A Dedicated Institute for Nursing Competitive Exam

RESPIRATORY SYSTEM

RESPIRETORY SYSTEM
The Respiratory System is a series of organ responsible for taking in O2 and expelling CO2.

 It Consists :-
1) Nose
2) Pharynx (Throat)
3) Larynx (Voice Box)
4) Trachea (Wind pipe)
5) Bronchi
6) Bronchioles
 Terminal Bronchioles
 Respiratory Bronchioles
7) Alveolus duct
8) Alveolus Sac
9) Alveoli

 Respiratory System divided in 2 parts (Anatomically)

1) Upper Respiratory System :- Nose , Pharynx.
2) Lower Respiratory System:- Larynx, Trachea, Bronchi, Bronchioles , Lungs.
 Respiratory System divided in 2 parts (Functionally)
1) Conductive Zone :- A series inter connecting cavities and tubes outside and within the lungs.
 Parts :- Nose, Pharynx, Larynx, Trachea, Bronchi, Bronchioles (Terminal bronchioles)
 No gas exchange so called dead space or dead zone.
 Total Volume fair in conductive zone 150 ml.
2) Respiratory Zone:-Gas exchange occurs in this zone.
1. Gt Consists : - Respiratory Bronchioles
Alveolus ducts
Alveolus sac
Alveoli
2. Total Volume of air in Respiratory Zone – 5 – 6 Liters.

NOSE
 Nose is the first respirator tract organ.
 Nose epithelium :-Pscudostratified ciliated columnar epithelium.
 Nose contain – Goblet cells – formation – MUCUS
Cilia – Expellant of mucus

Function of Nose :-

1. Filtering
Warming Inspired Air
Moisturing

2. Prevents Loss of water through Expired air.

Rhinitis :-Inflammation of Nasal Mucosa

Anosmia :- Loss of Smell

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PARANASAL SINUSES
 ParanasalSinuses :- Air Filled cavities in bone 4 Paranosal sinuses around the nose.

1) Maxillary Sinuses :-
 Largest paranosal sinuses
 Also Known as “Antrum of highmore” .
 Situated below the eyes.
2) Ethamoid Sinuses :-
 Situated b/w eyes
3) Frontal Sinuses :-
 Situated above eyes
4) Sphenoid Sinuses :-
 Situated behind eyes

 Functional Paranasal Sinus:-

 Make Lighten Skull
 Immunological defense
 Add resonance to voice

Sinusitis:- Inflammation of Paranasal Sinuses

PHARYNX
 It is also known as – Throat
 Funnel shaped tube
 Length - 12 cm
 Extension – Base of skull to 6thCrucial vertebrae.

 It has 3 parts .

1) Nasopharynx :-
 It situated behind eyes.
 It is upper part of pharynx
 Pharyngeal tonsils, (Adenoids)
2) Oropharynx :-
 It is situated posteriorly to oral cavity.
 It passage both air and food.
 It consists – Tonsil – palantine, lingual.

3) Laryngophrynx :-
 Also known as – Hypopharynx
 Present behind larynx
 Inferior portion of the pharynx.

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 RESPIRATORY SYSTEM

LARYNX
 It is also known as voice box
 It is formly cartilaginous structure
 Extension – C4 to C6

 Carilage of larynx :-Total 9 cartilage in larynx.

1) Cricoid cartilage
2) Thyroid cartilage Single
3) Epiglottis cartilage
4) Arytenoid cartilage
5) Cuneiform cartilage Paired
6) Corniculate cartilage

Epiglottis :-

 Leaf shaped
 It is situated at the top of larynx.
 It prevents entry of food into Respiratory tract during Swallowing.

TRACHEA
 It is also known as wind pipe.
 Located in front of esophagus.
 Length – 12.0 cm
 Diameter – 2.0 cm
 Extension :- Lower order of 6th crucial vertebrae to lower border of 4th thoracic vertebrae.
 Trachea Bifurcate in to 2 Primary bronchi at lower border of T4 or upper border of T5

Carina :- A Ridge of Cartilage in trachea that occurs between the division of two main Bronchi . It is
most sensitive area of respiratory tract for coughing reflex.

 The wall of trachea formation by 16-20 incomplete, Horizontal rings of Hyaline cartilage, resemble
the letters „c‟

BRONCHI
 Trachea divided into :-
1) Primary Bronchi – Alklas :- Main stem bronchi . They enter in lungs through Hilum.
2) Secondary Bronchi –Alklas :-Lobas Bronchi.
3) Tertiary Bronchi- Alklas :- Segmented Bronchi.

Bronchioles

1) Terminal Bronchioles :-
 Diameter less than 1 mm.
 Last part of conducting zone.

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 RESPIRATORY SYSTEM

2) Respiratory Bronchioles :-
 Diameter less than 5 mm.
 It is the first structure of Respiratory zone.
Alveolar Duct :- The duct that connect respiratory bronchioles to alveolar sac.
Alveolar Sac:-The alveoli form clusters, called alveolar sacs, that resemble bunches of grapes.

