Which statement about diaphragm movement and obesity is accurate in the context of stretcher transport?

• A. Movement of the diaphragm is unrestricted.
• B. Movement of the diaphragm is restricted.
• C. The diaphragm moves more easily due to gravity.
• D. The stomach occludes the inferior vena cava.

Answer: (B)

In obesity, extra abdominal mass increases intra-abdominal pressure and pushes the diaphragm upward. When a patient is lying supine on a stretcher, the diaphragm can’t descend fully during inspiration, so diaphragmatic excursion is restricted. This makes ventilation harder, increases the work of breathing, and can raise the risk of hypoventilation during transport.

The other ideas don’t fit this specific mechanism. Gravity doesn’t help the diaphragm descend in a supine patient, and the notion that the stomach occludes the inferior vena cava isn’t the mechanism at play here—though increased intra-abdominal pressure can affect venous return, the key point for diaphragm movement is the restricted excursion due to abdominal load.