RT (Egan's) Fundamentals CH. 9

Which of the following muscles are considered primary muscles of ventilation? 1. Diaphragm 2. Intercostals 3. Scalenes 4. Sternomastoid

1 and 2

The pulmonary venous circulation does which of the following? 1. Delivers oxygenated blood back to the heart. 2. Delivers deoxygenated blood to the lungs. 3. Empties into the left atrium. 4. Empties into the right atrium

1 and 3 only

What can the release of histamine and other chemical mediators from the mast cells in the airways cause? 1. Bronchoconstriction 2. Bronchodilation 3. Vasoconstriction 4. Vasodilation

1 and 4 only

How far is the diaphragm pulled down during tidal breathing?

1 to 2 cm

Which of the following statements is/are true of the pulmonary lymphatic system? 1. It consists of both superficial and deep vessels. 2. It drains into the right lymphatic or thoracic duct. 3. Vessels begin as dead-end lymphatic channels in the lung. 4. With phagocytes, it defends against foreign material.

1, 2, 3, and 4

Fluid transport to and from the lungs is provided by which of the following? 1. Bronchial circulation 2. Lymphatic system 3. Pulmonary circulation

1, 2, and 3

The subdivisions of the pharynx include which of the following? 1. Nasopharynx 2. Oropharynx 3. Laryngopharynx

1, 2, and 3

What may happen if the irritant receptors in the lung are stimulated? 1. Bronchoconstriction 2. Reflex closure of the glottis 3. Reflex slowing of the heart (bradycardia)

1, 2, and 3

Which of the following can impair or inhibit ciliary activity? 1. Drying of the respiratory tract mucosa 2. Exposure to smoke 3. Parasympatholytic drugs

1, 2, and 3

Which of the following help(s) comprise the defense system of the nose? 1. Clearance of foreign matter by ciliary action 2. Gross filtration by the large hairs of the nasal vestibule 3. Impaction of particulate foreign matter on the nasal mucosa 4. Laminar flow through the concha

1, 2, and 3 only

Which of the following are the primary functions of the nasal cavity? 1. Conduction of gases 2. Filtration and defense 3. Gas exchange 4. Heat and humidify

1, 2, and 4 only

Which of the following has/have been shown to injure the alveolar-capillary membrane? 1. Excessive pressures 2. Excessive tidal volumes 3. Increased intracranial pressures 4. Pulmonary hypertension

1, 2, and 4 only

Which has been shown to injure the alveolar-capillary membrane?

1. Excessive pressures, 2. Excessive tidal volume and 4. Pulmonary hypertension

Approximately how long is the trachea of an adult?

10 to 12 cm

What intercommunicating channels permit collateral venitlation between adjacent alveoli and primary lobules? 1. Bronchial anastomoses 2. Canals of Lambert 3. Pores of Kohn 4. Terminal bronchioles

2 and 3

What intercommunicating channels permit collateral ventilation between adjacent alveoli and primary lobules? 1. Bronchial anastomoses 2. Canals of Lambert 3. Pores of Kohn 4. Terminal bronchioles

2 and 3

The pulmonary arterial circulation does which of the following? 1. Delivers oxygenated blood back to the heart. 2. Delivers deoxygenated blood to the lungs. 3. Originates on the left side of the heart. 4. Originates on the right side of the heart.

2 and 4 only

Approximately how far do the normal adult lungs extend above the clavicles?

2 cm

Identify functions of airway mucus in the normal lung. 1. Increased mucus production decreases bronchospasm. 2. Protect the airways from excessive water loss. 3. Shield the airway from toxic particles. 4. Trap inhaled contaminants.

2, 3, and 4 only

Approximately what percent of the normal changes in thoracic volume during quiet inspiration is due to the action of the diaphragm?

75%

Limited, short-term spontaneous ventilation is possible in a patient with a paralyzed diaphragm because of:

Accessory muscle use

What pulmonary disorder could lead to acute flattening of the diaphragm?

Asthma

Where does the sternal angle lie?

At the join between the manubrium and sternal body

What determines the airway diameter in the normal lung?

Balance between sympathetic and parasympathetic tone

What is the major source of respiratory tract secretions in the normal lung?

Bronchial glands

Via what pathway does much of the bronchial venous drainage occur?

Bronchopulmonary veins emptying into pulmonary veins

At what point does the trachea branch into two main stem bronchi?

Carina

Compared to a normal diaphragm, contraction of a diaphragm that is low and flat may result in which of the following?

Compression of the thoracic cavity

What is the common name given to classify the airway from the nares to the terminal bronchioles?

Conducting airways

What is the primary purpose of the respiratory system?

Continuous absorption of oxygen (O2) and excretion of carbon dioxide

The abdominal muscles can actually contribute to inspiration by:

Contracting at end-exhalation.

The intercostal arteries, veins, and nerves run through which of the following?

