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95 Cards in this Set
- Front
- Back
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to where does the respiratory diaphragm attach?
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ribs, sternum, pericardium, pleura, lumbar spine
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viscera that can cause chest pain:
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heart, lungs, esophagus, liver, stomach
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sympathetic innervation of heart
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T1-6
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right sided sympathetic innervation to the heart goes where? and can cause what?
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SA node; supraventricular arrhythmias
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left sided sympathetic innervation to the heart goes where? and can cause what?
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AV node; ventricular arrhythmias
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pain referred from the ventricles goes where?
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C8-T3
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pain referred from the atria goes where?
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T4-6
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anterior Chapman point for myocardium (and bronchus, thyroid and esophagus)
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2nd ICS next to sternum BL
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posterior Chapman point for myocardium (and bronchus, thyroid and esophagus)
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between T2 and T3, between SP and TP, BL
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anterior Chapman point for adrenal gland
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lateral rectus abdominus inferior to costal margin
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posterior Chapman point for adrenal gland
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between T11 and T12, between SP and TP, BL
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what 2 biomechanical influences can effect cardiac function?
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severe scoliosis with convexity on the left and severe kyphosis
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where is the trigger point that can initiate/perpetuate supraventricular arrhythmias?
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pectoralis major muscle at the 5th ICS
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sympathetic innervation to the arms
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T2-8
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sympathetic innervation to the legs
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T11-L2
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which 2 cervical nerve roots contribute to the vagus nerve?
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C1 and C2
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to where can you apply pressure that will slow the heart by increasing parasympathetic innervation?
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carotid body, globe of the eye, occipitomastoid suture
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facilitation is driven by ___
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nociception
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normal stimuli are perceived as ___ due to facilitation
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pain
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from where is the heaviest concentration of nociceptive fibers?
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T4
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afferent nerves travel via the cardiac plexus to synapse with cervical ganglia where?
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C2,5,7
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segmental interneuons also receive input from what to regulatory mechanisms?
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chemo and baroreceptors
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heart and lungs drain to which lymphatic component?
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right bronchomediastinal trunk --> right lymphatic duct
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sympathetic innervation of the lymph ducts causes what?
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constriction
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redness and swelling with pain at the costosternal junction is called what syndrome?
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Tietzes syndrome
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viscerosomatic reflex pain from the coronary arteries goes where?
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upper half of left chest, left arm, left jaw, T1-6
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viscerosomatic reflex due to anterior wall infarct arises where?
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T2-3 on left
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viscerosomatic reflex due to inferior wall infarct arises where?
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T3-5 on left
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reflex pattern seen with HTN
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SD at C6, T2, T6
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tx of HTN
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decrease sympathetics at T1-L2 to decrease vascular resistance and tx posterior adrenal CP to decrease aldosterone
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in which position should you not tx someone with CHF?
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supine
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normalizing sympathetics in CHF causes decreased vasoconstriction which reduces what?
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afterload
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what biomechanical dysfunction will you see with arrhythmias?
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flattened thoracic kyphosis, crossover points in upper thoracics, scoliosis
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which cervical ganglia can influence a decreased propensity for arrhythmias?
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C2 - superior cervical ganglia
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what type of rib SD is seen post-CABG
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inhalation dysfunction
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should you do lymph pump on someone with acute cardiac failure?
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no
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what change in biomechanics will you see with coarctation of the aorta?
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greater UE musculature vs LE
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what change in biomechanics will you see with VSD in kids?
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bilateral prominence of anterior chest wall and bulging of sternum in upper 2/3
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what change in biomechanics will you see with VSD in adults?
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unilateral bulge at 4th and 5th ICS at left lower sternal border
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what change in biomechanics will you see with ASD?
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bulging in 2nd and 3rd ICS at left sternal border
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what are the key tx at cervical spine?
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parasympathetics and phrenic nerve
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what are the key tx at thoracic spine?
