Lecture+1+-+Cardiopulmonary+Anatomy+and+Physiology.pdf

Cardiopulmonary Anatomy and Physiology Dr. VanWye, PT, DPT, PhD Board-Certified Clinical Specialist in Cardiovascular and Pulmonary Physical Therapy Objectives 7250.1 – Describe the anatomy and physiology of the heart, lungs, and respiratory and circulatory system and the effects of exercise...

Cardiopulmonary Anatomy and Physiology Dr. VanWye, PT, DPT, PhD Board-Certified Clinical Specialist in Cardiovascular and Pulmonary Physical Therapy Objectives 7250.1 – Describe the anatomy and physiology of the heart, lungs, and respiratory and circulatory system and the effects of exercise on cardiorespiratory function. Cardiopulmonary Physical Therapy Step 1: Inspired O2 Step 6: Myocardial function Step 2: Airways Step 7: Peripheral Step 3: Lungs and chest circulation wall Step 8: Tissue extraction Step 4: Gas exchange and use of O2 Step 5: Perfusion Step 9: CO2 back to and out of the lungs Respiratory System Pump Bony thorax Muscles of ventilation Ventilation and gas exchange organ (lungs) Upper and lower airways Pulmonary circulation Ventilation vs. Respiration Ventilation Air movement Anatomical and mechanical (visible) Respiration Gas exchange Physiological (cellular, tissue level) Bony Thorax Sternum Ribs 7 True 8-12 False 11-12 Floating Muscles of Ventilation Inspiration/inhalation Expiration/exhalation Diaphragm (primary) Passive at rest naturalrecoil External intercostals Active with exertion Sternocleidomastoid Abdominal muscles Scalenes Internal intercostals Trapezius Respiratory System – Pump Pleura Parietal and visceral layers Pleural space (cavity) Pleural fluid  Ventilation Occurs due to a pressure gradient Air moves from high to low pressure Atmospheric pressure is 760 mmHg  02 21 in air Ventilation – Inspiration At rest, the lungs are compressed on all sides Anterior-posterior by the sternum and ribs Laterally by the ribs Inferiorly by the diaphragm When the inspiratory muscles contract, the thorax expands relieving the compression on the lungs Ventilation – Inspiration Anterior-posterior thorax expansion Pump handle Ventilation – Inspiration Lateral thorax expansion Bucket handle Ventilation – Inspiration Inferior expansion Diaphragm contracts and flattens, the lungs expand inferiorly Ventilation – Inspiration This thorax expansion increases lung volume/size The pressure in the lungs decreases to 760 mmHg Air rushes out into the atmosphere Gross Anatomy Apices of the Lungs 1. Trachea R L 1 2. Bronchi Upper or Upper or superior lobe superior lobe a. Right main bronchus 2b b. Left main bronchus 2a Middle lobe Lingula Lower or Lower or inferior lobe inferior lobe Bases  Application Right Main Bronchus 2a – Right main bronchus R L More vertical orientation Increased aspiration 2b risk 2a Ventilation and Gas Exchange Organ There is a conducting zone for ventilation These are the larger, upper airways that move air in and out of the lung space No gas exchange occurs in this zone dead Anatomical There is a respiratory zone for gas exchange These are the smaller, lower airways where gas exchange occurs space dead physiological The Conducting Zone Upper Airways 2 1. Pharynx 2. Larynx 3 3. Trachea 4. Right and left bronchi 4 5. Terminal bronchioles Terminal for theconductingzone 1 5 2 Respiratory Zone Lower airways Respiratory bronchioles Alveolar ducts Alveolar sacs Alveoli This is where gas exchange takes place Gas Exchange Also known as respiration Millions of alveoli provide a large surface areakeything Equal to the size of a tennis court Gas Exchange Alveoli are highly vascularized for O2 and CO2 exchange Capillaries lie on top of alveoli Interstitial or extracellular space Alveoli are composed of simple squamous epithelial tissue This provides a thin wall and surface area for simple diffusion Gas Exchange Ventilation-perfusion (V/Q) Disease can cause a mismatch V/Q is affected by gravity V/Q >1 Air and blood settle in ↓ perfusion (Q) the dependent zones Deadspace Blood weighs more, so Q V/Q