Thoracic cage and breathing mechanisms

Question 1

Where is tip of scapula?

Answer 1

T8

Question 2

Where is manubrio-stinal joint

Answer 2

T4/6

Question 3

Where does aorta intersect diaphragm?

Answer 3

T12

Question 4

Which ribs are least injured?

Answer 4

1,2,11,12

Question 5

Why is diaphragm higher on right?

Answer 5

Liver

Question 6

Which nerve supplies diaphragm?

Answer 6

Phrenic

Question 7

What is the hiatus?

Answer 7

Base of diaphragm, oesophagus, IVC and aorta go through

Question 8

What is the azygous vein?

Answer 8

Inter-costal veins drain here

Question 9

Innervation of phrenic nerve

Answer 9

3,4,5

Question 10

Is expiration passive or active?

Answer 10

Passive

Question 11

How to feel bucket handle?

Answer 11

Put hands under armpit around ribs

Question 12

Inspiration

Answer 12

Phrenic nerve stimulates diaphragm to contract

External intercostals contract to elevate ribs

Question 13

Accessory muscles of inspiration and their functions

Answer 13

Sternocleidomastoid - elevates sternum
Scalenes - fix 1 and 2 ribs
Pec maj and min - fix ribs 3,4,5 when scapula stabilised
Serratus anterior - when scapula stabilised, fixed 8 or 9 upper ribs

Question 14

How to tell if someone has COPD

Answer 14

They use neck muscles to breathe

Question 15

Expiration

Answer 15

Elastic recoil of chest wall and lungs = passive

Diaphragm and external intercostals relax

Question 16

Accessory muscles of expiration

Answer 16

Rectus and transversus abdominis

Increase intra-abdominal pressure

Question 17

What does pump handle do?

Answer 17

Increase front to back distance of chest

Question 18

What does bucket handle do?

Answer 18

Lateral ribs

Question 19

Pulmonary syndrome

Answer 19

Absence of pec major and sometimes ribs

Question 20

C2 lesion

Answer 20

Can’t use diaphragm or intercostals, no BP so ventilator

Question 21

C5 lesion

Answer 21

Diaphragm but no BP

Question 22

T2 lesion

Answer 22

Diaphragm and BP but not intercostals

Question 23

L1 lesion

Answer 23

Diaphragm and intercostals work but paralysed