Deck 1: The Airways and Alveoli

Question 1

Which of the following are the main functions of the nose?
I.Humidification
II.Heating
III.Filtering
IV.Immunity

A) I, II
B) III, IV
C) I, II, III
D) I, II, III, IV

Answer 1

I, II, III

Question 2

Which of the following pairs of reflexes is 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

Answer 2

Laryngeal and pharyngeal

Question 3

Routine evaluation of the ventilator circuit on a patient in the ICU reveals that there are no water droplets condensed on the inner surface of the ventilator's inspiratory tube and that secretions in the endotracheal tube are thick and difficult to remove when suction is applied.The best therapy to resolve this situation is:

A) Supply artificial heat and humidity
B) Extubate the patient
C) Increase water intake to the patient
D) Change the ventilator circuit

Answer 3

Supply artificial heat and humidity

Question 4

What is the most efficacious treatment for patients with obstructive sleep apnea?

A) Tongue resection
B) CPAP
C) Cervical collar
D) Sleep induction medicine

Question 5

A 15-year-old patient is brought to the emergency room with severe respiratory distress after aspirating a coin.Which of the following signs is the most suggestive of complete airway obstruction?

A) Low-pitched snoring sound
B) Inspiratory effort without sound or air movement
C) Increased work of breathing
D) Suprasternal retractions

Question 6

What size particles do not gain entry to the lower airways due to the filtering capacity of the nose?

A) >2 mm
B) >3 mm
C) >4 mm
D) >5 mm

Question 7

After a tracheal tube is in place, which action will form a seal between the tracheal wall and tube to minimize aspiration of pharyngeal contents?

A) The tip of the tube is placed against the carina.
B) The tip of the tube is wedged into the right mainstem bronchus.
C) The cuff is inflated.
D) No action is required.

Question 8

Which of the following structures is responsible for substantially increasing the surface area of the nasal cavity?

A) Nasal septum
B) Nares
C) Turbinates
D) Nasal fossae

Question 9

Individuals with obstructive sleep apnea typically have which of the following characteristics?
I.Snoring
II.Obesity
III.Narrow neck
IV.Daytime sleepiness

A) I, II, III, IV
B) I, II, III
C) I, II, IV
D) I, III, IV

Question 10

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

Question 11

In cases when an emergency airway opening is required, where should the incision be made?

A) Cricothyroid membrane
B) 1 to 3 cm below the cricoid cartilage
C) Carina
D) Corniculate cartilage

Question 12

In a deeply unconscious patient, what is the most common threat to upper airway patency?

A) Cervical spine movement
B) Bulbar paralysis
C) Neural compromise
D) Soft tissue obstruction

Question 13

What type of epithelium covers the posterior two-thirds of the nasal mucosa?

A) Squamous
B) Squamous, nonciliated
C) Pseudostratified, ciliated columnar
D) Pseudostratified, ciliated columnar with mucus-secreting glands

Question 14

Even if the endotracheal cuff is properly inflated, pharyngeal secretions will eventually migrate past the cuff into the lower airway.This event could make mechanically ventilated patients susceptible to the development of which of the following disorders?

A) Asthma
B) Ventilator-associated pneumonia
C) Bronchitis
D) Tracheitis

Question 15

Inflammation of which of the following anatomic structures is considered a life-threatening condition?

A) Vocal cords
B) Cricoid ring
C) Vallecula
D) Epiglottis

Question 16

What is the narrowest portion of the airway in the infant?

A) Vocal cords
B) Cricoid ring
C) Vallecula
D) Epiglottis

Question 17

When an endotracheal tube is introduced to a patient requiring mechanical ventilation, which of the following functions of the nose is lost?

A) Air-conditioning
B) Antibacterial
C) Antiinflammatory
D) Bactericidal

Question 18

What are considered the goals of humidification in mechanical ventilation regarding temperature and relative humidity (RH)?

A) 35°C to 37°C and 100% RH
B) 35°C to 37°C and 80% RH
C) 32°C to 34°C and 80% RH
D) 32°C to 34°C and 100% RH

Question 19

Which of the following maneuvers best describes the sniffing position?

A) Extending neck and extending jaw
B) Extending neck and applying pressure on the forehead
C) Extending neck and pulling chin
D) Pulling chin and flexing neck

Question 20

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

Question 21

Which of the following conditions are associated with neutrophilic infiltration of the airways?
I.Cystic fibrosis
II.COPD
III.Bronchiectasis
IV.Asthma

A) I, II, IV
B) I, II, III
C) II, III
D) I, II, III, IV

Question 22

Which of the following is the term that describes a volume of gas that is approximately 150 mL in the average adult and does not participate in gas exchange?

A) Tidal volume
B) Residual volume
C) Anatomical dead space
D) Shunt

Question 23

In the presence of high inspired oxygen concentrations, which substances are believed to produce alveolar injury?

A) Antitrypsins
B) Oxygen radicals
C) Surfactants
D) Fibrinogens

Question 24

If during normal breathing, inspired air reaches only 50% relative humidity at 37°C, what will be the humidity deficit as air passes through the trachea?

A) 11 mg of water vapor
B) 22 mg of water vapor
C) 33 mg of water vapor
D) 44 mg of water vapor

Question 25

Which group contains cells that engulf microorganisms and foreign material in the alveolus?

A) Type I
B) Type II
C) Type III
D) Macrophages

Question 26

If an endotracheal tube is inserted too far in the process of intubation, listening to the lungs will reveal:

A) Diminished breath sounds on the right side
B) Diminished breath sounds on the left side
C) Diminished breath sounds on both sides
D) No changes in breath sounds

Question 27

What sound is associated with high-velocity air flowing through a narrowed glottis?

A) Crackle
B) Stridor
C) Grunting
D) Wheeze

Question 28

Which of the following mechanisms explains why drowning victims often have little water in their lungs?

A) Bronchospasm
B) Vasospasm
C) Laryngospasm
D) Glossospasm

Question 29

A lateral soft tissue x-ray of the neck of a 5-year-old with respiratory distress reveals the classic "thumb sign." What is the most probable diagnosis?

A) Croup
B) Epiglottitis
C) Laryngitis
D) Asthma

Question 30

Which group of cells accounts for most of the alveolar surface?

A) Type I
B) Type II
C) Type III
D) Macrophages

Question 31

Which group of cells contains the lamellar bodies?

A) Type I
B) Type II
C) Type III
D) Macrophages

Question 32

If the delicate balance between mucus water content and airway humidity is affected, which of the following will occur to the mucus sheet?
I.It may become dehydrated.
II.It may become thick.
III.It may become immobile.
IV.It may become infected.

A) II, IV
B) I, II, III
C) II, III
D) I, II, III, IV

Question 33

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) III, IV

Question 34

What is the narrowest space of the airway that an endotracheal tube will go through in the adult larynx?

A) Epiglottis
B) Cricoid ring
C) Vallecula
D) Glottis