kine 3p92 midterm 1 v2

How many cervical vertebrae are there?

7 (C1-C7)

How many thorasic vertebrae are there

12 (T1-T12)

How many lumbar vertebrae are there?

5 (L1-L5)

How many sections of the sacrum are there?

5 composite pieces

How many sections of the coccyx are there?

4 composite pieces

define rostral

toward the forehead

Define caudal

At the rear or tail end

how many pairs of cervical spinal nerves are there?

8 pairs

How many pairs of thoracic spinal nerves are there?

12 pairs

how many lumbar spinal nerves are there?

5 pairs

How many sacrum spinal nerves are there?

5 pairs

How many coccyx nerves are there?

1 pair

What is the somatic nervous system

· Responsible for the innervation of the muscles, joints and skin

· In general, we are consciously aware of this activation

Define dermatome

Area of skin supplied by a single spinal nerve. An area of the skin supplied by the sensory axons of a particular spinal segment

Define Myotome

group of muscles that a single spinal nerve root innervates

What is the autonomic nervous system?

the part of the nervous system responsible for control of the bodily functions not consciously directed, such as breathing, the heartbeat, and digestive processes.

What is the sympathetic nervous system?

"Fight or flight" Blood pressure/heart rate increase, digestive slowing.

What is the parasympathetic nervous system?

"Rest and digest" Blood pressure/heart rate decrease, digestive increases.

What are the asending tracts

o Carry sensory information from the periphery to the brain

o Primary, secondary and tertiary* neurons

What are decending tracts?

o Carry information from the brain to the muscles

o Upper motor neurons and lower motor neurons

What is the lateral spinothalamic tract

Ascending tract that Carries pain and temperature sensations from the periphery to the brain

What is the anterior spinothalamic tract?

Ascending tract that Carries light touch, pressure, tickle and itch sensations from the periphery to the brain

What are the dorsal columns?

Two sets of ascending pathways in white matter, the fasciculus cuneatus and fasciculus gracilis, that carry sensory information (such as touch and pressure) originating from the upper and lower extremities.

What is the spinocerebellar tract?

Carries proprioceptive information from the periphery to the cerebellum which is used for coordination of movements and maintenance of posture

Describe the descending tract of the Pyramidal direct pathway

· Upper motor neurons synapse directly with lower motor neurons in the spinal cord (anterior horn of gray matter)

· Maintenance of muscle tone and controlling the speed and precision of skilled movements. (ex. Corticospinal tracts)

Describe the descending tract of the extrapyramidal pathway

· Upper motor neurons synapse in some intermediate nucleus rather than directly synapsing with lower motor neurons

· Involved in less precise motor control such as overall body coordination (Rubrospinal tract, vestibulospinal tract, reticulospinal tract)

What is the corticospinal system?

· Upper motor neurons originate in the cerebral cortex

Descend in the brainstem and eventually reach the caudal medulla.

· These upper motor neurons synapse with association neurons

· Association neurons synapse with lower motor neurons in the anterior horn of the gray matter

What is a preganglionic neuron?

The first neuron of the ANS; its cell body is in the nucleus of brainstem or spinal cord

What is a postganglionic neuron?

The nerve opposite the preganglionic neuron on the other side of the ganglionic synapse that receives the impluse.

What is a somatic/autonomic reflex?

• An involuntary motor response to a sensory stimulus • Involves:

o Sensory receptor

o Afferent neurono (Association Neuron) o Efferent neuron

o Effector cells

What are the 3 reasons SCI patients have respiratory problems?

1. Paralysis of the diaphragm and other muscles of inspiration cause ventilatory failure

2. Paralysis of the muscles of exhalation and coughing.

3. Autonomic imbalance (parasympathetic predominance) leads to unopposed bronchial constriction and mucous secretion

What is parasympathetic dominance?

· Very little sympathetic output to the respiratory tract

· Parasympathetic output leads to unobstructed bronchial constriction and mucus secreation

What happens in the lungs when they increase thoracic capacity?

-Increae in intrathoracic pressure

-Air gets drawn into the lungs

What happens in the lungs when there is a decrease thoracic capacity?

-decrease in intrathoracic pressure

-air is pushed out of the lungs

What does the diaphragm do?

· Principle muscle of inhalation

· When relaxed, the diaphragm is in dome-shaped position

· During contraction, the diaphragm flattens - increased volume of the intrathoracic cavity air is drawn into the lungs

What do the intercostals and accessory muscle do during inhalation?

· Contribute to breathing due to their action on the ribs

· Stabilize the rib during inspiration (prevent ribs from being drawn downward with diaphragm)

· Elevate the ribs during inspiration

What specifically do the intercostals do during inhalation?

· Pull the ribs closer together (causing elevation...if the first rib is stabilized)

· Prevent ribs from drawing inward when intrathoracic pressure falls

What specifically do the accessory muscles do during inhalation?

i) Scalenes:

· Stabilize the ribs and elevate first 2 ribs during inspiration

ii) Sternocleidomastoids

· Elevates the sternum during deep inspiration

iii) Pectoralis minor and serratus anterior

· Assist in rib elevation

What do the abdominals do during inhalation?

· Push in against the viscera, which in turn, push up against the diaphragm (optimal stretch)

· During inspiration, the abs relax ® allows viscera to protrude ® allows diaphragm to descend

What do the abdominals do during exhalation?

· Principle muscles of exhalation

i) Push the viscera up against the diaphragm ® the diaphragm goes up ® air is expelled

ii) Flex the trunk

iii) Stabilize the 12th rib

What do the intercostals do during exhalation?

i) When the 12th ribs is fixed, the intercostal action of drawing the ribs closer together causes a depression of the ribs

ii) Prevent ribs from bulging out during exhalation, therefore air is pushed directly upward and out of lungs

What does the diaphragm do during exhalation?

· Contracts eccentrically for first 2/3 of expiration slows the outflow of air

What innervates the diaphragm?

phrenic nerve (C3-C5)

What innervates the sternocleidomastoid?

spinal accessory nerve (C2-C3)

What innervates the scalene?

C3-C8

What innervates the pectorals minor?

medial pectoral nerve (C6-T1)

What innervates the serrates anterior?

long thoracic nerve (C5-C7)

What innervates the intercostals?

T1-T11

what innervates the abdominals?

T6-T12

What is paradoxical breathing?

When inhalation causes the abdomen deflate and chest to inflate

How do we evaluate inhalation function?

1. Watch the stomach rise during supine breathing

2. Measure chest expansion during breathing

3. Pulmonary function tests

o Vital capacity (max amount of air that can be exhaled after max inhalation)

o Negative inspiratory pressure

4. Arterial Blood gases (O2 and CO2)

5. Chest radiographs to assess diaphragm function

How do we evaluate exhalation function?

Spirometry measures:

· Peak cough flow (L/min)

· FEV1

What is pneumonia?

inflammation of the lungs. · Bacteria in respiratory secretion and lungs

What is Atelctasis?

· Loss of lung volume; Decrease or absence of air in the lung; Lung collapse

What causes Atelectasis?

1. Mucous block

2. Lack of deep inspiration ability

3. Bacteria and inflammatory cells in that part of the lung

Describe ventilatory failure

· Excessively high blood CO2

· Excessive low blood O2

· Necessity of ventilatory support

Define pneumohemothorax

air and blood in the chest