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1. Hysteresis is the graph of differential lung inflation and deflation pressures.
A) True
B) False
Points Earned: 1.0/1.0
Correct Answer(s): True
2. From the gross anatomy of the lungs, as separarated by fissures, how many lobes are noted in the right lung?
A) 2
B) 3
C) 4
D) 5
Points Earned: 2.0/2.0
Correct Answer(s): B
3. Which of the following structures is responsible for phonation?
A) Eustation tube
B) False vocal cords
C) True vocal cords
D) Glottis
Points Earned: 2.0/2.0
Correct Answer(s): C
4. LaPlace's law states that the smaller the radius of a sphere the greater the pressure needed to keep it open.
A) True
B) False
Points Earned: 1.0/1.0
Correct Answer(s): True
5. Normal daily mucus production is about:
A) 10ml
B) 50ml
C) 70ml
D) 100ml
Points Earned: 1.0/1.0
Correct Answer(s): D
6. Which of the following is the right sequence of events that generate a cough?
I. The glottis suddenly opens, explosively releasing compressed gas.
II. The diaphragm contracts, causing a deep inspiration.
III. The muscles in the larynx close the glottis, sealing the upper airway.
IV. A slight inspiratory pause occurs.
V. The abdominal expiratory muscles contract forcefully.
A) I, II, III, IV, V
B) II, IV, III, I, V
C) II, IV, III, V, I
D) II, IV, V, III, I
Feedback: The cough is produced in the following sequence:
1. The diaphragm contracts, causing a deep inspiration.
2. A slight inspiratory pause occurs.
3. The muscles in the larynx close the glottis, sealing the upper airway.
4. The abdominal expiratory muscles contract forcefully, generating a high intrapulmonary pressure against the closed glottis (as high as 100 to 200 cm H2O in healthy adults).
5. The glottis suddenly opens, explosively releasing compressed gas.Points Earned: 1.0/1.0
Correct Answer(s): C
7. Nitric oxide is a bronchodilator.
A) True
B) False
Points Earned: 1.0/1.0
Correct Answer(s): True
8. Tachypnea is an increase in the respiratory rate.
A) True/1.0
Correct Answer(s): True
B) False
Points Earned: 1.0
9. Which of the following pathologic processes is defined as perfusion in excess of ventilation, ie; atelectasis?
A) Shunt
B) Dead space
C) Hypoventilation
D) Diffusion deficit
Points Earned: 2.0/2.0
Correct Answer(s): A
10. Which of the following occurs during inspiration?
A) Diaphragm contracts and flattens
B) Intrathoracic pressure does not change
C) External intercostals relax
D) Thoracic volume decreases
Points Earned: 1.0/1.0
Correct Answer(s): A
11. The only complete ring of cartilage encircling the airway in the larynx or trachea is the:
A) Crocoid cartilage
B) Thyroid cartilage
C) Epiglottis
D) Larynx
Points Earned: 1.0/1.0
Correct Answer(s): A
12. The nasal openings are called:
A) chonae
B) septa
C) meatus
D) conchae
Points Earned: 1.0/1.0
Correct Answer(s): A
13. Match the phrases on the left with the most appropriate terminology on the right:
A. Pleural space
B. Costophrenic angle
C. Thoracentesis
D. Pulmonary ligament
E. Pneumothorax
F. Pleural effusion
G. Lingula
H. Parietal pleura
ABCDEFGHConnects visceral pleura with diaphragm
ABCDEFGHLeft lung portion overlapping heart
ABCDEFGHAttached to inner chest wall surface
ABCDEFGHBetween visceral and parietal membranes
ABCDEFGHDiaphragm meets chest wall
ABCDEFGHResult of inflamed pleural space
ABCDEFGHTube in pleural cavity
ABCDEFGHAir in pleural spacePoints Earned: 1.0/1.0
Correct Answer(s): Pulmonary ligament : Connects visceral pleura with diaphragm, Lingula : Left lung portion overlapping heart, Parietal pleura : Attached to inner chest wall surface, Pleural space : Between visceral and parietal membranes, Costophrenic angle : Diaphragm meets chest wall, Pleural effusion : Result of inflamed pleural space, Thoracentesis : Tube in pleural cavity, Pneumothorax : Air in pleural space
14. Which of the following represents the lung's overall contribution to homeostasis?
A) Metabolism of waste products from cellular metabolism
B) Excretion of liquid waste products
C) Control of blood pressure
D) Gas exchange and acid base balance
Points Earned: 2.0/2.0
Correct Answer(s): D
15. Parasympathetic stimulation raises the viscosity of airway secretion while sympathetic stimulation reduces the viscosity.
