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AnatomyRespiratory — Transcript

by Dr. Naveen Jalota, M.D. · 9,452 words · 1,382 segments · language en · Watch on YouTube

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0:00hello and welcome let's start talking
0:03about let's start by talking about the
0:06respiratory system so here now when we
0:08go through and we talked about the
0:10respiratory system again we'll go
0:11through first and we'll talk about all
0:12the different components there as well
0:15and then we'll go through each
0:16individual component like we did with
0:18gastrointestinal system so here first
0:20what we'll do is I'll introduce you to
0:23the components that make up this
0:24respiratory system and I'm gonna go
0:26through the basic functions and then
0:27we'll go through and hit each every each
0:29and every one of those different
0:31basically parts so here now when we go
0:34through you can see this is making up
0:36basically the respiratory system now we
0:38can see here the majority of it and
0:41there are some parts that we're not able
0:43to see that we're going to see why us
0:45zooming in on to the lungs and looking
0:47at them then in greater detail so first
0:50here let's see we could see when we talk
0:52respiratory system first we've got what
0:54we call the nose the nasal cavity will
1:02see our paranasal sinuses that we have
1:05already looked at and we've talked about
1:07in relation to all the various bones
1:10we've seen right around this nasal
1:13cavity your pharynx aka your throat your
1:21pharynx next in here we've got our
1:23larynx larynx and then we've got the
1:29trachea the trachea or windpipe aka
1:34right and then you can see here it
1:37divides the trachea divides it divides
1:39into our bronchi and then more
1:41specifically speaking you can see you
1:44can have right and left main bronchi or
1:46primary bronchi so that's what we're
1:50seeing here and then they're going to
1:52subdivide even further and further as
1:56they move deeper into the lungs kind of
1:59like arteries do so when we move there
2:04we'll see then the main bronchi plus
2:06they're successively smaller branches
2:09all the way to the level of the alveoli
2:14that are inside the lungs and then we'll
2:16look at all of that stuff when we move
2:18down to the inside of the lungs so all
2:23the various parts of the respiratory
2:25system now let's go through the basic
2:27functions here so we go through
2:28functions a main function we have here
2:31is gas exchange to supply the body with
2:35oxygen and rid the body of carbon
2:39dioxide remove co2 dispose of co2 now
2:44between the blood you can see an air so
2:47know how does all of this happen this is
2:50going to happen thanks to four processes
2:55that are going to collectively be called
2:59respiration now we'll go through we'll
3:04look at these four processes in a few
3:05seconds before we do that let me go to
3:07the rest of the functions here speech
3:09and other vocalization Oh faction the
3:15sense of smell right we've gone through
3:16we've talked about we've seen where that
3:18was also the respiratory system is going
3:21to help control the pH of the body the
3:23body's pH it'll work with will see our
3:26kidneys it aids in regulation of blood
3:32pressure by assisting angiotensin ii
3:36production if you recall our Roth system
3:40helps create pressure gradients for the
3:43flow of lymph and venous blood also it's
3:49involved with the expulsion of abdominal
3:51contents with defecation and we have the
3:56valsalva maneuver where you'll close the
4:01glottis applying pressure basically in
4:04that abdominal cavity so all various
4:09functions of the respiratory system
4:10let's focus in here on the first
4:12function this is what we're going to be
4:15really concerned with that's gas
4:16exchange right we talked about we'll
4:19talk to other vocalization in speech
4:21when we get to the vocal cords smell
4:23we've already checked out we've looked
4:24at pH control you'll see that in physio
4:27here we saw with endocrine okay this
4:31we're going to see with cardiovascular
4:33and in this here we saw now as we
4:36mentioned so let's talk then respiration
4:40let's talk four processes that we refer
4:41to as respiration now here these four
4:44processes that we refer to as
4:46respiration are going to be known as
4:48pulmonary ventilation number one
4:51pulmonary ventilation will see as number
4:54one when we talk pulmonary ventilation
4:57pulmonary ventilation is basically
5:00breathing so what I'll do is all right
5:01that appear as number one and then we'll
5:05write P and a V for pulmonary
5:09ventilation or breathing now when we
5:13talk pulmonary ventilation or breathing
5:15this is exactly what its name says
5:18pulmonary ventilation or like we said
5:20breathing this process okay this is one
5:24of the four processes that are going to
5:26cook are going to be basically making up
5:30what we call we said respiration where
5:32this is going to help with gas exchange
5:35so we'll see if one of these four
5:37processes aren't working doing their job
5:40basically then gas exchange respiration
5:43is not going to be occurring properly
5:45there either
5:46okay so first pulmonary ventilation
5:48pulmonary ventilation is the process of
5:49breathing you know like we said it's
5:51talking about the process of moving
5:53oxygen right in to and co2 out of oxygen
6:06into the lungs and co2 out of the lungs
6:15so again for you to be able to exchange
6:17gas you have to be able to get air into
6:21and out of the lungs so you have to be
6:24able to get air into and out of the
6:25lungs and we get more specific basically
6:27getting oxygen into and co2 out of the
6:30lungs right if we have this process
6:34let's say traumatic accident where you
6:38know a patient has
6:39something on top of their chest and you
6:42hear this a lot even I work on cars I
6:45like working on cars so I hear this a
6:47lot with mechanics give the car not
6:51being properly stabilized and it leading
6:55to a traumatic accident where now it's
6:58on the individual nobody is there or
7:01this individual is unable to get this
7:03vehicle off and now this pulmonary
7:05ventilation step is going to not be
7:07occurring so then gas exchange is not
7:10going to be occurring okay so you see
7:12how this is all part of a big picture so
7:14first you have pulmonary ventilation
7:15right so you have to be able to refresh
7:17these gases refresh this air next then
7:21we're going to talk about external
7:24respiration external respiration when we
7:27talk about external respiration the
7:29second process external respiration is
7:31talking about the movement of oxygen now
7:34from the lungs from the lungs into the
7:37blood let's just draw a blood vessel
7:40right here next to the lungs
7:45okay so here we're going to see in the
7:49next region this is actually your
7:50pulmonary circulation so here we can see
7:54now we've got air in right so oxygen
7:57made its way all the way down into the
8:00lungs okay so oxygen made its way all
8:07the way down right and co2 is what then
8:10made its way out is what we're looking
8:12at here okay so now we've got this
8:14oxygen inside the lungs now the second
8:17step okay the second step I'm talking
8:20about here external respiration okay
8:25external respiration you can see now is
