Chapter 1 The Anatomy and Physiology of the Respiratory System

TEST BANK FOR CARDIOPULMONARY ANATOMY AND PHYSIOLOGY ESSENTIALS OF RESPIRATORY CARE 7TH EDITION BY DES JARDINS Chapter 01: The Anatomy and Physiology of the Respitory System 1. Which of the following are primary components of the upper airway? a. nose, oral cavity, pharynx b. larynx, trachea, and bronchi c. nose, oral cavity, larynx and trachea d. nose, oral cavity, pharynx, larynx, and trachea ANSWER: a 2. Which of the following is NOT a primary function of the nose? a. humidfy inspired gas b. conduct gas and food to lower airway c. filter the inspired gas d. warm the inspired gas ANSWER: b 3. Which of the following are functions of the upper airway? I. Conduction of gas to lower airway II. Prevent foreign materials from entering lower airway III. Warm, filter, and humidify inspired gas IV. Aid in speech and smell a. I, II, III, and IV b. I, III, and IV only c. I, II, and III only d. I, II, and IV only ANSWER: a 4. Which structures form the upper third of the nose? I. Nasal bones II. Frontal process of maxilla III. Lateral nasal cartilage IV. Greater alar cartilage a. Nasal bones b. Frontal process of maxilla c. Lateral nasal cartilage d. Greater alar cartilage ANSWER: b Name: Class: Date: Chapter 01: The Anatomy and Physiology of the Respitory System 5. Which structure form the lower two-thirds of the nose? I. Lateral nasal cartilage II. Lesser and greater alar cartilages III. Septal cartilage IV. Fibrous fatty tissue a. Lateral nasal cartilage b. Lesser and greater alar cartilages c. Septal cartilage d. Fibrous fatty tissue ANSWER: c 6. What is the term for widening of the nostrils that can occur during respiratory distress? a. grunting b. retractions c. alar collapse d. nasal flaring ANSWER: d 7. Which of the following structures form the anterior nasal septum? I. Septal cartilage II. Vomer III. Perpendicular plate of ethmoid bone IV. Frontal process of maxilla a. Septal cartilage b. Vomer c. Perpendicular plate of ethmoid bone d. Frontal process of maxilla ANSWER: a 8. The lymphatic channels are larger and more numerous in what location? a. upper lobes b. right lower lobe c. left lower lobe d. middle lobes ANSWER: b Name: Class: Date: Chapter 01: The Anatomy and Physiology of the Respitory System 9. What is the term for the openings created by the alae nasi and septal cartilage? a. nares b. glottis c. vestibule d. choana ANSWER: a 10. What type of epithelium lines the anterior third of the nasal cavity? a. cuboidal b. pseudostratified ciliated columnar c. stratified squamous d. pseudostratified ciliated squamous ANSWER: c 11. In which structure would vibrissae normally be found? a. oropharynx b. laryngopharynx c. nasal cavity d. trachea ANSWER: c 12. What is the submucosal layer of the tracheobronchial tree? a. lamina propria b. cartilaginous layer c. epithelial lining d. mucous blanket ANSWER: a 13. What is another term for conchae? a. alae b. choana c. vestibule d. turbinates ANSWER: d Name: Class: Date: Chapter 01: The Anatomy and Physiology of the Respitory System 14. Where is the olfactory region located in the nasal cavity? a. choana b. vestibule c. superior and middle turbinates d. middle and inferior turbinates ANSWER: c 15. Which of the following sinuses are considered to be paranasal sinuses? I. Maxillary II. Frontal III. Ethmoid IV. Sphenoid a. Maxillary b. Frontal c. Ethmoid d. Sphenoid ANSWER: a 16. What effect, if any, would be expected from the topical application of phenylephrine on the nasal mucosa? a. vasoconstriction b. vasodilation c. no known effect d. bronchospasm ANSWER: a 17. Among pediatric patients, in which age range is epistaxis most prevalent? a. 10-14 years b. 2-10 years c. 8-16 years d. newborn -2 years ANSWER: b 18. Approximately what portion of the sense of taste is reliant upon the sense of smell? a. 60% b. 80% c. 40% d. 20% ANSWER: b Name: Class: Date: Chapter 01: The Anatomy and Physiology of the Respitory System 19. Which of the following can cause sinusitis? I. Upper respiratory infection II. Dental infection III. Air travel IV. Scuba diving a. Upper respiratory infection b. Dental infection c. Air travel d. Scuba diving ANSWER: b 20. In the oral cavity, what is the term for the space between the teeth and