A) True
B) False
Points Earned: 1.0/1.0
Correct Answer(s): True
16. Airway walls in the lung received blood from the:
A) Pulmonary arteries
B) Pulmonary veins
C) Bronchial arteries
D) Bonchopulmonary anastomoses
Points Earned: 1.0/1.0
Correct Answer(s): C
17. Which of the following are considered accessory muscles of exhalation?
A) Scalines
B) Pectorials
C) Abdominal Muscles
D) Diaphragm
Points Earned: 2.0/2.0
Correct Answer(s): C
18. Which of the following plays a major role in removing bacteria and other foreign material deposited within the acini?
A) Alveolar macrophages
B) Neutrophils in the alveolar blood supply
C) The mucocilliary blanket
D) Eosinophils in lung tissue
Points Earned: 1.0/1.0
Correct Answer(s): A
19. How many generations of bronchi are considered conducting airways (anatomical deadspace)?
A) 12
B) 16
C) 23
D) 26
Points Earned: 2.0/2.0
Correct Answer(s): B
20. Which of the following statements about the segmental anatomy of the lungs is true?
A) The right lung has eight segments, the left has ten.
B) The right lung has two lobes, the left lung has three.
C) Both lungs have the same number of lobes.
D) The left lung has eight segments, the right has ten.
Points Earned: 1.0/1.0
Correct Answer(s): D
21. List the following pulmonary structures in order following air as it enters the respiratory system.
1234567891011121314A) Bronchioles
1234567891011121314B) Larynx
1234567891011121314C) Segmental bronchi
1234567891011121314D) Subsegmental bronchi
1234567891011121314E) Nasal vestibule
1234567891011121314F) Nares
1234567891011121314G) Nasopharynx
1234567891011121314H) Oropharnx
1234567891011121314I) Carina
1234567891011121314J) Lobar bronchi
1234567891011121314K) Concha
1234567891011121314L) Mainstem (primary) bronchi
1234567891011121314M) Trachea
1234567891011121314N) HypopharynxPoints Earned: 14.0/14.0
Correct Answer(s): A:14, B:7, C:12, D:13, E:2, F:1, G:4, H:5, I:9, J:11, K:3, L:10, M:8, N:6,
22. Sharp inorganic crystal like asbestos fibres damage or kill macrophages causing the release of their toxic substances. These in turn attract fibroblasts that scar the affected lung.
A) True
B) False
Points Earned: 1.0/1.0
Correct Answer(s): True
23. If the lungs fail to empty normally during exhalation, because of either weakened elastic recoil forces or high resistance to airflow, the retained volume causes which change in the chest radiograph?
A) Flattening of the diaphragm
B) Bullae formation
C) Pneumothorax
D) Pleural effusion
Feedback: If the lungs fail to empty normally during exhalation, because of either weakened elastic recoil forces or high resistance to airflow, the retained volume abnormally flattens the diaphragm at the end of exhalation.Points Earned: 1.0/1.0
Correct Answer(s): A
24. Which of the following mechanisms is by far the most significant cause of thoracic cavity enlargement during inspiration?
A) Downward movement of the diaphragm
B) Upward movement of the diaphragm
C) Abdominal muscle contraction
D) Abdominal muscle relaxation
Feedback: The downward movement of the diaphragm is by far the most significant cause of thoracic cavity enlargement and is therefore most responsible for generating subatmospheric pressure in the thoracic cavity during inspiration.Points Earned: 1.0/1.0
Correct Answer(s): A
25. The skeletal muscles of the chest wall and the diaphragm are innervated by the autonomic nervous system, while the lung airways are innervated by the somatic system.
A) True
B) False
Points Earned: 1.0/1.0
Correct Answer(s): False
26. The sol layer of the mucociliary escalator is ?
A) Highly viscous
B) Very thick
C) Less viscous than the gel layer
D) On the top of the gel layer
Points Earned: 2.0/2.0
Correct Answer(s): C
27. Which of the following is the function of the surfactant?
A) Feed alveolar cell type I
B) Lower surface tension
C) Increase surface tension
D) Lubricate alveoli
Feedback: Dipalmitoyl phosphatidylcholine (DPPC) composes approximately 50% of surfactant’s phospholipid content and is primarily responsible for surfactant’s surface tension–lowering properties.Points Earned: 1.0/1.0
Correct Answer(s): B
28. Which of the following are collateral air passages that make it possible for the acinus and alveoli to receive ventilation from neighboring airways and alveoli?