8:29dealing with the movement of this oxygen
8:32from the lungs and into the blood vessel
8:35we have to be able to move that oxygen
8:38into the blood vessels and again
8:41vice-versa for co2 always think opposite
8:43for co2 now if this doesn't occur right
8:47gas exchange is it occurring again going
8:49back to the function so this here you
8:52can see is step
8:53to the number three is dealing with the
8:57transport we have to be able to move
9:00this gas now this oxygen to its proper
9:05place now this oxygen we're talking
9:07about moving to organs and tissues and
9:10cells so I'll just draw a little cell
9:12here just to kind of give you that idea
9:14and here you can see you've got a little
9:16epithelial cell okay so it's making up
9:19you know tissue is the big picture we
9:21want to get here so make this nucleus a
9:24little bit more circular alright so now
9:29we have to be able to move transport
9:32this gas right oxygen to the tissue
9:37cells and co2 vice-versa
9:40so this now is step three now step three
9:45is transport of gases so transport of
9:50respiratory gases now involves which
9:53system you can see now we've got
9:56cardiovascular system coming in so
9:58without the cardiovascular system these
10:00last two steps would not be able to
10:02occur now fibrosis is one problem that
10:07can occur here let's say an occlusion is
10:10another problem that can occur here now
10:12let's see and now step 4 step 4 is going
10:15to be internal respiration internal
10:20respiration now when we talk internal
10:23respiration internal respiration is
10:25going to deal with now the movement of
10:27these gases from that circulatory system
10:31from the blood vessels now from the
10:35blood the blood vessels to the tissues
10:38cells to the tissues cells so that
10:42oxygen now actually moving into the
10:44tissue cells and opposite up co2 as
10:49we've described so here you can see now
10:51this is internal respiration now these
10:54four steps these four processes
10:56collectively okay so we'll say here
11:00these four processes collectively make
11:06up what
11:07we referred to them as respiration and
11:21that is how gases will be exchanged at a
11:27basic level right at a basic level next
11:34time let's move down let's go through
11:36all of these different structures here
11:40now and let's actually classify them
11:42into two categories okay so let's do
11:46this let's look at then let's go back
11:50here
11:51so first way to divide these components
11:55you can see is a conduction it is going
11:58to be through this conducting division
11:59and respiratory division and also
12:01through an upper respiratory tract and a
12:04lower respiratory tract so let's do this
12:05division here first and then we'll jump
12:07into this division here in greater
12:09detail so here when we go through we
12:11talk upper respiratory tract nose
12:13through larynx lower respiratory tract
12:17then trachea down to the lungs trachea
12:22okay trachea through the lungs lower
12:25respiratory tract upper nose through
12:30larynx that's upper respiratory tract
12:34hiepro you're familiar with upper
12:36respiratory tract infection lower
12:37respiratory tract infection okay so this
12:39is where we're relating that to okay so
12:42that's what they're talking about
12:43they're talking about those specific
12:45regions or specific areas so let's
12:48divide everything up into zones
12:50conducting zone and respiratory zone so
12:52here first I want to talk to you about
12:54your respiratory zone now when we talk
12:56respiratory's own respiratory zone I
12:58want you to know first is your actual
13:01site of gas exchange it's the actual
13:04site of gas exchange it is composed of
13:09your respiratory bronchials your
13:15alveolar ducts
13:19and your alveoli these are all your
13:23microscopic structures so let's zoom in
13:26basically in here and let's look at all
13:29of those structures so let's move all
13:32the way to right inside of here now so
13:37first you can see the branching pattern
13:40through the lungs so I told you these
13:43primary bronchi are going to make their
13:45way deeper into the lungs and as they
13:46make their way deeper than lungs I told
13:48you they're going to give off
13:49successively smaller branches right so
13:51that's what you see we refer to this
13:53branching pattern as the bronchial tree
13:57branching pattern okay it looks like a
14:00tree and fall okay basically no leaves
14:04it's all the branches that you see there
14:05so here now you can see as we make our
14:09way all the way in so this is going all
14:10the way through okay this is the alveoli
14:13the ending basically so here now when we
14:17talk respiratory zone it's I told you
14:20the actual site of gas exchange so it's
14:22going to be made up of what we call the
14:26respiratory bronchioles so you can see
14:28coming all the way into here and making
14:32our way all the way right before the
14:35alveolar cluster you can see is the
14:39respiratory bronchial
14:40that's where then the respiratory zone
14:42will begin look at this picture here you
14:45can see coming all the way into the
14:47lungs making our way all the way towards
14:48the ending okay so we zoom in on this
14:51area here and we zoom in on that area
14:53here there's the same picture that we
14:54just saw you can see you got your
14:56terminal bronchioles then here you can
14:58see the respiratory bronchioles so it's
15:01composed of the respiratory bronchioles
15:03we said then the alveolar ducts right
15:06the ducts leading to the alveoli and
15:08then the alveoli themselves all
15:11microscopic structures that's why you
15:14can see here we've had to zoom in on
15:15these structures to be able to
15:17appreciate them so this is your
15:21respiratory zone from here down to the
15:26alveoli and if we
15:29from here okay from the terminal
15:31bronchioles if we go from these terminal
15:34bronchioles and we go basically all the
15:36way up and we go all the way up okay so
15:40if you go from the terminal bronchioles
15:42you got these bronchioles and we go all
15:44the way up back up into here all the way
15:49up into the trachea the larynx okay all
15:54the way back up into here now all of
15:57these structures now make up what we
15:59call the conducting zone what are they
16:02doing very good they're conducting this
16:06here they're conducting this air through
16:10two of the alveoli and away from the
16:14alveoli so these are what we call your
16:17conducting zone structures so we talk
16:20conducting zoning it includes all other
16:22respiratory passageways apart from what
16:26we saw those respiratory bronchioles the
16:29ducts of the alveoli and the alveoli
16:32themselves now what do these conducting
16:37zone structures do besides conduct air
16:40they're also going to they're also going
16:45to be responsible for cleaning
16:49humidifying warming and creating
16:55turbulence in this air which is going to
17:00be involved with again helping to clean
17:02and humidify and also warm this incoming
17:06air so by the time it reaches the
17:11alveoli the temperature has changed and
17:15it's cleaned and then we said the
17:19respiratory zone is the actual site of
17:22gas exchange you make sense so let's go
17:29through the various organs let's start
17:31with the nose first now when we talk
