Anatomy of Coughing

Question 1

What is contained in the carotid sheath

Answer 1

Jugular vein, common carotid artery, internal carotid artery and CNX

Question 2

Phrenic nerve

Answer 2

Anterior rami of C3, 4 and 5

Question 3

Muscles of normal inspiration

Answer 3

Internal intercostal, external intercostal and innermost intercostal muscles

Question 4

Intercostal nerves

Answer 4

Anterior rami of spinal nerves T1-T11

Question 5

Accessory muscles of deep inspiration

Answer 5

Sternocleidomastoid, scalene, pectoralis major and minor

Question 6

How does the pectorals major move the ribs

Answer 6

Upwards and outwards

Question 7

What position must the body be in for the pectoralis major to work during deep inspiration?

Answer 7

Upper limb position is fixed

Question 8

Where does the pectoralis major attach?

Answer 8

between sternum/ribs and humerus

Question 9

how does the pectoralis minor move the ribs

Answer 9

moves them superiorly towards coracoid process pf scapula

Question 10

where do the scalenus muscles attach

Answer 10

between C vertebrae and ribs 1 and 2

Question 11

which nerve controls the rima glottidis

Answer 11

CNX

Question 12

what type of muscle is the intrinsic muscles of the larynx

Answer 12

skeletal (voluntary) muscle

Question 13

where does CNX exit the skull

Answer 13

jugular foramen

Question 14

where does the CNX arise

Answer 14

medulla oblongata of brainstem

Question 15

How is intra-abdominal pressure built up and what does it do

Answer 15

By contract of the anterolateral abdominal wall muscles (intercostal nerves)
Pushes the diaphragm superiorly

Question 16

what are the muscles of deep expiration

Answer 16

anterolateral abdominal wall muscles

Question 17

anterolateral abdominal wall muscles include

Answer 17

rectus abdominus (6 pack)
external obliques 
internal obliques 
transverse abdominus

Question 18

what is an aponeurosis

Answer 18

a sheet of pearly white fibrous tissue that takes the place of a tendon in sheet like muscles with a wide area of attachment

Question 19

where do the aponeuroses of the right and left obliques and transverse abdominus blend

Answer 19

midline linea alba

Question 20

where do muscle fibres end and aponeuroses begin

Answer 20

linea semilunaris

Question 21

where does external oblique attach superiorly

Answer 21

superficial aspects of lower ribs

Question 22

where does external oblique attach inferiorly

Answer 22

anterior part of iliac crest and pubic tubercle

Question 23

where does internal oblique attach superiorly

Answer 23

inferior border of lower ribs

Question 24

where does internal oblique attach inferiorly

Answer 24

iliac crest and thoracolumbar fascia of lower back

Question 25

where does transversus abdominus attach superiorly

Answer 25

deep aspects of lower ribs

Question 26

where does transversus abdominus attach inferiorly

Answer 26

iliac crest and thoracolumbar fascia of lower back

Question 27

where does the rectus abdominus attach superiorly

Answer 27

xiphoid process and costal margin

Question 28

rectus sheath

Answer 28

formed by the 3 layers aponeuroses | contains the rectus abdominus

Question 29

nerves of the anterolateral abdominal wall

Answer 29

thoracoabdominal nerves subcostal nerve iliohypogastric nerve ilioinguinal nerve

Question 30

thoracoabdominal nerves

Answer 30

anterior rami of T7-T11

Question 31

subcostal nerve

Answer 31

anterior rami of T12

Question 32

iliohypogastric and | ilioinguinal nerve

Answer 32

both halves of anterior rami of L1

Question 33

gap between lung and parietal pleura in small pneumothorax

Answer 33

< 2cm

Question 34

which intercostal space is needle inserted into to manage a large pneumothorax

Answer 34

mid portion of 4th or 5th intercostal space

Question 35

what borders the safe triangle

Answer 35

pectoralis major anterior border of latissimus dorsi posterior border of pectoralis major

Question 36

which intercostal space is needle inserted into to manage a tension pneumothorax in an emergency

Answer 36

2nd or 3rd intercostal space in midclavicular line at sternal angle (rib 2 level)

Question 37

herniae definiton

Answer 37

any structure passing through another, so ending up in the wrong place

Question 38

two factors required for herniae development

Answer 38

weakness of one structure - commonly a body wall - and increased pressure on one side of said wall e.g. chronic cough

Question 39

herniae in which the herniated part of stomach is parallel to oesophagus

Answer 39

paraoesophageal hiatus herniae

Question 40

herniae in which the herniated part of stomach is slides through the oesophageal hiatus into the chest with the gastro-oesophageal junction

Answer 40

sliding hiatus herniae

Question 41

inguinal ligaments attach between

Answer 41

ASIS (anterior superior iliac spine) and pubic tubercle

Question 42

floors of inguinal canals formed by

Answer 42

medial halves of inguinal ligaments

Question 43

what forms the inferior border of the external oblique aponeuroses

Answer 43

inguinal ligaments

Question 44

entrance to inguinal canal

Answer 44

deep ring

Question 45

exit from inguinal canal

Answer 45

superficial ring - v shaped defect in external oblique aponeuroses

Question 46

where do inguinal herniae form

Answer 46

medial half of the inguinal region

Question 47

weakness and increased pressure factors in inguinal herniae

Answer 47

weakness - presence of inguinal canal | increased pressure - intra-abdominal pressure due to chronic cough

Question 48

what facilitates the descent of the teste into the scrotum

Answer 48

gubernaculum

Question 49

how are the internal oblique and transversus abdominus muscles anchored to the pubic bone

Answer 49

conjoint tendon - medial end of their combined aponeuroses

Question 50

covering of transversalis fascia forms

Answer 50

internal spermatic fascia

Question 51

covering of skeletal muscle fibres from internal oblique forms

Answer 51

cremasteric fascia

Question 52

covering of external oblique aponeurosis forms

Answer 52

external spermatic fascia

Question 53

spermatic cord contents

Answer 53

vas deferens, testicular artery and pampiniform plexus