I. Pores of Kohn
II. Canals of Lambert
III. Intraalveolar digitations
IV. Brewer connections
A) I, II
B) III, IV
C) I, II, III
D) I, III, IV
Feedback: Collateral air channels called pores of Kohn connect adjacent alveoli with one another (see Figure 1-13). The canals of Lambert connect terminal bronchioles and nearby alveoli. These collateral air passages make it possible for the acinus supplied by a mucous-plugged bronchiole to receive ventilation from neighboring airways and alveoli.Points Earned: 1.0/1.0
Correct Answer(s): A
29. Which of the following are lymphoid tissues present in the pharynx?
I. Adenoid tonsils
II. Nasal tonsils
III. Palatine tonsils
IV. Lingual tonsils
A) I, II
B) III, IV
C) I, II, III
D) I, III, IV
Feedback: These tissues include the pharyngeal (adenoid), palatine, and lingual tonsils (see Figure 1-3).Points Earned: 1.0/1.0
Correct Answer(s): D
30. What is the primary role of surfactant in the lung alveoli?
A) It increases surface tension.
B) It aids in the diffusion of gases.
C) It reduces surface tension.
D) It aids in mucocilliary clearance.
Points Earned: 1.0/1.0
Correct Answer(s): C
31. Pulmonary capillary circulation is controlled by the autonomic nervous system.
A) True
B) False
Feedback: Only local metabolites.Points Earned: 0.0/1.0
Correct Answer(s): False
32. The normal alveolar to alveolar-to-arterial oxygen pressure difference is due to anatomical dead space.
A) True
B) False
Correct Answer(s): False
33. Why do aspirated solid objects and fluids have a tendency to follow the straighter course of the right mainstem bronchus?
A) The left bronchus is more in line with the trachea
B) The right bronchus is more in line with the trachea
C) The left bronchus is shorter than the right
D) The right bronchus is larger than the left
Correct Answer(s): B
34. Although the diaphragm is the principal muscle of inspiration, it is not essential for survival.
A) TRUE
B) FALSE
Feedback: Although the diaphragm is the principal muscle of inspiration, it is not essential for survival. If paralyzed, the diaphragm is passive, moving up and down only in response to changes in pressure gradients.
Correct Answer(s): A
35. Compliance can be thought of as distensibility and compares lung pressure to lung volumes.
A) True
B) False
Correct Answer(s): True
36. Resting FRC levels are about 40% of TLC.
A) True
B) False
Correct Answer(s): True
37. Cigarette smoking causes all types of mucous cells to proliferate and spread into small bronchioles where they are normally absent.
A) True
B) False
Correct Answer(s): True
38. The major muscle(s) of ventilation is (are) called the:
A) Pulmonary ligament
B) Scalenes
C) Abdominals
D) Diaphragm
Correct Answer(s): D
39. Which of the following are characteristics of the trachea?
I. It begins at the level of the eighth cervical vertebra.
II. The point of division is called the carina.
III. It is approximately 11 cm long.
IV. It ends at the level of the fifth thoracic vertebra.
A) I, II
B) II, III, IV
C) I, II, III
D) I, III, IV
Feedback: The trachea begins at the level of the sixth cervical vertebra and in the adult extends for approximately 11 cm to the fifth thoracic vertebra. There it divides into the right and left mainstem bronchi, one for each lung (Figure 1-9). The point of division is called the carina. Inspired air becomes 100% saturated with water vapor and is warmed to body temperature (37° C) after it passes through two or three airway subdivisions below the carina.Points Earned: 1.0/1.0
Correct Answer(s): B
40. What maintains the negativity of intrapleural pressure?
A) Lymphatic drainage
B) Action of the diaphragm
C) Air in the space
D) A and B
Correct Answer(s): D
41. What is the normal composition of the surfactant?
A) 90% phospholipid and 10% protein
B) 50% phospholipid and 50% protein
C) 10% phospholipid and 90% protein
D) 30% phospholipid and 70% protein
Feedback: Pulmonary surfactant is a complex substance composed of 90% phospholipid and 10% protein.Points Earned: 1.0/1.0
