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Respiratory > Anatomy of coughing > Flashcards

Anatomy of coughing Flashcards

1
Q

What structures do you find the sensory receptors in the mucosa that are responsible for the cough?

A

Oropharynx
Laryngopharynx
Larynx
Respiratory tree

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2
Q

What nerves control the the diaphargm?

A

Phrenic nerves

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3
Q

What nerves control the intercostal muscles?

A

Intercostal nerves

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4
Q

What nerve causes adduction of the vocal cords to close the rima glottidis?

A

Vagus nerve

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5
Q

What prevents the stream of air coming out the nose as a sneeze?

A

The soft palate tenses and elevates to close of the entrance into the nasopharynx

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6
Q

What nerve causes the soft palate to tense?

A

Cranial nerve V - trigeminal

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7
Q

What verse causes the soft palate to elevate?

A

Vagus nerve

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8
Q

At what level does the larynx become the trachea and the pharynx become the oesophagus?

A

Level of the C6 vertebra

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9
Q

What is the sensory nerve supply to the mucosa lining of the nasal cavities, pharynx and larynx

A

Nasal cavity - CN V (trigeminal)
nasopharnyx and oropharnyx - CN IX (glossopharngeal)
Larynx - CN X (vagus nerve)

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10
Q

What are the sensory receptors stimulated in coughing?

A

CN IX and CN X

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11
Q

What is the carotid sheath?

A

Protective ‘tube’ of cervical deep fascia
Attaches superiorly to the bones of the base of the skull
inferiorly blends with the fascia of the mediastinum

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12
Q

What does the right carotid sheath contain?

A

Right…. vagus nerve, internal carotid artery, common carotid artery and internal jugular vein

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13
Q

Define the lower respiratory tract

A

Trachea –> alveoli

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14
Q

What lines the LRT and to what level?

A

Respiratory mucosa

To the level of the terminal bronchioles/alveoli

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15
Q

What makes up the pulmonary plexus?

A

Sympathetic axons
Parasympathetic axons
Visceral afferents

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16
Q

How do visceral pleura and respiratory tree visceral afferents connect with the CNS?

A

The plumonary visceral afferents travel from visceral pleura and respiratory tree to the plexus, then follow the vagus nerve to the medulla of the brainstem

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17
Q

What happens in inspiration?

A 
Diaphragm contracts and descends
Intercostal muscles contract 
Chest walls pull lungs outwards
Lungs expand 
Air flows down pressure gradient
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18
Q

How do the chest walls pull the lungs out with them?

A

Surface tension between the parietal and visceral pleurae created by the pleural fluid
Potential vaccum becomes actual vaccum when the chest wall begins to move .. sucks visceral pleura towards moving parietal pleura

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19
Q

What are the muscles of normal quiet inspiration?

A

Diaphragm

External, internal and innermost intercostal muscles

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20
Q

Where do phrenic nerves orginate?

A

Originate in the neck (C3-C5)
Combined anterior rami of cervicle spinal nerves 3, 4 and 5 and pass down between the lungs and the heart to reach the diaphragm.

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21
Q

Where are the phrenic nerves found?

A

Found in the neck on the anterior surface of scalenus anterior
Found in the chest descending over the lateral aspect of the fibrous pericardium anterior to the lung root

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22
Q

What do the phrenic nerves supply?

A

Supplies somatic sensory and sympathetic axons to:
- fibrous pericardium
- mediastinal parietal pleura
- diaphragmatic partietal pleura
- diaphragmatic parietal peritoneum
Supplies somatic motor axons to the diaphragm

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23
Q

What spinal nerves are the intercostal nerves?

A

Anterior rami of the spinal nerves T1-T11

24
Q

What are the accessory muscles of deep (forced) inspiration?

A

Pectoralis major
Pectoralis minor
Sternocleidomastoid
Scalenus anterior, medius and posterior

25
Q

Where does pectoralis major attach and what is its function?

A

Between sternum/ribs and humerus
Pulls trunk towards raised upper limb - “climbing” muscle
Pulls ribs upwards and outwards

26
Q

Where does pectoralis minor attach and what is its function?

