SLP 129 - Exam 2 (Respiration)

Starting at the top of the vertebral column and moving downward to its bottom, the sequence of vertebrae is categorized into regions in the following order:

Cervical, thoracic, lumbar, sacral, coccygeal

What is the muscular boundary between the thorax and the abdomen?

Diaphragm

Which of the muscles of the breathing apparatus has attachments to the sternum, ribs, and vertebrae?

Diaphragm

Ribs in the upper part of the thoracic region are attached:

To thoracic vertebrae in back and to the sternum (via bone) in front

A rule of thumb is that the muscles used for inhalation are confined to the (what region?)

thorax

A rule of thumb is that the muscles used for forced exhalation are in the (what region?)

abdomen

What is the difference between the pulmonary apparatus and the chest wall?

The pulmonary apparatus is the part of the breathing apparatus that contains air and allows air to be conducted from one place to another so that gases can be exchanged; the chest wall encases the pulmonary apparatus and includes the rib cage wall, abdominal wall, diaphragm, and abdominal content

The anatomical structures that connect the rib cage wall to the lungs are the:

Pleural membranes

Recoil force of the speech breathing apparatus is:

Greater as the breathing apparatus is moved farther from its rest position

What do the sternocleidomastoid, scalenus, and pectoralis major muscles have in common?

They are muscles whose contractions may lift the ribs and/or sternum

What is the name of the unlabeled bone in this picture?

Scapula

The sheet of muscles that fill the spaces between the ribs include:

The external and internal intercostal muscles

Which muscles have a structure and function similar to that of the external intercostal muscles, but whose location is restricted to the back of the rib cage wall with one point of attachment to a vertebra and the other point of attachment to ribs below?

Levatores costarums

The diaphragm muscle has attachments to the:

Sternum

Which of the following statements is true about the rectus abdominis muscle?

It is a vertically oriented muscle that forms part of the abdominal wall and inserts to the lower sternum and costal cartilages of ribs 5, 6, and 7

Pressure measured inside the lungs is called:

Alveolar pressure

What is the primary effect of gravity on the breathing apparatus?

In the upright position gravity acts on the rib cage wall in an expiratory direction and on the diaphragm-abdomen in an inspiratory direction, whereas in the supine position gravity acts on both parts of the chest wall in the expiratory direction

Which of the following statements is true?

a. There is a direct relationship between inspiration and dysphagia

b. At mid-range lung volumes, the chest wall can assume a wide range of different shapes

c. The shape of the chest wall can assume a wider range of shapes at the extremes of lung volume (e.g., 100% VC, or close to 0% VC) than at mid-range lung volumes (such as 40-50% VC)

d. The shape of the chest wall is dependent primarily on passive forces, like watching too much TV

maybe correct: b

incorrect: c

What bone is indicated here?

Ilium

What is being highlighted in this picture?

Thoracic vertebrae

When the diaphragm muscle contracts, it changes shape from:

A dome shape to a flatter shape

The term "active" force means:

The force is developed by contractions (activations) of muscles and recoil forces

The term "passive force" means:

The force is developed primarily by recoil of elastic structures which have been deformed from their rest positions

The internal intercostals (interosseous portion) are primarily muscles of ________________.

expiration

The diaphragm muscle is able to exert active force for:

Inspiration only

The volume of air moved into and out of the lungs during rest (or "quiet") breathing is called:

Resting tidal volume

The three forces we need to be most concerned about for respiration are:

torque, elasticity, gravity

Torque is involved primarily with:

the action of the ribs

Define a respiratory cycle

one instance of inspiration and one instance of expiration

During a respiratory cycle (when we are at rest), we typically inhale 500 ml of air. How much do we exhale?

500 ml

What is tidal volume?

the amount of air we inspire during a respiratory cycle

What is inspiratory reserve volume?

the amount of air that could be inhaled after a quiet (inhalatory) breath

What is expiratory reserve volume?

the volume of air that could be expired after (normal) expiration has occurred

What is residual volume?

the amount of air left in our lungs after we've exhaled as much as we can

If I am quietly breathing, and I inhale, and then exhale, what do you call the quantity of air that I could then inhale if I inhaled as much as I could?

inspiratory capacity

__________ is the amount of air left in our respiratory system after a passive exhalation.

functional residual capacity

_________ is the air that we use while inhaling and exhaling

tidal volume

_________ is the amount of air we can inhale after a quiet exhalation

inspiratory capacity

_________ pressure is the pressure inferior to the vocal folds

subglottal

When we speak, what happens to the amount of time we spend exhaling?

it increases

Which of the following muscles are considered muscles of inspiration?

a. transverse abdominus

b. interosseus portion of internal intercostals

c. levator costorum

d. external oblique abdominus

e. rectus abdominus

c. levator costorum

Which of the following muscles are considered accessory muscles of inspiration?

a. transverse abdominus

b. external oblique abdominis

c. rectus abdominis

d. trapezius

e. latissimus dorsi

d. trapezius

If I'm a brachial plexus, what portion of the spine do I emerge from?

the cervical vertebrae

When the diaphragm contracts in a person standing, which direction does it go?

inferior

Which of the following are muscles of expiration?

a. diaphragm

b. levator tromboni

c. transverse abdominis

d. scalenus

e. sternocleidomastoid

c. transverse abdominis

Which of the following are muscles of expiration?

rectus abdominis

What muscle does the phrenic nerve innervate?

diaphragm

During the "checking action" when we speak, what muscles are contracting that would not be contracting if we were quiet breathing?