lips? a. vibrissae b. ventricle c. vallecula d. vestibule ANSWER: d 21. What is the name of the structure that secures the tongue to the floor of the mouth? a. uvula b. extrinsic lingual muscles c. instrinsic lingual muscles d. lingual frenulum ANSWER: d 22. How many ribs are identified as true ribs, attached directly to the sternum? a. seven b. eight c. four d. six ANSWER: a 23. To what structure is the uvula attached? a. hard palate b. palatopharyngeal arch c. palatoglossal arch d. soft palate ANSWER: d Name: Class: Date: Chapter 01: The Anatomy and Physiology of the Respitory System 24. What is another name for the palatine tonsils? a. adenoids b. faucial c. lingual d. pharyngeal ANSWER: b 25. Which structure extends from the posterior nares to the superior portion of the soft palate? a. oropharynx b. palatine tonsils c. nasopharynx d. tongue ANSWER: c 26. Which epithelium is present in the nasopharynx? a. pseudostratified squamous b. stratified squamous c. cuboidal d. pseudostratified ciliated columnar ANSWER: d 27. What is another name for pharyngeal tonsils? a. palatine tonsils b. lingual tonsils c. faucial tonsils d. adenoids ANSWER: d 28. What is another name for the pharyngotympanic tubes? a. adenoids b. conchae c. auditory d. faucial ANSWER: c Name: Class: Date: Chapter 01: The Anatomy and Physiology of the Respitory System 29. What is the most frequent cause of hearing loss in young children? a. tonsillitis b. pharyngitis c. sinusitis d. otitis media ANSWER: d 30. Which structure extends from the soft palate to the base of the tongue? a. nasopharynx b. oropharynx c. uvula d. laryngopharynx ANSWER: b 31. What type of epithelium is found in the oropharynx? a. stratified squamous b. pseudostratified squamous c. pseudostratified ciliated columnar d. cuboidal ANSWER: a 32. What structure is located between the glossoepiglottic folds in the posterior oropharynx? a. vallecula epiglottica b. lingual tonsils c. rima glottidis d. palatine tonsils ANSWER: a 33. What spoon-shaped fibrocartilaginous structure covers the opening of the larynx during swallowing? a. vocal folds b. base of the tongue c. vallecula d. epiglottis ANSWER: d Name: Class: Date: Chapter 01: The Anatomy and Physiology of the Respitory System 34. What is a common site for misplacement of endotracheal tubes during emergency intubation? a. stomach b. left mainstem bronchus c. esophagus d. left upper lobar bronchus ANSWER: c 35. Which structure extends from the base of the tongue to the upper end of the trachea? a. laryngopharynx b. thyroid gland c. larynx d. rima glottidis ANSWER: c 36. Which of the following are functions of the larynx? I. Passageway for gas II. Protects against aspiration III. Generation of sounds for speech IV.Warming and filtration of inspired gas a. Passageway for gas b. Protects against aspiration c. Generation of sounds for speech d. Warming and filtration of inspired gas ANSWER: b 37. Which of the cartilages of the larynx are unpaired? a. thyroid, epiglottis, and arytenoid b. artyenoid, cuneiform, and corniculate c. thyroid, cricoid, and cuneiform d. thyroid, epiglottis, and cricoid ANSWER: d 38. To what structure does the upper portion of the thyroid cartilage attach by a membrane? a. mandible b. hyoid bone c. epiglottis d. tongue ANSWER: b Name: Class: Date: Chapter 01: The Anatomy and Physiology of the Respitory System 39. Which laryngeal cartilage is primarily responsible for preventing food, liquids, and foreign bodies from entering the lower airways? a. cricoid b. epiglottis c. thyroid d. corniculate ANSWER: b 40. Which laryngeal cartilage is shaped like a signet ring and forms a large portion of the posterior laryngeal wall? a. epiglottis b. cricoid c. cuneiform d. corniculate ANSWER: b 41. Which of the laryngeal cartilages are single? I. Cuneiform II. Thyroid III. Epiglottis IV. Cricoid a. Cuneiform b. Thyroid c. Epiglottis d. Cricoid ANSWER: b 42. What is the space between the true vocal cords called? a. vallecula b. vestibule c. rima glottidis d. choana ANSWER: c 43. What is not a common cause of posterior nosebleeds? a. nasal tumors b. serious nose trauma c. high altitude d. drug abuse ANSWER: c Name: Class: Date: Chapter 01: The Anatomy and Physiology of the Respitory System 44. Which of the following is a