Correct Answer(s): A
42. Which of the following prevents the aspiration of foods and liquid?
A) Cricoid cartilage
B) Epiglottis
C) Turbinates
D) Meatus
Points Earned: 1.0/1.0
Correct Answer(s): B
43. Descending from the larger airways, alveoli first appear in the:
A) Respiratory bronchioles
B) Terminal bronchioles
C) Conducting airways
D) Bronchi
Points Earned: 1.0/1.0
Correct Answer(s): A
44. At what point does the trachea branch into two mainstem bronchi?
A) Angle of Louis
B) Glottis
C) Cricoid cartilate
D) Carina
Points Earned: 1.0/1.0
Correct Answer(s): D
45. The adult trachea is approximately how long (median)?
A) 7cm
B) 9cm
C) 20cm
D) 11cm
Points Earned: 2.0/2.0
Correct Answer(s): D
46. Raw is typically the difference between dynamic and static compliance.
A) True
B) False
Points Earned: 1.0/1.0
Correct Answer(s): True
47. Which of the following is the source of innervation for the lung?
A) Somatic nervous sytem
B) Cranial nerves
C) Autonomic nervous system
D) Visceral nerves
Feedback: The skeletal muscles of the chest wall and diaphragm are innervated by the somatic nervous system, whereas the lung airways are innervated entirely by the autonomic nervous system.Points Earned: 1.0/1.0
Correct Answer(s): C
48. L/S ratios and PG levels indicate lung maturity in neonates.
A) True
B) False
Points Earned: 1.0/1.0
Correct Answer(s): True
49. Which of the following are explanations for the left hemidiaphragmatic surface to be slightly lower than the right?
I. The heart rests on the left half of the diaphragm, pushing it downward.
II The presence of air in the stomach acts as a vacuum pulling it downward.
III. The liver, directly below the right half of the diaphragm, props up this area.
A) I, II
B) III
C) I, II, III
D) I, III
Feedback: The left diaphragmatic surface is slightly lower than the right because (1) the heart rests on the left half of the diaphragm, pushing it downward, and (2) the liver, directly below the right half of the diaphragm, props up this area (see Figure 2-1).Points Earned: 1.0/1.0
Correct Answer(s): D
50. Inspired air becomes 100% saturated with water vapor and is warmed to body temperature at the point known as the:
A) Isothermic Saturation Boundry
B) Exothermic Desaturation Point
C) Endothermic Denaturation Border
D) Inspired Air Boundry
Points Earned: 1.0/1.0
Correct Answer(s): A
51. PEEP and FRC are related concepts.
A) True
B) False
Points Earned: 1.0/1.0
Correct Answer(s): True
52. Which of the following structures is an important landmark during the insertion of a tube into the trachea?
A) Thyroid cartilage
B) Cricoid membrane
C) Vallecula
D) Oropharynx
Feedback: The vallecula is an important landmark during the insertion of a tube into the trachea (intubation).Points Earned: 1.0/1.0
Correct Answer(s): C
53. What intercommunicating channels permit collateral ventilation between adjacent alveoli and primary lobules? I. Interalveolar (pores of Kohn) II. Bronchiole-alveolar (canals of Lambert) III. Cardiac notch
A) I, II, and III
B) I and II
C) II
D) II and III
Points Earned: 2.0/2.0
Correct Answer(s): B
54. Which of the following is considered internal respiration?
A) Bulk air flow between the lungs and atmosphere
B) Gas exchange in the cells
C) Ventilation
Points Earned: 2.0/2.0
Correct Answer(s): B
55. Which of the following is NOT a structural feature of the left lung?
A) Superior lobe
B) Hilum
C) Inferior lobe
D) Middle lobe
Points Earned: 2.0/2.0
Correct Answer(s): D
56. How many of the ribs articulate with thoracic vertebrae?
A) 12
B) 11
C) 7
D) 2
Feedback: The 12 thoracic vertebrae articulate with all 12 ribs, but not all ribs connect directly with the sternum anteriorly. The first 7 ribs connect directly with the sternum via cartilages and are called vertebrosternal ribs. Ribs 8 to 10 are connected to the lower sternum by a common cartilage and are called vertebrochondral ribs. The last 2 ribs, 11 and 12, do not connect with the sternum and are called floating ribs.Points Earned: 1.0/1.0
Correct Answer(s): A
57. The ability of the lung to maintain its shape is defined as:
A) Elastanse
B) Resistance
C) Compliance
D) Recoil
Points Earned: 1.0/1.0
Correct Answer(s): D
58. Which of the following are considered the primary respiratory muscles of inspiration (non-labored)? [pick as many as appropriate]
A) Trapezoids
B) Parasternal muscles
C) External intercostals
D) Diaphragm
E) Rectus abdominus
F) Sternocleidomastoids
G) Scalenes
H) Sternocleidomastoid
Correct Answer(s): B, C, D
59. Which of the following are the only accessory muscles of expiration?
A) Diaphragm
B) Intercostal muscles
C) Pectoralis major
D) Abdominal muscles
Feedback: Only the abdominals are accessory muscles of expiration.
