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WEEK 18:
Mechanisms of ventilation:
| Question | Answer |
|---|---|
| innervation of diaphragm | phrenic nerve C3-5 |
| diaphragm anteriorly attaches to | xiphoid process and costal margin |
| diaphragm laterally attaches to | ribs 6-12 |
| diaphragm posteriorly attaches to | T12 vertebra |
| diaphragm | dome shaped muscular partition |
| describe intercostal muscle fibre arrangement | obliquely angled from rib to rib |
| what happens to intercostal muscles to make the rib cage raise | external and internal intercostal muscle fibres contract which raises each rib towards the rib above |
| what happens to intercostal muscles to lower the rib cage | internal and innermost intercostal muscles depresses each rib to the rib below |
| accessory muscles | |
| SCM | |
| scalene muscles | help elevate ribs during forced breathing and prevent rib 1+2 from descending |
| pecs and trapezius function | fix pectoral girdle to raise rib cage |
| suprapleural membrane (cervicothoracic/ costovertebral fascia) | dense fascial layer attached to inner border of the first rib and costal cartilage anteriorly, posteriorly to C7 transverse process, and medially to the mediastinal pleura |
| how do babies breathe | abdominal breathing |
| why do babies using abdominal breathing | ribs are more horizontal so cant use pump/bucket handle movements, and intercostal muscles are weak |
| how does abdominal breathing occur | contracting diaphragm |
| respiratory distress | lungs fail to provide enough O2 to body |
| children are nasal breathers until | 4-6th weeks |
| symptoms of respiratory distress | cyanosis, rapid and shallow breathing, and rapid heart rate |
| main types of respiratory distress | neonatal (newborns) and acute respiratory distress syndrome (ARDS- affects at any age) |
| factors making you more susceptible to respiratory disease | |
| harrisons sulcus | |
| appearance of respiratory distress | |
| cyanosis | bluish discolourationn of skin and mucous membranes due to inadequate oxygenation and circulation |
| neonatal respiratory distress syndrome (NRDS) | premature babies do not have enough surfactant in lungs (made between 34-36 weeks) leading to death in newborns |
| intercostal retractions | skin and muscles get sucked in around the ribs when you inhale |
| acute respiratory distress syndrome (ARDS) | acute onset and poor oxygenation due to non compliant lungs, often seen with capillary endothelial injury + alveolar damage surfactant breaks down under the microscope |
| common causes of ARDS | lung infections |
| extra pulmonary sources | eg sepsis, trauma |
| chronic bronchitis of COPD | destroy cilia |
| emphysema in COPD | alveoli become damaged (over inflate) affecting gas exchange |
| how does sitting up and leaning forward (thinker) posture relieve dyspnoea | maximises inspiratory pressure by lifting shoulder girdle to improve action of both pectoralis major (deep inspiration) |
| diaphragmatic excursion | |
| non tension pneumothorax | |
| tension pneumothorax | |
| right main bronchus |
Created by:
kablooey
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