112 Myers Respiration & Posture
Terms in this set (66)
Describe the inspiration process ? How many phases?
elevation of ribs and increase in size of thoracic cavity due to descent of diaphragm and expansion of thoracic wall;pressure within thorax decreases (below atmospheric pressure), air rushes into the lungs(3 phases: quiet , deep and forced)
Describe the expiration process. How many phases?
depression of ribs causing decrease in size of thoracic cavity;pressure in thorax increases air is forced out of lungs (two phases: quiet and forced)
What is quiet inspiration and what muscles are involved?
inspiration with resting or sitting quietly; diaphragm and external intercostals as prime movers
What is deep inspiration?
some additional demand for air exchange (increased activity or disease states) in which increases in rate and depth occur
What is forced inspiration and what muscles are involved?
occurs when an individual is working very hard and needs a great deal of oxygen, it uses muscles of quiet inspiration plus accessory muscles
What is quiet expiration or exhalation and what muscles are involved?
passive action occurring through relaxation of diaphragm; elastic recoil of thoracic wall and lungs results in depression of ribs /no muscle action is occurring
What is forced expiration?
occurs when an individual is working very hard or lacks elastic recoil mechanism due to disease process
What muscles are involved with forced expiration?
muscles that can compress the abdomen to push the diaphragm up and muscles which pull down on the ribs)
The primary muscles of respiration include these.
diaphragm, external and internal intercostals
What is the diaphragm?
dome-shaped, thin musculotendinous sheath which composes the muscular floor of thoracic cavity and separates it from the abdominal cavity
Internal and external intercostal muscles actions include what?
externals elevate (inspiration) and internals depress (exhalation) the ribs
Describe the location of the diaphragm
it is located on the xiphoid process and the lower six ribs around the upper lumbar vertebrae and inserts onto itself on the central tendon (its highest point)
The diaphagm is pierced by three openings..name them
the esophagus, the aorta, and the inferior vena cava ( allows passage)
By which nerve is the diaphragm innervated?
the phrenic nerve of the brachial plexus which arises from the third, fourth, and fifth cervical nerves
Describe the fibers of the external intercostals
the external fibers are superficial and are oriented interiorly and medially (hands in pockets direction
Describe the fibers of the internal intercostals
the internal fibers are the opposite direction of the externals, i.e. superiorly and medially
When is the levator costarum used?
during deep inspiration
When is the serratus posterior superior used?
during deep inspiration
When is the serratus posterior inferior used?
during forced expiration
How do the sternocleidomastoid and scalenes help with breathing?
accessories during deep inspiration
List some of the accessory muscles of forced inspiration
levator scapula, upper trapezius, rhomboids, pectoralis minor
Name the deep inspiration accessory muscles
sternocleidomastoid,pec major, scalenes, levator costarum, serratus posterior superior
Name the forced expiration accessory muscles
rectus abdominis, external oblique and internal obliques, transverse abdominis, quadratus lumborum, serratus posterior inferior
The intercostals receive innervation from where?
spinal nerves at various levels
A patient with a spinal cord injury at C3 and above is likely to be what?
respirator dependent ( any cervical spinal cord injury will have some respiratory impairment)
What is the total lung capacity?
it can be divided into separate volumes (tidal volume, inspiratory and expiratory reserve as well as residual volume)
What is the tidal volume?
the volume of air moved in and out of the lungs during each ventilation cycle normally at rest
What is the average tidal volume for an adult?
about 500 mL of which 350 mL reach the alveoli and take place in gas exchange
What happens to the other amount of air which doesn't take place in gas exchange?
the residual amount is in your esophagus and trachea and keeps your lungs inflated
What is inspiratory reserve volume or inspiratory capacity?
the amount of air that can be taken into the lungs (above the tidal volume) upon forced inspiration
What is the expiratory reserve volume?
the amount of air that can be pushed out of the lungs (beyond the tidal volume) upon forced expiration
What is vital capacity?
the total volume of air that can be moved into and out of the lungs (suck in and blow) by voluntary control
Persons with COPD often have a barrel-chested appearance because of what?
air becomes trapped in the lungs at the end of quiet or forced expiration
Is quiet expiration an active or passive process?
passive, carried out by the decrease in intrathoracic volume caused by the elastic recoil of the lungs, thorax, connective tissues, etc.
