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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

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