subglottic airway obstruction usually caused by the parainfluenza virus? a. pharyngitis b. laryngotracheobronchitis (LTB) c. epiglottitis d. tonsillitis ANSWER: b 45. What is causative agent in the majority of cases of acute epiglottitis? a. Streptococcus b. MRSA c. Parainfluenza virus d. Haemophilus influenzae type B ANSWER: d 46. Which type of epithelium is present in the larynx above the vocal cords? a. pseudostratified squamous b. stratified squamous c. cuboidal d. pseudostratified ciliated columnar ANSWER: b 47. Which laryngeal muscles are primarily responsible for adduction of the vocal cords? a. transverse arytenoid b. lateral cricoarytenoid c. posterior cricoarytenoid d. thyroarytenoid ANSWER: b 48. Which of the following muscles pull the larynx and hyoid downward? a. suprahyoid group b. cricothyroid muscles c. posterior cricoarytenoid muscles d. infrahyoid group ANSWER: d Name: Class: Date: Chapter 01: The Anatomy and Physiology of the Respitory System 49. What is the secondary vital function of the larynx? a. Gag reflex b. Babinski reflex c. Valsalva’s maneuver d. Moro maneuver ANSWER: c 50. What type of epithelium extends from the trachea to the respiratory bronchioles? a. stratified squamous b. pseudostratified squamous c. cuboidal d. pseudostratified ciliates columnar ANSWER: d 51. What is the primary component of the mucous blanket in the tracheobronchial tree? a. glycoproteins b. water c. lipids d. DNA ANSWER: b 52. At what level in the tracheobronchial tree are cilia completely absent? a. respiratory bronchioles b. bronchioles c. lobar bronchi d. mainstem bronchi ANSWER: a 53. Which cranial nerve innervates the submucosal glands? a. tenth b. ninth c. seventh d. eighth ANSWER: a Name: Class: Date: Chapter 01: The Anatomy and Physiology of the Respitory System 54. What is the term for the viscous layer of the mucous blanket? a. gel b. epoxic c. basal d. sol ANSWER: a 55. How many times per minute do the cilia in the tracheobronchial tree move? a. 1500 times b. 2500 times c. 500 times d. 50 times ANSWER: a 56. When excessive secretions are present in the lungs, what term describes the sound heard by ascultation over large airways during exhalation? a. crackles b. stridor c. rhonchi d. wheeze ANSWER: c 57. Which of the following factors can alter the mucociliary transport mechanism? I. Excessive bronchial secretions II. Tobacco smoke III. Hypoxia IV. Air pollution a. Excessive bronchial secretions b. Tobacco smoke c. Hypoxia d. Air pollution ANSWER: b Name: Class: Date: Chapter 01: The Anatomy and Physiology of the Respitory System 58. Where are mast cells located in the tracheobronchial tree? I. Lamina propria II. Intra-alveolar septa III. Sub-mucosal glands a. Lamina propria b. Intra-alveolar septa c. Sub-mucosal glands d. ANSWER: a 59. Approximately how many IgE receptor sites are present on a single mast cell? a. 1,000 - 5,000 b. 1,000,000 - 5,000,000 c. 100 - 500 d. 100,000 - 500,000 ANSWER: d 60. When degranulation of mast cells occurs and chemical mediators are released, which of the following would occur in the lungs? I. Increased vascular permeability II. Increased mucus production III. Smooth muscle relaxation IV. Vasodilation with edema a. Increased vascular permeability b. Increased mucus production c. Smooth muscle relaxation d. Vasodilation with edema ANSWER: a 61. What is the term for the cartilaginous airways? a. respiratory unit b. acinus c. conducting zone d. tracheobronchial tree ANSWER: c Name: Class: Date: Chapter 01: The Anatomy and Physiology of the Respitory System 62. In cm, what is the average diameter of the adult trachea? a. 0.5 - 1.5 cm b. 2.0-3.5 cm c. 0.75 - 1.0 cm d. 1.5 - 2.5 cm ANSWER: d 63. What is the term for the bifurcation of the trachea? a. hilum b. carina c. concha d. choana ANSWER: b 64. In an adult, at what angle does the left mainstem bronchus branch from the trachea? a. 40-60 degrees b. 10-15 degrees c. 60-75 degrees d. 25-40 degrees ANSWER: a 65. What is the recommended “safe range” for endotracheal tube cuff pressures? a. 30-35 mm Hg b. 45-50 mm Hg c. 20-25 mm Hg d. 35-40 mm Hg ANSWER: c 66. Which vessel is the most commonly associated with massive hemorrhage following a tracheostomy? a. pulmonary artery b. subclavian artery c. carotid artery d. innominate