Mechanics of Ventilation Flashcards Preview

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Flashcards in Mechanics of Ventilation Deck (33):
1

Functions of thorax

Move with ventilation
Protect organs

2

What happens to the thorax as you age?

It widens and looses compliance (stiffer)
Loose AP diameter, ribs become more horizontal

3

Which ribs only articulate with 1 vertebral body?

1, 10, 11, 12

4

Is the thorax open chain or closed chain?

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

5

What do ribs articulate with?

Bodies, transverse processes and disc;
1, 10, 11, 12 with facets of body only

6

What is the axis of motion through in the Ribs?

Through the CV and the CT joints

7

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

close to the frontal plane

8

What plane is the movement for the upper ribs in?

sagittal plane

9

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

close to the sagittal plane

10

What plane is the movement for the lower ribs in?

frontal plane

11

What can the upper and lower ribs be compared to?

Upper ribs = pump handle
lower ribs = bucket handle

12

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

2 synovial joints: CV and CT

13

Describe the osteokinematic motion of the ribs:

ribs moving on the vertebral spine

14

Describe the expansion of the ribs:

doesn’t incorporate movement of the bones

15

Central tendon of diaphragm is

non-contractile

16

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

negative pressure

17

The diaphragm shortens during ______.

inspiration

18

At rest, diaphragm muscle fibers are oriented ______.

longitudinally

19

What muscles are primary muscles of inspiration?

diaphragm
intercostals
scalenes

20

When do scalenes have optimal length-tension?

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

21

What are the accessory muscles of inspiration?

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

22

When does the SCM kick in?

assists during inspiration with pathology or exertion

23

With a T3 SCI, what position makes breathing easier?

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

24

What adaptations occur with hyperinflated lungs during inspiration?

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

25

What are the muscles of expiration?

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

26

Describe the general results of expiration:

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

27

Describe the biomechanics of breathing:

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

28

Upward & outward motion of lower ribs is called

→ bucket handle motion

29

A/P motion of upper ribs is called

→ pump handle motion

30

What are the 3 phases of a cough?

1. deep inhalation
2. isometric contraction
3. forced expiration

31

What muscles are involved in cough?

rectus abdominus, transverse abdominus

32

What are consequences of ↑ WOB?

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

33

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

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