17:32about the nose the nose is the only
17:35externally visible part of this
17:39respiratory system everything else is
17:41hidden inside you don't see it
17:43pretty cool no we both are we talk about
17:45the knows the function of the nose
17:47number one it provides an airway for
17:49respiration number two it's going to
17:53moisten and warm this entering the air
18:00number three it filters and cleans
18:05inspired air number four it serves as a
18:12resonating chamber for speech number
18:18five
18:19it houses the olfactory or your smell
18:25receptors now when we talk about the
18:30structures in relation to the nose you
18:34can see the nose is going to be divided
18:36in two it's an external nose and an
18:40internal nasal cavity we erase all this
18:47so if you divided up into an external
18:50nose and an external nose and an
18:54internal nasal cavity so you could see
19:04that there then as two separate
19:10divisions in so here now let's focus in
19:15on this region in greater detail so we
19:17focus in on this region there that in
19:19greater detail here we could see first
19:21the external nose so let's go through
19:24the external nose and then we'll check
19:26out the internal notes now when we talk
19:28about this external nose the external
19:29nose you can see is made up of a few
19:31parts and we'll go through these few
19:33parts here you can see number one this
19:35external nose is found located between
19:37the orbits and then also superior to
19:40that oral cavity now here you can see
19:44first we have what we call the root of
19:47the nose is where the nose you can see
19:51is going to begin this is where then you
19:53can see those nasal bones
19:56are going to be found right articulating
20:00with the rest of these bones here here
20:05you can see in greater detail then those
20:09two nasal bones frontal bone if you
20:13recall then we had our maxillary bones
20:17right and then here we have cartilage
20:24are they telling us okay very good which
20:27cartilage which cartilage do we see out
20:31here making up that nose right is it
20:34fibrocartilage know is it elastic
20:39elastic was easy right because it's only
20:41found in its elastic it's easy because
20:45it's only found in the epiglottis and
20:48the ear that you have to know if at 40 s
20:50so nope no last one left so here then
20:56when we go through then we go through
20:57and you can see that those two nasal
20:59bones so the root we're going to see
21:02where that nose is going to begin at we
21:05refer to that then here we're going to
21:06see the bridge so this leads us to the
21:08bridge then here you can see you've got
21:11the bridge so the bridge in the root are
21:14found between the eyebrows and the
21:18orbits the orbital cavities the bridge
21:24then will lead us to the dorsum nasai
21:26the dorsum NASA this is that you can
21:28think of the arch the arch of the nose
21:32which will then lead us to the apex the
21:36apex or the terminal part the tip of the
21:38nose and then from the tip of the nose
21:41we can see if we flare laterally then we
21:45encounter the LA the wings at the wing
21:48like parts the LA and they're going to
21:54help form the nostrils
21:56they will help form daenerys the
21:59nostrils so when we talk then the nasal
22:03cavity the nasal cavity is internal it's
22:07found lying
22:09in and posterior to this external nose
22:16we've got first then veneers
22:19they're gonna allow air to pass into the
22:22nasal cavity the nostrils right next we
22:26have the nasal septum it divides the
22:28nasal cavity into equal right and left
22:30halves and you should be able to recall
22:33the bones that we have there and in the
22:37parts of the bones as well specifically
22:39speaking so let's look at the inside now
22:42when we look at the inside you got this
22:44view here in this view here okay some
22:47nice views let's zoom in on this views
22:49basically what we're doing here so here
22:51we could appreciate now the posterior
22:54nasal aperture the posterior nasal
22:58aperture is found you can see right
23:02inside of here this posterior nasal
23:06aperture is basically you could think of
23:09the archway and it allows this nasal
23:12cavity to be continuous with the nasal
23:16pharynx it allows the nasal cavity to be
23:23continuous with the nasal portion of the
23:26pharynx or more specifically speaking
23:29the nasal pharynx next then we're able
23:34to appreciate here the roof and the
23:36floor of the nasal cavity the roof of
23:40the nasal cavity is formed by the
23:44ethmoid bone and the sphenoid bones of
23:49the skull you can see that here very
23:53clearly now when we talk about the floor
23:57the floor of this nasal cavity is formed
24:01by the palate the palate we had two
24:06divisions hard and soft right so I'm
24:09just saying palate because both are
24:11involved here no here you can see first
24:13we have the hard palate and then here we
24:17can appreciate the soft palate which led
24:20us to the uvula the pendulous structure
24:23we saw at the dorsal aspect of that oral
24:26cavity and then the two here helped to
24:29close off that entrance into the nasal
24:31pharynx when we swallowed right we
24:32discussed all that when we talked about
24:34gastrointestinal system GI tract so you
24:40can see why then cleft lip cleft palate
24:45can become problematic for the patient
24:48and we have to go in surgically and help
24:51repair this next then we have the nasal
24:56vestibule so I want you to make sure you
24:58understand the cleft lip palate
25:00now your hundred-percent gear have to
25:02know everything about that we've talked
25:03about the bones and we've talked about
25:05this now and rinsing this condition
25:08second time now so nasal vestibule then
25:12we talk nasal vestibule the nasal
25:14vestibule vestibule we've used this term
25:16now a few times vestibule you can see
25:19now is a part of the nasal cavity that's
25:22found just superior to the nostrils it's
25:25the part of the nasal cavity just
25:27superior to the nostrils the nasal
25:30vestibule
25:31so the recess is a space you could think
25:33of found just superior to the nostrils
25:37it's lined with skin that's going to
25:41contain sebaceous glands sweat glands
25:47and numerous hair follicles those hair
25:54follicles will contain the Vibrio say
25:57the hairs those Vibrio say the hairs
26:00what they're going to do is they're
26:01going to they're going to filter horse
26:04particles from this inspired air they
26:08will filter very coarse particles from
26:12this inspired air you also have inside
26:19of here olfactory mucosa besides that
26:27I'm so you also have olfactory
26:29epithelium factory because you're gonna
26:31find her up inside of here besides we'll
26:34see basically nasal
26:36Koza so we're gonna have a couple of
26:38different types of miko say inside of
26:39here so first let's talk olfactory
26:41mucosa olfactory mucosa
26:44we've talked a little bit about before
26:45okay it's the olfactory because there's
26:48gonna be mucous membrane it lines the
26:50slit like superior region of the nasal
26:55cavities right specifically speaking we
26:57said it's found on the superior nasal
26:59conchae so you could see those right
27:02inside of here now again and this whole
27:07factory mucosa is going to contain your
