Diaphragm and Respiratory System Quiz
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Questions and Answers

What percentage of diaphragmatic muscle fibers are of the slow twitch fatigue-resistant variety?

  • 75%
  • 65%
  • 45%
  • 55% (correct)
  • What is the main role of the diaphragm?

  • Supporting the mediastinum
  • Abdominal straining
  • Expiratory
  • Inspiratory (correct)
  • What happens to the mediastinum when the diaphragm contracts during tranquil inspiration?

  • It ascends
  • It is disturbed
  • It descends
  • It remains unchanged (correct)
  • What is the source of the phrenic nerves that supply the diaphragm?

    <p>Third, fourth and fifth cervical myotomes</p> Signup and view all the answers

    What is the effect of the diaphragm's contraction on the lung bases during tranquil inspiration?

    <p>They descend</p> Signup and view all the answers

    What is the origin of the septum transversum?

    <p>Mesodermal folds</p> Signup and view all the answers

    What happens to the domes of the diaphragm during tranquil inspiration?

    <p>They descend</p> Signup and view all the answers

    What type of muscle cells invade the septum transversum?

    <p>Muscle cells derived from cervical myotomes</p> Signup and view all the answers

    What is the primary muscle responsible for inspiration?

    <p>Diaphragm</p> Signup and view all the answers

    What occurs during expiration?

    <p>The diaphragm is wholly passive and relaxes</p> Signup and view all the answers

    What is the result of the sliding type of hiatus hernia?

    <p>Gastro-oesophageal reflux</p> Signup and view all the answers

    What is the function of the intercostal muscles during respiration?

    <p>To stiffen the chest wall and prevent paradoxical movement</p> Signup and view all the answers

    What is the characteristic feature of hiccup?

    <p>A repeated, spasmodic contraction of the diaphragm</p> Signup and view all the answers

    What occurs during maximal inspiratory efforts?

    <p>Other muscles, in addition to the diaphragm, are active</p> Signup and view all the answers

    What is the effect of the paraoesophageal type of hiatus hernia?

    <p>Compression of the lower oesophagus and compromise of the blood supply</p> Signup and view all the answers

    What assists the relaxation of the diaphragm during expiration?

    <p>Elastic recoil of the lungs</p> Signup and view all the answers

    What is the level to which the central tendon can be depressed by further descent of the domes?

    <p>T8 to T9</p> Signup and view all the answers

    What is the most common cause of congenital diaphragmatic hernia?

    <p>Failure of pleuro-peritoneal membrane development</p> Signup and view all the answers

    What happens to the vena caval foramen during maximum inspiration?

    <p>It is pulled widely open to assist venous return</p> Signup and view all the answers

    Where is the smaller hernial site located?

    <p>At the junction of the costal margin—Morgagni's foramen</p> Signup and view all the answers

    What is the effect of diaphragmatic contraction on intra-abdominal pressure?

    <p>It increases the pressure</p> Signup and view all the answers

    What is the function of the muscle sling of the right crus?

    <p>To discourage food passage during swallowing</p> Signup and view all the answers

    During maximum inspiration, what happens to the ribs of the costal margin?

    <p>They evert in a 'bucket handle'-like movement</p> Signup and view all the answers

    What is the clinical manifestation of Bochdalek's foramen?

    <p>More often on the left side</p> Signup and view all the answers

    Study Notes

    Diaphragm and Respiratory System

    • The diaphragm is the main muscle of inspiration, and it is responsible for sucking down the lung bases and not disturbing the mediastinum.
    • During tranquil inspiration, the diaphragm's contraction only descends the domes, and in deeper breaths, further descent of the domes can depress the central tendon from T8 to T9 level.
    • Maximum inspiration involves further contraction of the muscle, which everts the ribs of the costal margin in a 'bucket handle'-like movement with widening of the subcostal angle.
    • The diaphragm is used also in abdominal straining, and its contraction is accompanied by closure of the glottis and subsequent release of trapped air to produce the characteristic sound of a hiccup.
    • Expiration is a passive process, where the diaphragm is relaxed, and its fibres are elongated by pressure from below.

    Thoracic Movements and Respiration

    • The external intercostals are most active in inspiration, and the internal intercostals are more important for expiration and stiffening of the chest wall.
    • Elastic recoil of the lungs assisted by contraction of the muscles of the abdominal wall makes the relaxed diaphragm regain its domed form during expiration.
    • Other muscles, such as scalene muscles, sternocleidomastoid, quadratus lumborum, erector spinae, and pectoralis major, contribute to chest expansion during maximal inspiratory efforts.

    Development of the Diaphragm

    • The diaphragm develops from four sources: septum transversum, third, fourth, and fifth cervical myotomes, pleuroperitoneal membranes, and oesophageal mesentery.
    • Failure of pleuroperitoneal membrane development is the most common cause of congenital diaphragmatic hernia.

    Diaphragmatic Hernia

    • The most common acquired variety of diaphragmatic hernia is the sliding type of hiatus hernia, where the oesophagogastric junction rises up into the thorax, encouraging gastro-oesophageal reflux.
    • The paraoesophageal (rolling) type is rarer, where the oesophagogastric junction remains in the abdomen, but a pouch of peritoneum containing a part of the stomach projects upwards alongside the oesophagus, compressing the lower oesophagus and compromising the blood supply of the herniated stomach.

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    Description

    Test your knowledge of the diaphragm's role in the respiratory system, including its muscle contraction and effect on lung bases and mediastinum.

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