A

Ribs 3-5 to the coracoid process of the scapula

Pulls the ribs 3-5 superiorly to the scapula

27
Q

Where does the sternocleidomastoid attach?

A

Sternum/clavicle and mastoid process of the temporal bone

28
Q

Where do the scalenus anterior, medius and posterior attach

A

Between cervical vertebrae and ribs 1 and 2

29
Q

Where do the intrinsic muscles of the larynx attach?

A

Between the cartilages

30
Q

What type of muscle are the intrinsic muscles of the larynx?

A

Skeletal (voluntary) muscles

31
Q

What nerves supply the intrinsic muscles of the larynx?

A

Somatic motor branches of the vagus nerve (CN X)

32
Q

What do the intrinsic muscles of the larynx do and what is their role in the cough reflex?

A

Move the vocal cords

Adduct the vocal cords to close the rima glottidis

33
Q

Name the 3 laryngeal cartilages

A

Thyroid
Cricoid
Arytenoid

34
Q

Where do the vagus nerves connect with the CNS?

A

The medulla or the brainstem

35
Q

What is the name of the hole in the base of the skull that the vagus nerves pass through?

A

Jugular foramen

36
Q

What is the vagus nerve contained in as it descends through the neck?

A

Carotid sheath

37
Q

What is the vagus nerve’s role in coughing?

A

Supplies somatic sensory to the mucosa lining the larynx and somatic motor axons to the the intrinsic muscles of the larynx

38
Q

What type of nerve supply does the vagus nerve have to the chest organs?

A

Parasympathic axons

39
Q

What is the mechanism of quiet expiration?

A 
Diaphragm relaxes and ascends 
Intercostal muscles relax
Chest walls return to resting position 
Lungs elastically recoil 
Air flows out of the lungs, down a pressure gradient
40
Q

What are the accessory muscles of deep (forced) expiration?

A

Anterolateral abdominal wall muscles

41
Q

Name the 4 anterolateral abdominal wall muscles on the right

A 
Right...
Rectus abdominis 
External oblique
Internal oblique
Transverus abdominus
42
Q

Where does the external oblique attach superiorly and interiorly?

A

Superiorly - the superficial aspects of the lower ribs

Inferiorly - the anterior part of the iliac crest and the pubic tubercle

43
Q

What is an aponeurosis?

A

A flattened tendon

44
Q

Where does the aponeurosis of right and left external oblique blend?

A

Midline linea alba

45
Q

Where does the internal oblique attach?

A

Superiorly - inferior border of the lower ribs

Inferiorly - iliac crest and the thoracolumbar fascia of the lower lack

46
Q

Where does the aponeurosis of right and left internal oblique blend?

A

Midline linea alba

47
Q

Where does the transverse abdominus attach?

A

Superiorly - deep aspects of the lower ribs

Inferiorly - iliac crest and thoracolumbar fascia of the lower back

48
Q

Where does the aponeurosis of right and left transverse abdominus blend?

A

Linea alba

49
Q

What is the rectus sheath constructed from?

A

The aponeuroses of the other 3 muscles

50
Q

What dived the 2 long flat muscles of the rectus abdominis into 4 smaller quadrate muscles?

A

Tendinous intersections

51
Q

Name the three thoracoabdominal nerves and where they originate from?

A 
Subcostal nerve (T12 anterior ramus)
iliohypogastric nerve (half of L1 anterior ramus)
 ilioinguinal nerve (the other half of L1 anterior ramus)
52
Q

What do tonic contractions of the anterolateral abdominal wall muscles do?

A

Maintain posture

Support the vertebral column

53
Q

What do contracts of the anterolateral abdominal wall muscles move?

A

The vertebral column - flexion, lateral flexion and rotations

54
Q

What do ‘guarding’ contracts of the anterolateral abdominal wall muscles protect?

A

Abdominal viscera

55
Q

Contracts of the anterolateral abdominal wall muscles increase intra-abdominal pressure. What 3 things does this assist?

A

Defecation
Micturition
Labour

56
Q

What kind of respiration does contraction of the anterolateral abdominal wall muscles aid?

A

Forced expiration

Respiratory (12 decks)

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