27:09smell receptors the main component we
27:11had there also inside of here is going
27:15to be then respiratory mucosa refer to
27:18it as respiratory mucosa now respiratory
27:21mucosa is going to be made up of pseudo
27:24stratified ciliated columnar epithelium
27:28pseudo stratified ciliated columnar
27:31epithelium it will contain scattered
27:36goblet cells that are going to rest on
27:42lamina propia
27:46that is richly supplied with mucous and
27:52serous glands which produced then mucous
28:00and watery fluid that's gonna contain
28:03enzymes within this nasal cavity we also
28:12have lots of sensory nerve endings so
28:17that nasal mucosa is richly supplied
28:21with sensory nerve endings when they
28:25come into contact with irritants this
28:29triggers the sneeze reflex so when they
28:33come into contact with irritants this
28:35trigger is the sneeze reflex and
28:38sneezing it forces air outward it forces
28:44air outward in a violent burst and
28:48that's a way
28:50of expelling those irritants from this
28:53pathway also within this cavity are
29:00going to be capillary plexuses capillary
29:04plexus are gonna be found in abundant
29:06quantities and they underlie the nasal
29:10epithelium what they're responsible for
29:14doing is they're responsible for warming
29:16this incoming air unfortunately
29:21sometimes putting our introducing our
29:26finger into the nasal cavity and
29:29reducing the digit into the nasal cavity
29:31and irritating the mucosa can lead to
29:35nosebleeds or even naughty of putting
29:42your finger inside your irritating
29:44scratching like this or you know doing
29:46other things there can also lead to
29:48these capillary plexuses bursting and
29:50you having what we call it these taxes
29:52they're bloody nose so nasal conchae you
29:59can see there's three we've spoken of
30:01them before now they're scroll like
30:05mucosa covered projections I've
30:07described them to you as and you can see
30:10they protrude medially from each lateral
30:13wall of the nasal cavity and they
30:17increase the mucosal surface area they
30:22enhance air turbulence in that cavity
30:28also again you have three of them one
30:33two three or they're better known as the
30:36superior nasal Concha middle nasal
30:39Concha and inferior nasal Concha and
30:42then right beneath each of them you can
30:45appreciate the meatus is the groove
30:50right that air is going to make its way
30:54through as it passes
30:59so grooves inferior to each of the
31:01conchae the missus man then paranasal
31:06sinuses we've talked about and we've
31:09talked about the paranasal sinuses and
31:10we've discussed about how they're going
31:13to be found we've seen them to be found
31:15in relation to the nasal cavity so make
31:19sure you review review those and go
31:21through those and check those out then
31:23as well so they surround the nasal
31:26cavity located in the frontal sphenoid
31:28ethmoid maxillary bones not only do they
31:31lighten the skull together with the
31:34cavities they're going to warm and moist
31:36in here let's move that into the pharynx
31:43let's move into the pharynx the throat
31:46area so let's zoom in on this area here
31:48and here you can see that post your
31:51knees aperture from this view you really
31:52can't appreciate it as well as you can
31:54appreciate it right in here you can see
31:56the archway much better right inside of
31:58here
32:03so let's zoom in on them basically this
32:07area here we've got now the pharynx your
32:09throat right we referred to it as we
32:12said it's a funnel-shaped now I want you
32:15to know this pharynx is going to extend
32:17it extends about five inches from the
32:23base of the skull to the level of c6 to
32:32the level of c6 so one two three four
32:36five six level of c6 we could see there
32:41now the functions of this pharynx okay
32:44so let's zoom in on this picture let's
32:47move to this picture you can see all the
32:52way through when we talk about the
32:55pharynx its function is that it contains
32:58I'm sorry it's gonna connect it'll
33:00connect the nasal cavity it'll connect
33:06the nasal cavity down too you can see
33:10this oral pharynx it'll connect this
33:13oral cavity also down to the sorrel
33:15pharynx the nasal cavity connect
33:17smelling to the laser friends but then
33:18also down to the oral pharynx you can
33:19see which then all connect down into the
33:22laryngopharynx so it connects nasal
33:27cavity the oral cavity right to the
33:31larynx and this esophagus inferiorly
33:38from these two superior locations so
33:43larynx we're gonna look at in greater
33:44detail esophagus you're going to have
33:47back here so it connects these two
33:52cavities down to these two cavities
33:55basically all your throat or your
34:01pharynx if you're speaking again in
34:04medical terms so let's go through the
34:07nasal pharynx first cuz we've already
34:09talked about the oral we've already
34:10talked about the low angle right so
34:11let's talk nasal pharynx when top nasal
34:15pharynx posterior to the nasal cavity
34:17inferior to the sphenoid bone which we
34:21have right up in here and we talked
34:23about getting to the pituitary gland I
34:24told you we're gonna make our way to
34:26right through this cavity right inside
34:29of here no need to make your way up
34:31through here and go we'll try to come
34:33underneath here right through here so
34:39inferior to the sphenoid bone and
34:43superior to the level of the soft palate
34:45and superior to the level of the soft
34:49palate
34:51here's your nasal pharynx right again
34:54you can see that there it's function it
34:58serves as an air passageway nowadays I
35:03think some young individuals are
35:04allowing it to serve as a passageway for
35:06food items right putting spaghetti in
35:09here and lots of other things and
35:11bringing it down the mouth and they're
35:13doing these little tricks there I guess
35:15they got tired and bored of eating tied
35:17pots so they came to this thing and now
35:19I don't know what the newer generation
35:21does it's changing every few years I
35:25hear of you
35:27update me with the newer trends so here
35:31maybe somebody will email me and let me
35:32know what the new trend is now right
35:34went from Tide Pods to I don't know
35:39inhaling snorting condoms I believe it
35:42was to then putting food through this
35:44fairing so you can see the generations
35:47have changed a bit and their activities
35:50have changed a bit as we progress every
35:54generation has their own thing there
35:56right so now when we cope them to talk
35:57about the nasopharynx so it serves as an
36:00air passageway oral and luring go we
36:04talked about already before because
36:05we've already talked about digestive
36:07systems so digestive system digestive
36:09tract so now we talk nasal Franks nasal
36:13Franks I'd like you to know is lined
36:14with pseudo stratified ciliated
36:15epithelium pseudo stratified ciliated
36:17epithelium now located inside of here
36:21are going to be the Ferengi Ilan Souls
36:22here we can appreciate the Ferengi Oh
36:24tonsils the fringe of tonsils them
36:27affected are gonna be known as your
36:28adenoids your adenoids you can see
36:32they're located high on the posterior
36:33wall don't they are located high up on
36:36the posterior wall and what they do is