ALVEOLI
 It is also known as Acini
 It has elastic recoil capacity.
 It is balloon – like air sac located at the distal ends of the Bronchial tree.
 Lungs have 300 million alveoli.
 Alveloli has 2 types of Epithelium cells.
1) Type I alveolar cells - These cells responsible for gas exchange.
2) Type II alveolar cells – These cells secrete surfactant. Surfactant lower the surface tension and
prevents collar sec of alveoli
 Diameter less than 1 mm.
 Last part of conducting zone.

LUNGS
 Paired Organ
 Cone shaped
 Situateed in Thoracic cavity.

Media Sternum :- Space b/w both lungs.

Hilum :- It is the side of entrance or exit of structure associated lungs – Bronchi pulmonary vessels , nerve.

Right Lung Left Lung

Weight 700 gm 600 gm
Lobe 3 lobe :- 2 Lobe
 Superior  Superior
 Middle  Inferior
 Inferior
Fissure 2Fissure :- 1 Oblige
 Horizontal  Longer , narrower
 Oblige
Short , wides

PLEURA
 Double layers serous membrane:-
 It has 2 layers :-
1) Parietal pleura - Layers attached thoracic cavity.
2) Visceral pleura - Attach lungs.
 Pleural Cavity :- Space between parietal pleura and visceral pleura.
 Pleural Fluid :- Fluid in pleural cavity . Normal 10-20 rt.

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RESPIRATION
 External Respiration :- Exchange of gases between blood and lungs.
 Internal Respiration :- Exchange of gases between blood and tissue.

Muscles involved in normal Respiration :-

Inspiration :-

 Diaphragm :-Main muscles of respiration . Supplied by phrenic nerve.

 External Intercostal muscles
 Expiration :-Passive process. No muscles are involved
 Composition of Air :-
Inspired Air Expired Air
Oxygen 21% 16%
CO2 0.04% 4%
Nitrogen 78% 74 -78%

1. Lungs Capacity :- Lung capacity are the combination of two or more lung volume
(A) Inspiratory Capacity (IC) :-
It is the maximum volume of air than can be inspired starting from end expiratory
position
IC - TV+IRV - 500+3300 - 3800 ml
(B) Functional Residual Capacity (F.R.C.):-
This is the volume of air remaining in lungs after normal expiration
FRC = ERV+RV - 1000+ 1200 = 2200ml
(C) Vital Capacity :-
it is the maximum amount of air that can be expelled out forcefully after a
maximum inspiration
VC= TV+IRV+ERV=500+3300+1000= 4800 ml

(D) Total Lung Capacity :-

It is the amount of air present in the lungs after a maximum (deep) Inspiration it
include all volumes
TLC = TV+IRV+ERV+RV=500+3300+1000+1200 - 6000ml

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 RESPIRATORY SYSTEM

A. Respiratory Centers :-
 Respiratory center are group of neurons , which control the rate , Rhythm and
force of respiration
 Depending upon the situation the respiratory centers are classified into two
groups. :-
(a) Medullary Centers :- Situated at medulla oblongata.
It consist of-
(i) Inspiratory Center :-
This center generate inspiratory ramp signal by of their autorythmic
property
It is responsible for basic (normal) Rhythm of respiration
(ii) Expiratory Center :-

Normally , Expiratory center are inactive during quiet breathing and

become active during forced breathing.

(b) Pontine Centers :-

Situated in pons.
It consist of
(i) Apneustic Center :-
 It increases depth of inspiration
(ii) Pheumotaxic Center :-
It Increase respiratory rate by reducing the duration of inspiration.

 Eupnea :- Normal Respiratory pattern

 Tachypnea :- Increase in the rate of Respiration .
 Bradypnea :- Decrease in the rate of Respiration
 Apnea :- Temporary arrest of breathing.
 Hypernea :- Increase in pulmonary ventilation due to increase in rate or force of
Respiration.
 Hypoxia:-reduced availability of oxygen to the tissue.
 Hypercapnea:-increased CO2 content of blood.
 Hypocapnea:-decreased CO2 content in blood.
 Cyanosis:-diffused bluish coloration of skin and mucus membrane.
 Dyspnea:-difficulty in breathing (AIR hunger).