artery ANSWER: d Name: Class: Date: Chapter 01: The Anatomy and Physiology of the Respitory System 67. In the newborn, at what angles do the right and left mainstem bronchi form with the trachea? a. both form a 55 degree angle b. right forms a 60 degree angle, left forms a 25 degree angle c. right forms a 25 degree angle, left forms a 60 degree angle d. both form a 40 degree angle ANSWER: a 68. In an adult, into which structure would an endotracheal tube likely enter if the tube is inadvertently advanced too far? a. left lower lobar bronchus b. left mainstem bronchus c. right mainstem bronchus d. right middle lobar bronchus ANSWER: c 69. How many second generation bronchi would you find in a healthy adult tracheobronchial tree? a. 3 b. 2 c. 6 d. 5 ANSWER: d 70. How many segmental bronchi are found in each of the lungs? a. each lung has 8 b. 8 in right lung, 10 in left lung c. 10 in right lung, 8 in left lung d. each lung has 10 ANSWER: c 71. What is another term for primary lobule? I. Acinus II. Functional units III. Terminal respiratory unit IV. Lung parenchyma a. Acinus b. Functional units c. Terminal respiratory unit d. Lung parenchyma ANSWER: b Name: Class: Date: Chapter 01: The Anatomy and Physiology of the Respitory System 72. At which airway generation do Canals of Lambert appear? a. 12-15 b. 16 - 19 c. 6-9 d. 20-26 ANSWER: b 73. At what point in the tracheobronchial tree are Clara cells present? a. bronchioles b. respiratory bronchioles c. subsegmental bronchi d. terminal bronchioles ANSWER: d 74. How does the total cross-sectional area of the tracheobrochial tree change from the trachea to the respiratory zone? a. It increases steadily to the terminal bronchioles then increases significantly in the respiratory zone b. It decreases slightly to the terminal bronchioles then decreases significantly c. It remains steady throughout the tracheobronchial tree d. It increases steadily through the lobar bronchi then increases significantly through the remaining airway generations ANSWER: a 75. Which structures are nourished by the bronchial arteries? a. trache through the terminal bronchioles b. respiratory zone c. noncartilaginous airways only d. trachea and mainstem bronchi only ANSWER: a 76. In the adult male, approximately how many alveoli are present in the lungs? a. 180 million b. 300 million c. 600 million d. 130 million ANSWER: b 77. What type of epithelium composes 95% of the alveolar surface? a. Type IV (pseudostratified squamous) b. Type I (squamous pneumocyte) c. Type II (cuboidal) d. Type III (macrophages) ANSWER: b Name: Class: Date: Chapter 01: The Anatomy and Physiology of the Respitory System 78. In the lungs of a healthy young adult male, what is the average surface area available for gas exchange? a. 50 square meters b. 100 square meters c. 300 square meters d. 70 square meters ANSWER: d 79. Which alveolar cells are considered to be the source of pulmonary surfactant? a. Type I b. Type II c. Type III d. Type IV ANSWER: b 80. What is the term for the openings in the walls of interalveolar septa? a. Loose space b. Clara cells c. Canals of Lambert d. Pores of Kohn ANSWER: d 81. What is the average thickness of the Type I alveolar cell? a. 1-5 mm b. 0.1-0.5 mm c. 1-5 microns d. 0.1-0.5 microns ANSWER: d 82. Which alveolar cells are macrophages? a. Type IV b. Type III c. Type I d. Type II ANSWER: b 83. In which portion of the primary lobule does the majority of gas exchange occur? a. Type II pneumocyte b. loose space of intestitium c. Pores of Kohn d. tight space of interstitium ANSWER: d 84. Which is not a wall layer for pulmonary arteries? a. tunica intima b. tunica externicus c. tunica adventitia d. tunica media ANSWER: b 85. What type of epithelium is present in the pulmonary capillaries? a. cuboidal b. pseudostratified columnar c. squamous d. pseudostratified squamous ANSWER: c Name: Class: Date: Chapter 01: The Anatomy and Physiology of the Respitory System 86. How many pulmonary veins empty into the left atrium? a. 8 b. 4 c. 2 d. 0 ANSWER: b 87. From what area deep in the lungs do lymphatic vessels arise? a. Type II alveolar cells b. tight space of interstitium c. Type III alveolar cells d. loose space of interstitium ANSWER: d 88. On which portion(s) of the right lung surfaces would the