Anatomy 3 Flashcards

1
Q

where does stimulation of sensory receptors occur

A

oropharyngeal mucosa
laryngopharyngeal mucosa
laryngeal mucosa

LRT - respiratory mucosa - trachea to bronchioles

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2
Q

when are CN V and CN IX stimulated

A

sneezing

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3
Q

when are CN IX and CN X stimulated

A

coughing

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4
Q

what and where are the carotid sheaths

A

protective tubes of cervical - neck - deep fascia

attach superiorly - to bones of base of skull
blends inferiorly with fascia of mediastinum

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5
Q

what do the carotid sheaths contain

A

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

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6
Q

what does the pulmonary plexus contain

A

sympathetic axons
parasympathetic axons
visceral afferents

(in bifurcation bit of trachea)

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7
Q

how do all motor axons travel

A

from tracheal bifurcation along branches of respiratory tree to supply all the mucous glands & all bronchiolar smooth muscles

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8
Q

how do pulmonary visceral afferents travel

A

from visceral pleura & respiratory tree to plexus
then follow vagus nerve to medulla of brainstem

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9
Q

what happens with the phrenic nerves and the diaphragm in a deep forced inspiration

A

greater outflow of APs of longer duration
via phrenic nerve
causes diaphragm to flatten then descend maximally

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10
Q

what are the muscles of normal quiet inspiration

A

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

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11
Q

what are the accessory muscles of deep forced inspiration

A

pectoralis major
pectoralis minor
sternocleidomastoid
scalenus anterior, medius, posterior

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12
Q

what and where are the intrinsic muscles of larynx

A

all skeletal voluntary muscles
attach between cartilages

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13
Q

what do the intrinsic muscles of larynx do

A

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

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14
Q

what can the vocal cords do

A

approx in midline closing rima glottidis

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15
Q

what’s an important function to coughing with the vagus nerves

A

supplying somatic sensory & somatic motor axons to larynx
- s to mucosa lining larynx
- m to intrinsic muscles of larynx

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16
Q

what are the vagus nerves supplying when they descend posteriorly

A

parasympathetic axons to chest organs
- including lungs via pulmonary plexus

17
Q

what are the accessory muscles of deep forced expiration

A

diaphragm
right & left anterolateral abdominal wall

18
Q

what are the anterolateral abdominal wall muscles

A

rectus abdominal
external oblique
internal oblique
transversus abdominus

19
Q

what are the functions of these aa muscles

A

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

20
Q

what happens with dynamic airway compression in asthma

A
  • expiration difficult
  • build up of air trapped in alveoli can lead to rupture of lung & visceral pleura
21
Q

how’s a pneumothorax diagnosed

A

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

22
Q

what are the consequences of mediastinal shift

A

tracheal deviation
- away from side of unilateral tension pneumothorax
- palpable in jugular notch

SVC compression
- less venous return to heart -> hypotension

23
Q

what’s the management of a large pneumothorax

A

needle aspiration - thoracentesis
siting of a chest drain both procedures via - 4th or 5th intercostal space in midaxillary line

24
Q

where does the need pierce thru in large pneumothorax management

A

skin
superficial/deep fascia
3 layers of intercostal muscles
parietal pleura

25
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
26
where does the cannula pass thru
skin superficial/deep fascia 3 layers of intercostal muscles parietal pleura