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DISORDERS OF RESPIRATORY SYSTEM

Bronchial Asthma
Bronchial asthma is a reversible bronchospasm, in which there is inflammation and
narrowing of bronchial lumen due to its hyperactive response to a certain stimuli which leads
to wheezing and coughing an difficulty in breathing.
Types of Bronchial Asthma:
1. Extrinsic Asthma – Allergic asthma
2. Intrinsic Asthma – Non allergic asthma

Bronchial Asthma Triggers:

1) Allergy such as food, pollen, dust (Allergy is the most commonest trigger of asthma)
2) Infections such as colds, flu or pneumonia
3) Smoking
4) Physical exertion
5) Air pollution and toxins
6) Weather, especially extreme change in temperature
7) Drugs such as Aspirin, NSAIDs and Beta-blockers
8) Food additives
9) Emotional stress
Sign and symptoms :-
a) Dyspnea
b) Cough
c) Wheezing sound – Classical symptom of asthma
d) Use of accessory muscles of breathing
e) Cyanosis
f) Tachycardia
g) Anxiety and restlessness
h) Tightness of chest
i) Diaphoresis

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Investigations:

a) History collection – Family History

Environment History
Allergy History
b) Physical Examination – Wheezing sound
c) Blood Test – Increase IgE and eosinophills count
d) Pulmonary function test – Confirmatory test
e) ABG analysis

Primarycare:-
 Makethepatientcomfortablebygivingsemifowler’spositiontofacilitatethefulllungexpansi
onandairexchange.
 Start a slow I/V infusion for giving emergency drugs and preventingdehydration.
 Start humidified oxygen therapy at the rate of 3 to 5 litters/minute.
 Checkthevitalsigns(temperature,respiration,pulserate/heartrateandbloodpressure)as
wellasbreathsoundsconstantlytoseeifthepatient’svitalsignsarestabilisedandhis/herbre
athinghasimproved.

Medical Management :-

a) B2 adrengeric agonist – Salbutabone , terbutaline , salmeterol , Drug of choice asthma

b) Anti-cholinergics – ipratropium bromide
c) Methyl xanthines – theophylline , aminophylline
d) Anti-inflamatory drugs – Beclomethasone prednisolone

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 RESPIRATORY SYSTEM

COPD (Chronic obstructive pulmonary disease)

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that
causes obstructed airflow from the lungs. Progressive airflow limitation associated with
inflammatory response.

COPD includes:

A. Chronic bronchitis :- It is a chronic productive cough for 3 months in each of two

successive years in a patient.
B. Emphysema :- Abnormal and permanent enlargement of the airspace distal to the
terminal bronchios that is accompanied by destruction of the airspace wall.

Etiology:-
a) Smoking (Most commonest cause of COPD)
b) Environment pollution
c) Infection (Bacterial viral)
d) Alpha 1 antitrypsin deficiency (Emphysema)
e) Occupational exposure

Clinical manifestation:-

a) Cough
b) Dysnea
c) Restlessness
d) Cyanosis
e) Tripod position
f) Chest tightness
g) Fatigue
h) Weight loss

Diagnostic evaluation:-
a) History collection
b) Physical examination- Barrel shaped chest(Emphysema)
c) Pulmonary function tests(Confirmatory test)
d) Arterial blood gas analysis
e) Chest X-ray

Medical Management:-
a) B2 adrengeric agonist – Salbutabone , terbutaline , salmeterol
b) Anti-cholinergics – ipratropium bromide Drug of choice COPD
c) Methyl xanthines – theophylline , aminophylline
d) Anti-inflamatory drugs – Beclomethasone prednisolone
e) Mucolytics – Bromhexine , Ambroxol

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 RESPIRATORY SYSTEM

Non Pharmacological:-

a) Oxygen therapy
b) Nebulization
c) Deep breathing exercises
d) Coughing exercises
e) Spirometric exercises

Nursing Management:-

a) Assess the respiratory condition

b) Check vital signs
c) Monitor pulse oximetry
d) Assess lung sounds
e) Assess skin colour , temperature
f) Provide semi-fowlers positions
g) Administer medicine as per doctors order

Complications:-
a) Respiratory failure
b) Pneumonia
c) Death
d) Depression

PNEUMONIA
Pneumonia is an infection of the lungs that is characterised primarily by inflammation of the
alveoli in the lungs or by alveoli which are filled with fluid

Pneumoniacancausemildtosevereillnessinpeopleofallages.Itistheleadingcauseofdeathinchildreny
oungerthan5yearsofageworldwide. It is usually characterized by consolidation.

Consolidation:- It is a pathological process in which the alveoli are filled with a mixture of
inflammatory exudate, bacteria and WBC.

Types of pneumonia :-

1. Community acquaired pneumonia(CAP):-

It occurs either in the community setting or within first 48 hours of hospitalization.
the most frequent causative agents are S.pneumoniae, H.influenzae, psuedomanas.

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 RESPIRATORY SYSTEM

2. Hospital – acquired pneumonia (nosocomial pneumonia) :-

 It is defined as the onset of pneumonia symptoms more than 48 hours after
administration of hospital.
 The most frequent organism responsible are Escherichia coli, klebsiella, and
staphylococcus aureus.
.

3. Immuno compromised host pneumonia :-

The responsible organism are pneumocystic carinii, hemophillus influenza.

4. Aspiration pneumonia:-
It refers to the pulmonary consequences resulting from the entry of endogenous or
exogenous substance into the lower AIRWAYS.

