Respiratory System Notes / exam prep

 

Notes By Billy Staggs Cahill

Fall / 2017

Onondaga Community College

Anatomy & Physiology / Nursing

 

 

 

resp1

resp2

resp3

resp4

resp5

resp6

resp7

resp8

resp9

resp10

resp11

resp12

resp13

resp14

resp15

resp16

Exhalation:

  • forceful  exhalation:  active  process
  • muscles  of  exhalation  contract

+  rectus  abdominis

+  internal  intercostals

Factors  influencing  pulmonary  ventilation

  • factors  effecting  rate  of  airflow  and  ease  of  pulmonary  ventilation:
  1. surface   tension
  2.  compliance  of  lungs
  3.  airway  resistance

+  surface  tension

  • must  be  overcome  for  inhalation
  • SURFACTANT :  mix  of  phospholipids  and  lipoproteins  prevents  total  alveolar  deflation  during  exhalation
  • respiratory  distress  syndrome

Factors  influencing  pulmonary  ventilation

+  compliance

  • how  much  effort  needed  to  stretch  lungs  and  chest  wall
  • high  compliance:  chest  wall  expands  easily

INFLUENCED  BY:

  • surface  tension:  surfactant  increase  compliance
  • elasticity:  increase  compliance
  • pulmonary  fibrosis,  scoliosis,  emphysema  

+ airway  resistance  

  • some  resistance  normal
  • narrowing  of  airway  or  obstruction  ↑  resistance  and  more  pressure  needed  for  airflow:  asthma 

LUNG VOLUME AND CAPACITIES 

Samples:

lung v1

 

lung v2

lung v3

lung v4

  • At  rest

+  average  respiratory  rate:  12  breaths  /  minute

+ adapts  to  O2  needs

+  adults  (rest):  12  –  18  br  /  min

(exercise):  40

+  child  (rest):  18  –  20  br  /  min

(exercise):  60

Tidal  volume  (Vt):  volume  of  one  breath:  500  ml  /  breath

Respiratory  minute  volume:  total  volume  of  air  moved  in  /  out  each  minute

(resp  rate  (BPM))  x  (Vt)

=  600  ml  /  min  or  6  L  / min

ALVEOLAR  VENTILATION

alve1

alve2

alve3

alve lec

Visual Notes:

visual1

visual2

visual3

visual4

visual5

visual6

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Lab Practical Prep / Lab # 2

Billy Staggs Cahill

Nursing Student – RN

Fall 2017

Instructor: Dr. Vera Mcilvain PhD 

Anatomy & Physiology

 

Nurses notes / fractures and dressings: 

fracture9

fracture7

fracture8

This patient’s open fracture has been stabilized c external fixation and the wound has been partially closed c antibiotic beads. . . 
fracture1
Antibiotic Beads:

fracture6

___________________________________________________________________

The skeletal system includes:

Bone (hardest connective tissue) 

  • cells, collagen fibers, dense mineralized ground substance 

bones1bones2

Cartilage

Ligaments connect bone – to – bone

Tendons connect skeleton muscle to bone

Other connective tissues

Blood supply and nerves run through the bone

bones3

bones4

PRIMARY FUNCTIONS OF THE SKELETAL SYSTEM:

structural support – site for attachment of tissues and organs

storage of minerals and lipids – calcium salts, yellow bone marrow 

blood cell production – red, white platelets produced in red bone marrow

protection – heart, lungs, brain, spinal cord, reproductive organs 

leverage / movement (together w / skeletal muscle)

bone marrow

Notes and study guide 

 

tib fib 3

Intercondylar eminence, Lateral condyle, Medial malleolus of tibia, Anterior border, Tibial tuberosity, Lateral malleolus, Head of fibula

  • Do not get tuberosity and tubercle confused! Tubercle is the ribs NOT THE FIB – TIB!
  • A and P view — head of fibula same name / fibula head is head of fibula posterior / anterior — SAME!
  • fibula is the smaller bone, TIBIA IS THE LARGER BONE

 

tib fib4

tib fib5

tibfib6

Recall: Sisters — TIB – FIB. “Mrs. Tib and Miss Fib

foot 1

D ⇒ M ⇒ P

  • Distal / Middle / Proximal

    Phalanges – x – X – x

    foot 2

  • I, II, III, IV, V — x – x – x – x – x
  • Toe is I

3 circ

THREE CIRCLES:

Cuneiform — cUnee – form

  1. Medial cuneiform
  2. Intermediate cuneiform
  3. Lateral cuneiform

THEY ARE SIDE – SIDE – SIDE @ top foot, starting below toe. 

