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Respiratory Anatomy & Disease Mechanisms > The Coughing Reflex (ANATOMY) > Flashcards

The Coughing Reflex (ANATOMY) Flashcards

1
Q

Coughing occurs in response to the stimulation of receptors in _______ (3)

A

Oropharyngeal mucosa
Laryngopharyngeal mucosa
Laryngeal mucosa

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2
Q

From which cranial nerve will the nasopharynx and oropharynx relay action potentials from?

A

CN IX (Glossopharyngeal nerve)

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3
Q

From which cranial nerve does the laryngopharynx relay action potentials from?

A

CN X (Vagus nerve)

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4
Q

What are carotid sheaths?

A

Protective “tubes” of cervical deep fascia

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5
Q

Where do the carotid sheets attach?

A

Superiorly to the bones of the base of the skull

Blend inferiorly with the fascia of the mediastinum

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6
Q

What do the carotid sheaths (right/left) contain? (4)

A

Vagus nerve
Internal carotid artery
Common carotid artery
Internal jugular vein

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7
Q

How do visceral pleura & respiratory tree visceral afferents connect with the CNS? (3)

A

Sympathetic trunk
Pulmonary plexus
Vagus nerve (in the carotid sheath)

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8
Q

What is meant by “visceral afferent”?

A

Sensory nerve (that arrives) from an organ

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9
Q

What does the pulmonary plexus contain? (3)

A

Sympathetic axons
Parasympathetic axons
Visceral afferents

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10
Q

What is a plexus?

A

An intertwining of nerves

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11
Q

The sympathetic and parasympathetic axons in the pulmonary plexus are _____ nerves that supply the _____

A

motor

heart

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12
Q

The motor axons travel from the tracheal _____ along the branches of the _________ to supply all ____ & ______

A

bifurcation
respiratory tree
mucous glands & bronchiolar smooth muscles

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13
Q

Describe the route of the pulmonary visceral afferents from the visceral pleura to the medulla

A

From visceral pleura & respiratory tree to the plexus then follow the vagus nerve to the medulla to the brain

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14
Q

Once the sensory receptors have been stimulated the CNS responds by rapidly coordinating _____

A

Deep inspiration

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15
Q

Deep inspiration requires use of ___(4)

A

Diaphragm
Intercostal muscles
Accessory muscles of inspiration

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16
Q

Which nerves innervate the diaphragm?

A

Phrenic nerves

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17
Q

Which nerves innervate the intercostal muscles?

A

Intercostal nerves

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18
Q

What is the difference between quiet and forced inspiration in terms of action potentials via the phrenic via?

A

In deep/forced inspiration a greater outflow of action potentials with a longer duration cause the diaphragm to flatten&descend maximally

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19
Q

What are the muscles of normal (quiet) inspiration?

A

External intercostal muscles
Internal intercostal muscles
Innermost intercostal muscles

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20
Q

The intercostal nerves are the anterior rami of which spinal nerves?

A

T1-T11

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21
Q

What are the accessory muscles of forced / deep inspiration?

A

Pectoralis Major
Pectoralis minor
Sternocleidomastoid
Scalenus anterior, menus & posterior

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22
Q

Where does the pectoralis major attach?

A

Between the sternum/ribs & humerus

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23
Q

What is the function of the pectoralis major?

A

Adduction and medial rotation of the humerus

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24
Q

What position must the upper limb be in so the pectoralis major can pull the ribcage upwards/outwards?

A

Upper limb position is “fixed”

E.g. by holing on to the air of the chair or the thigh

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25
Q

What is the recruitment of accessory muscles a clinical sign of?

A

Dyspnoea?

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26
Q

What is the function of the pectoralis minor in terms of deep inspiration?

A

Puling ribs 3-5 superiorly towards the coracoid process of the scapula

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27
Q

Where does the sternocleidomastoid attach?

A

Between the sternum/clavicle & mastoid process of the temporal bone

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28
Q

Where do the scalenus anterior, medius & posterior attach?

A

Between cervical vertebrae & ribs 1&2

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29
Q

Which nerve stimulates the adduction of the vocal cords to close the rims glottidis during the coughing reflex?

A

CN X - Vagus nerve

30
Q

Where do the vocal cords approximate?

A

Midline

31
Q

Where do the intrinsic muscles of the larynx attach?

A

Between the cartilages

32
Q

What do the intrinsic muscles of the larynx move? What does this result?

A

The cartilages - movement of the vocal cords

33
Q

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

A

Skeletal (voluntary) muscle

34
Q

What type of nerve is CN X?

A

Mixed (sensory & motor)

35
Q

Where does the cranial nerve connect with the CNS?