Risk factor of Pneumonia :-

 Smoking.
 Alcoholism.
 Otherseriousillnesses,suchasheartdisease,livercirrhosisordiabetesmellitus.
 Recentsurgeryortrauma.
 Childrenyoungerthan1yearofageandadultsolderthan65yearsofage.
 Viralinfectionssuchas:cold,flu,laryngitisetc.
 Chronicobstructivepulmonarydisease(COPD),emphysemaandasthma.
 HIV/AIDS,malignantdiseases,stroke.
 Exposuretosmoke/dust/airpollution.

Stages of pneumonia:-
1. Hyperemia (congestion): First 24 to 48 hours
2. Red hepatization : 2 to 4 days
3. Grey heaptization : 4 to 8 days
4. Resolution : more than 8 days

Clinical Menifestation:-
 Coughwithsputum
 Fever
 Shortnessofbreath,whichmayoccurduringclimbingstairs
 Chestpainthatgetsworsewhentakingadeepbreath(pleuriticpain)orwhilecoughing
 Fastheartbeat
 Fatigue

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 Excessivesweatingandclammyskin
 Nausea,vomitinganddiarrhea
 Lossofappetite,lowenergyandfatigue
 Confusionordeliriumespeciallyinolderpeople
 Duskyorpurplishskincolor(cyanosis)duetopoorlyoxygenatedblood

Investigations :
1. History Taking
2. physical examination
3. Chest X-ray
4. Sputum culture
5. Arterial blood gas analysis

PreventiveMeasuresofPneumonia
 Washhandsregularly
 Refrainfromsmoking
 Avoidexposuretodust,chemicalsorairpollution
 Avoidseasonalallergies
 Eathealthy
 Exercisedaily

Management of Pneumonia:-
1. Specific antibiotic therapy
2. Administer oxygen
3. Bronchodilator medications
4. Postural drainage
5. Bed rest

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 Respiratory System
MCQ {CHO}
MCQs
Q.1 Bleeding from the nose is known as : Q.16 The exchange of gases inside the lungs
(a) Epistaxis (b) Haemoptysis actually occurs inside tiny sacs called :
(c) Hematemesis (d) Haematuria (a) Bronchi (b) Cilia
Q.2 Blood into sputum of patient called : (c) Capillaries (d) Alveoli
(a) Haemoptysis (b) Epistaxis Q.17 The ________________ membrane
(c) Hemetemesis (d) Melena surrounds the lungs :
Q.3 What condition is responsible for (a) Pericardial (b) Mediastinal
inspiration ? (c) Pleural (d) Peritoneal
(a) Contraction of intercostals muscles Q.18 Atmospheric pressure is important in the
(b) Dilatation of intercostals muscles process of _______________
(c) Contraction of diaphragm (a) Blood flow (b) Micturation
(d) Both (a) and (c) (c) Reproduction (d) Breathing
Q.4 The organ which is located in the pleural Q.19 The destruction of alveolar walls is called:
cavity of the thorax is : (a) Empyema (b) Bronchitis
(a) Liver (b) Heart (c) Emphysema (d) Lung abscess
(c) Lungs (d) Kidneys Q.20 The collapse of the alveoli is prevented by:
Q.5 Bleeding from nose is termed as- (a) Cilia (b) Mucus
(a) Hyperemesis (b) Haemoptysis (c) Surfactant (d) Pleural fluid
(c) Hematemesis (d) Epistaxis Q.21 During, swallowing food is stopped from
Q.6 Removal of an entire lung is called as : entering the larynx by the :
(a) Lobectomy (a) Esophagus (b) Pharynx
(b) Pneumonectomy (c) Eustachian Tube (d) Epiglottis
(c) Segmental resection Q.22 The surfactant is responsible for :
(d) Wedge resection (a) Bronchiectasis
Q.7 Right lung has how many lobes ? (b) Prevention of pulmonary embolism
(a) 2 (b) 3 (c) Prevention f collapse of alveoli
(c) 4 (d) 5 (d) Prevention of emphysema
Q.8 Rings found of trachea are_____________ Q.23 The lung function tests are determined by:
in number : (a) Tonometer (b) Spirometer
(a) 8-10 (b) 5-7 (c) Sphygmomanometer
(c) 16-20 (d) 10-13 (d) Barometer
Q.9 Adam’s apple is related to : Q.24 Normal tidal volume is :
(a) Pharynx (b)Larynx (a) 100ml (b) 600ml
(c) Trachea (d) Esophagus (c) 400ml (d) 500ml
Q.10 The trachea or wind pipe is made up of Q.25 Amount of air inspired a normal a normal
cartilage rings; shape of the rings is : adult healthy person during rest a single
(a) C shaped (b) S shaped breathing :
(c) Cone shaped (d) Straight (a) 200ml (b) 300ml
Q.11 In human body, right lung has : (c) 400ml (d) 500ml
(a) One lobe (b) Two lobes Q.26 The average tidal volume is :
(c) Three lobes (d) Four lobes (a) 500ml (b) 250ml
Q.12 Which gases also work as a respiratory (c) 150ml (d) 600ml
stimulant Q.27 In majority of the cases the causative
(a) O2 (b) Co2 organism for sore throat is :
(c) N2 O (d) CO (a) Gonococci
Q.13 During internal respiration gases exchange (b) Staphylococci
occur between : (c) Meningococci
(a) Between lungs and environment (d) Streptococci
(b) Between blood vessels and tissues Q.28 The common cause for bacterial sore throat
(c) Between heart and lungs is :
(d) All above (a) Streptococcus pyogenes
Q.14 Right lung has how many lobes : (b) Mycoplasma pneumonia
(a) 1 (b) 2 (c) Corynbacterium
(c) 3 (d) 4 (d) Mycobacterium
Q.15 How many lobes are present in Right lung? Q.29 A pulmonary infection is located inside the:
(a) 7 (b) 2 (a) Brain (b) Heart
(c) 3 (d) 9 (c) Lungs (d) Nails

