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Respiratory anatomy > Anatomy of Coughing > Flashcards

Anatomy of Coughing Flashcards

1
Q

What sensory receptors are stilumated in coughing

A
  1. Oropharyngeal mucousa
  2. Laryngopharyngeal mucousa
  3. Laryngeal mucousa
  4. Lower respiratory tracts - respiratory mucousa
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2
Q

What is the nerve supply to the sensory receptors in sneezing

A

CNV or CN IX

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3
Q

What is the nerve supply to the sensory receptors in Coughing

A

CNIX and CNX

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4
Q

What are carotid sheeths

A
  • Protective tubes of Cervical deep fascia
  • Attach supperiorly - bones of basel skull
  • Inferiorly - blends with the fascia of the mediastinum
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5
Q

What do the carotid sheeths contain

A
  1. Vagus nerve
  2. Internal carotid artery
  3. Common carotid arery
  4. Internal juglular vien
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6
Q

What does the Pulmonary plexus contain

A
  1. Sympathetic nerves- motor
  2. Parasympathetic nerves - motor
  3. Visceral afferents - Sensory
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7
Q

how do pulmonary visceral afferents take impluses to the brainstem

A

Travel form visceral pleura and the respiratory tree to the plexus and then followe the vagus nerve to the medulla

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8
Q

How do the motor (sympathetic and parasympathetic) supply the repsiratory tree and mucousal glands

A

All motor neurons travel along the bifurcaiton of the trachea along the branches to supply all Mucousal glands and all the Bronchiole smooth muscle

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9
Q

How does the diaphragm carry out deep inspiration

A

greater outflow of longer duration of action potentials via the phrenic nerve

  • causes diapragm to flatten out then descend maximally
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10
Q

What are the muscles of normal quite breathing

A
  1. internal intecostal
  2. external intercostal
  3. inner most intercostal

(diaphragm)

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11
Q

What is the nerve supply to the inntercostal muscles

A

Intercosral nerves

  • Anterior rami of spinal nerves
  • T1-T11
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12
Q

How do the intercostal muscles carry out deep forceful inspiration

A

in a deep forceful inspiration the intercostal muscles contract forcefully and elevate the ribs maximally

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13
Q

What are the Accessory muscles of Deep forced inspiration

A
  • pectoralis major
  • pectoralis minor
  • Scalanous anterior, Medius and posterior
  • Sternocleidomastoid
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14
Q

What is the attachment, function and innervation of pectoralis muscle

A

Attachment

  • ​between sternum/ribs and humerus ​

Function

  • Adducts and medially rotates the humerus
  • If upper-limb position is fixed
  • pull ribs upwards and outwards

​Innervation

  • Brachail plexus - medial and lateral pectoral nerves
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15
Q

What is the function of the pectoralis minor muscle

A

Can pull ribs 3-5 supeirorly towards the coricoid process of the scapula

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16
Q

What are the attachments of the sternocliedomastoid muscle

A

Attachment

  • Between sternum/clavical and mastoid process of the temporal bone
17
Q

What are the attachments of the scalenus anterior, medus and posterior

A
  • cervical vertebrae
  • rib 1 and 2
18
Q

what is the anatomy of the larnyx

A
19
Q

What are the vocal cords and the Rima glottis

A
  • supperior parts of the larnxny
  • Rima glottis is the space between the vocal cords
  • The vocal cords can aapproximate in the midline closing the rima glotttis
20
Q

What are the intrinsic muscles of the larnyx

A
  • Skeletal muscle attach between the cartilageous
  • Move the cartilageous resulting in the movement of the vocal cords

Innervation

  • supplied by somatic motor
  • Branches from vagus nerve - CNX

These muscles adduct the vocal cords during cough relflex

21
Q

What is the anatomy of the right and left vagus nerves

A
  • They are mixed cranial nerves
  • connect with the CNS at the medulla
  • Base of skeleton part of the course = jugular foramen
  • Descends through the neck witihn the carotid sheath
22
Q

Function of vagus nerve in coughing

A

Supply somatic sensory and motor axons to the larynx ​

  • Seconsry = Muscosa of larynx
  • Motor = intrinsic muscles of larynx
23
Q

Vagus supply to the Chest organs

A
  • Descends posteiror to the root of the lungs
  • Parasympathetic supply to chest organs

