Chpt 15 Thorax, lungs

• Nasal Cavity: nose, warms, humidifies, filters the air we breath
• Pharynx: back of throat. Connects nose and larynx. and Mouth and esophagus
• Larynx: under chin, just a passage way includes the voice box
• Bronchi and Pleura: upper trachea, anterior to esophagus

• Lower trachea: anterior to esophagus
• Carina: 2 main branches that turn intothe two seperate bronchi
• Bronchi: 2 main stems. 5 twigs/segments
• Brochioles: the tree limbs
• Alveolar duct
• alveolar sac

Lungs

• Apex is top of lung
• Base is bottom of lung is concave where it meets the diaphram

External: gas exchange between lungs and blood. O2 moves from the alveoli-blood and CO2 moves from blood-alveoli

Internal: gas exchange between blood & body tissues. O2 goes-lungs-blood-tissue. CO2 moves from tissue to blood-r heart for reoxygenation

Cellular: gas exchange with cells

blood vessels, nerves and lymphatics in each lung. Blood flow is brochial and pulmonary arteries

provides airway between the larynx and bronchi

airway is between the primary, secondary and tertiary branches. transportation of gases. Mucous is aroung to carry stuff out

a "cardiac notch" spot for the heart to sit

it is a little shorter due to liver

no gas exchange

TAKES PLACE! If no surfactant=atelectaisis with is difficult breathing.

Increase volume/inspiration=contraction/squishing of diaphram. Expiration=expansion of diaphram

breath. CO2 build up forces us to breath

it is a serous, protective lining of the lungs. It reduces friction and maintains NEGATIVE PRESSURE!

• Suprasternal Notch: hole between clavicles. right above the manubrium
• Angle of Louis: triangle formed between the clavicles and point at top of sternum
• Costal Angle: formed by bottom of sternum and ribs

• Inferior angle of scapula: find bottom then follow in to spine=at 10th rib
• Vertebra prominens
• twelth rib

straight down sternum.

down middle of armpit.

Children: bronchiectasis: dilation of bronchial tree. d/t weakening of muscles, cystic fibrosis: sticky, thick mucous buildup in lungs

Adults: lung cx, pneumonia, chronic bronchitis, emphysema

Elderly: pulmonary fibrosis

vertical line. Starts in middle of either the left or right clavical and goes

• AA: Sarcoidosis: inflammation and makes little lumps of cells
• Caucasians: cystic fibrosis: thick mucous

SOB

• Children: nose breath, fast and use abdomen
• Elderly: alveoli and cillia stiffens, overall volume decreases. Have weaker intercostal muscles d/t no longer deep breathing no longer really active so dont use the muscles.
• Pregnant: intercostal angle widens, increase O2 consumption/needs

• AA: increase risk d/t urban/city living
• Asians: smaller chests
• Native Americans: tight living quarters
• Irish: mining/occupational risks

line straight down spine

• Normal: chest transverse is 2x the size of the AP, costal angle <90, rib angle 45
• Barrel: ratio 1:1, equal, costal angle >90, rib angle >45. COPD, emphysema. Cant get air out. Air trapped inside.
• Pectus Carinatum: protrusion in chest, rickets causes this. Weakness and give/poke out under the weight
• Pectus Excavatum: depression in chest (Michelle's Son)

work anterior, posterior, lateral. Work from apex to base. Compare side to side.

• Clubbing: longterm O2 status
• Capillary refill issues: current/present O2 status

decreased lung capacity. catch it while young to wear a "brace" to move it back

• Retraction: occur during inspiration d/t obstruction of freely inflowing air. EX. tracheal/laryngeal obstruction or Foreign body
• Bulging: occurs during expiration d/t an obstruction of freely outflowing air. Ex. enlarged heart, aortic aneyrism, pleural effusion (fluid buildup) sharp pain when cough, pneumothorax

• Tachy-20-24
• Brady->12
• Apnea-no respiration for 10+secs
• Eupnea-12-20

laying flat

energy with each breath cuz the alveoli dont completely collaspe. Like blowing out a candle. The expiration is controlled.

thin and frothy

prululent sputum