36:39they help trap and destroy pathogens
36:42they will trap and destroy pathogens
36:44that are entering the nasal pharynx that
36:49are going to be entering into the nasal
36:50pharynx we can also appreciate the
36:54opening of the fringe or tympanic tube
36:56that we've already talked about
36:57now this opening here is going to allow
37:01us to drain the middle ear as we have
37:03seen before it allows also a middle ear
37:07pressure to equalize with atmospheric
37:11pressure so you can see those fringe of
37:16tympanic tubes they open into the
37:19lateral walls of the nasal pharynx
37:27and then here we have the uvula we said
37:30it was a pendulous structure moves
37:32superiorly which is gonna be an action
37:36that's gonna help to close off the nasal
37:38pharynx when we're swallowing right
37:42because we want food to make its way
37:43down into the esophagus we described
37:47here we have the oral pharynx then the
37:50oral pharynx found lying posterior to
37:52the oral cavity it's continuous with
37:56that oral cavity through the archway
37:58here that's known as the isthmus of the
38:01fauci's it's like a constricted region
38:03here it becomes a small let's see
38:06isthmus and then you can see it widens
38:08back out I knew the word always I didn't
38:16really understand until I got to
38:17Catalina Island I like to hike on and
38:19camp on this side and it's there's an
38:24isthmus there in the water basically
38:26it's where you can see the island
38:28instead of it being completely huge on
38:31the sides it kind of comes in and then
38:33it widens back out and this is like the
38:37area where we like to stay up and then
38:39come back here to the secluded area as
38:40well so isthmus is the term you're
38:43trying to understand next in here we
38:45have basically the oral pharynx I'd like
38:50you to know is gonna be lined by a
38:51protective stratified squamous
38:52epithelium so it's lined by a protective
38:55stratified squamous epithelium next in
39:02are the Palatine and lingual tonsils so
39:04here you can appreciate Palatine tonsils
39:06and then lingual tonsils we've got right
39:08here as well
39:09now Palatine tonsils are going to be
39:12pear if I was a pear they're lying
39:14embedded in the oral pharyngeal mucosa
39:17they're found lying embedded in the oral
39:22pharyngeal mucosa of the lateral walls
39:25of the fauci's the lingual the lingual
39:32are going to be found covering the
39:33posterior surface of the tongue again
39:37protecting the entrance into
39:41the pharynx you can see that pharynx is
39:44heavily guarded by security that are
39:49there to trap and destroy pathogens that
39:52may be entering into the pharynx the
39:56Palatine tonsils most oftenly infected
40:02the laryngopharynx the laryngopharynx is
40:05found located below you can see inferior
40:08to the oral pharynx below the oral
40:10pharynx it serves along with that oral
40:14pharynx it serves as a passageway for
40:19food air and liquids and it's line by
40:27stratified squamous right
40:35non-keratinized if you recall let's talk
40:40then larynx we're not going to move down
40:42here because we've already done that
40:44right we talked about the inferior
40:46continuation of the laryngopharynx and
40:48we said that was the esophagus so
40:51anterior to the lowering of fangs we
40:53could move into the larynx so let's zoom
40:55in on this structure right inside of
40:58here when we zoom in on this structure
41:00right inside of here this is what we
41:02have then anterior view posterior view
41:08and a medial view here's the tongue
41:12right no no that's your epiglottis you
41:16have the glottis cut in half right
41:21through the middle that's what we're
41:22seeing here so let's go through the
41:25larynx so nice anterior view the larynx
41:27is going to be your voice box
41:29aka your voice box it extends it extends
41:34about two inches it extends about two
41:36inches from c3 to c6 extends about two
41:41inches from c3 okay to about c6
41:48superiorly it attaches to the hyoid bone
41:53you can see that there and we resume
41:54on this you can see that they're very
41:57nicely it opens into the laryngopharynx
42:02the larynx opens into the laryngopharynx
42:08inferiorly it is continuous with the
42:10trachea inferior Li you can see it's
42:14continuous with the trachea now here is
42:19all trachea two main tasks we talk
42:24function let's top function function
42:27there's two main tasks number one it's
42:29to provide will see two main tasks are
42:32going to be to provide number one and
42:35open a patent airway so number one it's
42:38to provide a patent or an open airway
42:41number two its function is to act as a
42:44switching mechanism its function is to
42:47act as a switching mechanism so that way
42:50you can route food to its proper place
42:53and air to its proper place right even
42:56if we don't allow it to happen if we
42:58start to breed when we're swallowing
43:01that leads to them the food content
43:03making its way to the wrong tube we set
43:05the wrong when we say the wrong in
43:08laymen terms went down the wrong pipe
43:10and that's exactly what you see is
43:12happening there so next time here the
43:16third function third function is its
43:18involved with voiced production voice
43:20production and we're going to see the
43:22vocal cords in here that'll be
43:24responsible for that voice production so
43:27let's go through the clip of the
43:28structure let's look at the structure of
43:30wiring so when we look at the structure
43:31of the larynx it's made up of an
43:33intricate arrangement it's got an
43:36intricate arrangement of nine cartilages
43:39that are connected by membranes and by
43:42ligaments except for the epiglottis
43:50which is made up of elastic cartilage
43:54all laryngeal cartilages are hyaline
43:57cartilage okay so you got to make sure
44:00we've got that established there thyroid
44:02cartilage we could look at first so here
44:04we've got our thyroid cartilage and we
44:05talked about the thyroid cartilage the
44:07thyroid cartilage
44:08a nice large shield shaped cartilage
44:12it's formed by the fusion of these two
44:18cartilage plates and here you can see
44:21that fusion we have at the point of the
44:24fusion what we call the laryngeal
44:26prominence or Adam's apple so it's a
44:31midline where the two cartilage plates
44:38come together we have a nice learned
44:42your prominence there Adam's apple there
44:44so he marks the fusion point this
44:47thyroid cartilage in males is much
44:50larger in size why very good
44:56testosterone okay so nice thyroid
45:01cartilage we can appreciate their then
45:03here we could see the creek oi cartilage
45:05creek or cartilage quick quick cartilage
45:07is inferior to the thyroid cartilage it
45:10is ring shaped ring shaped so look at
45:15the back when we look at the back let's
45:17see here
45:18you can see the thyroid card is not good
45:20ring shape so it's not going all the way
45:21around but right in here the creek Koide
45:23is coming all the way around so this is
45:24the back part of it that's the front
45:26that we've been looking at that's what
45:28you're seeing here it's found perched a
45:34talked and anchored to the trachea
45:37inferiorly so it's found on top of and
45:40anchored to the trachea which is found