Parasympathetic supply to the lungs via pulmonary plexus

24
Q

Other functions of the vagus nerve

A

On surface of the stomach divid into many parasymthetic branches ​

  • For the fore-gut and mid-gut organs
25
Q

How does the vagus nerve pass through the diaphragm

A

on the oesophgus

26
Q

what is the action of the accessory muscle of deep forced Expiration

A
  • Diaphragm relaxes
  • right and left anteriolateral abdominal wall muscles contract forcefully
  • this increases intra-abdominal pressure
  • compressed abdominal contents push the diaphragm forcefully superiorly
  • Intra-thoracic pressure increases
  • this increases pressure within the respiratory tree inferior to the vocal cords
27
Q

What are the muscle of the anteriolateral abdominal wall

A
  • rectus abdominus
  • External oblique
  • Internal oblique
  • Transvere abdominus
28
Q

What is the Linea alba (white line)

A

the aponeurosis of the right external oblique (and the internal oblique and the transverse oblique) blends with the aponeurosis of the left external oblique (and internal and transverse) at the midline

29
Q

What are the attachments of the of the external oblique muscles

A

Superiorly

  • superficial aspects of the lower ribs

Inferiorly

  • Anterior part of the illiac crest and pubic tubercle
30
Q

What is the Linea semilunaris (located on the right and left)

A
  • Where the muscle fibres end and aponeurosis begins
31
Q

What are the attachments of the internal oblique muscle

A

Superiorly

  • Inferior boarder of the lower ribs

Inferiorly

  • Illiac crest and thoracolumbar fascia of lower back

Fibre direction = Same as the internal interscostal muscles

32
Q

What are the attachments of the transverse abdominus muscle

A

Superiorly

  • deep aspects of the lower back

inferiorly

  • illiac Cresnt and thoracolumbar fascia
33
Q

What is the anatomy of the retus abdominis muscle

A
  • Vertically running muscle
  • contained within the rectus sheeth (tendenous muscle envolope)- formed from the aponeurosis of the 3 muscles

origin

  • 5-7 costal cartilages and xiphiod prosses

inseriton

  • pubis - between pubic tubercle and symphysis
34
Q

What are tendinous intersections

A
  • fibrous bands that cross the 2 rectus abdominus muscles
  • divide the muscles into 3-4 smaller quadrate muscles
  • 6 pack
35
Q

What is the nerve supply to the abdominal muscles carrying somatic sensory, motor and sympathetic nerve fibres

A

Thoracoabdominal Nerves

  • 7-11 intercostal nerves
  • travel anteriorly then their terminal branches leve the intercostal spaces
  • leave space in the plane between the internal oblique and transverse abdominis as thoracoabdolimnal nerves
36
Q

What are other nerve supply to the abdominal wall carrying somatic motor, sensory and sympathetic nerve fibres

A
  • Subcostal nerve - T12 anterior ramus
  • Illiohypogastric nerve - half of L1 anterior ramus
  • Ilioinguinal nerve - other half of L1
37
Q

Function of anteriolateral abdominal muscles

A
  • Maintain posture - tonic (continous low level) contraction
  • Support vertebral column - Tinoc contraction
  • movement of vertebral column - flextion, lateral flexion and rotation
  • Gaurding - protect abdominal viscera via contraction
  • increasing intra- abdominal pressure- defecation, micturition and labour
  • Forced expiration
38
Q

Cough reflex

A

A.stimulation of sensory receptors in the mucosa of the:

  1. oropharynx
  2. laryngopharynx
  3. larynx
  4. respiratory tree (trachea to bronchioles)

B.the CNS responds by rapidly coordinating the following:

  1. a DEEP inspiration using the diaphragm (phrenic nerves), intercostal muscles (intercostal nerves) & “accessory muscles of inspiration”
  2. adduction of the vocal cords to close the rima glottidis (vagus nerves)
  3. contraction of the anterolateral abdominal wall muscles (intercostal nerves) to build up intra-abdominal pressure which pushes the diaphragm superiorly and builds up pressure in the chest/respiratory tree inferior to the adducted vocal cords
  4. the vocal cords suddenly abduct to open the rima glottides (vagus nerves)
  5. the soft palate tenses (CN V) and elevates (vagus nerves) to close off the entrance into the nasopharynx and direct the stream of air (at ~100mph!!) through the oral cavity as a cough rather than through the nasal cavity as a sneeze!

Respiratory anatomy (3 decks)

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