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sympathetics and Chapman points
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what are the key tx at thoracic outlet?
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lymph
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what are the key tx at rib cage?
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sympathetics, lymph, venous, mechanical
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what are the key tx at TA diaphragm?
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lymph, venous, ventilatory mechanisms
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what is the set up for crossed hand, upper thoracic HVLA?
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SB neck toward restriction and rotate toward ease
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for what is the seated thoracic HVLA most effective?
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predominate SBing SD
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to where do you apply pressure during the arcuate ligament release?
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anteriorly and laterally on 12th rib
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sympathetic innervation of lungs
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T1-6
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sympathetic innervation of trachea and bronchi
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T1-6
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sympathetic innervation of visceral pleura
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T1-6
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sympathetic innervation of parietal pleura
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T1-11
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sympathetic innervation of the lungs causes what changes?
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inhibits bronchial gland secretion; increases # of goblet cells; dilates bronchioles; vasconstriction
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Hering-Breuer reflex:
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stretch receptors sense increased inflation sends signal via vagus to turn off respiration
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muscle involved in movement of rib 1
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anterior and middle scalenes
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muscle involved in movement of rib 2
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posterior scalene
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muscle involved in movement of rib 3-5
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pectoralis minor
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muscle involved in movement of rib 6-8
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serratus anterior
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muscle involved in movement of rib 9-11
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latissimus dorsi
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muscle involved in movement of rib 12
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quadratus lumborum
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which is the key rib in an inhalation rib dysfunction?
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bottom rib
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which is the key rib in an exhalation rib dysfunction?
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top rib
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a line drawn between which 2 joints indicates the direction of rib motion?
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costotransverse and costovertebral
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which ribs move by pump handle motion?
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ribs 1-5
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which ribs move by bucket motion?
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ribs 8-10
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which ribs move by caliper motion?
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ribs 11-12
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if rib 1 is elevated, how is T1 SB and R?
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T1 rotates and SBs to the opposite side
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SD consequence of coughing
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exhalation rib dysfunction, pain in serratus anterior
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SD consequence of scalene overuse
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TOS, cervical myositis
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SD consequence of diaphragm restriction
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poor lymph and venous return
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SD consequence of poor chest compliance
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restrictive patten/lung disease
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SD consequence of upper thoracic SD
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bronchiole hyperactivity, wheezing, dyspnea
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what makes up the thoracic inlet?
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manubrium, clavicles, first ribs, body of T1
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pulmonary viscerosomatic reflex for lung
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T3-4 lateralized
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pulmonary viscerosomatic reflex for bronchomotor (asthma)
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T2 on left
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pulmonary viscerosomatic reflex for bronchial mucosa
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T2-3 lateralized
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anterior Chapman point for bronchial
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2nd ICS
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posterior Chapman point for bronchial
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T2
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anterior Chapman point for upper lung
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3rd ICS
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posterior Chapman point for upper lung
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between T3 and T4
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anterior Chapman point for lower lung
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4th ICS
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posterior Chapman point for lower lung
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between T4 and T5
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pre-op and post-op tx to prevent pneumonia
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pre-op: C3-5; post-op: C3-5 and rib raising
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triad of asthma
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wheezing, cough, dyspnea
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what can be a trigger for asthma?
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GERD
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Lymph from EAM drains where?
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parotid channel
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Lymph from sinuses drain where?
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submandibular channel
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Lymph from the parotid channel drains where?
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deep cervical nodes
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Lymph from submandibular channel drains where?
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deep cervical nodes
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Lymph from EAM drains where?
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parotid channel
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Lymph from sinuses drain where?
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submandibular channel
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Lymph from the parotid channel drains where?
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deep cervical nodes
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Lymph from submandibular channel drains where?
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deep cervical nodes
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Is inhalation dysfunction associated with extension or flexion?
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extension
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Is exhalation dysfunction associated with extension or flexion?
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flexion
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