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Which of the following is abnormal lumbar curvature?
Lordosis
Which of the following parts of the sternum is the most inferior?
Xiphoid Process
Which of the following groups of vertebrae are fused together?
Sacral
Coccygeal
The "atlas" is one of the _____ vertebrae
Cervical
Which of the following is abnormal thoracic curvature?
Kyphosis
Rip #9 connects to the sternum how?
It connects via a costal cartilage that is shared with other ribs
The ischium is part of the _____ bone?
Coxal
The trachea begins at the _____
Base of the Larynx
Put in the right order (from large to small)
Bronchi
Bronchioles
Alveolar sacs
Alveoli
The rings in the trachea are horseshoe shaped to
Allow the esophagus to expand into the trachea during swallowing
All branches of the bronchi terminate in _____
Alveoli
The outer surface of the lungs is lined by the _____
Visceral pleura
The pleural linkage connects via _____
Suction
If the alveoli were spread out, they would cover about _____
300 m2
Which of the following can elevate rib 5?
External Intercostals
Pectoralis Minor
Serratus Anterior
Which muscles attach to vertebrae?
Levatores Costarum
Which of the following does NOT elevate the ribs (directly)?
Sternoclaudistemoid
Which of the following does not attach to the rib 1?
Pectoralis Minor
Which portion of the diaphragm is the largest?
Costal
Which of the following is NOT a major inhalatory muscle?
Pectoralis Major
How do external and internal intercostals differ?
Externals are inhalatory, internals are exhalatory
Internals course superiorly toward the sternum, externals course inferiorly toward the sternum
Internals are deep to the externals
Which muscles attach to the vertebrae?
Serratus Posterior Inferior
Quadratus Lumborum
Which of the following is NOT an abdominal muscle?
Transverse Throacis
Which abdominal muscle is the only one that courses parallel to the midline of the body?
Rectus Abdominus
Which abdominal muscle is the deepest?
Transverse Abdominus
Which muscle is located on the anterior portion of the inside of the rib cage?
Transverse Thoracis
Which type of rib motion can be approximated with a pump handle?
Anteroposterior
Newtown's Law uses _____
Pressure difference
What is the amount of air in the lungs at Resting Expiratory Level (REL)?
Functional Residual Capacity (FRC)
1 ml = __ cc
1
Which of the following are functions of the respiratory system?
Exchange of gases
Speech production
What does Boyle Law relate?
Pressure and volume: As one increases, the other decreases
How much air is in the lungs after a maximal inspiration?
Total Lung Capacity (TLC)
What is the amount of air expired in a maximal expiration from end-expiratory level?
Expiratory Reserve Volume (ERV)
Muscle effort during inspiration is necessary to overcome _____
Elastic recoil of lung-thorax unit
Resistance to airflow through respiratory airways
Resistance to deformation or respiratory tissues
If lung-thorax unit is moved to a lung volume > 37% VC, _____?
Recoil forces produce positive alveolar pressures
Gravitationary forces will try to force exhalation
At REL, ____
The elastic recoil of the rib cage and lungs is balanced
Relaxation curve. What does it mean if a point is in the green region?
Net expiratory muscle activity
At REL, _____
Either inhalation or exhalation requires active muscle effort
In sustained phonation, lung volume ___ with time while alveolar pressure ____ with time
Stays the same
For the region of the relaxation curve above REL, relaxation pressure is _____, resulting in an _____ recoil force
Positive, expiratory
The Pressure Relaxation Curve shows that
Recoil force depends on lung volume
Muscle pressure required for speech =
Speech Pressure - Relaxation Pressure
For louder phonation, the speaker must change the _____
Speech Pressure Line
Disease affects the _____ of the relaxation curve
Slope
Posture (being upright vs supine) affects the _____ of the relaxation curve
Horizontal position
Which of these is/are DIRECT lung volume measurement instruments?
Wet Spirometer
Which of these uses a pressure transducer?
