Anatomy of coughing Flashcards

(56 cards)

1
Q

What structures do you find the sensory receptors in the mucosa that are responsible for the cough?

A

Oropharynx
Laryngopharynx
Larynx
Respiratory tree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What nerves control the the diaphargm?

A

Phrenic nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What nerves control the intercostal muscles?

A

Intercostal nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What nerve causes adduction of the vocal cords to close the rima glottidis?

A

Vagus nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What prevents the stream of air coming out the nose as a sneeze?

A

The soft palate tenses and elevates to close of the entrance into the nasopharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What nerve causes the soft palate to tense?

A

Cranial nerve V - trigeminal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What verse causes the soft palate to elevate?

A

Vagus nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

At what level does the larynx become the trachea and the pharynx become the oesophagus?

A

Level of the C6 vertebra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the sensory nerve supply to the mucosa lining of the nasal cavities, pharynx and larynx

A

Nasal cavity - CN V (trigeminal)
nasopharnyx and oropharnyx - CN IX (glossopharngeal)
Larynx - CN X (vagus nerve)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the sensory receptors stimulated in coughing?

A

CN IX and CN X

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the carotid sheath?

A

Protective ‘tube’ of cervical deep fascia
Attaches superiorly to the bones of the base of the skull
inferiorly blends with the fascia of the mediastinum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does the right carotid sheath contain?

A

Right…. vagus nerve, internal carotid artery, common carotid artery and internal jugular vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Define the lower respiratory tract

A

Trachea –> alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What lines the LRT and to what level?

A

Respiratory mucosa

To the level of the terminal bronchioles/alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What makes up the pulmonary plexus?

A

Sympathetic axons
Parasympathetic axons
Visceral afferents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do visceral pleura and respiratory tree visceral afferents connect with the CNS?

A

The plumonary visceral afferents travel from visceral pleura and respiratory tree to the plexus, then follow the vagus nerve to the medulla of the brainstem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What happens in inspiration?

A
Diaphragm contracts and descends
Intercostal muscles contract 
Chest walls pull lungs outwards
Lungs expand 
Air flows down pressure gradient
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do the chest walls pull the lungs out with them?

A

Surface tension between the parietal and visceral pleurae created by the pleural fluid
Potential vaccum becomes actual vaccum when the chest wall begins to move .. sucks visceral pleura towards moving parietal pleura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the muscles of normal quiet inspiration?

A

Diaphragm

External, internal and innermost intercostal muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Where do phrenic nerves orginate?

A

Originate in the neck (C3-C5)
Combined anterior rami of cervicle spinal nerves 3, 4 and 5 and pass down between the lungs and the heart to reach the diaphragm.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Where are the phrenic nerves found?

A

Found in the neck on the anterior surface of scalenus anterior
Found in the chest descending over the lateral aspect of the fibrous pericardium anterior to the lung root

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What do the phrenic nerves supply?

A

Supplies somatic sensory and sympathetic axons to:
- fibrous pericardium
- mediastinal parietal pleura
- diaphragmatic partietal pleura
- diaphragmatic parietal peritoneum
Supplies somatic motor axons to the diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What spinal nerves are the intercostal nerves?

A

Anterior rami of the spinal nerves T1-T11

24
Q

What are the accessory muscles of deep (forced) inspiration?

A

Pectoralis major
Pectoralis minor
Sternocleidomastoid
Scalenus anterior, medius and posterior

25
Where does pectoralis major attach and what is its function?
Between sternum/ribs and humerus Pulls trunk towards raised upper limb - "climbing" muscle Pulls ribs upwards and outwards
26
Where does pectoralis minor attach and what is its function?
Ribs 3-5 to the coracoid process of the scapula | Pulls the ribs 3-5 superiorly to the scapula
27
Where does the sternocleidomastoid attach?
Sternum/clavicle and mastoid process of the temporal bone
28
Where do the scalenus anterior, medius and posterior attach
Between cervical vertebrae and ribs 1 and 2
29
Where do the intrinsic muscles of the larynx attach?
Between the cartilages
30
What type of muscle are the intrinsic muscles of the larynx?
Skeletal (voluntary) muscles
31
What nerves supply the intrinsic muscles of the larynx?
Somatic motor branches of the vagus nerve (CN X)
32
What do the intrinsic muscles of the larynx do and what is their role in the cough reflex?
Move the vocal cords | Adduct the vocal cords to close the rima glottidis
33
Name the 3 laryngeal cartilages
Thyroid Cricoid Arytenoid
34
Where do the vagus nerves connect with the CNS?
The medulla or the brainstem
35
What is the name of the hole in the base of the skull that the vagus nerves pass through?
Jugular foramen
36
What is the vagus nerve contained in as it descends through the neck?
Carotid sheath
37
What is the vagus nerve's role in coughing?
Supplies somatic sensory to the mucosa lining the larynx and somatic motor axons to the the intrinsic muscles of the larynx
38
What type of nerve supply does the vagus nerve have to the chest organs?
Parasympathic axons
39
What is the mechanism of quiet expiration?
``` Diaphragm relaxes and ascends Intercostal muscles relax Chest walls return to resting position Lungs elastically recoil Air flows out of the lungs, down a pressure gradient ```
40
What are the accessory muscles of deep (forced) expiration?
Anterolateral abdominal wall muscles
41
Name the 4 anterolateral abdominal wall muscles on the right
``` Right... Rectus abdominis External oblique Internal oblique Transverus abdominus ```
42
Where does the external oblique attach superiorly and interiorly?
Superiorly - the superficial aspects of the lower ribs | Inferiorly - the anterior part of the iliac crest and the pubic tubercle
43
What is an aponeurosis?
A flattened tendon
44
Where does the aponeurosis of right and left external oblique blend?
Midline linea alba
45
Where does the internal oblique attach?
Superiorly - inferior border of the lower ribs | Inferiorly - iliac crest and the thoracolumbar fascia of the lower lack
46
Where does the aponeurosis of right and left internal oblique blend?
Midline linea alba
47
Where does the transverse abdominus attach?
Superiorly - deep aspects of the lower ribs | Inferiorly - iliac crest and thoracolumbar fascia of the lower back
48
Where does the aponeurosis of right and left transverse abdominus blend?
Linea alba
49
What is the rectus sheath constructed from?
The aponeuroses of the other 3 muscles
50
What dived the 2 long flat muscles of the rectus abdominis into 4 smaller quadrate muscles?
Tendinous intersections
51
Name the three thoracoabdominal nerves and where they originate from?
``` Subcostal nerve (T12 anterior ramus) iliohypogastric nerve (half of L1 anterior ramus) ilioinguinal nerve (the other half of L1 anterior ramus) ```
52
What do tonic contractions of the anterolateral abdominal wall muscles do?
Maintain posture | Support the vertebral column
53
What do contracts of the anterolateral abdominal wall muscles move?
The vertebral column - flexion, lateral flexion and rotations
54
What do 'guarding' contracts of the anterolateral abdominal wall muscles protect?
Abdominal viscera
55
Contracts of the anterolateral abdominal wall muscles increase intra-abdominal pressure. What 3 things does this assist?
Defecation Micturition Labour
56
What kind of respiration does contraction of the anterolateral abdominal wall muscles aid?
Forced expiration