Correct Answer(s): D
60. Which of the following is the primary muscle active in quiet breathing?
A) Diaphragm
B) Intercostal muscles
C) Pectoralis major
D) Abdominal muscles
Feedback: The major primary muscle active in quiet breathing is the diaphragm.
Correct Answer(s): A
61. Where in the airway is the tracheostomy performed?
A) Cricothyroid membrane
B) 1 to 3 cm below the cricoid cartilage
C) Carina
D) Corniculate cartilage
Feedback: The membranous space between the thyroid and cricoid cartilages, the cricothyroid membrane (see Figure 1-6), is sometimes the puncture site for an emergency airway opening when structures above it are occluded. A longer-term surgical opening into the airway (tracheostomy) is generally located 1 to 3 cm below the cricoid cartilage.Points Earned: 1.0/1.0
Correct Answer(s): B
62. Because of dichotomous branching bronchial tubes become narrower and narrower in diameter. This means the airflow has to squeeze through a smaller diameter and therefore speeds up as it approaches the alveoli.
A) True
B) False
Points Earned: 1.0/1.0
Correct Answer(s): False
63. According to Poiseuille’s law, if an airway’s radius decreases to one half of its original size, what pressure will be required to maintain the original flow through the airway?
A) 2 times more pressure
B) 4 times more pressure
C) 8 times more pressure
D) 16 times more pressure
Feedback: Poiseuille’s law states that under laminar flow conditions, the pressure required to drive a given flow through a tube increases if the tube length or gas viscosity increases. However, more striking is the increased pressure needed to maintain a given flow rate when tube radius decreases. The equation shows that if an airway’s radius decreases to one half of its original size (e.g., by bronchospasm or mucosal edema), 16 times more pressure is required to maintain the original flow through the airway.Points Earned: 1.0/1.0
Correct Answer(s): D
64. Which of the following structures, when inflamed in infants, is a life-threatening condition?
A) Vocal cords
B) Cricoid ring
C) Vallecula
D) Epiglottis
Feedback: Inflammation of the epiglottis (epiglottitis) is a life-threatening emergency in infants and requires immediate placement of an artificial airway by skilled medical personnel.Points Earned: 1.0/1.0
Correct Answer(s): D
65. Accesory muscles are all of the following except:
A) Diaphragm
B) Scalene muscles
C) Sterno-mastoid
D) Intercostal
Points Earned: 2.0/2.0
Correct Answer(s): A
66. Of the following which is NOT a function of the nose?
A) Filtration
B) Maintaining warmth of air into the lungs
C) Humidify
D) Gas exchange
Points Earned: 1.0/1.0
Correct Answer(s): D
67. Identify the non articulating, sesmoid bone that is located superior to the vocal cords in the larynx.
A) Costal bone
B) Femer
C) Hyoid
D) Hyperlarynxial bone
Points Earned: 2.0/2.0
Correct Answer(s): C
68. Cigarette smoking makes the macrophages release powerful enzymes (proteases) that also destroy the elastic lung tissue.
A) True
B) False
Points Earned: 1.0/1.0
Correct Answer(s): True
69. What is the name of the thin membrane covering the chest wall of the thorax?
A) Parietal pleura
B) Visceral pleura
C) Cupula
D) Mesothelioma
Points Earned: 1.0/1.0
Correct Answer(s): A
70. In a deeply unconscious patient, which of the following is the most common threat to upper airway patency?
A) Cervical spine movement
B) Bulbar paralysis
C) Neural compromise
D) Soft tissue obstruction
Feedback: Deep unconsciousness may relax pharyngeal muscles enough to allow the base of the tongue to fall back against the posterior wall of the pharynx, occluding the upper airway. This soft tissue obstruction is the most common threat to upper airway patency.Points Earned: 1.0/1.0
Correct Answer(s): D
71. Which of the following structures of the airways does not have cartilage and depends on the retractile forces of lung tissue to open?