Is forced expiration an active or passive process?
active; involves active contraction of expiratory muscles such as the abdominals
Is quiet inspiration an active or passive process?
both quiet and forced inspiration are active processes
What is the residual volume?
the amount of air left in your lungs so that your lungs don't collapse
Distinguish between respiration, breathing, and ventilation
respiration usually describes gas exchange whereas breathing and ventilation refer to the movement of air
Trace an oxygen molecule through the body
in through the mouth/nose, trachea, bronchi, splits into bronchioles, alveolar ducts, alveoli (air sacs), diffuses across the alveolar wall, picked up by the bloodstream by a pulmonary capillary (where it's in the blood plasma or latches onto hemoglobin), lungs, pulmonary vein, heart (left atrium, left ventricle), out through aorta, arterial system, capillaries (crosses the capillary wall), tissues where it can be used
How does carbon dioxide make its way through the body ?
picked up at capillary wall on venous side, venules, veins, heart and vena cava, right atrium and right ventricle, pulmonary arteries (things are reversed), lungs, capillary wall into an alveoli and gets exhaled
What would happen to breathing with a severe postural deviation?
thoracic cavity will be reduced, potential space is reduced, ability to increase is reduced, mobility might be reduced
What would a severe forward head do to breathing?
potentially close the airway slightly, possibly affect accessory muscles, possibly lengthen airway and the dead space plus increase friction; more effort will be required
O - inner surfaces of ribs 6-12, posterior xyphoid process, bodies of L1-L3; I - central tendon near dome; N - phrenic nerve (C3-C5) A - primary muscle of inspiration
What, then, is posture?
Posture is the position or alignment of your body segments in relationship to each other (and gravity) at any point in time; in other words, it's dynamic
Posture is static and what else?
it's also dynamic
Good spinal posture results from maintaining what?
the normal curves of the spine
What are the curves of the spine?
the cervical and lumbar regions are both normally lordotic, the thoracic and sacral are kyphotic
What are the five regions of the vertebral column?
1. cervical (7 bones) 2. thoracic (12) 3. lumbar (5 bones) 4. sacral (5 bones, fused) 5. coccygeal (3-5 bones, fused)
Why is beneficial to have curvature of the spine?
curved configuration provides strength and resilience to vertebral column; absorbs more impact
In space, why might it still be necessary to use muscular contraction to hold a position?
there might be an intrinsic tightness to opposing muscles (e.g. pecs might be on a stretch)
At birth, there's only a what kind of curve?
a kyphotic, flexed curve which is not fixed, but bendable (the primary curve)
When are other curves of the spine developed?
when they are needed (e.g. engaging with the world causes the head to begin lifting and curves developing)
Through which points does the line of gravity pass on a person with ideal posture?
through ext. auditory meatus/through bodies of lumbar vertebrae/slightly posterior to hip/slightly anterior to knee and ankle
Why do people have poor posture?
muscular tightness/weakness,trauma,poor habits,body-fat distribution,disease, or heredity
Why is good posture important?
decreases the stress on ligaments, muscles, and tendons (if incorrect, more stress) ; improves function and decreases muscle energy ;helps keep the body's cog balanced over its bos
Regarding children, at about what age do the postural faults go away ?
by about 4 or 5, a child can be judged posturally almost like an adult
What are the antigravity muscles?
those necessary to prevent us from falling-typically the knee extensors, hip extensors, trunk extensors and muscles about the ankle
What is postural sway?
anterior-posterior motion of the upright body caused by motion occurring primarily at the ankles (mostly ant/post but some lateral muscles, too)
What causes postural sway?
result of constant displacement and correction of the center of gravity within the base of support
Which muscles are affected in an anterior pelvic tilt?
the back extensors and hip flexors might be tight while the abdominals and hip extensors might be elongated
If standing on one leg, what keeps you level?
the hip abductors on standing leg and adductors co-contract to help keep your pelvis level
What do we look for in an anterior-posterior postural assessment?
(think of plumb line) level head, spinal curves, level shoulders, scapular borders (3 inches or less from spine), level pelvis (PSIS), neutral hips, knees, parallel feet without pronation or supination and vertical calcaneal tendons
What do we look for in a lateral view postural assessment?
(think of plumb line) external auditory meatus, acromion, greater trochanter, anterior to knee and lateral malleolus, level head, normal curves, ASIS and pubic symphysis same plane, hips in neutral (not in flexion), neutral knees and ankles
What should we comment on with respect to handedness patterns?
we should note and comment on normal handedness patterns
What will you see in a right handed individual?
right shoulder slightly lower, right iliac crest slightly higher (paraspinals have squeezed them together); usually hip shift to right and compensatory curve (scoliosis) resulting from the iliac crest
What will we comment on with respect to sitting?
if feet are flat and thighs are parallel to the ground
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