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 MCQs
Q.30 The exercise that would be most beneficial Q.40 How a nurse will teach Breathing exercise
for a client with COPD is for a patient with chronic bronchitis ?
(a) Controlled coughing (a) Use chest breathing
(b) Whistling while exhaling (b) Use diaphragmatic breathing
(c) Deep breathing (c) Use open mouth breathing
(d) Use of spirometer (d) Use deep inhalation breathing
Q.31 Expanded from of SARS is : Q.41 Diagnosis of COPD can be firmly made by :
(a) Severe acquired respiratory syndrome (a) Spirometry (b) X – ray chest
(b) Severe acute respiratory syndrome (c) Auscultation (d) Blood tese
(c) Severe acute reproductive syndrome Q.42 Exchange of gases between the blood and
(d) Severe acquired reproductive syndrome lungs is called as
Q.32 Organ affected into SARS : (a) Oxygenation
(a) Lungs (b) Heart (b) External respiration
(c) Liver (d) Brain (c) Internal respiration
Q.33 The most common accurate way to (d) Excretion
determine the need for oxygen in a patient Q.43 Exchange of gases between the blood and
with COPD is by : the cells is known as
(a) Observing the skin colour (a) Oxygenation
(b) Noting changes in the vital signs (b) External respiration
(c) Asking how the patient feels (c) Internal respiration
(d)Blood gas analysis (d) Excretion
Q.34 A diagnosis of pneumonia is typically Q.44 In following which is not an organ of
achieved by which of the following respiratory system
diagnostic tests ? (a) Larynx (b) Pharynx
(a) Arterial blood gas (ABG) analysis (c) Oesophagus (d) Bronchi
(b) Chest X-ray Q.45 What do you mean by sinuses
(c) Blood cultures (a) Space between two bones
(d) Sputum culture and sensitivity (b) Cavities in the bones
Q.35 When a patient is receiving aminophylline, (c) Space between two tissue layers
the nurse should observe for : (d) Space between two lungs
(a) Visual disturbance Q.46 What is the function of conchae in the nasal
(b) Decreased output cavity
(c) Decreased pulse rate (a) They secrete mucus
(d) Hypotension (b) They increase the surface area
Q.36 Which of the following symptoms is (c) They decrease the surface area
common is Asthma ? (d) They have no function
(a) Barking Cough (b) Bradycardia Q.47 In following which is a function of nose in
(c) Dry productive cough human being
(d) Wheezing (a) Filtering the inspired air
Q.37 Asthma is best characterized as : (b) Humadification of inspired air
(a) An inflammatory (c) Sense of smell
(b) A steady progressive disease (d) All
(c) An obstructive disease with loss of Q.48 Length of pharynx in an adult is about
alveolar walls (a) 6-8 cm (b) 12-14 cm
(d) A chronic obstructive disorder (c) 20-25 cm (d) 50 - 54 cm
characterized mucus production Q.49 Opening of the auditory tube found in-
Q.38 COPD stands for : (a) Nasopharynx
(a) Chronic obstructive pulmonary disease (b) Oropharynx
(b) Continuous obstructive pulmonary (c) Laryngophaynx
disease (d) Oesophagus
(c) Chronic operative pulmonary disease Q.50 Which structure is known as voice box
(d) Chronic oesophageal pulmonary disease (a) Pharynx (b) Larynx
Q.39 Why patient of pneumonia advise for (c) Oesophagus
complete bed test : (d) Intercostal muscles
(a) To reduce O2 demand Q.51 Adam's apple is more prominent in
(b) To reduce metabolism (a) Adult male (b) Adult female
(c) To improve O2 consumption (c) Male child (d) Female child
(d) To increase CO2