A) Trachea
B) Lobar bronchi
C) Bronchioles
D) Segmental bronchi
Points Earned: 2.0/2.0
Correct Answer(s): C
72. Gas exchange in the alveoli is accomplished by:
A) Active transport
B) Osmosis
C) Filtration
D) Diffusion
Points Earned: 2.0/2.0
Correct Answer(s): D
73. Which of the following two reflexes are responsible for preventing aspiration of foreign material into the lungs?
A) Laryngeal and pharyngeal
B) Laryngeal and carinal
C) Pharyngeal and carinal
D) Laryngeal and vocal cord
Feedback: Deeply unconscious persons sometimes lose the pharyngeal and laryngeal reflexes and aspirate foreign material into their lungs.Points Earned: 1.0/1.0
Correct Answer(s): A
74. What is the name of the most superior part of the sternum?
A) Manubrium
B) Angle of Louis
C) Xyphoid process
D) Sternal notch
Points Earned: 2.0/2.0
Correct Answer(s): D
75. Pharyngeal tonsils are also called:
A) Palentine tonsils
B) Lingual tonsils
C) Adenoids
D) Uvula
Points Earned: 2.0/2.0
Correct Answer(s): C
76. Chronic sinus infections sometimes lead to lower respiratory tract infections.
A) True
B) False
Points Earned: 1.0/1.0
Correct Answer(s): True
77. Which of the following statements are true of the phrenic nerves?
I. They originate from spinal nerves C3 to C5.
II. They enter the chest in front of the scalenus muscle.
III. They are sandwiched between subclavian arteries and veins.
IV. Nerve injury is associated paralysis of the diaphragm.
A) I, II
B) III, IV
C) I, II, III
D) I, II, III, IV
Feedback: The paired phrenic nerves supply motor innervation to the diaphragm. They originate from the right and left cervical nerve plexuses as branches of cervical spinal nerves C3 to C5 (Figure 2-5). Phrenic nerves cross in front of the scalenus anterior muscles of the neck and enter the chest, sandwiched between subclavian arteries and veins. Thoracic surgery, neck trauma, and cancerous tumors sometimes injure or compress the phrenic nerve, causing paralysis of the diaphragm. However, breathing may still be possible if intercostal nerves and muscles are intact.Points Earned: 1.0/1.0
Correct Answer(s): D
78. What is the narrowest portion of the airway in the adult larynx?
A) Vocal cords
B) Cricoid ring
C) Vallecula
D) Glottis
Feedback: The glottis is the narrowest part of the adult larynx.Points Earned: 1.0/1.0
Correct Answer(s): D
79. What causes air to move in or out of the lungs while keeping the lungs in an inflated state?
A) Volume gradients
B) Pressure gradients
C) Temperature gradients
D) Flow gradients
Feedback: Pressure gradients cause air to move in or out of the lungs and are responsible for keeping the lungs in an inflated state.Points Earned: 1.0/1.0
Correct Answer(s): B
80. What is the volume of gas found in the "conducting airways" called?
A) Shunt space.
B) Acini.
C) Laminar propria.
D) Anatomical dead space.
Points Earned: 1.0/1.0
Correct Answer(s): D
81. Which of the following nerves supply motor stimulation directly to the diaphragm?
A) Vagus nerve
B) Laryngeal nerve
C) Phrenic nerve
D) Glossopharyngeal nerve
Points Earned: 1.0/1.0
Correct Answer(s): C
82. Which of the following mechanisms is responsible for the creation of the subatmospheric pressure between the lung and chest wall?
I. Both lungs and chest wall pull outward.
II. The lung has a tendency to recoil inward and pull away from the chest wall.
III. The thorax has a tendency to recoil outward, away from the lung.
A) I, II
B) III
C) I, II, III
D) II, III
Feedback: The healthy lung has a tendency to recoil inward and pull away from the chest wall. At the same time, the thorax has a tendency to recoil outward, away from the lung. These two oppositely directed recoil forces create a subatmospheric pressure between the lung and chest wall.Points Earned:
Correct Answer(s): D
83. Stimulation of the irritant receptors in the lung can result in which of the following (as a defense mechanism)? 1. Bronchoconstriction 2. Reflex closure of the glottis 3. Reflex slowing of the heart (bradycardia)
A) 2 and 3
B) 1, 2, and 3
C) 1 and 3
D) 2
Points Earned: 1.0/1.0
Correct Answer(s): B
84. How many single cartilages are there in the larynx? (be careful!)
A) 3
B) 6
C) 9
D) 12
Points Earned: 2.0/2.0
Correct Answer(s): A
85. What is the term that describes the presence of fluid in the pleural space caused by inflammation?
A) Pleural effusion
B) Thoracentesis
C) Pleural rub
D) Pneumothorax
Feedback: If the pleural membranes become inflamed by disease, fluid may form in the pleural space, creating a pleural effusion.Points Earned: 1.0/1.0
Correct Answer(s): A
86. The carina is the point of division for the mainstem bronchi. The external landmark for this division point is the fifth thoracic vertebra.
