Mechanics of Ventilation Flashcards

1
Q

Functions of thorax

A

Move with ventilation

Protect organs

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2
Q

What happens to the thorax as you age?

A

It widens and looses compliance (stiffer)

Loose AP diameter, ribs become more horizontal

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3
Q

Which ribs only articulate with 1 vertebral body?

A

1, 10, 11, 12

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4
Q

Is the thorax open chain or closed chain?

A

Closed chain, excluding ribs 11 and 12 (open chain)

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5
Q

What do ribs articulate with?

A

Bodies, transverse processes and disc;

1, 10, 11, 12 with facets of body only

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6
Q

What is the axis of motion through in the Ribs?

A

Through the CV and the CT joints

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7
Q

What plane is the axis of rotation for the upper ribs?

A

close to the frontal plane

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8
Q

What plane is the movement for the upper ribs in?

A

sagittal plane

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9
Q

What plane is the axis of rotation for the lower ribs?

A

close to the sagittal plane

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10
Q

What plane is the movement for the lower ribs in?

A

frontal plane

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11
Q

What can the upper and lower ribs be compared to?

A

Upper ribs = pump handle

lower ribs = bucket handle

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12
Q

Ribs 1-10 articulate posteriorly with vertebral bodies by what joint(s)?

A

2 synovial joints: CV and CT

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13
Q

Describe the osteokinematic motion of the ribs:

A

ribs moving on the vertebral spine

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14
Q

Describe the expansion of the ribs:

A

doesn’t incorporate movement of the bones

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15
Q

Central tendon of diaphragm is

A

non-contractile

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16
Q

Displacement of the diaphragm causes _______ , which draws air in.

A

negative pressure

17
Q

The diaphragm shortens during ______.

A

inspiration

18
Q

At rest, diaphragm muscle fibers are oriented ______.

A

longitudinally

19
Q

What muscles are primary muscles of inspiration?

A

diaphragm
intercostals
scalenes

20
Q

When do scalenes have optimal length-tension?

A

late inspiration

remember, they attach to cervical vertebrae-ribs 1/2 and act to lift thorax up

21
Q

What are the accessory muscles of inspiration?

A

SCM, upper traps, serratus anterior, pec major/minor (reverse action), lats(reverse action)

22
Q

When does the SCM kick in?

A

assists during inspiration with pathology or exertion

23
Q

With a T3 SCI, what position makes breathing easier?

A

supine: abdominal contents have external support of table (could also use abdominal binder in seated)

24
Q

What adaptations occur with hyperinflated lungs during inspiration?

A

increased lateral excursion, trap elevation. adaptations due to decreased contractility of diaphragm and chest wall due to length-tension changes.

25
Q

What are the muscles of expiration?

A

abdominals (rectus, external, internal, transverse), triangularis sterni, QL

26
Q

Describe the general results of expiration:

A

passive, thorax returns to resting state, diaphragm returns to dome shape, abdominal contents return to starting position

27
Q

Describe the biomechanics of breathing:

A

diaphragm contracts, ↑ intra-abdominal pressure, ↑ thoracic volume vertically/transversely, ↓ intrathoracic pressure

28
Q

Upward & outward motion of lower ribs is called

A

→ bucket handle motion

29
Q

A/P motion of upper ribs is called

A

→ pump handle motion

30
Q

What are the 3 phases of a cough?

A
  1. deep inhalation
  2. isometric contraction
  3. forced expiration
31
Q

What muscles are involved in cough?

A

rectus abdominus, transverse abdominus

32
Q

What are consequences of ↑ WOB?

A

↑ levels of 02 demand, ↑ recruitment of accessory muscles, ↑ 02 COST OF VENTILATION
(these are result of pathology)

33
Q

Decreased compliance of thoracic cage due to R thoracic scoliosis leads to:

A

R side compressed: decreased ability to contract because of decreased length
L side stretched: decreased ability to contract because of increased length