Deck 8: The Respiratory System

Question 1

The human genome contains _____ pairs of chromosomes.

A)16
B)23
C)46
D)50

Answer 1

B

Question 2

By which of the following routes does blood flow through the umbilical cord between the placenta and the fetus?

A)one umbilical vein and one umbilical artery
B)one umbilical vein and two umbilical arteries
C)two umbilical veins and one umbilical artery
D)two umbilical veins and two umbilical arteries

Answer 2

B

Question 3

Abnormalities of the placenta that can cause intrauterine growth retardation or fetal asphyxia include which of the following?
I)abnormal implantation of the placenta
II)separation of the placenta from the uterine wall
III)decreased placental blood flow

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

Answer 3

D

Question 4

Which factors contribute to maintaining a patent ductus arteriosus during fetal life?
I)large amounts of fetal hemoglobin
II)low PaO₂
III)presence of LDH
IV)presence of prostaglandins

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

Question 5

What is the primary purpose of the respiratory system?

A)continuous absorption of oxygen and excretion of carbon dioxide
B)filtering to prevent allergens and microbes from reaching the lungs
C)transport oxygenated blood to the tissues
D)warm and humidify inspired gas

Question 6

What is meant by "internal respiration"?

A)any gas exchange that occurs inside the body
B)consumption of oxygen in the mitochondria
C)continuous absorption of oxygen and excretion of carbon dioxide
D)exchange of gases between the blood and the tissue

Question 7

In the fetal heart, the foramen ovale allows blood to flow between which two structures?

A)bypass the liver and enter the inferior vena cava
B)pulmonary artery to aortic arch
C)right atrium to left atrium
D)right atrium to left ventricle

Question 8

Which of the following is an index commonly used to determine relative lung maturity?

A)FRC/TLC ratio
B)L:S ratio
C)RQ ratio
D)SP-A

Question 9

What percentage of right ventricular output is circulated through the fetal lungs?

A)10%
B)35%
C)75%
D)100%

Question 10

What maintains lung inflation during fetal development?

A)fetal lung fluid
B)radial tethering
C)rigidity of the chest wall
D)surfactant

Question 11

The fetus is potentially viable if born at the end of which stage of development?

A)alveolar
B)canalicular
C)pseudoglandular
D)saccular

Question 12

During a vaginal delivery, what facilitates the removal of fetal lung fluid from the pulmonary system?

A)high PaO₂
B)low intrapulmonary pressures
C)thoracic compression
D)triaging of core functions

Question 13

During which phase of fetal development do mature alveoli appear?

A)alveolar
B)canalicular
C)pseudoglandular
D)saccular

Question 14

Developmental morphogenesis of the human respiratory system can be categorized into:

A)three periods
B)five stages
C)6 weeks
D)40 weeks

Question 15

By what mechanism does gas exchange across the lung occur?

A)active transport
B)facilitated diffusion
C)facilitated transport
D)simple diffusion

Question 16

What genetic disorder has been linked to emphysema?

A) $\alpha$ ₁-antitrypsin deficiency
B) $\beta$ protease dysfunction
C)IgA deficiency
D)X-linked agammaglobulinemia

Question 17

The fetus is potentially viable if born prematurely after how many weeks of gestation?

A)12 to 16 weeks
B)18 to 20 weeks
C)24 to 26 weeks
D)28 to 32 weeks

Question 18

What would be a normal P₅₀ for a fetus?

A)10
B)15
C)20
D)25

Question 19

Which of the following diseases have been found to have a genetic component?
I)cancer
II)asthma
III)pneumonia
IV)pulmonary fibrosis

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

Question 20

Which chromosome has been found to carry the defective gene responsible for the development of cystic fibrosis?

A)1
B)7
C)15
D)23

Question 21

Infants are more susceptible to profound hypoxemia than are adults.

A)true
B)false
C)unable to determine

Question 22

What are rib pairs 11 and 12 known as?

A)false ribs
B)faux ribs
C)floating ribs
D)true ribs

Question 23

Infants can generate auto-PEEP by which of the following methods?

A)active expiration
B)increased diaphragmatic excursion
C)laryngeal braking
D)retractions

Question 24

Which of rib pairs connect directly to the sternum?

A)1 and 4
B)1 and 7
C)1 and 12
D)11 and 12

Question 25

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

A)angle of Louis
B)manubrium
C)vertebral process
D)xiphoid process

Question 26

Approximately how many alveoli are there in a 10-year-old's lung?

A)50 million
B)200 million
C)350 million
D)500 million

Question 27

Which of the following would NOT promote transition from fetal circulation to a normal extrauterine circulatory pattern?

