Omm Pulmonary

Front 1

Muscle used for Muscle Energy: 1st Rib

Back 1

Anterior and middle scalenes

Front 2

Muscle used for Muscle Energy: 2nd Rib

Back 2

Posterior Scalene

Front 3

Muscle used for Muscle Energy: Ribs 3-5

Back 3

Pectoralis Minor

Front 4

Muscle used for Muscle Energy: Ribs 6-8 (9)

Back 4

Serratus anterior

Front 5

Muscle used for Muscle Energy: Ribs 9-11

Back 5

Latissimus Dorsi

Front 6

Muscle used for Muscle Energy: Rib 12

Back 6

Quadratus Lumborum

Front 7

"What lymphatics
drain the lungs?"

Back 7

"Right lymphatic duct
(The same as the heart)
"

Front 8

What are the autonomic levels for the lungs?

Back 8

"Sympathetics
=
T1-T6
Parasympathetics
=
CN X
OA, C1, C2"

Front 9

Palpatory testing for somatic dysfunction in patients with pulmonary disease typically reveals disfunction at what levels?

Back 9

"T1-T9 (mostly T1-T5)
C2-C4"

Front 10

"Effect of parasympathetic stimulation on the bronchial glands
"

Back 10

"Bronchial glands are Inhibited resulting in an
Increased Ciliated/Goblet Ratio and hence thinning mf ucous. Bronchial muscles also constrict"

Front 11

Sympathetic Levels Lungs?

Back 11

T1-T6

Front 12

Sympathetic Levels Trachea & Bronchi?

Back 12

T1-T6

Front 13

Sympathetic Levels Visceral Pleura?

Back 13

T1-T6

Front 14

Sympathetic Levels Parietal Pleura?

Back 14

T1-T11

Front 15

Sympathetic effects on bronchial muscles

Back 15

"Dilation of bronchial muscles"
Vasoconstriction: diminishes nutrient supply to the tissues (incl. medications) & reduces lymphaticovenous drainage.

Front 16

"When treating a patient with bronchospasm which side of the autonomic system should be treated first?
Why?"

Back 16

"Treat the parasympathetic side of the autonomic system first to decrease any neurally mediated bronchoconstriction"

If the sympathetic side of the system is treated first, the patient may go into acute refractory bronchospasm"

Front 17

Sympathetic effects on bronchial glands

Back 17

"Increased number of goblet cells with decreased vascular elements -> Leads to thick and sticky respiratory"
Inhibits secretion -> leading to dryness and cracking of the mucosa allowing for secondary bacterial infections B"
epithelium (hyperplasia) -> decreased mobility f the mucous

Front 18

Why is parasympathetic dominance of the respiratory system important?

Back 18

" It keeps the bronchial mucous secretions clear and saliva-like, yet sticky, while easing ciliary clearance
"

Front 19

What is the importance of parasympathetic dominance for the respiratory airways?

Back 19

"To keep the mucous secretions clear and saliva-like but sticky. Also to ease ciliary clearance
"

Front 20

Stretch receptors transmit signals via the___. When the lungs are inflated, how does this affect respiration?

Back 20

"Vagus Nerve: when the lungs are inflated this signal turns off respiration
"

Front 21

T/F: The vagus reflex is sensitive to stretch caused by air & fluid - causing cessation or slowing of the respiratory signal.

Back 21

"FALSE: it does not differentiate.
The carotid body, in contrast, senses need for more oxygen and an increased rate of respiration"

Front 22

"The ___ reflex mechanism cannot distinguish between air sacs filled with air and those filled with fluid

Back 22

"Hering-Breuer Reflex"

Front 23

How does parasympathetic dominance of the respiratory system affect smooth muscle tone?

Back 23

"This dominance does cause a slight amount of increased smooth muscle tone of the bronchial tubes
"

Front 24

"Type of stimulation responsible for the production of profuse, clear, & thin secretions from the mucosa of the nasophayrnx and sinuses
"

Back 24

"Parasympathetic Hyperactivity: Also Bronchoconstriction
Pulmonary vasodilation
"

Front 25

What baroreceptor is sensitive to oxygen?