45:44inferior to it let's
45:51turn this larynx around and here we can
45:56appreciate them so you're gonna say we
45:58you said nine cartilages we've only gone
46:01through two and here you can see now one
46:06two three pairs so that's two total
46:09there and in pairs so that's two two two
46:12six seven we talked about eight we
46:17talked about in the ninth we'll do that
46:18big log okay so let's talk eret annoyed
46:21cartilage error - annoyed cartilages you
46:23can appreciate here this nice triangular
46:26pyramid shaped cartilage nice pyramid
46:30shaped cartilage it's the most important
46:35one here because it's going to anchor
46:37the vocal folds it will anchor the vocal
46:41folds and then we can see right above it
46:48see it right above it perched above it
46:50curricula cartilage also found as a pair
46:53curricula cartilage and then here we've
46:57got on the lateral walls the cuneiform
47:01cartilages also found as a pair so it's
47:04two four six seven eight cartilages that
47:08we have taken care of now these three
47:10pairs of small these three pairs are
47:13small cartilages they form part of the
47:16lateral and posterior walls of the
47:19larynx and again the air tuner is the
47:22most important there then the last
47:26cartilage epiglottis the ninth cartilage
47:29it's flexible it's spoon shaped it's
47:33composed of elastic cartilage and is
47:38almost entirely covered by tastebud
47:41containing mucosa in fur in class you
47:48would really impress me if you were able
47:49to tell me basically what nerve is gonna
47:52be providing innervation to that area
47:54very good I knew you all knew right we
48:02said seven in the front
48:049 is what we have in the back rack 10
48:11making our way all the way to the back
48:13okay so tent nerd next then we've got
48:18our sole epiglottis is taken care of our
48:21epiglottis almost entirely covered by
48:23taste but continued mucosa and you can
48:25see the epiglottis is gonna be found
48:26extending from the posterior aspect of
48:29the tongue so it's extending from the
48:31posterior aspect of the tongue let me
48:33show it to you there very well or you
48:35can see it here very well so it's
48:40extending from the posterior aspect of
48:42the tongue to its anchoring point to its
48:47anchoring point on the anterior rim of
48:50that thyroid cartilage so let's zoom in
48:54on this - its anchoring point on the
49:04anterior room of the thyroid cartilage
49:08vocal folds you can see here and
49:12vestibular folds we could see right
49:14above and kind of lateral to them so
49:16let's look at them from a better view so
49:19here this view you can see first let's
49:21orient ourselves we have the tongue here
49:23right so the oral cavity is about in
49:25this area here we've got the tongue so
49:27moving to the back of the tongue is what
49:28we see here so basically what we have
49:30here is you've got your patient lying
49:32down and you're looking down into that
49:34oral cavity you're looking at the top
49:36and basically you're looking from here
49:39and your patient is lying down and
49:40you're looking down into this area right
49:43in here with their head tilted back okay
49:46you're looking right into this area here
49:48that's what this view here is so here
49:52that we can appreciate first your vocal
49:55folds your vocal folds of your true
49:57vocal cords your true vocal cords you
50:01can see here very nicely and here very
50:04nicely also known as mucosal folds they
50:08are pearly white in color pearly white
50:11in color because they lack blood vessels
50:14because they lack blood vessels their
50:17core
50:18their core is going to be formed by
50:20ligaments and they're composed of
50:24elastic fibers these ligaments again
50:32they're composed largely of elastic
50:34fibers next we have the glottis the
50:40glottis is the area from one end of you
50:45could see those vocal folds to the other
50:49end of the vocal folds this is the
50:55opening through which air passes to make
51:01its way into the lungs glottis has to be
51:12patent we maintain a patent it's open
51:16right the only time it closes is during
51:20swallowing during swallowing next thing
51:25you have your vestibular folds your
51:27vestibular folds and we talked about the
51:29vestibular folds you can appreciate the
51:30vestibular folds here we said superior
51:32lateral to the vocal folds so that's
51:37tubular folds your false vocal cords or
51:41false mucosal folds their superior and
51:45lateral to the vocal folds like humps
51:49kind of you can dink on the sides and
51:55then we have our trachea so this will
51:58then lead us down to the trachea we talk
52:02trachea trick is your windpipe so let's
52:04focus on the trachea so here we have a
52:07trachea and we'll talk about the trachea
52:08your windpipe it descends it descends
52:13from the larynx through the neck and
52:16into the mediastinum it ends by dividing
52:23into the two main bronchi at mid thorax
52:33the trachea is about four inches long
52:37and has a diameter of about
52:42three-quarters of an inch so 3/4 of an
52:46inch diameter it's flexible and mobile
52:52as well it's flexible and mobile now
52:59when we talk about the histology when we
53:01focus in on the histology here we can
53:03appreciate that let's zoom in on
53:05basically the same thing here you could
53:08see now we are going to see it's made up
53:11of mucosa number one so here we could
53:14see we've got mucosa submucosa and then
53:18we've got hyaline cartilage underneath
53:20so let's zoom in on that mucosa the
53:23mucosa is going to contain goblet cells
53:29so pseudostratified we can see there
53:33pseudostratified columnar ciliated
53:37epithelium that will contain goblet
53:41cells and it has a thick lamina propria
53:48has a thick lamina propria with a rich
53:53supply of elastic fibers providing its
53:57support
54:00so all making up the mucosa see yuga
54:05epithelium and lamina propria next and
54:13we can appreciate the submucosa when we
54:15talk about the submucosa you can see the
54:18submucosa is special here as well
54:20because it contains glands also the
54:22submucosa is the connective tissue layer
54:25that's deep to the mucosa and it
54:30contains saero mucous glands the
54:36submucosa is supported by 16 to 20 C
54:42shaped
54:45rings of hyaline cartilage that are
54:51encased by adventitia that are encased
54:55by adventitia so adventitia then you can
55:00appreciate here is the outermost layer
55:02of connective tissue next then let's
55:09move back and let's talk about the
55:12Carina the Carina is found on the lowest
55:18tracheal cartilage this Carina it you
55:23can see as projecting you really can't
55:26see that here but it's going to be found
55:27projecting posteriorly it kind of
55:31projects posteriorly and basically marks
55:35the point where the trachea divides
55:37where the trachea ends and it divides
55:43and you can see the trachea branches it
55:46branches into two main bronchi we said
55:52the two primary bronchi so here then we
55:57can see the bronchial tree will begin
55:59now the bronchial tree is the branching
56:02pattern of the Airways that we can
56:05appreciate here so it starts with the
56:09bronchi the right and left bronchi the
56:12right and left main bronchi or primary
56:15bronchi we said they are going to be
56:18formed when the trachea is going to