CUNEIFORMS:

M I L 

medial — INTERMEDIATE — lateral 

In feet — Metatarsal, in hand / fingers — Metacarpal 

—– SCAPULA

scapula

L and R scapula / both birds peaking out (A, B , F, G) and lower curves inward (D)  > < 

bone1

RECALL:

Looooooooooooooong

short

FLAT

IRreGulaR

 

Anterior 

skel1

Posterior 

skel2

 

a to b

 

Repetitive patterns, mapping, points and memorization OF the skeletal system

 

Recall notes:

Femur – upper leg next to gluteal, below gluteal, has sockets, longish neck and ONE bone. 

Greater and lesser trochanter / curvature / angular neck / 

  • fovea capitis above head / head / neck / 

  • @ bottom → ” the condyles” – lateral/ medial

  • → epicondyle and condyle

  • EPI →  UPPER, condyle is just condyle below epicondyle

  • “wrap” →  patellar surface Anterior / Posterior→  intercondyler fossa, which is where a socket / “dip” is.

  •  A → patellar surface / P → “socket in back” → intercondylar fossa. INTER → “enter bone” place for bone to join.

  • Intercondylar Fossa!

  • medial → “middle” Lateral /   \ Lateral condyle, epicondyle

  • ———— ↑ (line above) intercondylar fossa is LINEA ASPERA, ASPERA! LINEA ASPERA! LINEA ASPERA! 

  • gluteal tuberosity ↑ linea aspera

  • GREATER and lesser trochanter! G and L TROCHANTER

femur1

femur2

Tibia and Fibula – bottom leg before feet / malleolus! NOT condyle! MALLEOLUS! Lateral & Medial

  • head of fibula bot A and S / tibial tuberosity is ANTERIOR always front q x no matter what! TIBIAL TUBEROSITY!

  • ^^ ← Intercondylar eminence / two @ top →→ Intercondylar eminence /

  • lateral malleolus is the bottom of fibula / point outwardly / medial malleolus is middle and bottom tibia! Medial MALLEOLUS is the tibia and Lateral MALLEOLUS is the fibula 

  • ANTERIOR BORDER is the tibia ↑ medial malleolus

  • REMEMBER TIBIAL TUBEROSITY IS ANTERIOR!

tib and fib 1

tib and fib 2

TIBIA AND FIBULA

sacrum

Sacrum → APEX – top of coccyx

Body @ top / posterior — sacral promontory @ top / anterior

MEDIAN SACRAL CREST / NOT medial, but median!

Radius and Ulna

ur

DISTAL RADIOULNAR JOINT

RADIUS / ULNA

DISTAL RADIOULNAR JOINT

 

randu2

 

E  head of radius  D → neck of radius C → radial tuberosity  F → olecronon G → trochlear notch H → coronoid process I → proximal radioulnar joint K → interosseous membrane B → radius J → ulna A → radial styloid process N → distal radioulnar JOINT! (DO NOT THINK NOTCH! IT IS A JOINT) M → ulnar styloid process L → head of ulna

radius and ulna

  • 1 → distal radioulnar joint

  • 2  → ulnar styloid process

  • 3 → olecronon

  • 4 → trochlear notch

  • 5 → coronoid process (notice the triangular top)

  • 6 → radial styloid process

  • 7 → radial tuberosity

  • 8 → head of radius (think of nail head for identification in lab)

  • 9 → radial notch of the ulna / proximal radioulnar JOINT

  • 10 → lateral epicondyle

  • 11 → olecronon fossa

  • 12 → coronoid fossa 

 PROXIMAL AND DISTAL ENDS! – DISTAL RADIOULNAR JOINT AND PROXIMAL RADIOULNAR JOINT

Radius: Thumb Side, Ulna: Little Finger Side.

radius frac

FEMUR (the condyle and trochanter bone)

femurl1

1 → head of femur

2 → lesser trochanter

3 → medial epicondyle

4 → linea aspera

5  →  lateral epicondyle

6 → greater trochanter

7 → lateral condyle

8  → medial condyle

9 → patellar surface

10  → neck of femur 

femurl3

 

femurl2

  1. Recall:
  2. FEMUR — condyle and epicondyle , lateral & medial
  3. TIBIA AND FIBIA — malleolus, medial and lateral
  4. FEMUR — lesser and greater trochanter
  5. RADIUS AND ULNA — styloid process, radial and ulnar, also distal and proximal radioulnar joints
  6. FEET — cuneiforms, medial, intermediate and lateral + calcaneus, cuboid, talus, navicular
  7. HAND — “ates”, hamate, lunate, capitate + triquetrum, pisiform, trapezium, trapezoid, scaphoid

FEET — tarsals

HANDS — carpals 

w / feet — recall cuboid:

cuboid

  • the sides and top, etc look like a cuboid, not exact, but close

cuboid 2

CUBOID is aligned w/ the cuneiforms (medial —  intermediate — lateral) → CUBOID

navicular and calcaneus are below and appear bigger / longer (to me anyway)