A

At the medulla oblongata of the brainstem

36
Q

Through which structure do the vagus nerves (left&right) pass through the neck?

A

Within the carotid sheath

37
Q

What is the important function of CN X to coughing?

A

Supply somatic sensory & somatic motor tons to the larynx

38
Q

To which part of the larynx do the sensory parts of CNX go?

A

Mucosa lining of the larynx

39
Q

To which part of the larynx do the motor parts of CNX go?

A

Intrinsic muscles of the larynx

40
Q

In the chest, the vagus nerves descend ______ to the chest organs (including the lungs via the pulmonary plexus)

A

posterior

41
Q

The vagus nerves pass through the diaphragm on the _______

A

oesophagus

42
Q

Where do the vagus nerves divide into many parasympathetic braches?

A

On the surface of the stomach

43
Q

Which structures do the parasympathetic branches of the vagus nerve supply? (2)

A

Foregut & Midgut organs

44
Q

Does the vagus or the phrenic nerve pass anterior to the root of the lung?

A

The phrenic nerve

45
Q

What is the purpose of anterolateral abdominal wall muscle contraction in terms of the cough reflex?

A

Raise intra-abdominal pressure

46
Q

Which muscles forcefully increase the the intra-abdominal pressure during deep expiration?

A

Right & left anterolateral abdominal wall and the diaphragm

47
Q

Which muscles are involved in deep expiration? (4 - right & left of each)

A

Rectus abdominis
External oblique Internal oblique
Transverses abdominus

48
Q

What is an aponeurosis?

A

Flattened tendon

49
Q

The aponeurosis of the right external oblique blends with the aponeurosis of the left external oblique the the midline ________

A

Linea alba

50
Q

Where does the external oblique attach superiorly?

A

Superficial aspects of the lower ribs

51
Q

Where does the eternal oblique attach inferiorly?

A

Anterior part of the iliac crest & the pubic tubercle

52
Q

The fibre direction of the external oblique is the _____ as the external intercostal muscle

A

same

53
Q

Where is the lines semilunaris? (right and left)

A

Where the muscle fibres end and the aponeurosis begins

54
Q

_____ of the right internal oblique bless with the aponeurosis of the _______ at the midline linea alba

A

Aponeurosis

Left internal oblique

55
Q

Where does the right internal oblique attach superiorly?

A

The inferior border of the lower ribs

56
Q

Where does the internal oblique attach inferiorly?

A

Iliac crest & thoracolumbar fascia of the lower back

57
Q

Does the internal oblique have the same/opposite fibre direction as the internal intercostal muscles?

A

same

58
Q

Where does aponeurosis of the right transverses abdomens blend with the aponeurosis of the left transversus abdomens?

A

Linea alba

59
Q

Where does the transversus abdominus attach superiorly?

A

Deep aspects of the lower ribs

60
Q

Where does the transversus abdominus attach inferiorly?

A

Iliac crest & thoracolumbar fascia of the lower back

61
Q

What encapsulates the rectus abdominus?

A

Internal oblique
External oblique
Skin
Transversus abdominis

62
Q

Where does the the rectus abdominis attach superiorly?

A

Xiphoid process

Costal margin

63
Q

Where does the rectus abdominis attach inferiorly?

A

Pubis bone

Pubic symphysis

64
Q

The somatic motor, somatic sensory and sympathetic nerve fibres supplying the structures of the abdominal part of the body wall (soma) are convey within the _____

A

thoracoabdominal nerves

65
Q

The 7th-11th intercostal nerves travel ______ then their terminal branches leave the _________ in which plane?

A

anteriorly
intercostal spaces

In the plane between the internal oblique & transversus abdominus

66
Q

What is the name of the nerves in the plane between the internal oblique & transversus abdominus?

A

Thoracoabdominal nerves

67
Q

What innervates the upper part of the abdominal wall?

A

Thoracoabdominal nerves

68
Q

What innervates the area below T12?

A

Subcostal nerve

69
Q

What does the iliohypogastric nerve innervate?

A

Half of L1 anterior ramus

70
Q

What does the ilioinguinal nerve innervate?

A

Half of L1 anterior ramus

71
Q

What are the functions of tonic (continuous low level) contractions of anterolateral abdominal muscles?

A

Maintain posture

Support the vertebral column

72
Q

What are the function of contractions of the anterolateral abdominal muscles?

A

Movements of the vertebral column (flexion; lateral flexion; rotations)
Guarding - protect the abdominal viscera
Increase intra-abdominal pressure (to assist defecation; micturition; labour)
Aid forced expiration

Respiratory Anatomy & Disease Mechanisms (13 decks)

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