56:21split and divide the trachea splits and
56:26divides we said here at the Carina and
56:28this Carina has found at the level of t7
56:33thoracic vertebra number seven around t7
56:37the right primary main bronchi is wider
56:43it's shorter and it's also more vertical
56:50compared to the left
56:55so keeping that in mind I'd like you to
56:57know foreign bodies objects become
57:00lodged in this right side much more
57:03easier compared to than this light this
57:06left side so as we said these primary
57:12bronchi are going to make their way
57:13deeper into the lungs and they'll branch
57:15and here you can see they branch into
57:18then the low bar or the secondary
57:22bronchi the low bar or the secondary
57:25bronchi the low bar or secondary bronchi
57:28now these low bar secondary bronchi are
57:30subdivisions of the main bronchi there
57:33are three on the right and two on the
57:36left
57:37each supplying a lung lobe they will
57:45then enter further into the lungs and
57:47divide for me the segments or tertiary
57:51bronchi segmental or tertiary bronchi
57:59now these segments or tertiary bronchi
58:01are subdivisions of each lobe are
58:03bronchi and they themselves are going to
58:06divide into smaller bronchi as well
58:09eventually forming for us the
58:12bronchioles or we refer to as the little
58:16bronchi these are passages that are
58:19smaller than one millimeter in diameter
58:23when we talk bronchioles now it took
58:26bronchioles let's move into the
58:28bronchioles the bronchioles now are made
58:30up of you can see basically starting
58:34with the terminal bronchioles moving
58:35into the respiratory bronchus and then
58:37all the way through to the alveoli so we
58:40talk bronchioles little bronchi are
58:42smaller passages that are smaller than
58:44one millimeter in diameter so first
58:46let's talk terminal now bronchioles so
58:50from the bronchioles we reach the
58:52terminal bronchioles now terminal
58:53bronchioles are gonna be even smaller
58:54branches basically now the terminal
58:56bronchioles are the tiniest bronchioles
59:01that we've seen so far
59:03and these terminal bronchioles are
59:05passageways that are less than 0.5
59:09millimeters in diameter and we said now
59:15at the terminal bronchioles this is
59:17where the conducting zone ends leading
59:20us then to the respiratory bronchioles
59:22now the respiratory bronchioles are
59:24within the lung this is the area where
59:30we set our respiratory zone begins and
59:32they will lead us to the alveolar ducts
59:36the alveolar ducts then they're
59:41consisting of diffusely arranged rings
59:44of smooth muscle cells as we can see
59:49along the terminal bronchioles and
59:52respiratory bronchioles also smooth
59:55muscle so when you talk asthma this is
59:58going to be one of the mechanisms that
59:59can initiate asthma by causing a
1:00:02constriction of those passageways the
1:00:04other is inflammation within that
1:00:07bronchial itself leading to the pathway
1:00:11the passageway the pathway being shut
1:00:13off right because of inflammation inside
1:00:15sometimes then you can have both happen
1:00:19bronchospasms due to the muscle and also
1:00:22inflammation so then you need both
1:00:25medications so now when we go through we
1:00:28talk about the alveolar sacs let's talk
1:00:31about the alveolar sacs the alveolar
1:00:32sacs are gonna be tiny clusters so here
1:00:34you can see one alveolar sac is another
1:00:36alveolar sac tiny clusters of grapes you
1:00:38can think of tiny clusters of alveolar
1:00:41of alveoli the alveolar sacs so now
1:00:44let's look at the alveoli themselves all
1:00:46right because we need to see what one
1:00:47alveoli looks like so here you can
1:00:49appreciate the microscopic basically
1:00:53depiction the respiratory bronchioles
1:00:55leading to then a whole bunch of alveoli
1:00:56you've seen all these alveoli in class
1:00:58right on the first exam you're able to
1:01:01go through and identify everything that
1:01:03you had in here so here when we look at
1:01:07those alveoli in greater detail this is
1:01:09what we're seeing okay same thing we're
1:01:13seeing here now these alveoli they're
1:01:15made up you can see here of a whole
1:01:17bunch of different cells so now these
1:01:19alveoli a long width you can see
1:01:23the actual blood vessel are going to
1:01:29help make up what's called the
1:01:30respiratory membrane so we talk a
1:01:31respiratory membrane the respiratory
1:01:32membrane is formed by the alveolar walls
1:01:36and the alveolar walls are made up
1:01:40themselves where's my mouse you know we
1:01:43could see the alveolar walls themselves
1:01:45are made up of primarily a single layer
1:01:49of squamous epithelial cells right we've
1:01:53seen those they are also known as type 1
1:01:55pneumo sites scattered in between these
1:01:59cells are type tunable sites which
1:02:03produce surfactant and also
1:02:07antimicrobial proteins surfactant
1:02:11decreases surface tension and it's
1:02:15produced around 24 weeks in the fetus
1:02:20around 24 weeks in the fetus so anything
1:02:26that's basically born before that it's
1:02:29going to require intervention compared
1:02:37to 1 after that in relation to you know
1:02:42pulmonary intervention next in here we
1:02:45can see also we have so type 1 and type
1:02:482 cells and we also have macrophages we
1:02:50can appreciate inside of there as well
1:02:52okay so that's one part of the
1:02:55respiratory membrane and then on the
1:02:57other side you can see you've got the
1:02:58actual blood vessels this is the
1:03:01pulmonary circulation we talked about so
1:03:03here then you've got stuck here so we
1:03:12can appreciate okay
1:03:15the endothelial cells of the blood
1:03:17vessels again simple squamous epithelia
1:03:19and then here between the two you've got
1:03:22the fused basement membranes of the two
1:03:26so that makes up your respiratory
1:03:28membrane that makes up your respiratory
1:03:31membrane you've got basically blood on
1:03:33one side and gas on the other and
1:03:34exchange is happening you learn
1:03:37in biology thanks to we also talked
1:03:40about in here as well
1:03:41diffusion right movement from an area of
1:03:46high to low
1:03:47thanks to concentration differences so
1:03:51I'll just buy you that one word
1:03:52diffusion see what bio teaches you bio
1:03:56is a very important class that's why
1:03:58it's a prereq here next let's talk about
1:04:02the lungs themselves let's get into the
1:04:04lungs so when we talk about the lungs
1:04:06lungs are going to be found as a pair
1:04:08they occupy all the thoracic cavity
1:04:12except for the mediastinum right because
1:04:15the mediastinum then you can see is
1:04:16occupied by other structures the
1:04:19function of the lungs is to transport
1:04:22oxygen from the atmosphere into the
1:04:24bloodstream and to release carbon
1:04:27dioxide from the bloodstream into the
1:04:29atmosphere now when we talk about the
1:04:33structures in relation to the lungs
1:04:35first we can appreciate here the apex of
1:04:38the lung so the apices we can see in
1:04:41relation to both lungs the apex is the
1:04:44narrower superior tip of the lungs and
1:04:48you can see here it's found deep to the
1:04:51clavicles deep to the clavicles I tell
1:04:54my physiology students when you need to
