ANHB2212 Final: ANHB2212 EXAM NOTES: Thoracic Cavity and Lungs

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Thoracic Cavity and Lungs
Mechanisms of Breathing:
• Breathing → repetitive cycle of inspiration and expiration
• Different types of breathing
o Quiet
â–Ş Relaxed, unconscious, automatic
â–Ş Diaphragm and intercostal muscles
o Forced
â–Ş Unusually deep or rapid breathing
â–Ş Diaphragm, intercostal muscles, accessory muscles
• Inspiration
o Active part of breathing
o Air is sucked into the lungs by reduction in the intra-thoracic
pressure associated with increased thoracic volume
o External intercostal muscles contract after nervous impulse
stimulus
o Diaphragm moves down towards abdomen → induces expansion
of thoracic cavity
o Lung is connected to chest wall via pleura → because of the pleura
the lungs and chest are pulled in opposite directions
o Result → negative pressure in pleural cavity keeps the lungs
expanded and decrease pressure in alveoli → pressure gradient
o Air flows down gradient and ventilates alveoli
• Expiration
o Passive part of breathing
o Elastic recoil of the alveoli forces the air out of the lungs
o Intercostal muscles contract (via ribs) and move into original
position
o Diaphragm moves back → reduces space in thoracic cavity →
increase pressure in lungs
o Recoil of thoracic cage compresses the lungs and raises the intra-
pulmonary pressure → +10cm H2O
o In forced breathing the accessory muscles raise the pressure
substantially → +40cm H2O
The Thoracic Cage:
• Comprises the thoracic vertebrae, ribs and sternum
• Ribs and sternum form the rib cage that support the walls of the thoracic
cavity
o Broad inferiorly
o Narrow superiorly
o Relatively flattened in the anterior-posterior plane
• 2 functions
o Protection for structures within the thoracic cavity
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o Attachment point for muscles involved in
â–Ş Respiration
â–Ş Movement of vertebral column
â–Ş Movement of pectoral girdle and upper limbs
• 12 thoracic vertebrae are posterior
• Sternum is anterior
• 12 ribs on each side and respective costal cartilage
o True ribs
▪ First 7 pairs → vertebrosternal ribs
â–Ş Articulate directly via separate costochondral cartilages to
sternum
â–Ş Gradually increase in length and radius of curvature
o False ribs
▪ Comprise ribs 8-10 → vertebrochondral ribs
â–Ş Fuse together before reaching sternum
â–Ş Shared costochondral cartilage
o Floating ribs
â–Ş Ribs 11-12
â–Ş Do not articulate with sternum
• Thoracic inlet
o Superior opening of thoracic cage
o 5cm anteroposteriorly, 10cm transversely
o Bounded by
â–Ş Superior border of manubrium
â–Ş Posteriorly by body of T1
â–Ş Laterally by inner border of 1st ribs
• Thoracic outlet
o Inferior opening
o Bounded by
â–Ş Posterolaterally by 12th rib
â–Ş Anteriorly by xiphoid process
▪ Anterolaterally by costal margin → cartilaginous ends of
ribs 7-10
• Costal margin
o Portion of the inferior side of the thorax
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o Defined by articulated cartilage of ribs 7-10
o Forms a large inverted V-shape on inferior border
Joints of the Ribs and Sternum:
• Ribs articulate with sternum via costal cartilage
• Extends medially from anterior rib ends and articulate with the sternum
(ribs 1-5) or costal arch (ribs 6-12)
• Shows typical structure of hyaline cartilage
• Bound to sternal end by continuity of periosteum of bone and
perichondrium of cartilage
• Semi-moveable joint → permits flexibility in the rib cage whilst keeping
ribs connected to sternum → allows rib cage to expand with lungs
• Also serves to some degree as a shock absorber to anterior blows to the
thoracic cage
• First rib articulates via a synchondrosis → little flexibility
• 2-7th ribs articulate via a synovial sternocostal joint → allows slight plane
movement
• Joint between manubrium and body of sternum is a synchondrosis →
manubriosternal
• Joint between body and xiphoid process is also a synchondrosis →
xiphisternal
• Sternal angle increases with inspiration
• True and false ribs articulate with vertebrae by 2 joints
o Costovertebral
o Costotransverse
• Costovertebral joints
o Between the bodies of each 2 typical thoracic vertebrae
o Cupped depression in IVD that is completed superior and
inferiorly by slightly concave facets in the side of adjacent
vertebrae
o Head of each typical rib has 2 articular facets → superior and
inferior
o Both fit into depressions → crest bounf to IVD by short, thick,
intra-articular ligament
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