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 MCQs
Q.52 The most prominant cartilage foundin Q.65 Total number of lobes found in right lung,
larynx is known as are
(a) Thyroid (b) Cricoid (a) Two lobes
(c) Arytenoid (d) Epiglottis (b) Three lobes
Q.53 By which cartilage of larynx, Adam's apple (c) Four lobes
is formed (d) Five lobes
(a) Thyroid (b) Cricoid Q.66 Left lung is divided into
(c) Arytenoid (d) Epiglottis (a) Two lobes
Q.54 The space between the vocal cords isknown (b) Three lobes
as (c) Four lobes
(a) Epiglottis (b) Glottis (d) Five lobes
(c) Adam's apple (d) Vermis Q.67 During breathing which structure prevents
Q.55 The organ which plays an important role in friction between two layers of lungs
production of sound is known as (a) Subarachnoid space
(a) Mouth (b) Larynx (b) Pericardial sac
(c) Pharynx (d) Teeth (c) Pleural cavity
Q.56 Volume of the voice produced by a man (d) Subdural space
depends upon Q.68 In following which layer covers each lobe of
(a) Length of the cords the lung and passes into the fissures that
(b) Tightness of the cords separate lobes
(c) Force with which the cords vibrate (a) Parietal pleura
(d) Shape of the mouth (b) Visceral pleura
Q.57 In following which organ prevents the food (c) Endocardium
from passing into the lower respiratory tract (d) Myocardium
(a) Pharynx (b) Oesophagus Q.69 At which level the trachea is divided into
(c) Epiglottis (d) Larynx bronchi
Q.58 In following which organ is known as a (a) At the level of 5th thoracic vertebra
windpipe (b) At the level of 3rd thoracic vertebra
(a) Larynx (b) Trachea (c) At the level of 4th thoracic vertebra
(c) Lung (d) Bronchi (d) At the level of 5th cervical vertebra
Q.59 Length of trachea is about Q.70 Surfactant is related with
(a) 10-12 cm (b) 25-30 cm (a) Respiration
(c) 40 - 45 cm (d) 2 - 4 cm (b) Digestion
Q.60 In following which structure is found (c) Excertion of urine
posterior to trachea (d) Secretion of pituitary harmone
(a) Larynx (b) Bronchi Q.71 What is the action of surfactant in human
(c) Oesophagus body
(d) Isthmus of the thyroid gland (a) It prevents the alveoli from drying out
Q.61 Which organ is superiorly associated with (b) Reduces surface tension
the trachea (c) During expiration it prevents alveolar
(a) Larynx (b) Bronchi wall from collapsing
(c) Oesophagus (d) All of the above
(d) Isthmus of the thyroid gland Q.72 The main muscles used in respiration, are
Q.62 Number of incomplete rings found in (a) Intercostal muscles
trachea are (b) Diaphragm
(a) 2 - 4 (b)10-12 (c) Biceps and triceps muscles
(c) 16 - 20 (d) 30 – 35 (d) Both A and B
Q.63 What is the shape of cartilage rings found in Q.73 Number of intercostal muscles in human
trachea being are
(a) V - shaped (b) C - shaped (a) 12 pairs
(c) 0 - shaped (d) J - Shaped (b) 7 pairs
Q.64 In following which structure is not found in (c) 11 pairs
mediastinum (d) 10 pairs
(a) Heart Q.74 Intercostal muscles are found
(b) Trachea (a) In between ribs
(c) Lungs (b) In between thoracic vertebra
(d) Oesophagus (c) In between thoracic and cervical vertebra
(d) In front of ribs