A)closure of the foramen ovale
B)constriction of the ductus arteriosus
C)decreased pulmonary vascular resistance
D)decreased systemic vascular resistance

Question 28

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

A)anchor of the upper chest for diaphragmatic contraction
B)diminish the energy wasted by inefficient muscular contraction
C)increase in the anteroposterior diameter of the chest
D)increase in the lateral dimensions of the chest

Question 29

Where does the sternal angle lie?

A)at the depression in the body of the sternum to which the clavicles attach
B)at the join between the manubrium and sternal body
C)at the superior edge of the sternum
D)where the xiphoid process connects to the sternum

Question 30

Which of the following muscles are considered primary muscles of ventilation?
I)diaphragm
II)intercostals
III)scalenes
IV
Sternomastoid

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

Question 31

What is rather unique regarding the blood supply to the lung?

A)It receives blood from right and left ventricles.
B)It requires no dedicated blood supply as it exists in a gas environment.
C)Pulmonary venous drainage contributes to the normal anatomic shunt.
D)The pulmonary arteries are the primary source of oxygen for lung structures.

Question 32

What strong stimulus to the infant provides the impetus for the first breathe?

A)acidosis
B)exposure to warmth
C)fright from passing through the birth canal
D)high PaO₂

Question 33

What is the physiologic result of the infant's more compliant thorax compared with that of an adult?

A)It is easier for the infant to breathe.
B)Their functional residual capacity is reduced based on ideal body weight (IBW).
C)They breathe larger tidal volumes based on IBW.
D)They have less of a tendency to develop atelectasis.

Question 34

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

A)cupula
B)mesothelioma
C)parietal pleura
D)visceral pleura

Question 35

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

A)anterior axillary line
B)midaxillary line
C)midclavicular line
D)midsternal line

Question 36

What is the function of the thorax?

A)facilitate digestion
B)heat, humidify, and filter gases
C)protect the vital organs
D)vocalization

Question 37

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

A)costal groove on the top of each rib
B)costal groove on the bottom of each rib
C)fibers of the intercostal musculature
D)surface of the parietal pleura

Question 38

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

A)angle of Louis
B)cricoid cartilage
C)suprasternal notch
D)xiphoid process

Question 39

How short could the trachea of small preterm infant to be?

A)2 cm
B)4 cm
C)6 cm
D)8 cm

Question 40

What factor contributes to increased likelihood of an upper airway obstruction in an infant compared to an adult?

A)higher percentage of body fat
B)higher volumes of sinus discharge
C)relatively smaller head size
D)tongue that is proportionally larger

Question 41

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

A)adult respiratory distress syndrome
B)asthma
C)atelectasis
D)pneumonia

Question 42

Which accessory muscles of ventilation work to pull the ribs closer together?

A)external intercostals
B)internal intercostals
C)scalenes
D)sternocleidomastoids

Question 43

What is the lowest level on the spinal cord that an injury could cause diaphragmatic impairment or paralysis?

A)C3
B)L2
C)S5
D)T4

Question 44

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

A)15
B)25
C)50
D)75

Question 45

Which of the following is the most important ventilatory function of the scalene muscles?

A)activate if intrathoracic pressure fall to -40 cm H₂O
B)elevate and fix the first seven ribs
C)lift upper chest particularly during times of high ventilatory demand
D)support the trachea within the thorax during heavy exercise

Question 46

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

A)composes part of anatomic shunt
B)liquid barrier for pathogens
C)part of pulmonary blood flow
D)reduces friction

Question 47

What important role does the diaphragm play other than contraction during inspiration?

A)enhances cardiac output
B)facilitates the final push for giving birth
C)active during forced exhalation
D)serves as a secondary muscle of expiration

Question 48

The nerves that innervate the diaphragm arise from which area?

A)lumbar region of the spine
B)sacral vertebrae 4 and 5
C)spinal plexuses at T2 to T11
D)spinal nerves C3 to C5

Question 49

The diaphragm is innervated by which of the following nerves?

A)glossopharyngeal
B)phrenic
C)seventh cranial
D)vagus

Question 50

To what structures do the parietal pleural membranes adhere or cover?

A)fissures
B)intrapulmonary bronchi
C)lung
D)mediastinum

Question 51

The abdominal muscles can actually contribute to inspiration by contraction at the end of exhalation.

A)true
B)false
C)unable to determine

Question 52

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

A)external intercostals
B)pectoralis
C)scalenes
D)sternocleidomastoids

Question 53

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

A)angle of Louis
B)costophrenic angle
C)diaphragmatic groove
D)oblique fissure

Question 54

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

A)compression of the thoracic cavity
B)enhanced venous return and thus cardiac output
C)greater diaphragmatic efficiency
D)larger than normal change in thoracic volume

Question 55

Which of the muscles below when stimulated will contract and push up on the diaphragm?
I)external intercostals
II)external obliques
III)internal obliques
IV)rectus abdominous

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

Question 56

Which accessory muscles are active during resting and active inspiration and pull up on all the ribs expanding the thorax?

