Question 1

Patients with COPD have a difficult time getting air out of the lungs during expiration.A physical therapist may be able to offer assistance by instructing the patient on ways to actively contract the .

Accepted Answer

When a patient with COPD actively contracts the abdominal muscles during expiration,additional air can be moved from the lungs.

Question 2

While dining with friends,a young lady begins to choke and eventually becomes unconscious.Given the anatomy of the tracheobronchial tree,you would determine the foreign object was most likely in the portion of the lung.

Accepted Answer

Given the angle and continuous nature of the trachea and the right mainstem bronchus,it is more likely to aspirate foreign objects there.

Question 3

The sternocleidomastoid (SCM)muscle is considered an accessory muscle of respiration.When the head is fixed,the SCM muscle creates an increase in the anteroposterior diameter of the thorax.However,this is not the primary function of this muscle.What does the SCM do when not serving as an accessory respiratory muscle?

Accepted Answer

The SCM muscle has a right and left muscle,resulting in forward head flexion when both contract.When one SCM muscle contracts,it tilts the head toward the shoulder of the same side and rotates the face toward the opposite shoulder.

Question 4

What structure in the circulatory system is said to have a higher proportion of connective tissue?

Accepted Answer

Larger vessels have the higher proportion of connective tissue to withstand the intense pressure as the blood is ejected from the left ventricle.The elastic recoil also aids in forward movement of the blood after the initial contraction subsides.

Question 5

During the active contraction of this muscle,the thoracic volume is increased vertically and transversely,thus creating a forward push of the internal organs.What muscle is this?

Accepted Answer

The diaphragm is the only muscle with the mechanical advantage to complete the activities described during an active contraction.

Question 6

The accessory action of the trapezius muscles is said to be:

Accepted Answer

Contraction of trapezius provides stabilization for the serratus anterior and pectoralis minor to serve as accessory elevators of the ribs.

Question 7

The diaphragm is the principal muscle of respiration.During the quiet phase of breathing in the supine position,the diaphragm is said to be responsible for of the tidal volume as opposed to sitting or standing when it is responsible for of the tidal volume.

Accepted Answer

In the supine position, the diaphragm is responsible for three-fourths of the tidal volume due to the effect of gravity on abdominal contents, which makes diaphragmatic movement more significant. In contrast, when sitting or standing, the diaphragm accounts for two-thirds of the tidal volume, as other muscles of respiration contribute more significantly in these positions.

Question 8

Movement of the lower ribs during inspiration is described as:

Accepted Answer

The ribs are fixed anteriorly by the articulation with the sternum and posteriorly by the articulation to the transverse processes of the thoracic vertebrae; therefore,the lateral aspects are free to move with inspiration and expiration.

Question 9

The heart muscle receives blood supplied by the right and left coronary arteries.The right coronary artery supplies all of the following except:

Accepted Answer

This area gives rise to the coronary arteries and does not actually receive perfusion.

Question 10

The heart is composed of four chambers and three layers of muscle.The thickest layer of the heart is the:

Accepted Answer

The prefixes provide information: epi- is on top or outer,endo- is internal or smooth,and myo- is muscle.

Question 11

The accessory action of the internal intercostal muscles is said to be:

Accepted Answer

Whereas contractions of the intercartilaginous portions are inspiratory,contraction of the interosseous portions approximates the ribs,thereby serving a more expiratory function.

Question 12

The accessory action of the serratus anterior muscles is said to be:

Accepted Answer

With the superior aspect of the muscles fixed,a contraction would result in elevation of the first and second ribs,thus increasing the anteroposterior diameter.

Question 13

The palatine tonsils can be found in which area of the upper airways?

Accepted Answer

Although the tonsils can be said to be generally a structure of the pharynx,the area is so large that it has been further subdivided into three parts to more clearly identify those features in each area.The palatine tonsils are therefore located in the oropharynx.

Question 14

Identify the structures that carry deoxygenated blood away from the heart to the lungs.

Accepted Answer

Arteries always carry blood away from the heart; it makes no difference if the blood is oxygenated or deoxygenated.The fact that the arteries referenced are identified as pulmonary should tell the reader that the blood is deoxygenated.

Question 15

The bifurcation of the trachea into the right and left mainstem bronchi occurs near what anatomic landmark?

Accepted Answer

This landmark also occurs at the thoracic vertebrae levels of T4 and T5; this is also the articulation of the manubrium and the body.

Question 16

The mucociliary escalator,which is responsible for propelling mucus by the cilia,can become paralyzed.When this occurs,mucus accumulates in the distal airways.All of the following are potential causes of paralyzation for the escalator except:

Accepted Answer

There is no medical indication that the use of supplemental oxygen will result in the improper function of the mucociliary escalator

Question 17

The root of the lung or the hilus is the area where many structures enter the lung.The mainstem bronchi,pulmonary artery,pulmonary veins,bronchial arteries and veins,and lymph vessels are located here.The hilus is opposite the vertebral level of what thoracic bodies?

Accepted Answer

This area must be slightly lower than the bifurcation of the trachea if the mainstem bronchi also enter at this level.

Question 18

Expansion of the thorax is essential to create the necessary pressure gradients for respiration to occur.The movement of the skeletal system,specifically the upper ribs,is described as which type of movement?

Accepted Answer

This movement increases the anteroposterior diameter and the depth of respiration; this movement results from the position of the scapulae posteriorly and the weight of the shoulder and arm and prevents more lateral swing of the ribs with inspiration.

Question 19

The bronchi divide into many sections anteriorly,superiorly,posteriorly,and inferiorly,ultimately forming the tracheobronchial tree,which is composed of how many generations?

Accepted Answer

The tracheobronchial tree is composed of 23 generations of divisions from the bronchi, ultimately ending in the terminal bronchioles which lead to the alveoli.

Question 20

The phrenic nerve passes through the diaphragm along with the inferior vena cava.Both of these structures pierce the diaphragm and create which opening?

Accepted Answer

The phrenic nerve and the inferior vena cava both pass through the diaphragm via the vena caval opening, which is the largest opening in the diaphragm. The esophageal opening is for the passage of the esophagus, the aortic opening is for the passage of the aorta, and there is no lymphatic opening in the diaphragm.

Quiz 3: Cardiovascular and Pulmonary Anatomy