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Breathing
Breathing (pulmonary ventilation) consists of two cyclic phases:
inhalation, also called inspiration - draws gases into the lungs. exhalation, also called expiration - forces gases out of the lungs.
Costa
12 pasang Posterior: melekat pada vertebra Costa 1- 7 : di bagian anterior melekat ke sternum melalui cartilago Costa 8-10 : saling melekat satu dengan lainnya, kemudian bersama-sama melekat pada costa ke 7 via cartilago costa Costa 11-12 : melayang, tidak memiliki perlekatan di bagian anterior
Cartilago Costa
Cartilago hyaline Menghubungkan 7 costa pertama ke sternum dan costa 8-10 ke cartilago di atasnya
m. Intercostalis externus
Lapisan superficial Arah ke bawah depan (caudoventral) Penempelan: dari tuberculum costa ke costochondral junction Di anterior menjadi membrana intercostal Fungsi mengangkat costa
m. Intercostalis internus
Lapisan Intermediat Arah ke bawah belakang (caudodorsal) Dari sternum melekat ke angulus costa Di posterior menjadi membrana intercostal Fungsi menurunkan costa
m. Intercostal Innermost
Lapisan otot paling dalam Tidak menutup intercostal secara penuh Meloncat melewati satu-atau lebih spatium intercostal Internal: fascia endotracheal dan pleura parietal External: n. intercostal dan vasa Fungsi mengangkat costa
Otot-otot Pernapasan
Diaphragmmajor inspiratory mm.
External intercostal muscles are inspiratory! Intercostals & accessory mm also help under stress
Expiratorynormally passive, only use mm. to expel things (cough) & when in extreme states (aggressive exercise)
Diaphragma
Otot-otot Pernapasan
During inspiration, the scalene muscles and external intercostals contract. Both sets of muscles are therefore considered primary, and not accessory, muscles of respiration.
Scalene muscle
Muscles of Respiration
1. The diaphragm muscle inserts vertically into a horizontal membranous tendon. Because of its large zone of apposition with the chest wall, the diaphragm depresses like a piston, with little change in curvature until high lung volumes are achieved. This lowers pleural pressure, expands lower ribs, and sucks inward on upper ribs.
2. The crural diaphragm, which depresses the posterior section and doesnt affect the ribs, is innervated by C4-5. The costal diaphragm is innervated by C3-4.
Otot-otot Pernapasan
Inspiration Active contraction of diaphragm (expanding rib cage), passive outward movement of abdominals (opposite for expiration) Otot-otot yang mengangkat costae pada waktu menarik napas biasa ialah : 1. 2. 3. 4. m. intercostalis externus m. levator costae m. serratus posterior superior m. intercartilagineus
m. Levator costae
Pada keadaan dypsnoe berkontraksi juga : 1. mm. Scaleni, 2. m. sternomastoideus, 3. m. pectorales major 4. m. pectoralis minor 5. m. latissimus dorsi ,dan 6. m. serratus anterior
m. Pectoralis major
m. Pectoralis minor
Otot-otot Pernapasan
Pada waktu mengeluarkan napas, costae turun oleh karena berat mereka, berat sternum, berat otot-otot yang menggantung pada mereka dan kekenyalan cartilago costalis Pada keadaan dypsnoe, untuk meniup atau berbicara diperlukan juga kontraksi dari otot-otot : m. subcostalis m. transversus thoracis m. serratus posterior inferior m. obliquus abdominis externus et internus, m. rectus abdominis dan m. transversus abdominis
m. Transversus thoracis
m. subcostalis
Otot-otot Pernapasan
m. Seratus post.inf.
m. Rectus abd.
Control of Ventilation
Center of respiratory
a. Main Groups 1. Pontine Respiratory Group (PRG) 2. Medulla: Dorsal & ventral respiratory groups (DRG & VRG) rostral & caudal VRGmainly expiratory nn. medial VRG (nucleus ambiguous)mainly inspiratory nn. b. Vagus nerveimportant modifier of output from each brainstem nucleus ( tone) c. Spinal-Muscle Anatomy 1. Major respiratory motor neurons found in cervical (C3-C5=phrenic), thoracic, lumbar cord 2. Innervate intercostals, diaphragm, & abdominal mm 3. Separate tracts for voluntary & involuntary mm Corticospinal tract (CST)voluntary Anteriolateral Systemautomatic (involuntary) d. Pre-Botzinger Complexcontains anatomical site of pattern generator neurons
Boyles Law
The pressure of a gas decreases if the volume of the container increases, and vice versa. When the volume of the thoracic cavity increases even slightly during inhalation, the intrapulmonary pressure decreases slightly, and air flows into the lungs through the conducting airways. Air flows into the lungs from a region of higher pressure (the atmosphere)into a region of lower pressure (the intrapulmonary region). When the volume of the thoracic cavity decreases during exhalation, the intrapulmonary pressure increases and forces air out of the lungs into the atmosphere.
Respiratory Cycle
Figure 10.9
Figure 10.10A
Carotid and aortic bodies: sensitive to carbon dioxide, pH, and oxygen levels Conscious control: resides in higher brain centers; ability to modify breath is limited
Regulation of Breathing
Figure 10.13
Central chemoreceptors: in medulla (brain interstitial fluid) Stimulated by: 1. P.CO2 (via pH: most important) Peripheral chemoreceptors:
2. P.O2
3. pH
fig 13-33
26
fig 13-34
Acts on peripheral chemoreceptors ( P.O2 depresses central chemoreceptors) relatively insensitive (potentiated by P.CO2) responds to P.O2, not O2 content (i.e. not to anemia or CO poisoning)
27
Diseases
a. Cheyne-Stokes breathing patternscaused by head injuries or CNS dysfunction; => TV & breathing f / in periodic cycles b. Apneustic Breathing patternsmay be caused by CNS injury; pattern of sustained inspiration w/ brief expiration c. Sleep apneamay occur briefly in normal indiv. d. Obstructive Airways or Drugsmay change ability to respond to hypercapnic challenges