muscles of inspiration

What is the name of the structure immediately superior to the trachea?

larynx

The bronchioli terminate as _________

air sacs/alveoli

As you inhale, the pressure in the lungs is ______ (so air rushes in). That is the basis for Boyle's Law.

negative

As you exhale, the pressure in the lungs is _____.

positive

The ______ is the opening through which the spinal column passes.

vertebral foramen

The ______ is the opening through which arteries pass in cervical vertebrae.

transverse foramen

It may help to think of the bony thorax as a box. In thinking of this box, think of the individual surfaces. The upper surface would be _______.

shoulders

It may help to think of the bony thorax as a box. In thinking of this box, think of the individual surfaces. The anterior surface would be the _______.

sternum

It may help to think of the bony thorax as a box. In thinking of this box, think of the individual surfaces. The _______ form the lateral surfaces.

ribs

It may help to think of the bony thorax as a box. In thinking of this box, think of the individual surfaces. The _______ form the posterior surface of this box.

vertebrae

It may help to think of the bony thorax as a box. In thinking of this box, think of the individual surfaces. The _______ form(s) the floor or inferior-most surface.

pelvic bones

What muscles are these?

Serratus posterior superior

What muscle is this?

Sternocleidomastoid

Alveolar pressure can be increased (made more positive) by:

Contracting abdominal muscles and/or contracting the internal intercostal muscles, or both at the same time (with no other muscles activated)

What category does the levator costorum longis fit into most appropriately?

accessory muscle of inspiration

What muscle is this?

Pectoralis minor

What muscle is this?

Serratus anterior muscle

Why can the rib cage wall generate both positive and negative passive forces?

Because the rib cage wall can be stretched (at larger lung volumes) or compressed (at smaller lung volumes) relative to its unlinked rest position

What is the function of this muscle?

Accessory muscle of inspiration

Which of the following structures of the speech breathing apparatus can generate active force only in the expiratory direction?

The abdominal wall

Among the following options, what is the largest lung capacity?

vital capacity

"Shape" of the chest wall is represented by:

The relative sizes of the rib cage wall and abdominal wall

What is the innervation for the pectoralis minor?

brachial plexus (cervical nerves)

What is the innervation for the pectoralis major?

brachial plexus (cervical nerves)

What is the innervation for the trapezius?

XIth cranial nerve

What is the innervation for the levator scapulae?

cervical plexus

What is the innervation for the serratus anteriors?

brachial plexus (cervical nerves)

The spinal nerves that innervate muscles of the breathing apparatus emerge from a level of the spinal cord more or less at the same level along the body axis of the innervated muscle. The one exception is:

The diaphragm muscle, innervated from spinal nerves emerging from cervical segments of the spinal cord

Where in the nervous system is the central pattern generator for breathing located?

The brainstem

What kind of afferent information may affect the volume (depth) and rate of tidal breathing?

Information on oxygen in the blood and carbon dioxide in the cerebrospinal fluid

The alveoli, the terminal structures in the pulmonary apparatus, serve the purpose of:

Taking oxygen from inspired air and delivering it to the bloodstream, and taking carbon dioxide from the bloodstream and delivering it to air in the lungs for expiration

Which of the following statements is true about tidal breathing in the upright body position?

The diaphragm muscle produces the contractions to expand the pulmonary apparatus for inspiration, and expiration is primarily driven by passive force (although the abdominal muscles are tonically active)

In tidal breathing, air flows into the pulmonary apparatus during inspiration because:

Alveolar pressure is made slightly lower than atmospheric pressure by increasing the size of the pulmonary apparatus

In an extended steady utterance such as a sustained vowel, how do the volumes of the rib cage wall and abdominal wall change throughout the utterance?

Both decrease

In an extended steady utterance, which of the following statements is accurate?

Net muscular effort is constantly changing, beginning as negative effort and eventually changing to positive effort

What set of conditions in the breathing apparatus is typical of running speech?

Speech produced with midrange lung volumes, a constantly changing mix of passive forces and small active forces to meet the target alveolar pressure, rapid inspirations and relatively slow expirations

Which part of the body generates most of the expiratory muscle effort for running speech produced in an upright body position?

Abdominal wall

If a person were to have severed phrenic nerves, which of the following muscles could she or he use to help him or her breathe?

levator scapulae

Your next patient has severely reduced tidal volume during speech. What equipment could have been used to measure tidal volume

wet spirometer

The speech breathing differences observed among people of different body types seems to be most obvious in:

Movement of the abdominal wall

During expiration, the air pressure in the lungs, relative to atmospheric pressure will be:

relatively positive

What happens to the duration of exhalation during speech breathing, compared to quiet breathing?

it increases

A person has a resting tidal volume of 500 ml of air. What do you conclude?

there is nothing to be concerned about

Expiratory reserve volume is:

that volume of air that could be expired after expiration has occurred

The action of the ribs could best be described as:

torque

What do muscles do, actively?

they contract

One instance of inspiration and one instance of expiration describes what?

one respiratory cycle

You sit and quietly breathe, breathing in and breathing out. The next time you exhale, you then breathe in as much air as you possibly can. What is that last quantity of air called—the one you inhaled?

inspiratory capacity

You are working in a hospital with a trauma unit. You will be working with a patient who suffered from pneumothorax. What is a possible cause of that?

knife wound to the chest

A quantity of air exists that cannot be forcibly exhaled but that remains in the lungs after a forced exhalation. What is that quantity called?

residual volume

From the previous question, why is it important for us to have some air remaining in the lungs after a forced exhalation?

to prevent collapsed lungs