A) True
B) False
Points Earned: 2.0/2.0
Correct Answer(s): True
87. The true vocal folds form a triangular opening leading into the trachea.
A) True
B) False
Points Earned: 2.0/2.0
Correct Answer(s): True
88. Which of the following is not considered a laryngeal cartilage?
A) Epiglottis
B) Cunniform
C) Hyoid
D) Corniculate
E) Cricoid
F) Thyroid
G) Arytnoid
Points Earned: 2.0/2.0
Correct Answer(s): C
89. The left bronchus is smaller in diameter than the right but twice as long.
A) True
B) False
Points Earned: 1.0/1.0
Correct Answer(s): True
90. The gas exchange zone (acinus or primary lobule) consists of which of the following structures?
I. Terminal bronchioles
II. Alveoli
III. Acini
IV. Respiratory bronchioles
A) II and III only
B) I, II, and III only
C) II, III and IV only
D) I, II, III, and IV
Points Earned: 1.0/1.0
Correct Answer(s): C
91. What is the major source of respiratory tract secretions in the normal lung?
A) Goblet cells
B) Bronchial glands
C) Mast cells
D) Clara cells
Points Earned: 1.0/1.0
Correct Answer(s): A
92. The most common threat to maintaining an open upper airway involves inappropriate positioning of the:
A) Tongue
B) Epiglottis
C) Soft palate
D) Tonsils
Points Earned: 1.0/1.0
Correct Answer(s): A
93. All of the following are parts of the sternum except the:
A) xiphoid process.
B) manubrium.
C) body of the sternum
D) carina.
Points Earned: 1.0/1.0
Correct Answer(s): D
94. During cardiopulmonary resuscitation involving cardiac compressions, care must be taken not to compress which of the following parts of the sternum because its fracture may damage underlying organs?
A) Manubrium
B) Xiphoid process
C) Angle of Louis
D) Body
Feedback: During cardiopulmonary resuscitation involving cardiac compressions, care must be taken not to compress the xiphoid process because its fracture may damage underlying organs.Points Earned: 1.0/1.0
Correct Answer(s): B
95. Which of the following structures comprise the sternum? 1. Xiphoid process 2. Manubrium 3. Body 4. Costal cartilage
A) 1 and 3
B) 2 and 4
C) 1, 2, 3
D) 1, 2, 3, 4
Points Earned: 1.0/1.0
Correct Answer(s): C
96. The diaphragm is innervated by which of the following nerves?
A) Phrenic
B) Vagus
C) Glossopharyngeal
D) Seventh cranial
Points Earned: 1.0/1.0
Correct Answer(s): A
97. Which of the following structures located in the nasal, oral and laryngeal pharynx are part of the lymphatic system and defend against infection in the upper airways?
A) Concha
B) Smooth muscle
C) Tonsils
D) Vocal cords
Points Earned: 2.0/2.0
Correct Answer(s): C
98. How many floating ribs are there in the normal adult?
A) 2
B) 7
C) 10
D) 12
Points Earned: 2.0/2.0
Correct Answer(s): A
99. Pulmonary surfactant (Choose the BEST answer).
A) Acts like standard detergents at body temperature
B) Reduces alveolar surface tension
C) Reduces pulmonary airway resistance
D) Is produced by the type I alveolar epithelial cells
Points Earned: 1.0/1.0
Correct Answer(s): B
100. Upper airway resistance is less than lower airway resistance.
A) True
B) False
Points Earned: 1.0/1.0
Correct Answer(s): False
101. During inspiration pleural pressure......
A) Increases (more negative)
B) Decreases (less negative)
C) Stays the same
D) What is pleural pressure?