 

clavicle

R and L hints:

  1. Humerus – hold the bone so that the capitulum and trochlea face YOU (anterior)

-if the head faces left – it is a left humerus

  1. Ulna – face the trochlear notch away from you (U-shaped process) and look at the olecranon

-ask yourself – on what side is the radial notch?
-if it is on the right – it is a right ulna

3. Radius – orient the bone with the round head UP and the distal end DOWN
-look at “bumps” at the distal end
-look for the styloid process at the distal end
-if it is on the right side – it is a right radius

4. Scapula – hold the bone with the spine facing YOU and the apex facing DOWN
-if the acromion faces left – it is a left scapula
-NOTE: the corocoid process is spelled with a “c” and so is “scapula”

5. Femur – the head must face IN and the lesser trochanter must be on the BACK side of the bone
-so hold the bone so that the head is on top and the trochanters are on the BACK surface of the bone
-if the head faces left – it is a left femur

6. Tibia – hold the bone so that the intercondylar eminence is towards the top and you are looking at the tibial tuberosity
-if the medial malleolus on the distal end is on the left side – it is a left tibia

7. Clavicle – a. point the flat sternal end toward the midline
b. the clavicle bulges OUT then IN
c. the conoid tubercle must point DOWN

TELLING THE TYPES OF VERTEBRAE APART

  1. Cervical – three holes, forked spinous process
  2. Thoracic – one hole, long, thin spinous process
  3. Lumbar – one hole, processes are thick and large
  4. Atlas – looks very different, almost like a circle
  5. Axis – look for the “dens” near the body

Corocoid – “c” in scapula
Coronoid – “n” in ulna (or mandible)
Conoid – is the clavicle

 

Mesenchyme

Microsoft Word - Frontiers Manuscript 061513 Revised Manuscript

Ossification — Bone formation 

ossification

mesen2

oss1

 

It’s all transitory

Derived!

Origin of bone cells

FROM BONE CELL LINEAGE ——

osteogenic cell develops into an osteoblast:

osteogenic cell →→ osteoblast →→ osteocte

bone cell

osteo1

OSTEOCLAST is from white blood cell lineage

lacunae

osteocytes 

  • most numerous
  • mature bone cells / non – dividing
  • develop from osteoblasts
  • one osteocyte / lacuna (space)
  • connected by canaliculi 

cana

canaliculi — small canal or tubular passage

can –  a – lick – u lie

cana2

functions:

x – bone maintenance nutrients / waste exchange

x – turnover of matrix components

x – repair damage

x – “strain sensors”

x – can convert back to osteoblasts or osteoprogentetor if needed

 

 

 

 

Metabolism / Triglycerides

Notes by: Billy Staggs Cahill

Nursing Student – RN

A&P Instructor: Dr. Vera Mcilvain PhD / Adjunct Professor 

Fall 2017

Onondaga Community College 

tri info

triglyc

triglyc2

   Chylomicrons

  • Are lipoproteins
  • they consist of 95% triglycerides (core, inside)
  • They transport dietary lipids from the intestines to other parts of the body

 

Adipose Tissue

adipose1

adipose2

adipose3

 

Lipid Panel

Checks for different types of cholesterol. There are good and bad kinds of fats.

It is recommended by the American Heart Association, anyone 21 and older get checked frequently / have a lipid panel done every 5 years.

There should be an overnight fast before the lipid panel is given. 

There are hardly any symptoms when triglycerides are high.  “silent but can be deadly” 

lipid panel

Dieting for triglycerides:

  • Target: To decrease triglyceride levels
  • Remember: Eating before a lipid panel is given can influence the results

The patient must be informed of a good diet to help lower triglyceride levels / cholesterol.

There are many different diets, ways, routes to target levels.

Quick Notes:

A good breakfast with milk, fruit and wheat toast is a start, eat a light weight meal q 2 – 4 hrs.

Cut sugars — replace c fruit, this can eliminate the craving for sugars / carbs

Eat fiber

Limit fructose

moderately low – fat diet

omega -3 fatty acids

Exercise regularly

Examples:

Replace x sugar craving c fruit: if a desire for a piece of cake / replace c  apple or orange (any fruit desired).

x – breakfast → fruit, wheat toast, no more than 1 egg

x lunch →  fruit or vegetable c tuna, wheat bread, chicken or anything healthy that cuts fat. Take vitamin in between meals.

x dinner →  vegetable, replace starch, flour c sweet potatoes, green beans, &c. fish, chicken, wheats, fruit snacks, peanut butter, &c. All good / limit serving / maintain good eating habits c nutrition.

q d / take vit / omega / exercise / eat healthy / watch carb intake along c sugars / glucose &c.

  • Sensible decisions to maintain good triglycerides.
  • Once back to normal, keep practicing good health

tri food