PAS PAS Breathing Patterns & Postural Control 2 — Questions and Answers
Question 1: A client with a habitually elevated sternum and depressed lower ribs is demonstrating which positional breathing dysfunction?
- Exhaled rib positioning with impaired inhalation expansion
- Inhaled rib positioning with impaired exhalation (Correct answer)
- Normal resting rib position
- Lateral rib flaring
Correct answer: Inhaled rib positioning with impaired exhalation
An elevated sternum with depressed lower ribs represents an inhaled (inspiratory) rib cage position, limiting the ability to fully exhale and reset the diaphragm.
Question 2: Which corrective cue is MOST effective to help a client transition from apical to diaphragmatic breathing?
- 'Allow your belly to gently rise as you inhale, then let it fall as you exhale' (Correct answer)
- 'Pull your stomach in tightly before each breath'
- 'Shrug your shoulders up toward your ears to expand the lungs'
- 'Hold your breath for 5 seconds at the top of each inhale'
Correct answer: 'Allow your belly to gently rise as you inhale, then let it fall as you exhale'
Cueing abdominal rise on inhalation directs the client's attention downward, encouraging the diaphragm to descend and reducing upper-chest accessory muscle recruitment.
Question 3: How does chronic postural stress (e.g., sustained forward head posture) alter breathing biomechanics?
- It shortens the scalenes and SCM, elevating the upper ribs and promoting apical breathing (Correct answer)
- It lengthens the pectoralis minor, increasing tidal volume
- It flattens the thoracic spine, improving diaphragm mechanics
- It reduces cervical lordosis, decompressing the phrenic nerve
Correct answer: It shortens the scalenes and SCM, elevating the upper ribs and promoting apical breathing
Sustained forward head posture adaptively shortens the scalenes and SCM, which elevate the upper ribs and convert the breathing pattern to shallow, apical mechanics.
Question 4: The relationship between the diaphragm and pelvic floor in postural control is best described as:
- They co-contract to form a pressure cylinder that stabilizes the lumbar spine (Correct answer)
- The diaphragm contracts while the pelvic floor relaxes to allow inhalation
- They work in alternating opposition with no shared stabilization role
- The pelvic floor is active only during exhalation
Correct answer: They co-contract to form a pressure cylinder that stabilizes the lumbar spine
The diaphragm and pelvic floor co-activate together with the deep abdominals and multifidus to create the intra-abdominal pressure cylinder essential for spinal stability.
Question 5: A PAS specialist teaching the 'exhalation reset' technique instructs the client to fully exhale before bracing. The primary goal is to:
- Lower the ribcage to a neutral position before activating the core (Correct answer)
- Maximize inhalation volume on the next breath
- Reduce blood pressure during exercise
- Stretch the intercostal muscles
Correct answer: Lower the ribcage to a neutral position before activating the core
Full exhalation drops the ribcage into a neutral, stacked position over the pelvis, creating the optimal alignment from which the diaphragm and core can engage effectively.
Question 6: Which breathing pattern assessment tool measures the ratio of chest versus abdominal expansion during quiet breathing?
- Respiratory induction plethysmography (RIP) or movement assessment bands (Correct answer)
- Spirometry
- Peak flow meter
- Capnography
Correct answer: Respiratory induction plethysmography (RIP) or movement assessment bands
Respiratory induction plethysmography or simple movement-sensing bands around the thorax and abdomen quantify the relative contribution of chest versus abdominal breathing.
PAS PAS Breathing Patterns & Postural Control 2
A client with a habitually elevated sternum and depressed lower ribs is demonstrating which positional breathing dysfunction?