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M103 T1 > M103 T1 L5 > Flashcards

M103 T1 L5 Flashcards

1
Q

What are the two types of respiration?

A

thoracic

abdominal

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2
Q

What are the two phases of respiration?

A

inspiration

expiration

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3
Q

What effects does inspiration have on the body?

A

increase in intra-thoracic diameter/volume

decrease in intra-pleural pressure

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4
Q

What happens during inspiration?

A

PP is pulled outwards, which pulls the VP along with it
lung pressure is lower compared to atmospheric pressure
so air rushes into the lungs

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5
Q

What happens during expiration?

A

there is a decrease in intra-thoracic diameter/volume
increased intra-pleural pressure
air is expelled from lungs

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6
Q

What happens to the lateral diameter of the thorax during inspiration?

A

it increases as the lateral edges of ribs are elevated supero-laterally in the bucket handle movement

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7
Q

What happens to the anterior posterior diameter of the thorax during inspiration?

A

increases
pump handle movement - the anterior ends of the ribs are raised, takes the sternum with it
the movement is facilitated by costal cartilages

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8
Q

Which three muscles are responsible for quiet / passive inspiration?

A

external intercostals
diaphragm
scalene muscles

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9
Q

Which three muscles are responsible for forced inspiration?

A

pectoral muscles
sternocleidomastoid
latissimus dorsi

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10
Q

What happens to the vertical diameter of the thorax during abdominal breathing and why?

A

it increases

the diaphragm descends on contraction, compressing abdominal organs

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11
Q

What are the three sections of the diaphragm?

A

sternal
costal
lumbar

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12
Q

What structures attatch to the diaphragm?

A

the pericardium

parietal pleura

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13
Q

What structures are sensorily innervated by the phrenic nerve?

A

Pericardium, Parietal peritoneum
Central region of diaphragm
the mediastinal and diaphragmatic parietal pleura

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14
Q

Where is the right phrenic nerve found?

A

it passes on right wall of SVC

it descends on the pericardium over right atrium to diaphragm (near the IVC orifice)

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15
Q

What four structures is the SA node regulated by? (PAAS)

A

Parasympathetic fibres (vagus nerve)
autonomic nerves via the cardiac plexus
Afferent nerves
Sympathetic fibres

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16
Q

What does recurrent laryngeal nerve compression cause?

A

local cord paralysis

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17
Q

Why is it important to know the coronary circulation dominance?

A

bc when a coronary artery becomes blocked, the extent of its supply to the myocardium will affect potential damage
knowing which coronary artery is dominant allows us to predict the impact of damage to it example: if heart is of right dominance and right artery becomes blocked/damaged, more structures are at risk

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18
Q

Why is expiration normally a passive process?

A

bc the elastic recoil of lungs the chest wall falls back into resting position

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19
Q

Which muscle groups are responsible for forced expiration on contraction?

A

the accessory / abdominal muscles

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20
Q

Which four muscles are responsible for forced expiration?

A

internal intercostals
oblique and transverse abdominal muscles
quadratus lumborum

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21
Q

How far down does the diaphragm move on contraction (inspiration)? When is this reduced?

A

up to 5-10 cm

during preganancy

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22
Q

How many muscular slips are in the sternal part of the diagphragm?

A

two

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23
Q

Which two ligaments are contained in the lumbar part of the diagphragm?

A

the medial and lateral arcuate ligaments

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24
Q

What is the relationship between the lungs and atmospheric pressure?

A

at rest, internal lung pressure = atmospheric pressure

on inspiration, internal lung pressure is lower than atmospheric pressure

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25
Q

What happens in the bucket handle movement?

A

if the bucket standing up and the handle was as low as it could go
then you raised the bucket handle so that it was perpendicular to the sides of the bucket / parallel to the base of the bucket

26
Q

How does the bucket handle movement correspond to the movement of inspiration by the ribs?

A

if each rib was a bucket handle they move up and away from the center of the bucket on inspiration

27
Q

What is the difference between thoracic and abdominal breathing?

