Anatomy 3 Flashcards
where does stimulation of sensory receptors occur
oropharyngeal mucosa
laryngopharyngeal mucosa
laryngeal mucosa
LRT - respiratory mucosa - trachea to bronchioles
when are CN V and CN IX stimulated
sneezing
when are CN IX and CN X stimulated
coughing
what and where are the carotid sheaths
protective tubes of cervical - neck - deep fascia
attach superiorly - to bones of base of skull
blends inferiorly with fascia of mediastinum
what do the carotid sheaths contain
vagus nerve - X - travels back to CNS in it
internal carotid artery
common carotid artery
internal jugular vein
() IX doesn’t fully travel in it - enters in superior part
what does the pulmonary plexus contain
sympathetic axons
parasympathetic axons
visceral afferents
(in bifurcation bit of trachea)
how do all motor axons travel
from tracheal bifurcation along branches of respiratory tree to supply all the mucous glands & all bronchiolar smooth muscles
how do pulmonary visceral afferents travel
from visceral pleura & respiratory tree to plexus
then follow vagus nerve to medulla of brainstem
what happens with the phrenic nerves and the diaphragm in a deep forced inspiration
greater outflow of APs of longer duration
via phrenic nerve
causes diaphragm to flatten then descend maximally
what are the muscles of normal quiet inspiration
external intercostal
internal intercostal
innermost intercostal
intercostal nerves = anterior rami of spinal nerves T1-T11
deep forced inspiration - intercostal muscles contract forcefully and raise ribs maximally
what are the accessory muscles of deep forced inspiration
pectoralis major
pectoralis minor
sternocleidomastoid
scalenus anterior, medius, posterior
what and where are the intrinsic muscles of larynx
all skeletal voluntary muscles
attach between cartilages
what do the intrinsic muscles of larynx do
move cartilages resulting in movement of vocal cords
all supplied by somatic motor
- branches of vagus nerve - CN X
adduct vocal cords during cough reflex
what can the vocal cords do
approx in midline closing rima glottidis
what’s an important function to coughing with the vagus nerves
supplying somatic sensory & somatic motor axons to larynx
- s to mucosa lining larynx
- m to intrinsic muscles of larynx
what are the vagus nerves supplying when they descend posteriorly
parasympathetic axons to chest organs
- including lungs via pulmonary plexus
what are the accessory muscles of deep forced expiration
diaphragm
right & left anterolateral abdominal wall
what are the anterolateral abdominal wall muscles
rectus abdominal
external oblique
internal oblique
transversus abdominus
what are the functions of these aa muscles
tonic continuous low level contractions maintain posture and support vertebral column
- mechanical back pain improved by abdominal muscle exercises depending on causes
contractions make movements of vertebral column (spine)
- flexion, lateral flexion, rotations
‘guarding’ contractions protect abdominal viscera
contractions increase intra-abdominal pressure to assist
- defecation, micturition, labour
contractions aid forced expiration
what happens with dynamic airway compression in asthma
- expiration difficult
- build up of air trapped in alveoli can lead to rupture of lung & visceral pleura
how’s a pneumothorax diagnosed
History:
as per clinical lectures
Examination:
reduced ipsilateral chest expansion
reduced ipsilateral breath sounds
hyper-resonance on percussion
Investigation (CXR):
absent lung markings peripherally
lung edge visible
what are the consequences of mediastinal shift
tracheal deviation
- away from side of unilateral tension pneumothorax
- palpable in jugular notch
SVC compression
- less venous return to heart -> hypotension
what’s the management of a large pneumothorax
needle aspiration - thoracentesis
siting of a chest drain both procedures via - 4th or 5th intercostal space in midaxillary line
where does the need pierce thru in large pneumothorax management
skin
superficial/deep fascia
3 layers of intercostal muscles
parietal pleura
what happens in emergency management of tension pneumothorax
large guage cannula inserted into pleural cavity via 2nd or 3rd intercostal space in midclavicular line on side of tension pneumothorax
where does the cannula pass thru
skin
superficial/deep fascia
3 layers of intercostal muscles
parietal pleura
