves) –Reservoir Orthostatic hypotension Muscle pump

32. Coronary arteries Perfuse heart - diastole Tachycardia – dec perfusion Collateral flow Ischaemia Angina Spasm Atherosclerosis Emboli

33. Total blood volume 5000mls Systemic 4000mls Pulmonary 1000mls Blood pressure –Hypertension –Hypotension Cardiac failure

34. Blood Red blood cells White blood cells Platelets Plasma –Proteins –Clotting factors