Points Earned: 1.0/1.0
Correct Answer(s): A
102. What is the primary function of the epiglottis?
A) Serves as a point of attachment for the vocal cords
B) Provide for variations in vocal tone during phonation
C) Divert food around the glottic opening during swallowing
D) Cover the glottic opening during forced expiration
Points Earned: 1.0/1.0
Correct Answer(s): C
103. Lamellar bodies released into the alveoli by type II pneumocytes are the source of alveolar surfactant phospholipid.
A) True
B) False
Points Earned: 1.0/1.0
Correct Answer(s): True
104. Which of the following are the primary muscles that contract in a normal exhalation (non labored)?
A) Diaphragm
B) External intercostals
C) Rectus abdominus
D) None
Points Earned: 2.0/2.0
Correct Answer(s): D
105. Of the following, the structure essential in generating high pressure during a cough is the:
A) Vallecula
B) Epiglottis
C) Cricothyroid ligament
D) Vocal cords
Points Earned: 1.0/1.0
Correct Answer(s): D
106. In the larynx, laryngospasm occurs if anything but air attempts to enter the airway.
A) True
B) False
Points Earned: 2.0/2.0
Correct Answer(s): True
107. What is the primary function of the pleural fluid?
A) To bring nutrients to lung tissue and carry away waste products.
B) To provide white blood cells and macrophages to protect the lung from infection.
C) To allow the two pleural membranes to glide over each other during inspiration
D) To maintain a negative pressure between the lungs and chest wall.
Points Earned: 1.0/1.0
Correct Answer(s): C
108. The respiratory muscles would have to work harder in all of the following conditions EXCEPT:
A) A decrease in lung compliance
B) An increase in tidal volume demand
C) A decrease in airway resistance
D) A decrease in the production of surfactant
Points Earned: 1.0/1.0
Correct Answer(s): C
109. Which of the following is not a structural feature of the left lung?
A) Superior lobe
B) Hilum
C) Cardiac notch
D) Middle lobe
Points Earned: 1.0/1.0
Correct Answer(s): D
110. Residual volume (RV) can be exhaled and measured by a spirometer.
A) True
B) False
Points Earned: 1.0/1.0
Correct Answer(s): False
111. Which function of the nose is lost if a plastic endotracheal tube is inserted through the nose or mouth and into the trachea?
A) Air-conditioning
B) Antibacterial
C) Antiinflammatory
D) Bactericidal
Feedback: If a plastic endotracheal tube (Figure 1-4) is inserted through the nose or mouth and into the trachea, the air-conditioning function of the nose is lost and unmodified cool, dry gas directly enters the trachea. This places a heavy burden on the tracheal mucosa, which is not designed to accommodate cool, dry gases.Points Earned: 1.0/1.0
Correct Answer(s): A
112. Match the following lower airway structures with the appropriate statement:
A. Conducting airways
B. Alveoli
C. Clara cells
D. Acinus
E. Pores of Kohn
F. Respiratory bronchioles
G. Parenchyma
ABCDEFGElastic fibers forming lung tissue
ABCDEFGSource of secretions in terminal bronchioles
ABCDEFGGas-exchanging sacs
ABCDEFGMark the beginning of the gas exchange zone
ABCDEFGAirways that do not participate in gas exchange
ABCDEFGConnect adjacent alveoli
ABCDEFGFunctional respiratory unitPoints Earned: 7.0/7.0
Correct Answer(s): Parenchyma : Elastic fibers forming lung tissue, Clara cells : Source of secretions in terminal bronchioles, Alveoli : Gas-exchanging sacs, Respiratory bronchioles : Mark the beginning of the gas exchange zone, Conducting airways : Airways that do not participate in gas exchange, Pores of Kohn : Connect adjacent alveoli, Acinus : Functional respiratory unit
113. Cartilage initially encircles the dividing bronchi but becomes more irregular and discontinuous until it is completely replaced by smooth muscle in the bronchioles.
A) True
B) False
Points Earned: 1.0/1.0
Correct Answer(s): True
114. Widespread sympathetic innervation of the lung airways accounts for the adrenergic bronchodilation in adults.
A) True
B) False
Points Earned: 1.0/1.0
Correct Answer(s): False
115. In the presence of high inspired oxygen concentrations, which substances are believed to produce alveolar injury?
A) Antitrypsin
B) Oxygen radicals
C) Surfactant
D) Fibrinogen
Feedback: Apparently, overproduction of these toxic O2 radicals occurs in the presence of high inspired oxygen concentrations, leading to alveolar tissue injury, a condition known as oxygen toxicity.
Correct Answer(s): B