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 MCQs
Q.75 The organ which separates the thoracic and Q.84 What is the formula for measuring vital
abdominal cavities is known as capacity
(a) Lung (a) VC = Tidal Volume + Inspiratory
(b) Heart Reserve volume + Expiratory
(c) Diaphragm Reserve Volume
(d) Stomach (b) VC = Tidal Volume + Inspiratory
Q.76 What does happen during relaxation of Capacity + Residual Volume
muslces of diaphragm except (c) VC = Tidal Volume + Inspiratory
(a) Length of thoracic cavity decreases Reserve Volume + Residual
(b) Pressure in thoracic cavity increases Volume
(c) Air is expelled from the lurigs (d) VC = Tidal Volume + Inspiratory
(d) Length of thoracic cavity increases Capacity + Expiratory Capacity
Q.77 Which condition is responsible for Q.85 In normal adult Tidal Volume is about
inspiration (a) 1000 ml (b) 50 ml
(a) Contraction of intercostal muscles (c) 2500 ml (d) 500 ml
(b) Dilatation of intercostal muscles Q.86 Amount of 02 in inspired air is about
(c) Contraction of diaphragm (a) 21% (b) 78%
(d) Both a and c (c) 45% (d) 60%
Q.78 During resting stage, time period of Q.87 Which gas is found in maximum amount in
inspiration is about inspired air
(a) 1 second (a) Oxygen (b) CO,
(b) 2 second (c) Nitrogen (d) Chlorine
(c) 3 second Q.88 Amount of Nitrogen in inspired air is about
(d) 4 second (a) 21% (b) 78%
Q.79 The amount of air passing into and out of (c) 0.04% (d) 2%
the lungs during each cycle of respiration is Q.89 The partial pressure of oxygen in
known as deoxygenated and oxygenated blood
(a) Tidal Volume respectively are
(b) Inspiratory Reserve Volume (a) 40 mm Hg and 100 mm Hg
(c) Inspiratory Capacity (b) 60 mm Hg and 120 mm Hg
(d) Residual Volume (c) 20 mm Hg and 60 mm Hg
Q.80 The extra volume of air that can be inspired (d) 100 mm Hg and 140 mm Hg
during maximal inspiration is known as Q.90 In deoxygenated blood, partial pressure of
(a) Tidal Volume 02 and CO, respectively are
(b) Inspiratory Reserve Volume (a) 40 mm Hg and 80 mm Hg
(c) Inspiratory Capacity (b) 60 mm Hg and 90 mm Hg
(d) Residual Volume (c) 40 mm Hg and 44 mm Hg
Q.81 The amount of air remaining in the air (d) 24 mm Hg and 20 mm Hg
passages and alveoli at the end of quiet Q.91 In following, partial pressure of which gas
expiration is termed as remains constant in both oxygenated and
(a) Expiratory Reserve Volume deoxygenated blood
(b) Residual Volume (a) O2 (b) CO,
(c) Functional Residual Capacity (c) N2 (d) None of above
(d) Vital Capacity Q.92 Exchange of gas between alveoli of lungs
Q.82 The largest volume of air which can be and blood is taken place by
expired from the lungs during maximal (a) Diffusion (b) Osmosis
expiration is termed as (c) Filteration (d) All
(a) Expiratory Reserve Volume Q.93 In the blood most of O2 is carried in
(b) Residual Volume combination with
(c) Functional Residual Capacity (a) Water (b) RBC
(d) Vital Capacity (c) Hb (d) Iron
Q.83 The air remaining in the lungs after forceful Q.94 Priority nursing diagnosis in a patient with
expiration is known as pneumonia will be-
(a) Expiratory Reserve Volume (a) Altered mucous membranes
(b) Residual Volume (b) Impaired gas exchange
(c) Functional Residual Capacity (c) Altered nutrition less than body
(d) Vital Capacity requirement
(d) Activity intolerance

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 MCQs
Q.95 Under normal physiological conditions, the Q.105 Dyspnoea means-
respiratory centre is stimulated by- (a) Absence of breathing
(a) Oxygen (b) Lactic acid (b) Increase respiratory rate
(c) Carbon dioxide (d) Calcium ions (c) Decrease respiratory rate
Q.96 Meaning of Cheyne strokes respiration is- (d) Difficulty in breathing
(a) Periods of tachypnea alternating with Q.106 In following which is lower airway
periods of apnea disorder-
(b) Periods of hyperpnea alternating with (a) Rhinitis (b) Pharyngitis
periods of apnea (c) Asthma (d) Laryngitis
(c) An increase in both rate and depth of Q.107 Smoking cause all except-
respiration (a) Chronic bronchiti,s
(d) Deep, regular and sighing respirations (b) Bronchectasis
Q.97 The most reliable way to assess the (c) Emphysema
respiratory status of a patient is (d) Bronchogenic carcinoma
(a) Observe the chest rising and falling Q.108 Fowler's position facilitates-
(b) Listen and feel the air movement (a) Expansion of lung
(c) Observe the colour of sclera (b) Digestion of food
(d) None of the above (c) Ingestion of food
Q.98 A patient who is experiencing dyspnoea (d) All
should be placed in- Q.109 Asthma is a-
(a) Orthopneic position (a) Neurological disorder
(b) Supine position (b) Cardiovascular disorder
(c) Left lateral position (c) Intestinal disorder
(d) Lithotomy position (d) Respiratory disorder
Q.99 The sensor of pulse oximeter can be applied Q.110 Treatment plan of Asthma includes-
to the all following body parts except one- (a) Maintain patent airway
(a) Earlobe (b) Finger (b) Maintain nutrition
(c) Lip (d) Thumb and toe (c) Maintain proper breathing pattern
Q.100 Most common complication of chronic (d) All of the above
asthma is- Q.111 Which of the following drug is not used in
(a) Atelactasis asthma-
(b) Emphysema (a) Bronchodilators
(c) Pneumothorax (b) Steroids
(d) Pulmonary fibrosis (c) Anticholinergics
Q.101 To facilitate maximum air exchange, a (d) Antacids
patient should be placed in the- Q.112 Aims of medical management of a patient
(a) Supine position with COPD is to-
(b) Orthopneic position (a) Improve ventilation
(c) High-Fowler's position (b) Remove bronchial secretion
(d) Semi-Fowler's position (c) Improve general health
Q.102 Which is the best time to take sputum (d) All
specimen- Q.113 Collapse of lung tissue is termed as-
(a) After awakening in morning (a) Atelactesis
(b) Before bed time (b) Bronchiectesis
(c) After having lunch (c) Trachiobronchitis
(d) In between lunch and dinner (d) Pheumonia
Q.103 Which of the following is the commonest Q.114 Which of the following is not a risk factors
symptom of foreign body in the respiratory for Pneumonia-
passage of a child- (a) Respiratory infections
(a) Vomiting (b) Cough (b) Malnutrition
(c) Wheezing (d) Cyanosis (c) Urinary tract infection
Q.104 Which of the following feature is (d) Prolonged immobility
consistent with longterm COPD- Q.115 Causative organism for Pneumonia is-
(a) Hypoxemia (a) Streptococcus
(b) Hypercapnia (b) Staphylococci
(c) Leukopenia (c) Hemophilds influenzae
(d) All of the above (d) All