Pneumotachograph
Body Plethysmography
A manometer measures _____
Pressure
A body plethysmograph measures _____
Air flow
A magnetometer measures lung volume by recording _____, and respiratory induced plethysmography records _____
A-P diameter, rib cage circumference
A pneumotachograph measures _____
Air flow
A mercury strain gauge measures lung volume ____, and a wet spirometer _____
Indirectly, directly
Two elastic bands with embedded electrical wires positioned around the chest wall and
abdomen are used to sense the cross-sectional area of the chest and abdominal wallsthat can be used to represent the total lung volume change at the body surface
Respiratory Induced PlethysmographyRespiratory
Two electromagnetic coils are positioned to detect changes of chest and abdominal
wall changes that summed together represent the total lung volume change
Magnetometer
A tube filled with mercury experiences a resistance to current related to the cross
sectional area of the tube that changes with chest wall and abdominal wall movements
Mercury Strain Gauge
The body is enclosed within a box with an airtight seal. During breathing the pressure
changes within the box are measured in relation to the pressure drop across a resistive screen
Body Plethysmograph
A mesh screen that offers a resistance to airflow measures a pressure drop across the
screen related to the rate of airflow through the screen
Pneumotachograph
A U-shaped tube filled with water that measures the difference in height of the two
columns of water equal to the magnitude of oral pressure
U-tube Water Manometer
What is the force exerted by air against 1 sq. in. of earth at sea level?
14.7 lb/sq. In
Lung volume is high, and alveolar pressure is less than atmospheric pressure: What is being described?
Inhalation
Producing a fricative is an example of _________ airflow
Tuburlent
What percentage of vital capacity is described as Resting Expiratory Level (REL)?
37%
Amount of air inspired or expired during a respiratory cycle
Tidal Volume
Maximum amount of air that can be inhaled from end-inspiratory level
Inspiratory Reserve Volume (IRV)
Maximum amount of air that can be exhaled from end-expiratory level
Expiratory Reserve Volume (ERV)
Amount of air remaining in the lungs after maximum expiration
Residual Volume (RV)
Maximum amount of air that can be inspired from REL
Inspiratory Capacity (IC)
Volume of air in lungs and airway at REL
Functional Residual Capacity (FRC)
Amount of air in lungs and airway after maximum inspiration
Total Lung Capacity (TLC)
Maximum amount of air that can be expired after maximum inspiration
Vital Capacity (VC)
In the supine position (laying on your back), gravity is _____________
(inspiratory/expiratory) on the rib cage, __________ (inspiratory/expiratory) on the
diaphragm and ____________ (inspiratory/expiratory) on the abdomen.
Expiratory, expiratory, expiratory
In the upright position, gravity is ___________ (inspiratory/expiratory) on the rib cage,
_____________(inspiratory/expiratory) on the diaphragm and ____________
(inspiratory/expiratory) on the abdomen.
Expiratory, inspiratory, inspiratory
If recoil forces are not providing enough force to sustain vowel production, what type of muscle action is needed to meet the demands of the utterance?
Expiratory muscle action
If the lung-thorax unit is moved to a lung volume below 37% VC, recoil forces generated will produce ____________ (positive/negative) alveolar pressures if recoil takes place
negative
Muscle energy expended during inspiration is used to overcome:
Resistance to airflow through respiratory airways
Resistance to deformation of respiratory tissues
Elastic recoil of lung-thorax unit
A healthy respiratory system with pleural linkage intact working to maintain negative pressure between the visceral pleura and the parietal pleura can be described as an intact _______ - ________ Unit.
Lung-Thorax
The lungs are ___________ relative to the disconnected state and the thorax is ____________ relative to the disconnected state.
expanded, compressed
A sick patient has high lung compliance, and decreased elastic recoil. What is an
example of a lung disease that would satisfy this description?
Chronic Obstructive Pulmonary Disease (COPD)
What are the 5 groups of vertebrae?
Cervical
Thoracic
Lumbar
Sacral
Coccygeal
What are the abnormal spinal curvatures, and which part of the vertebral column do they affect?
Kyphosis → Increase in convexity of thoracic curve, May inhibit rib cage movement
Lordosis → Increase in concavity in lumbar region, May be due to poor posture
Scoliosis → Abnormal lateral curvature
What are the components of the sternum?
Manubrium -- uppermost segment
Body - longer narrow structure
Xiphoid process - inferior most of sternum
What are the components of the rib cage?
7 true ribs, 3 false ribs, 2 floating ribs
What are the components of the pelvic girdle?
Pair of Coxal bones
- Illium
- Ischium
- Pubis
Sacrum → Fused sacral vertebrae
Coccyx → Fused coccygeal vertebrae
What are the components of the pectoral girdle?
Clavicle (collarbone)
Scapula (shoulder blade)
What are the components of the respiratory passage?
