Limited, short-term spontaneous ventilation is possible in a patient with a paralyzed diaphragm because of_____________________
a. reflex diaphragm activity
b. accessory muscle use
c. active exhalation
d. high intraabdominal pressures
ANS: B
Although the diaphragm is the primary ventilatory muscle, it is not essential for survival. Limited, short-term ventilation is possible using accessory muscles, even if the diaphragm is paralyzed. The diaphragm does not actively participate in exhalation. During exhalation, it returns to its resting position during the passive recoil of the lungs and thorax. During forced exhalation, abdominal wall muscles compress the abdominal cavity and increase pressure in the abdominal cavity. This forces the diaphragm upward and compresses the lungs and forces gas from them. The dia-phragm performs important functions other than ventilation. It aids in generating high in-traabdominal pressures by remaining fixed while the abdominal muscles contract. This facilitates vomiting, coughing, sneezing, defecation, and parturition.
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