Anatomy of Coughing Flashcards
What is contained in the carotid sheath
Jugular vein, common carotid artery, internal carotid artery and CNX
Phrenic nerve
Anterior rami of C3, 4 and 5
Muscles of normal inspiration
Internal intercostal, external intercostal and innermost intercostal muscles
Intercostal nerves
Anterior rami of spinal nerves T1-T11
Accessory muscles of deep inspiration
Sternocleidomastoid, scalene, pectoralis major and minor
How does the pectorals major move the ribs
Upwards and outwards
What position must the body be in for the pectoralis major to work during deep inspiration?
Upper limb position is fixed
Where does the pectoralis major attach?
between sternum/ribs and humerus
how does the pectoralis minor move the ribs
moves them superiorly towards coracoid process pf scapula
where do the scalenus muscles attach
between C vertebrae and ribs 1 and 2
which nerve controls the rima glottidis
CNX
what type of muscle is the intrinsic muscles of the larynx
skeletal (voluntary) muscle
where does CNX exit the skull
jugular foramen
where does the CNX arise
medulla oblongata of brainstem
How is intra-abdominal pressure built up and what does it do
By contract of the anterolateral abdominal wall muscles (intercostal nerves)
Pushes the diaphragm superiorly
what are the muscles of deep expiration
anterolateral abdominal wall muscles
anterolateral abdominal wall muscles include
rectus abdominus (6 pack) external obliques internal obliques transverse abdominus
what is an aponeurosis
a sheet of pearly white fibrous tissue that takes the place of a tendon in sheet like muscles with a wide area of attachment
where do the aponeuroses of the right and left obliques and transverse abdominus blend
midline linea alba
where do muscle fibres end and aponeuroses begin
linea semilunaris
where does external oblique attach superiorly
superficial aspects of lower ribs
where does external oblique attach inferiorly
anterior part of iliac crest and pubic tubercle
where does internal oblique attach superiorly
inferior border of lower ribs
where does internal oblique attach inferiorly
iliac crest and thoracolumbar fascia of lower back
where does transversus abdominus attach superiorly
deep aspects of lower ribs
where does transversus abdominus attach inferiorly
iliac crest and thoracolumbar fascia of lower back
where does the rectus abdominus attach superiorly
xiphoid process and costal margin
rectus sheath
formed by the 3 layers aponeuroses
contains the rectus abdominus
nerves of the anterolateral abdominal wall
thoracoabdominal nerves
subcostal nerve
iliohypogastric nerve
ilioinguinal nerve
thoracoabdominal nerves
anterior rami of T7-T11
subcostal nerve
anterior rami of T12
iliohypogastric and
ilioinguinal nerve
both halves of anterior rami of L1
gap between lung and parietal pleura in small pneumothorax
< 2cm
which intercostal space is needle inserted into to manage a large pneumothorax
mid portion of 4th or 5th intercostal space
what borders the safe triangle
pectoralis major
anterior border of latissimus dorsi
posterior border of pectoralis major
which intercostal space is needle inserted into to manage a tension pneumothorax in an emergency
2nd or 3rd intercostal space in midclavicular line at sternal angle (rib 2 level)
herniae definiton
any structure passing through another, so ending up in the wrong place
two factors required for herniae development
weakness of one structure - commonly a body wall - and increased pressure on one side of said wall e.g. chronic cough
herniae in which the herniated part of stomach is parallel to oesophagus
paraoesophageal hiatus herniae
herniae in which the herniated part of stomach is slides through the oesophageal hiatus into the chest with the gastro-oesophageal junction
sliding hiatus herniae
inguinal ligaments attach between
ASIS (anterior superior iliac spine) and pubic tubercle
floors of inguinal canals formed by
medial halves of inguinal ligaments
what forms the inferior border of the external oblique aponeuroses
inguinal ligaments
entrance to inguinal canal
deep ring
exit from inguinal canal
superficial ring - v shaped defect in external oblique aponeuroses
where do inguinal herniae form
medial half of the inguinal region
weakness and increased pressure factors in inguinal herniae
weakness - presence of inguinal canal
increased pressure - intra-abdominal pressure due to chronic cough
what facilitates the descent of the teste into the scrotum
gubernaculum
how are the internal oblique and transversus abdominus muscles anchored to the pubic bone
conjoint tendon - medial end of their combined aponeuroses
covering of transversalis fascia forms
internal spermatic fascia
covering of skeletal muscle fibres from internal oblique forms
cremasteric fascia
covering of external oblique aponeurosis forms
external spermatic fascia
spermatic cord contents
vas deferens, testicular artery and pampiniform plexus
