BIOMECHANICS OF

RESPIRATION

MODERATOR: Ms FIONA
PRESENTOR: VIDHISHA PAI
CONTENTS

1. INTRODUCTION
2. STRUCTURE AND FUNCTION
3. ARTICULATION OF THE RIB CAGE
4. KINEMATICS OF THE RIBS AND MANUBRIOSTERNUM
5. MUSCLES ASSOCIATED WITH THE RIB CAGE
6. PATHOLOGICAL CHANGES IN STRUCTURE AND FUNCTION
INTRODUCTION
 The thorax, consists of - thoracic vertebrae, the ribs, and the sternum
 Provides base for muscle attachment
 provides protection for the heart ,lungs and viscera
 most important function is its role in ventilation

The process of ventilation depends on the

mobility of the bony rib thorax ability of the muscles to move the thorax
 VENTILATION - The exchange of air between the lungs and the atmosphere so that
oxygen can be exchanged for the carbon dioxide in the alveoli
 INSPIRATION
It’s an active process
The size of the thoracic cavity by contraction of appropriate muscles
The expansion of lungs is associated with a in the pressure in the lungs
parenchyma

 EXPIRATION
It is a passive process
Elastic recoil of the thoracic wall and lungs cause passive expiration
STERNUM
 Osseous protective plate for the heart , composed of the manubrium, body, and
xiphoid process
 The manubrium and the body of the sternum form a dorsally concave angle of
approximately 160°
THORACIC VERTEBRAE AND RIBS
 There are 12 thoracic vertebrae that make up the posterior aspect of the rib cage
 Typical thoracic vertebra- The vertebral body and transverse processes have six
costal articulating surfaces, four on the body (a superior and an inferior costal
facet, or demifacet, on each side) and one costal facet on each transverse process
RIB CAGE
 12 pairs of ribs
 The posteriorly located head of each rib articulates with contiguous thoracic
vertebral bodies
 The costal tubercles of ribs 1 to 10 also articulate with the transverse processes of
thoracic vertebrae
 Anteriorly, ribs 1 to 10 are joined either directly or indirectly to the sternum
through their costal cartilages
 Vertebrosternal (or “true”) ribs ( rib 1 through 7) - true ribs because each rib,
through its costocartilage, attaches directly to the sternum
 Vertebrochondral (or “false”) ribs- The costocartilage of ribs 8 through 10
articulates with the costocartilage of the superior rib, indirectly articulating with
the sternum via rib 7
 The 11th and 12th ribs are called “floating” ribs because they have no anterior
attachment to the sternum
ARTICULATIONS OF THE RIB CAGE
1. Manubriosternal and Xiphisternal Joints
2. Costovertebral joints
3. Costotransverse joints
4. Costochondral and chondrosternal joints
5. Interchondral joints
Manubriosternal and Costovertebral and Costochondral, costosternal
xiphisternal joint costotransverse joint and interchondral joints
KINEMATICS OF THE RIBS AND MANUBRIOSTERNUM
 The movement of the rib cage is an amazing combination of complex geometrics
that are governed by
1. the types and angles of the articulations
2. the movement of the manubriosternum
3. the elasticity of the costal cartilages.
 The costovertebral and costotransverse - single axis of motion - passing through
the centers of both joints
 The axes of rotation for the upper ribs - closest to the frontal plane;
motion of those ribs - sagittal plane
 The axes of rotation for the lower ribs - toward the sagittal plane ;
motion of those ribs - frontal plane
 The axes of rotation for ribs 11 and 12 pass through the costovertebral joint only
(no costotransverse joint)
 The axes of rotation for these last two ribs also lie close to the frontal plane
PUMP-HANDLE MOTION
 During inspiration, the costovertebral joint moves superiorly and anteriorly,
elevating the first rib
 Ribs 2 through 7, which are attached to the body of the sternum, increase in
length and mobility
 In these upper ribs, most of the movement occurs at the anterior aspect of the rib
 The costocartilage - rotates upward, becomes horizontal with inspiration
 The movement of the ribs – sternum moves ventrally and superiorly
 The greatest effect of the motion of the upper ribs and sternum increase in
the anteroposterior (A-P) diameter of the thorax.
 This combined rib and sternal motion (sagittal plane ) - termed as “pump-
handle” motion of the thorax
BUCKET- HANDLE MOTION
 Elevation of ribs 8 through 10 occurs about an axis of motion lying more towards
the sagittal plane
 The lower ribs have a more angled shape
 lower ribs - more motion at the lateral aspect of the rib cage
 The greatest effect of the elevation of the lower ribs increase in the
transverse diameter of the lower thorax
 This motion (frontal plane) - termed as “bucket-handle” motion of the thorax
PRESSURE CHANGES DURING VENTILATION
1. INTRA-PULMONARY PRESSURE ( INTRA –ALVEOLAR PRESSURE)

Intra-pulmonary pressure = atmospheric pressure

(normal : 760mmHg )
Beginning of Inspiration-
Volume decreases

Intrapulmonary pressure decreases to approx. 3mmHg below atmospheric

pressure(i.e.757mmHg), but regains the full atmospheric pressure at end-inspiration
Expiration -
It is passive ,elastic recoil of the lungs causes the intrapulmonary pressure to swing
slightly to positive side (3mmHg i.e. 763mmHg ) but regains the atmospheric
pressure value at end-expiration
2. INTRA-PLEURAL (OR INTRA –THORACIC) PRESSURE