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 MCQs
Q.116 Which of the following investigation is Q.127 Exchange of gases takes place in which part
performed for the diagnosis of Pneumonia- of the body?
(a) Blood culture (a) Liver
(b) Chest x-ray (b) Kidney
(c) Sputum culture (c) Lung
(d) All (d) Heart
Q.117 Causative organism of Tuberculosis is- Q.128 The goal of pursed lip breathing exercise is
(a) Streptococci to:
(b) Staphylococci (a) Prevent aspiration pneumonia
(c) Mycobacterium tuberculosis (b) Strengthen the diaphragm
(d) Mycobacterium laprae (c) Loosen the bronchial secretions
Q.118 Mycobacterium Tuberculosis is a- (d) Reduce the amount of trapped air
(a) Virus Q.129 A space called the ____ is found between
(b)- Acid fast bacilli the two pleural cavities:
(c) Acid fast fungi (a) Serosa
(d) Protozoa (b) Parietal
Q.119 DOTs therapy is used for the treatment of- (c) Soleus
(a) Diarrhoea (d) Mediastinum
(b) Leprosy Q.130 Normal tidal volume is …………..
(c) Tuberculosis (a) 500 ml
(d) Polio (b) 750 ml
Q.120 Differential symptom of TB include- (c) 1000 ml
(a) Fever (d) 1500 ml
(b) Hemoptysis Q.131 The most commonest cause of Asthma is
(c) Chills (a) Allergy
(d) Vomitting (b) Microbial infection
Q.121 Mantoux test is used for the diagnosis of- (c) Pulmonary hypertension
(a) Tuberculosis (d) Pneumothorax
(b) Polio Q.132 Which diagnostic test will be ordered to
(c) Diphtheria confirm pneumonia?
(d) Leprosy (a) Arterial blood gas (ABG)
Q.122 In DOTs diagnosis of tuberculosis is made (b) Chest X-ray
on the basis of- (c) Blood cultures
(a) X-ray finding (d) Sputum culture and sensitivity
(b) Sputum examination Q.133 A client has received a preliminary
(c) Both (a) & (b) diagnosis of tuberculosis. What is the
(d) Urine examination definitive diagnostic test to be done
Q.123 Removal of entire lung is known as- (a) Chest X-ray
(a) Lobectomy (b) Mantoux test
(b) Pneumonectomy (c) Sputum culture
(c) Gastrectomy (d) Tuberculin test
(d) Orchiectomy
Q.124 Which of the following respiratory disease
is characterized by periods of reversible
ronchospasm-
(a) Lung abscess (b) Rhinitis
(c) Pharyngitis (d) Asthma
Q.125 Most prominent cause of Lung-cancer is-
(a) Cigarette smoking
(b) Alcoholism
(c) Exposure in sunlight
(d) High fiber diet
Q.126 The best method for assessing respiration in
a non-responsive person is:
(a) Put hand in front of nose
(b) Look listen and feel
(c) Put the hand on the chest
(d) Hear heartbeat

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 MCQs

1 A 21 D 41 A 61 A 81 C 101 B 121 A
2 A 22 C 42 B 62 C 82 A 102 A 122 C
3 D 23 B 43 C 63 B 83 B 103 B 123 B
4 C 24 D 44 C 64 C 84 A 104 D 124 D
5 D 25 D 45 B 65 B 85 D 105 D 125 A
6 B 26 A 46 B 66 B 86 A 106 C 126 B
7 B 27 D 47 D 67 C 87 C 107 B 127 C
8 C 28 A 48 B 68 B 88 B 108 A 128 D
9 B 29 C 49 A 69 A 89 A 109 D 129 D
10 A 30 C 50 B 70 A 90 C 110 D 130 A
11 C 31 B 51 A 71 D 91 C 111 D 131 A
12 B 32 A 52 A 72 D 92 A 112 D 132 D
13 B 33 D 53 A 73 C 93 C 113 A 133 C
14 C 34 D 54 B 74 A 94 B 114 C
15 C 35 C 55 B 75 C 95 C 115 D
16 D 36 D 56 C 76 D 96 B 116 D
17 C 37 A 57 C 77 D 97 B 117 C
18 D 38 A 58 B 78 B 98 A 118 B
19 C 39 A 59 A 79 A 99 C 119 C
20 C 40 B 60 C 80 B 100 B 120 B

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