A

thoracic - the size of the thoracic cage increases

abdominal - the diaphragm pushes down into the abdominal cavity

28
Q

What is the antero-posterior movement compared to?

A

a pump handle movement

29
Q

What is the transverse / lateral movement compared to?

A

bucket handle movement

30
Q

What happens during the pump handle movement?

A

the lever on the pump is hanging downwards at an angle

It is raised so that it is pointing upwards

31
Q

How does the pump handle movement correspond to the movement of inspiration by the manubrium?

A

Anterior ends of ribs are raised during inspiration
Elevation causes sternum to also be raised
Movement is facilitated by costal cartilages
Results in an increase in antero-posterior diameter of chest cavity

32
Q

What happens to the diaphragm on inspiration?

A

it contracts and presses down

33
Q

What are the names of the three scalene muscles? (MAP)

A

middle
anterior
posterior

34
Q

What is the origin of the sternomastoid?

A

the manubrium and the clavicle

35
Q

What is the diaphragm lined by?

A

by the diaphragmatic parietal pleura

36
Q

What are the three origins of the diaphragm?

A

the xiphoid process
costal cartilages
the lumbar attachment

37
Q

Which costal cartilages make up one of the diaphragm origins?

A

ribs 7-10

ribs 11 & 12

38
Q

What is the lumbar attachment of the diaphragm?

A

the medial arcuate ligament
the lateral arcuate ligament
the lumbar vertebral bodies

39
Q

What is the insertion of the diaphragm?

A

the central tendon

40
Q

Where are the three openings in the diaphragm?

A 
Opening for Inferior Vena Cava (T8)
Oesophageal hiatus (T10)
Aortic hiatus (T12)
41
Q

What passes through the aortic hiatus?

A

the thoracic duct

the azygos vein

42
Q

What provides the blood supply to the diaphragm?

A

the superior & inferior phrenic arteries

43
Q

How far down does the diaphragm move during quiet inspiration compared to forced inspiration?

A

quiet - 2cm

forced - 7 - 10cm

44
Q

What are the actions of the diaphragm?

A

descending during quiet and forced inspiration
aids venous return
spasms - responsible for hiccups
urinating and defecation
lifting heavy objects (braces vertebral column)
child birth

45
Q

What can be the effect of Pancoast Tumours?

A

if the tumour gets big enough on the left hand side, it can compress the recurrent laryngeal nerve

46
Q

What is a consequence of recurrent laryngeal nerve compression?

A

voice hoarseness

can be misdiagnosed

47
Q

What arteries is the diaphragm supplied by?

A

superior and inferior phrenic arteries

48
Q

What is the diaphragm like?

A

thin but a strong aponeurosis

49
Q

Where does the pericardium insert into the diaphragm?

A

via the central diaphragmatic tendon on its superior surface

50
Q

Where does the parietal pleura attach to the diaphragm?

A

it lines the diaphragm’s superior surface

51
Q

What is the parietal pleura otherwise known as?

A

Diaphragmatic pleura

52
Q

Where is the left phrenic nerve found?

A

it runs over the aortic arch and pulmonary trunk
it descends on the pericardium over left ventricle to diaphragm (near the cardiac apex)
it passes anterior to the bronchi

53
Q

What is the heart innervated by?

A 
autonomic nerves via the cardiac plexus
parasympathetic fibres (vagus nerve) and sympathetic fibres 
sensory nerves
54
Q

Where do the sympathetic fibres innervating the heart originate from?

A

the T1-T5 levels of spinal cord and associated paravertebral ganglia

55
Q

What are afferent nerves otherwise known as?

A

sensory nerves

56
Q

What other nerves do sensory nerves travel to the heart with?

A

with sympathetic nerves

57
Q

What is recurrent laryngeal nerve compression caused by?

A

a cancer of upper lobe of either lung

58
Q

Where is the sternomastocloid located?

A

behind the ear

59
Q

What are the veins that supply the diaphragm?

A

internal thoracic vein

IVC and azygos vein

60
Q

What are the accessory expiratory muscles / the abdominal muscles?

A

rectus abdominis, external oblique, internal oblique, and transversus abdominis

M103 T1 (6 decks)

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