1 and 2 mechanisms of ventilation

Question 1

what is the role of epligottis?

Answer 1

protects aiways

prevents choking

Question 2

where does the diaphragm attach in the thorax?

Answer 2

anteriorly: xiphoid process and costal cartilages

laterally ribs 6-12

posteriorly t12

Question 3

which muscles are used for inspiration and expiration

Answer 3

inspiration: external and internal contracts to raise rib to rib above- raise rib cage

forced expiration internal and innermost contract to depress rib, lowers rib cage

expiration is passive

Question 4

accessory muscles of respiration

Answer 4

SCM

scalene muscles

pecs and trapezius

Question 5

movement of the rib cage during respiration

Answer 5

sternum: pump handle in AP direction
ribs: bucket handle- transverse

Question 6

how do babies breathe differently to adults?

Answer 6

•Babies can only breathe via abdominal breathing (contraction of abdomen)

Newborn ribs more horizontal so cant use pump/bucket handle movements

Intercostals weak

Question 7

breathing in children

what type of breathing

what are they at risk of and why

Answer 7

nasal breathers until4-6 weeks

short neck and shorter narrow airways- airway obstruction

tongue larger than mouth- more likley to obstruct unconscious airways

higher resp rate

Question 8

what can accessory muscle use at rest be a sign of

Answer 8

respiratory distress

Question 9

Neonatal respiratory distress syndrome (NRDS)

Answer 9

• Affects premature babies, if they are born before their lungs are fully developed and capable of working properly
• The more premature the baby, the more likely it is that s/he will have respiratory distress syndrome

Question 10

Acute respiratory distress syndrome (ARDS)

Answer 10

• Fluid / proteins leak from the blood vessels into the alveoli (air sacs)
• Lungs become stiff and so don’t work normally
• Breathing becomes difficult

pneumonia is common cause

Question 11

tension and non tension pneumothorax

Answer 11

Non tension; air in pleural cavity, mediastinum at midline

tension: deviated mediastinum, diaphragm is unequal,

air gets trapped in cavity due to flap closing and cant get out- pressure on heart

Question 12

emphysema

Answer 12

COPD

overinflated alveoli

Question 13

chambers at the surfaces of heart

Answer 13

Anterior or sternocostal: mostly of right (with bit of left)

ventricle

Inferior or diaphragmatic: L (with bit of R) ventricle Posterior or base: mostly L (and bit of R) atrium and pulmonary vv

Pulmonary: mostly L ventricle, in cardiac notch of L lung

Question 14

landmarks for heart borders

Answer 14

Superior: from L cc 2 to R cc 3

Right: from R cc3 to cc6; mainly R atrium with SVC

and IVC

Inferior: lies on diaphragm central tendon; from R cc6 to L ics 5; mainly R ventricle and part of L ventricle

Left: from L ics5 and back to L cc2; mainly L ventricle and maybe some L atrium

2,3,5,6

Question 15

valve position landmarks

Answer 15

PAMT 3344

retrosternal close to midline

Pulmonary (P): medial to L cc3

Aortic (A): medial to L ics3

Bicuspid or Mitral (M): medial to L cc4

Tricuspid (T): medial to R ics4

Question 16

what is pleuritis and how can you identify this?

Answer 16

inflammation of pleura

can rub together- stethoscope

Question 17

in supine patients, which bronchopulmonary segments does fluid tend to drain to

Answer 17

apical and posterior segments of the inferior lobe

Question 18

Answer 18