1:04:56listen when you need to auscultate the
1:04:59apices you're going to auscultate above
1:05:01the clavicles above the clavicles next
1:05:08thing we have the base the opposite
1:05:09usually to the APUs to the apex the base
1:05:12is going to be as it's going to be found
1:05:14as concave it's found as a concave
1:05:18region it's going to be found at the
1:05:24inferior surface of the lungs and the
1:05:28base rests on top of the diaphragm a
1:05:31rests on top of the diaphragm
1:05:39next then we've got the hilum we can
1:05:43appreciate the pulmonary high lung we
1:05:47talk pulmonary hilum this is basically
1:05:50an indentation on the medial surface of
1:05:54each of the lungs where you'll see the
1:05:59blood vessels the bronchi lymphatic
1:06:06vessels and nerves enter and exit the
1:06:12lungs so this is all that pulmonary
1:06:16hilum now we can also appreciate here
1:06:23our pleura the pleura you can see is
1:06:27nice and continuous with each other
1:06:31right because when we talk to each other
1:06:33there's two different layers you have a
1:06:34Vista when you have a parietal you can
1:06:38see that there very nicely so way back
1:06:39to lungs left lung is going to be
1:06:42slightly smaller it gets divided into
1:06:46two lobes a superior and an inferior
1:06:49lobe these are the subdivisions and the
1:06:55oblique fissure is responsible for
1:06:59dividing you can see those two loads
1:07:01from one another oblique fissure because
1:07:08of the way it comes in and then we got
1:07:12we've got the cardiac notch now the
1:07:15cardiac notch is going to be found you
1:07:19can see on the medial surface of that
1:07:21left lung and that cardiac notch is a
1:07:24concavity
1:07:26it's a concavity on the medial aspect
1:07:29and this cardiac notch is molded too and
1:07:34it accommodates the heart so that's why
1:07:37this side you can see is a little bit
1:07:38smaller this lung compared to the right
1:07:41that heart is going to be occupying you
1:07:43can see most of the space right in here
1:07:49next time we talk right lung right lung
1:07:52divided up into three lobes you've got a
1:07:55superior lobe a middle lobe and an
1:07:58inferior lobe and these subdivisions you
1:08:02can see they're very nicely the superior
1:08:04lobe is divided from the medial herbs
1:08:07from the middle lobe
1:08:08thanks to you can see this horizontal
1:08:10fissure the middle lobe is subdivided
1:08:14from this inferior lobe thanks to the
1:08:16oblique fissure so again they help
1:08:26divide the lung into three lobes these
1:08:29fissures next then we talk about our
1:08:33bronchopulmonary segments now I'd like
1:08:38you to know each of these
1:08:39bronchopulmonary segments are going to
1:08:41be served by their own artery and vein
1:08:45so that exemplifies the dual circulation
1:08:49that we're going to see in relation to
1:08:50the lungs then we talk about lung tissue
1:08:56lung tissue is basically mostly elastic
1:09:00connective tissue it's mostly elastic
1:09:04connective tissue and we use the term
1:09:11given our stroma so stroma is going to
1:09:15be a term describing basically lung
1:09:17tissue and how it's made up of mostly of
1:09:19elastic connective tissue and then again
1:09:21it provides support to the epithelium so
1:09:24stroma is basically the support for the
1:09:26epithelia we could see there next time
1:09:28let's talk about let's talk about our
1:09:32pleura so I talked pleura pleura always
1:09:35described as being thin double layered
1:09:39right you've got pride on you got
1:09:40visceral then double layered serosa so
1:09:43one layer lining the cavity and one
1:09:45layer right on top of the lung it's on
1:09:46the lung you can't even separate the two
1:09:48from each other the lung and the
1:09:49visceral pleura they're that adhere to
1:09:51one another so here and then the
1:09:53visceral the pride are continuous with
1:09:55one another you could see here as well
1:09:56again so here now when you talk a pleura
1:10:02double-layered serous member
1:10:03between the two then your pleural cavity
1:10:05contains pleural fluid which is going to
1:10:08help prevent friction amongst other
1:10:10things there as well now when you talk
1:10:11muscles of respiration
1:10:12so you took muscles of respiration here
1:10:14then we get into first the diaphragm
1:10:17also in the external intercostal muscles
1:10:19they are the muscles of inspiration
1:10:22now when the diaphragm muscles activated
1:10:24thanks to we've seen the different nerve
1:10:26so this is all coming into play now this
1:10:29will cause the muscle to flatten and
1:10:31then we've talked about how we have
1:10:32pleura coming down this will cause the
1:10:34pleura to then pull be pulled on as well
1:10:37and that causes the lung to be pulled on
1:10:39so that causes along them to expand
1:10:41helping to get air in along with that
1:10:43the external cost those are gonna pull
1:10:45you can see those lungs up and out and
1:10:49when they pull the Mons up and out again
1:10:51you've got pleura private pleura on the
1:10:53inside we pull that private pleura as
1:10:55well which then pulls on the visceral
1:10:58which then is adhered on to the lungs
1:11:00which pulls on the lungs again causing
1:11:02air to make its way into the lungs in an
1:11:04opposite you've got external you've got
1:11:07expiration now an expiration the
1:11:10internal intercostals are gonna come
1:11:11together and they're going to cause
1:11:13you'll see the ribs to be depressed and
1:11:16pushed down basically which is going to
1:11:18then cause the air to be pushed out of
1:11:20the lungs along with them you can see
1:11:22you've got these other muscles in here
1:11:24as well and these other muscles of the
1:11:26chest the neck and the abdomen are also
1:11:28then going to be involved there as well
1:11:30helping to get air out of the lungs now
1:11:33all of this is going to be controlled by
1:11:35the you can see respiratory centers
1:11:39which are gonna be found not only in
1:11:41ponds but the medulla but then also
1:11:44higher brain centers you can see are
1:11:45involved there as well higher brain
1:11:47centers are going to influence the
1:11:48pontine respiratory group the PRG
1:11:51the pontine respiratory group then is
1:11:53going to you can see influence the
1:11:55Ventura on the dorsal respiratory groups
1:11:57the vrg and the DRG which then also are
1:12:00influenced by chemo receptors okay and
1:12:03these chemo receptors are gonna be found
1:12:05located you will see in various
1:12:06locations so here we could see the
1:12:08respiratory centers of the medulla pons
1:12:10right inside of here and they modify
1:12:13breathing not only modifying breathing
1:12:15but also
1:12:17the pace the rate and the depth of
1:12:20breathing we can see here but then also
1:12:22now the input sources we have here are
1:12:26gonna include chemoreceptors we
1:12:27mentioned central chemoreceptors and
1:12:29peripheral chemoreceptors there
1:12:30chemoreceptors so you have to understand
1:12:32that now but now exactly what they're
1:12:34monitoring stretch receptors irritate
1:12:37receptors and also higher brain centers
1:12:38the cortex that the hypothalamus and in
1:12:41the limbic system all involved with then
1:12:45breathing

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