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A) True
B) False
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
Correct Answer(s): B
A) Eustation tube
D) Glottis
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
A) 10ml
B) 50ml
C) 70ml
D) 100ml
Correct Answer(s): D
6. Which of the following is the right sequence of events that generate a cough?
III. The muscles in the larynx close the glottis, sealing the upper airway.
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).
Correct Answer(s): C
A) True
B) False
A) True/1.0
B) False
A) Shunt
B) Dead space
C) Hypoventilation
D) Diffusion deficit
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
Correct Answer(s): A
A) chonae
B) septa
C) meatus
D) conchae
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
Correct Answer(s): D
A) True
B) False
A) Pulmonary arteries
B) Pulmonary veins
C) Bronchial arteries
D) Bonchopulmonary anastomoses
Correct Answer(s): C
A) Scalines
B) Pectorials
C) Abdominal Muscles
D) Diaphragm
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
Correct Answer(s): A
A) 12
B) 16
C) 23
D) 26
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.
D) The left lung has eight segments, the right has ten.
Correct Answer(s): D
21. List the following pulmonary structures in order following air as it enters the
respiratory system.
1234567891011121314A) Bronchioles
1234567891011121314B) Larynx
1234567891011121314F) Nares
1234567891011121314G) Nasopharynx
1234567891011121314H) Oropharnx
1234567891011121314I) Carina
1234567891011121314K) Concha
1234567891011121314M) Trachea
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
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?
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?
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
A) Highly viscous
B) Very thick
Correct Answer(s): C
D) Lubricate alveoli
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
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
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
Correct Answer(s): C
A) True
B) False
A) True
B) False
Correct Answer(s): B
A) TRUE
B) FALSE
Correct Answer(s): A
A) True
B) False
A) True
B) False
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
A) Pulmonary ligament
B) Scalenes
C) Abdominals
D) Diaphragm
Correct Answer(s): D
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
A) Lymphatic drainage
D) A and B
Correct Answer(s): D
41. What is the normal composition of the surfactant?
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
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
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
Correct Answer(s): D
A) 7cm
B) 9cm
C) 20cm
D) 11cm
Correct Answer(s): D
46. Raw is typically the difference between dynamic and static compliance.
A) True
B) False
47. Which of the following is the source of innervation for the lung?
A) Somatic nervous sytem
B) Cranial nerves
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
A) True
B) False
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.
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:
Correct Answer(s): A
A) True
B) False
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
B) I and II
C) II
D) II and III
Correct Answer(s): B
C) Ventilation
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
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
Correct Answer(s): D
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
Correct Answer(s): D
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
A) Cricothyroid membrane
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
A) True
B) 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?
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
Correct Answer(s): D
A) Diaphragm
B) Scalene muscles
C) Sterno-mastoid
D) Intercostal
Correct Answer(s): A
A) Filtration
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
Correct Answer(s): C
A) True
B) False
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
Correct Answer(s): A
70. In a deeply unconscious patient, which of the following is the most common
threat to upper airway patency?
B) Bulbar paralysis
C) Neural compromise
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
Correct Answer(s): C
A) Active transport
B) Osmosis
C) Filtration
D) Diffusion
Correct Answer(s): D
73. Which of the following two reflexes are responsible for preventing aspiration of
foreign material into the lungs?
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
Correct Answer(s): D
A) Palentine tonsils
B) Lingual tonsils
C) Adenoids
D) Uvula
Correct Answer(s): C
76. Chronic sinus infections sometimes lead to lower respiratory tract infections.
A) True
B) False
77. Which of the following statements are true of the phrenic nerves?
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.
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
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?
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
Correct Answer(s): B
84. How many single cartilages are there in the larynx? (be careful!)
A) 3
B) 6
C) 9
D) 12
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
87. The true vocal folds form a triangular opening leading into the trachea.
A) True
B) False
A) Epiglottis
B) Cunniform
C) Hyoid
D) Corniculate
E) Cricoid
F) Thyroid
G) Arytnoid
Correct Answer(s): C
89. The left bronchus is smaller in diameter than the right but twice as long.
A) True
B) False
90. The gas exchange zone (acinus or primary lobule) consists of which of the
following structures?
I. Terminal bronchioles
II. Alveoli
III. Acini
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
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
Correct Answer(s): A
93. All of the following are parts of the sternum except the:
A) xiphoid process.
B) manubrium.
D) carina.
Correct Answer(s): D
A) Manubrium
B) Xiphoid process
C) Angle of Louis
D) Body
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
Correct Answer(s): C
A) Phrenic
B) Vagus
C) Glossopharyngeal
D) Seventh cranial
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
Correct Answer(s): C
98. How many floating ribs are there in the normal adult?
A) 2
B) 7
C) 10
D) 12
Correct Answer(s): A
Correct Answer(s): B
100. Upper airway resistance is less than lower airway resistance.
A) True
B) False
Correct Answer(s): A
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
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
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
Correct Answer(s): D
106. In the larynx, laryngospasm occurs if anything but air attempts to enter the
airway.
A) True
B) False
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
Correct Answer(s): C
108. The respiratory muscles would have to work harder in all of the following
conditions EXCEPT:
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
Correct Answer(s): D
110. Residual volume (RV) can be exhaled and measured by a spirometer.
A) True
B) 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
ABCDEFGGas-exchanging sacs
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
114. Widespread sympathetic innervation of the lung airways accounts for the
adrenergic bronchodilation in adults.
A) True
B) False
A) Antitrypsin
B) Oxygen radicals
C) Surfactant
D) Fibrinogen
Correct Answer(s): B