Trachea → Horseshoe-shaped rings of cartilage that extend from cricoid cartilage to the start of bronchi
Bronchi → branches that extend from the trachea deep into the lung, terminating in alveoli
Lungs
- Alveoli → where the gas transfers occurs
What is meant by the term pleural linkage, and how is it accomplished? Why is it significant?
includes the parietal pleura, the visceral pleura and the intrapleural space. The intrapleural space is at a negative pressure relative toatmospheric, so that the pleurae "suck" together
Inhalation (major muscles)
Diaphragm → Moves inferiorly and flattens as it contracts, increasing the volume of the thoracic
Cavity and decreasing the volume of the abdominal cavity
Central tendon
Sternal portion
Costal portion
Vertebral portion
External Intercostals
Inhalation (accessory muscles)
function to raise some or all of the ribs to increase thoracic volume
Levatores Costarum
Serratus Posterior Superior
Pectoralis Major
Pectoralis Minor
Subclavius
Serratus Anterior
Sternocleidomastoideus
Scalenes
Exhalation (major muscles)
abdominal muscles all attached to the abdominal aponeurosis
Rectus Abdominis
External Obliques
Internal Obliques
Transverse Abdominis
Exhalation (accessory muscles)
Subcostals
Internal Intercostals
Transverse Thoracis
Quadratus Lumborum
Serratus Posterior Inferior
What is abdominal aponeurosis, and what is its role in respiration?
Superior attachments:
- Lower fibers of pectoralis major
- Xiphoid process of sternum
- Costal cartilages
Inferior attachments:
- Pubic symphysis
- Anterior iliac spine via inguinal ligament
At midline, visible as thick fibrous band called linea alba
Moving Laterally:
- Divides into internal and external sheath which surround the Rectus Abdominus
- Sheaths come together again to form linea semilunaris
- Sheaths separate into four layers that separate transverse abdominus, the internal obliques and external obliques
T.I.E.
- Three layers moving from deeper to superficial
- RA is not layered with others
The thoracic cage expands in three dimensions during inhalation. What are they, and how is expansion accomplished?
Vertical - diaphragm contraction
Transverse - elevation and rotation of curved ribs (water bucket)
Anterior Posterior - anterior and superior movement of sternum (pump handle)
The Respiratory System is contained in the body's trunk/torso. It is comprised of two cavities divided by a structure. What are the cavities, and what is that structure?
left and right pleural cavities within the thoracic cavity, separated by the diaphragm
What is the respiratory system responsible for? What are its two functions?
The structures involved in the exchange of gases between the blood and external environment
How are Boyle's Law and Newton's Law applied to respiration?
Boyle's Law → Pressure of a gas is inversely proportional to its volume, with temperature constant
- P~(1/V), or PV = constant
- This law uses absolute pressure, not pressure differences
Newton's 2nd Law of motion → An unbalanced force acting on a body (solid, liquid, gas) causes
an acceleration
- A pressure difference is an unbalanced force
- Re airflow, what's important is pressure difference, not absolute pressure
The lung-thorax unit consists of...
Lungs, pleural linkage, thorax
If the lungs were removed from the pleural linkage, they would rest in a collapsed state. Why?
Pneumothorax
Pulmonary Apparatus - Chest Wall Unit
The resting size of the pulmonary apparatus is larger when linked than unlinked
The resting size of the chest wall is smaller when linked than unlinked
Starting at REL, explain a typical respiratory cycle.
Lungs expand via contraction of inspiratory muscles (A)
Increased lung volume results in decreased alveolar (lung) pressure(B)
Negative alveolar pressure results in inward flow of air that varies inmagnitude with alveolar pressure change (C)
At end of inspiration, lung volume change ceases, alveolar pressurereturns to atmospheric pressure, inward flow of air stops (G)
Lungs volume decreases via relaxation of inspiratory muscles (D)
Decreasing lung volume results in increased alveolar (lung) pressure (E)
Positive alveolar pressure results in outward flow of air that varies in magnitude with alveolar pressure change (F)
At end of exhalation, lung volume change ceases, alveolar pressure returns to atmospheric pressure, outward flow of airstops
What force(s) act on the system once we have moved away from REL? Explain in detail the force(s), what they affect, and how they differ.
Lungs "want" to be in the collapsed state in isolation
Rib Cage "wants" to be further expanded in isolation
Pleural linkage forces two parts to meet a compromise position
- Lungs expanded relative to disconnected state
- Rib Cage compressed relative to disconnected state
Contents of abdominal cavity also affect this position