Back 25

"Carotid Body - sends its signals to the respiratory center
(medulla)"

Front 26

With lung tissue congestion, the respiratory center receives information from the vagus nerve: what happens next?

Back 26

"This limits the excursion of the diaphragm"

Front 27

"Posture: Diaphragm's greatest excursion is in what position?"

Back 27

"The supine position"

Front 28

"Thoracic Diaphragm motion increases the volume of the thorax in __ planes of motion.
Describe these"

Back 28

"3 Planes of Motion"

Front 29

What are the 3 planes of motion of the throacic diaphragm?

Back 29

"*Inferior/Superior*
(limited by mediastinum)
*Transverse*
(Ribs 6-12, buck-handle motion)
*Anterior/Posterior*
(Ribs 1-5, pump-handle)"

Front 30

The key areas to be evaluated in pulmonary disease are?

Back 30

"1. Occiput, C1, C2: vagus, parasympathetic (viscerosomatic/somato-visceral)
2. C3-5: phrenic nerve, motor and sensory diaphragm (somatosomatic)

3. Thoracolumbar junction and diaphragm (mechanical)

4. Thoracic outlet (mechanical)
5. Entire thoracic cage (mechanical).
6. T1-6: sympathetic for pulmonary tract (viscerosomatic/somato-visceral)
7. Chapman's reflexes (viscerosomatic/somato-visceral)"

Front 31

When there is pneumonia there are? Chapman points
Chapman Points for Bronchial?

Back 31

"~ Anterior ~
Intercostal space between the 2nd and 3rd ribs close to the sternum.

~ Posterior ~
Midway between the spinous process and the tips of the transverse processes at T2"

Front 32

Chapman Points Upper Lung?

Back 32

" ~ Anterior ~
Intercostal space between the 3rd and 4th ribs close to the sternum.

~ Posterior ~
Midway between the spinous processes and the tips of the transverse processes of T3 and T4"

Front 33

Chapman Points Lower Lung?

Back 33

"~ Anterior ~
Intercostal space between the 4th and 5th ribs close to the sternum.

~ Posterior ~
Midway between the spinous processes and the tips of the transverse processes of T4 and T5
"

Front 34

"Tender Points, Anterior vs Posterior?"

Back 34

"~ Anterior Reflex Tender Points ~
Diagnostic Purposes
~ Posterior Tender Points ~
Are treated, by applying inhibitory pressure in a slow circular fashion for 10 to 30 seconds until any associated tissue texture change resolves
"

Front 35

Chapman points at the 2nd intercostal space suggest problems with?

Back 35

"2nd intercostal space
=
Thyroid, Myocardium, Esophagus,"

Front 36

What are Chapman Reflex Points?

Back 36

Small nodules of tissue texture change that are 2-3 mm in diameter, that demonstrate sharp, pinpoint nonradiating tenderness

Front 37

"Which reflex is encountered in any condition where the viscera receive parasympathetic innervation from the Vagus nerve"

Back 37

"The Occiput-C2 Reflex

Consequently, it may be found in association with, but is not specifically diagnostic for, pulmonary disease
"

Front 38

The "Asthma Reflex"

Back 38

T2 left

Front 39

Anterior bronchial Chapman's reflex

Back 39

Intercostal space between the 2nd and 3rd ribs close to the sternum

Front 40

Posterior bronchial Chapman's reflex

Back 40

Midway between the spinous process and the tips of the transverse processes at T2

Front 41

Anterior upper lung Chapman's reflex

Back 41

Intercostal space between the 3rd and 4th ribs close to the sternum

Front 42

Posterio upper lung Chapman's reflex

Back 42

Midway between the spinous processes and the tips of the transverse processes of T3 and T4

Front 43

Anterior lower lung Chapman's reflex

Back 43

Intercostal space between the 4th and 5th ribs close to the sternum

Front 44

Posterior lower lung Chapman's reflex

Back 44

Midway between the spinous processes and the tips of the transverse processes of T4 and T5