Costal groove on the bottom of each rib

What is the name given to the acute angle formed by the costal pleura joining the diaphragmatic pleura?

Costophrenic angle

What is the only complete circular cartilage of the larynx?

Cricoid

What external landmark can be used to show the highest point the dome of the right hemidiaphragm reaches in a healthy individual?

Eighth rib posteriorly

What is the leaf-shaped cartilage that extends from the base of the tongue and is attached by ligaments to the thyroid cartilage?

Epiglottis

What forces establish the sub-atmospheric pressure found in the pleural space?

Equal opposing tendency of the chest wall to expand and lung to collapse

What will most commonly blunt the costophrenic angle as seen on chest radiograph in an upright individual?

Excess fluids

What is meant by "internal respiration"?

Exchange of gases between the blood and the tissue

What is your primary concern if you discover that a patient does not have a gag reflex?

Fear of aspiration of bacteria or food

Which of the following describes a function of pulmonary circulation?

Filtering of blood clots

How does the lung parenchyma receive most of its O2?

From the alveolar gases

What is the space that separates the true vocal cords?

Glottis

What is the name of the reflex associated with the sensory stimulation of the pulmonary stretch receptors that stimulates a deeper breath upon inspiration?

Head's paradoxical

What is the name of the negative feedback reflex associated with the termination of inspiration?

Hering-Breuer

What does the "pump handle" movement of rib pairs 2 through 7 achieve?

Increase in the anteroposterior diameter of the chest

How does the body compensate for a pulmonary embolus that occludes a branch of the pulmonary artery?

Increased bronchial arterial flow to the area

The upper respiratory tract traditionally ends at what point?

Inferior border of the larynx

Why is pulmonary surfactant such an important biologic substance?

It promotes lung stability

What is unique regarding the blood supply to the lung?

It receives blood from right and left ventricles

Compared with the systemic circulation under normal conditions, pressure in the pulmonary circulation is:

Lower

Pressures in the pulmonary circulation are lower than those in the systemic circulation because of what characteristic of the pulmonary circulation?

Lower resistance than the systemic circulation

What is the name of the upper portion of the sternum?

Manubrium

Why is the left lung narrower than the right lung?

Mediastinal organs push laterally into the left hemithorax.

To what structures do the parietal pleural membranes adhere?

Mediastium

Running vertically down each hemithorax anteriorly is an imaginary line that is used as an anatomical landmark. What is that line called?

Midclavicular line

What is the name given to the action produced by the forward stroking of millions of cilia?

Mucociliary escalator

Into what structure do the eustachian tubes drain?

Nasopharynx

What is the name of the thin serous membrane that covers the inner layer of the thoracic wall?

Parietal pleura

When a COPD patient leans forward braced in a tripod position, this lends particular advantage to which accessory muscles of inspiration?

Pectoralis

Which of the following nerves innervates the diaphragm?

Phrenic

What is the primary function of the larynx?

Protect airway during eating or drinking

What is the function of the thorax?

Protect the vital organs

How does the lung respond to regional lung hypoxia?

Pulmonary artery vasoconstriction

How would lung perfusion in a "zone 1" area best be described?

Reduced

What is the function of the very small amount of pleural fluid that is found in the pleural space?

Reduces friction

What results in partial or total obstruction of the airway in an unconscious patient?

Relaxation of tongue and hypopharyngeal muscles

By what mechanism does gas exchange across the lung occur?

Simple diffusion

What position is used to open the airway in an unconscious patient?

Sniff position

The nerves that innervate the diaphragm arise from which area?

Spinal nerves C3 to C5

What is the name of the external landmark that identifies the point at which the trachea branches into the right and left main stem bronchi?

Sternal angle

What is the mediastinum?

Structure separating the right and left thoracic cavities

What does the detection of lymphatic channels on standard chest radiographs indicate?

System that is overwhelmed by excessive fluid

What will happen when the lung is surgically removed from the thorax?

The lung will collapse

Why do most aspirated objects and fluids end up in the right main stem bronchus instead of the left main stem bronchus?

The right bronchus is more in-line with the trachea

Which of the following statements describes a normal adult lung?

The right lung has three lobes and two fissures

What is the primary mechanism that stops the lungs from collapsing at the end of exhalation?

There is an equal opposing tendency of the chest wall to expand

What is the cartilage that is commonly referred to as the Adam's apple?

Thyroid

What are the three bony projections that arise from the lateral walls of the nasal cavity that enhance filtration and humidification?

Turbinates

What type of alveolar cells cover over 90% of the surface area of the alveolar-capillary membrane?

Type II cells

Which type of lung cells secretes pulmonary surfactant?

Type II pneumocytes

Three-folds of tissue between the posterior base of the tongue and the epiglottis form a small space that is a key landmark in oral intubation. What is this called?

Vallecula