The pressure (slight subatmospheric pressure) change caused between the pleural
layers (-2mmHg) at the start of inspiration is called intrapulmonary pressure.
 The negative intra-pleural pressure is directly proportional to the amount of
thoracic expansion .
 Inspiration- intra-pleural pressure decreases about -6mmHg .
 Expiration- intra-pleural pressure returns back to -2mmHg.
LUNG VOLUMES AND CAPACITIES
Lung volumes
1. Tidal Volume- Normal : 500ml
- Respiratory muscle weakness or depression of respiratory centre
2. Inspiratory Reserve Volume (IRV) - Normal : 2000-3200 ml
3. Expiratory Reserve Volume (ERV) - Normal : 750 -1000ml
4. Residual Volume (RV) - Normal :1200ml
5. Closing Volume (CV)
Capacities
1. Inspiratory capacity (IC) = TV+IRV ; Normal = 2500-3700ml
2. Expiratory capacity (EC) = TV+ERV ; Normal= 1250-1500ml
3. Vital capacity (VC) = TV+IRV+ERV ; Normal= 4.8 - males , 3.2 L -females
MUSCLES ASSOCIATED WITH THE RIB CAGE

PRIMARY MUSCLES OF VENTILATION

 These include the diaphragm, the intercostal muscles (particularly the parasternal
muscles), and the scalene muscles.
 These muscles all act on the rib cage to promote inspiration.
 There are no primary muscles for expiration because expiration at rest is passive
1. DIAPHRAGM
 The diaphragm is the primary muscle of ventilation.
 The diaphragm is a circular set of muscle fibers that arise from the sternum, ribs,
and vertebral bodies.
 The fibers travel cephalad (superiorly) from their origin to insert into a central
tendon. There is no bony insertion site, making the diaphragm unique.
2. INTERCOSTAL MUSCLES

 The parasternal muscles - primary muscles of ventilation.

 The external intercostal muscles - raise the lower rib up to the higher rib
(inspiratory motion) ; internal intercostal muscles - lower the higher rib onto the
lower rib (expiratory motion)
 Action of the parasternal muscles - rotation of the costosternal junctions
 The primary function of the parasternal muscles - stabilization of the rib cage

opposes the decreased intrapulmonary pressure generated during

diaphragmatic contraction

prevents paradoxical, or inward, movement of the upper chest wall during inspiration
3. SCALENE MUSCLES
 These muscles arise from the transverse processes of the cervical vertebrae and
they are attached to the 1st and 2nd ribs
 In forced inspiration they raise the ribs
ACCESSORY MUSCLES OF VENTILATION

1. Sternocleidomastoid
2. Pectoralis major
3. Pectoralis minor
4. Subclavius
5. Levatores costorum
6. Abdominal muscles
7. Transversis thoracis (triangularis sterni)
RELATION OF RESPIRATION TO THE SPINAL
COLUMN
1. BACKWARD BENDING
 sternum elevated
 Abdominal wall tension and spread of ribs is
 First rib – elevates the sternum – as rib is short and greater excursion range than the
others
The lower ribs are also held down by the tension in abdominal wall

decrease in the saggital diameter and increase in lung space in the longitudinal direction
 In this position – excursion is limited – partly by

Position of spine action of abdominal wall upon the lower ribs

2. FORWARD BENDING
 ribs are crowded in the front
 Lungs crowded and excursion limited as it is in hyperextension

3. LATERAL BENDING
 Convex side- ribs spread and thoracic space -
 Concave side- ribs crowded and lung space –

4. NORMAL UPRIGHT POSITION

 Most serviceable
 Military/attention pose – most favourable
PATHOLOGICAL CHANGES IN STRUCTURE AND
FUNCTION
Chronic Obstsructive Pulmonary Disease(COPD)

The static or resting position of the thorax

elastic recoil properties of the lungs pulling inward normal outward spring of the ribcage

 Imbalance in COPD - alters both lung volumes and ventilator capacities

 An increase in the A-P diameter of the hyperinflated thorax (it becomes more of a barrel shape)
 flattening of the diaphragm at rest
SCOLIOSIS
 In scoliosis, the thoracic vertebrae laterally deviates and rotates alters alignment
of costovertebral and costotransverse articulating surfaces
The rib cage volume changes asymmetrically

Concave side Convex side

Decrease in intercostal spaces Widened intercostal spaces
Decrease in lung volume Increase in lung volume
KYPHOSIS
 reduces the amount of space in the chest , mobility of the rib cage and expansion
of the lungs
 Restrictive ventilatory impairement – d/t reduced thoracic volume in kyphosis -
declining pulmonary function
 thoracic muscle weakness
PECTUS CARINATUM

 Decreased lung compliance

 Chest wall is rigid in moderate to severe cases held in outward
 Use of accessory muscles during exercise
PECTUS EXCAVATUM
 The pectus excavatum does not affect directly any of the respiratory muscle
groups
 There is decrease in maximal inspiratory and expiratory pressure
 Decreased chest wall compliance would require a higher then usual pressure to
achieve the same degree of lung inflation
THANK YOU!!!