majority of lymphatic vessels be located? a. upper lobes b. Lymphatic vessels are distributed equally on all lobes c. middle lobe d. lower lobes ANSWER: d 89. What is the term for the vessels adjacent to peribronchovascular lymphatic vessels? a. tertiary lymphatics b. cardinal lymphatics c. Type IV lymphatics d. juxta-alveolar lymphatics ANSWER: d 90. What effect does stimulation of the beta 2 receptors have on the pulmonary system? a. bronchdilation b. vasoconstriction c. vasodilation d. bronchoconstriction ANSWER: a 91. Which neurotransmitter is released when the parasympathetic system is activated? a. prostaglandin b. epinephrine c. norepinephrine d. norepinephrine ANSWER: d 92. What is the general term for drugs that block the effects of the parasymphathetic nervous system on the bronchial smooth muscle? a. anticholinergic b. parasympathomimetic c. sympathomimetic d. beta adrenergic ANSWER: a Name: Class: Date: Chapter 01: The Anatomy and Physiology of the Respitory System 93. What effect does stimulation of the sympathetic nervous system have on the body? I. Dilates the pupils II. Causes bronchodilation III. Increases rate and force of cardiac contractions a. Dilates the pupils b. Causes bronchodilation c. Increases rate and force of cardiac contractions d. ANSWER: a 94. When an acute asthma episode occurs, which quick relief agent is most commonly administered? a. formoterol b. arformoterol c. albuterol d. salmeterol ANSWER: c 95. In the healthy adult, what are the normal anterior boundaries of the lungs? a. Between first and eigth ribs b. Between the second and eleventh ribs c. Between first and sixth ribs d. Between the second and ninth ribs ANSWER: c 96. What is the term for the uppermost portion of the upright lung? a. hilum b. lingula c. apex d. base ANSWER: c 97. How many bronchopulmonary segments are located in the lower lobe of the right lung? a. 4 b. 5 c. 2 d. 3 ANSWER: c 98. What is the term for the therapeutic positional measures which utilize gravity to assist in secretion removal from the lungs? a. chest wall oscillation b. percussion c. postural drainage d. vibration ANSWER: c Name: Class: Date: Chapter 01: The Anatomy and Physiology of the Respitory System 99. Which structures are contained in the mediastinum? I. Trachea II. Great vessels III. Portions of the esophagus IV. Pituitary gland a. Trachea b. Great vessels c. Portions of the esophagus d. Pituitary gland ANSWER: d 100. What is the term for the potential space between the visceral and parietal pleura? a. pericardial cavity b. thoracic cavity c. pleural cavity d. mediatinum ANSWER: c 101. What is the superior portion of the sternum called? a. manubrium sterni b. body c. maxilla sterni d. xiphoid process ANSWER: a 102. What is the term for inflammation of the pleural membranes? a. pleurisy b. empyema c. pneumothorax d. pleural effusion ANSWER: a 103. What is the term for the abnormal collection of fluid in the pleural cavity? a. empyema b. hemothorax c. pneumothorax d. pleural effusion ANSWER: d 104. In a pneumothorax, where does the abnormal collection of air accumulate? a. pleural cavity b. mediastinum c. thoracic cavity d. pericardium ANSWER: a 105. What is one of the most common iatrogenic complications from a thoracentesis? a. pleural effusion b. empyema c. pneumothorax d. hemorrhage ANSWER: c Name: Class: Date: Chapter 01: The Anatomy and Physiology of the Respitory System 106. Which two muscles come together at the central tendon? a. sternum b. trapezius c. external intercostals d. hemidiaphragm ANSWER: d 107. Which nerves supply the primary motor innervation to the right and left hemidiaphragms? a. vagus b. phrenic c. Thoracic nerves 1-3 d. IX cranial ANSWER: b 108. Which structure moves in a “pump handle-like motion” during inspiration? a. diaphragm b. sternum c. external intercostals d. internal intercostals ANSWER: b 109. Which of the following are scalene muscles? I. Anterior II. Exterior III. Medial IV. Posterior a. Anterior b. Exterior c. Medial d. Posterior ANSWER: d 110. Which of the following are accessory muscles of expiration? I. Rectus abdominis II. Transverse abdominis III. Internal intercostals IV. Pectoralis major a. Rectus abdominis b. Transverse abdominis c. Internal intercostals d. Pectoralis major ANSWER: d