A)external intercostals
B)internal intercostals
C)scalenes
D)sternocleidomastoids

Question 57

As ventilatory muscles, the sternomastoids do which of the following?

A)elevate the upper chest, increasing chest anteroposterior diameter
B)elevate the ribs and decrease chest anteroposterior diameter
C)increase lateral chest movement during inspiration
D)lower the sternum, thus increasing chest anteroposterior diameter

Question 58

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

A)fifth rib posteriorly
B)sixth rib posteriorly
C)seventh rib posteriorly
D)eighth rib posteriorly

Question 59

How far is the diaphragm pulled down during tidal breathing?

A)1 to 2 cm
B)3 to 5 cm
C)6 to 8 cm
D)8 to 10 cm

Question 60

Limited, short-term spontaneous ventilation is possible in a patient with a paralyzed diaphragm.

A)true
B)false
C)unable to determine

Question 61

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

A)Radial tethers, stretched to their maximum length, then halt lung collapse.
B)Surfactant neutralizes the tendency of the lung to collapse.
C)There is a tendency of the chest wall to lock at the level of FRC.
D)There is an equal opposing tendency of the chest wall to expand.

Question 62

Fluid transport to and from the lungs is provided by which of the following?
I)bronchial circulation
II)lymphatic system
III)pulmonary circulation

A)II and III
B)I and III
C)II only
D)I, II, and III

Question 63

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

A)2 cm
B)3 cm
C)4 cm
D)5 cm

Question 64

Which of the following describes a function of pulmonary circulation?

A)breakdown of angiotensin II
B)filtering of blood clots
C)production of erythropoietin
D)regulation of breathing

Question 65

Which of the following statements is NOT true regarding the pulmonary circulation?

A)Pulmonary blood flow is highly dependent on gravity.
B)The pulmonary circulation is a low-pressure system.
C)Toward the top of the upright lung, blood flow is high.

Question 66

The pulmonary venous circulation does which of the following?
I)delivers oxygenated blood back to the heart
II)delivers unoxygenated blood to the lungs
III)empties into the left atrium
IV)empties into the right atrium

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

Question 67

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

A)bronchial veins emptying into the inferior vena cava
B)bronchopulmonary veins emptying into pulmonary veins
C)direct connections between bronchial and pulmonary arteries
D)thebesian venous drainage into the heart chambers

Question 68

Why is the left lung narrower than the right lung?

A)Liver compresses the left lung.
B)Mediastinal organs push laterally into the left hemithorax.
C)There is poorer blood flow during fetal development.
D)There is upward pressure of the abdominal contents.

Question 69

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

A)increased
B)normal or average
C)reduced

Question 70

What percentage of the alveolar surface is covered with pulmonary capillaries?

A)60%
B)70%
C)80%
D)90%

Question 71

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

A)The lung will appear to undergo no change.
B)The lung will collapse.
C)The lung will expand.
D)The response of the lung will depend on its age and pathology.

Question 72

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

A)higher
B)lower
C)the same

Question 73

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

A)air
B)bile
C)excess fluids
D)liver on the right, intestines on the left

Question 74

How does the lung respond to regional lung hypoxia?

A)bronchial artery vasoconstriction
B)bronchial artery vasodilation
C)pulmonary artery vasoconstriction
D)pulmonary artery vasodilation

Question 75

What forces establish the subatmospheric pressure found in the pleural space?

A)contraction of accessory muscles of inspiration
B)contraction of expiratory muscles
C)equal opposing tendency of the chest wall to expand and lung to collapse.
D)effect of gravity, particularly at the base of the lungs

Question 76

The pulmonary arterial circulation does which of the following?
I)delivers oxygenated blood back to the heart
II)delivers unoxygenated blood to the lungs
III)originates on the left side of the heart
IV)originates on the right side of the heart

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

Question 77

Which of the following statements describe a normal adult lung?

A)The left lung is bisected by two fissures.
B)The left lung has an upper, a middle, and a lower lobe.
C)The right lung has only an upper and a lower lobe.
D)The right lung has three lobes and two fissures.

Question 78

How does the lung parenchyma receive most of its oxygen?

A)from the alveolar gases
B)from the bronchial arteries/capillaries
C)from the pulmonary arteries/capillaries
D)from the pulmonary lymphatic system

Question 79

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

A)higher resistance than the systemic circulation
B)less blood flow than the systemic circulation
C)lower resistance than the systemic circulation
D)more blood flow than the systemic circulation

Question 80

What is the mediastinum?

A)membranous sac surrounding the heart and great vessels
B)middle layer of muscle fibers constituting the heart
C)point of division of the trachea into the bronchi
D)structure separating the right and left thoracic cavities