Which of the following are the PRIMARY muscles of respiration? (Select All that Apply.)

intercostals

scalene

sternomastoid

diaphragm

pectoralis major

Answer and Explanation

Correct Answer : A,D

A. Intercostals: The intercostal muscles, including the external and internal intercostals, are primary muscles of respiration. They play a crucial role in expanding and contracting the thoracic cavity during inhalation and exhalation, facilitating airflow into and out of the lungs.

B. Scalene: The scalene muscles assist in elevating the first two ribs during deep inhalation, making them accessory muscles of respiration rather than primary muscles. They support breathing but are not the main muscles involved in the normal respiratory cycle.

C. Sternomastoid: The sternocleidomastoid muscles are also considered accessory muscles of respiration. They help elevate the sternum during forced inhalation, but they are not classified as primary muscles of respiration, which are more involved in the regular breathing process.

D. Diaphragm: The diaphragm is the primary muscle of respiration and is crucial for normal breathing. It contracts and flattens during inhalation, increasing the volume of the thoracic cavity and allowing air to flow into the lungs. This muscle is essential for the majority of airflow during normal breathing.

E. Pectoralis major: The pectoralis major is primarily involved in shoulder movement and is not a primary muscle of respiration. Although it can assist during forceful inhalation when the arms are raised, it does not function as a main muscle in the respiratory process.

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Correct Answer is C

Explanation

A. Behind with the nurse's hands placed firmly around his neck: This approach may be perceived as threatening or invasive, potentially increasing the patient's apprehension and discomfort. It is important to maintain a respectful and gentle approach, especially when working with a patient who may already feel uneasy.

B. Behind with hands placed on throat: Similar to option A, examining from behind and placing hands on the throat may cause anxiety and discomfort for the patient, particularly if they are not familiar with the procedure. This method does not provide a clear line of sight or reassurance for the patient.

C. The front with the nurse's thumbs placed on either side of his trachea and his head tilted forward: This technique is the most appropriate approach for examining the thyroid gland. Positioning the patient in front allows for better communication and visibility. Placing the thumbs on either side of the trachea is a standard method for palpating the thyroid, and having the patient tilt their head forward can help relax the neck muscles, making the examination more comfortable. Additionally, this approach allows the nurse to explain the procedure more easily, even with language barriers.

D. Have the patient perform the exam: While patient involvement in their care can be empowering, asking the patient to perform the exam may not be appropriate for a thyroid examination, as the nurse must assess the gland's size, consistency, and any potential nodules. This approach may also lead to further anxiety for the patient, who may not know how to perform the exam correctly.

A. Mitral and pulmonic B. Aortic and pulmonic C. Mitral and tricuspid D. Tricuspid and aortic

Correct Answer is B

Explanation

A. Mitral and pulmonic: The mitral valve closure is best heard at the apex of the heart (the left fifth intercostal space) rather than at the base. The pulmonic valve is indeed located near the base but, combined with the mitral valve, does not represent the sounds best heard at the base of the heart.

B. Aortic and pulmonic: The aortic and pulmonic valves are located at the base of the heart. The aortic valve is located in the right second intercostal space at the sternal border, while the pulmonic valve is located in the left second intercostal space. The closure of these valves (S2) is typically loudest at this area, making this option correct.

C. Mitral and tricuspid: The mitral valve is best heard at the apex, and the tricuspid valve is best heard along the left lower sternal border. Both valves are not located at the base of the heart.

D. Tricuspid and aortic: The tricuspid valve is not located at the base of the heart; it is situated along the left lower sternal border, while the aortic valve is at the base. Therefore, this combination does not represent the best valves to listen for at the base.

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Which of the following are the PRIMARY muscles of respiration? (Select All that Apply.)

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