Textbook CH 1

Question 1

why are rib fractures extremely painful

Answer 1

profound nerve supply

Question 2

therapists should recommend _____ when helping those with rib fractures

Answer 2

breathing
splinting
coughing strategies

Question 3

compare the right and left hemidiaphragms

Answer 3

right - protected by the liver and stronger

left - more subject to rupture/hernia

Question 4

openings of the diaphragm? what goes through them?

Answer 4

vena caval - IVC
esophageal - esophagus / gastric vessels
aortic - aorta, thoracic duct, azygos veins

Question 5

which directions does the diaphragm contraction open in the thorax

Answer 5

cephalocaudal
anterior posterior
lateral

Question 6

how does COPD affect the diaphragm

Answer 6

flattening of the diaphragm due to the presence of hyperinflated lungs

• will have to use accessory muscles to trigger inspiration

Question 7

external intercostal contraction causes

Answer 7

lower ribs to be pulled up / out and expanding the chest

Question 8

contraction of the SCM causes

Answer 8

elevation of sternum
increasing the anteroposterior diameter of the chest

Question 9

contraction of the scalenes causes

Answer 9

elevate and fix the first/second ribs

Question 10

role of external vs internal intercostals

Answer 10

external - elevate ribs, expand lungs
internal - depress ribs, collapse lungs

Question 11

pleuritis/pleurisy

Answer 11

inflammatory response within the pleura
- presence of pleural chest pain/abnormal friction rub in auscultation

Question 12

what may cause laryngitis in a clinical setting

Answer 12

endotracheal intubation
- inflammatory response (laryngitis) that causes hoarseness and pain during speech

Question 13

how is the lower respiratory tract divided

Answer 13

tracheobronchial tree / conducting airways

and

acinar / terminal respiratory units

Question 14

what is the tracheobronchial tree involved in vs not involved in

Answer 14

is - movement of air to and from respiratory units
isn’t - exchange of gasses in lungs

Question 15

most abundant cells in the bronchial epithelium

Answer 15

ciliated cells
- involved in the removal inhaled particulate matter

Question 16

what two cells in the bronchial epithelium secrete? what do they secrete?

Answer 16

mucous (goblet) / serous cells

mucus

Question 17

where are mucous (goblet) cells

Answer 17

more numerous in large airways/trachea

Question 18

where are serous cells

Answer 18

extrapulmonary bronchi

Question 19

cigarette smoking causes? what is the importance of this

Answer 19

paralysis of ciliated epithelial cells

inability to dislodge inhaled particulates can increase one’s risk of developing respiratory infections

Question 20

what makes up the acinus

Answer 20

respiratory bronchioles
alveolar ducts
alveoli

Question 21

parasympathetic output in the lung

Answer 21

bronchial constriction
pulmonary arterial vasodilation
increased glandular secretion

Question 22

sympathetic output in the lungs

Answer 22

bronchial relaxation
pulmonary arterial vasoconstriction
decreased glandular secretion

Question 23

what is the point of maximal impluse?

Answer 23

apex striking the chest wall

Question 24

how does maximal impulse change

Answer 24

becomes more lateral in those with left ventricular hypertrophy due to increased mass of left ventricle

Question 25

cardiac tamponade

Answer 25

inflammation of the pericardium causing fluid to accumulate in the pericardial space

Question 26

what does cardiac tamponade cause

Answer 26

compromises contractility and cardiac function

Question 27

traits of myocardial cells

Answer 27

automaticity rhythmicity conductivity

Question 28

what is automaticity

Answer 28

ability to contract in the absence of stimuli

Question 29

what is rhythmicity

Answer 29

ability to contract in a rhythmic manner

Question 30

what is conductivity

Answer 30

ability to transmit nerve impulses

Question 31

synctium

Answer 31

conducting myocardial cells joined by intercalated disks

Question 32

what vessels go to the right atrium? where do they get blood?

Answer 32

SVC - head and UE IVC - trunk and LE coronary sinus - venous return from heart

Question 33

value of central venous pressure

Answer 33

0-8 mmHg

Question 34

what is central venous pressure

Answer 34

normal diastolic pressure needed to enable filling

Question 35

diastolic vs systolic pressures of the right ventricle

Answer 35

diastolic - 0-8mmHg systolic - 15-30 mmHg

Question 36

what causes right ventricular hypertrophy? why does this happen and what is the result of this?

Answer 36

chronic lung pathologies (COPD/pulmonary fibrosis) increased pressure in pulmonary vasculature causes workload of ventricle to increase results in right ventricular failure

Question 37

cor pulmonale

Answer 37

aka right ventricular hypertrophy

Question 38

normal filling pressure of left ventricle

Answer 38

4-12 mmHg

Question 39

how is back flow prevented in the pulmonary veins

Answer 39

pectinate muscles extend from atria to veins and act like a sphincter

Question 40

mitral valve insufficiency results in

Answer 40

increased left atrial pressures -- more likely to have a-fib

Question 41

role of chordae tendinae

Answer 41

attach leaflets to papillary muscles of myocardium

Question 42

what are the conduction pathways that exist between SA and AV node

Answer 42

anterior tract of Bachman middle tract of Wenckebach posterior tract of Thorel

Question 43

what are the aortic sinuses of Valsalva

Answer 43

three dilations above the attached margins of the cusps of the aortic valve near the root of the aorta

Question 44

branches of right coronary artery

Answer 44

right marginal posterior descending artery

Question 45

branches of the left coronary artery

Answer 45

left anterior descending circumflex

Question 46

LAD supplies

Answer 46

anterior and septal aspects of left ventricle

Question 47

where does the circumflex artery run

Answer 47

coronary sulcus

Question 48

what chambers does the right coronary artery supply

Answer 48

right ventricle inferior / posterior portions of left ventricle SA and AV node

Question 49

circumflex artery supplies

Answer 49

lateral left ventricle