Question 1

Which of the following best describes the impact of anatomic shunt?&#10;A) Systemic arterial blood can never have the same partial pressure of oxygen as the alveolar gas.&#10;B) Systemic venous blood will have the same partial pressure of oxygen as the alveolar gas.&#10;C) Systemic arterial blood will have the same partial pressure of oxygen as the alveolar gas.&#10;D) Systemic arterial blood will have a higher partial pressure of oxygen than the alveolar gas.&#10;

Accepted Answer

The normal process of anatomical shunting meAnswer that systemic arterial blood can never have the same partial pressure of oxygen as the alveolar gas; this gives rise to the normal alveolar-to-arterial oxygen pressure difference, or P(A - a)O₂.

Question 2

What is the effect of parasympathetic stimulation on airway secretions?&#10;A) Increased production and viscosity&#10;B) Thin watery secretions&#10;C) Decreased production&#10;D) No change&#10;

Accepted Answer

Parasympathetic stimulation increases the production of mucous glycoproteins, raising the viscosity of airway secretions. In contrast, sympathetic stimulation produces thin, watery secretions.

Question 3

A 25-year-old is brought to the emergency department after a car versus pedestrian accident.She suffered fractures of vertebrae C2 and C3.Which of the following respiratory muscles will be compromised by this cervical injury?
I.Diaphragm
II.Intercostal muscles
III.Abdominals
IV.Accessory muscles

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

I, II, III

Accepted Answer

Spinal cord injury at the levels of C2 and C3 impairs respiratory muscle function because respiratory muscles receive nerve input from the spinal cord at or below these cervical vertebrae. This includes the major muscles involved in inspiration and expiration: the diaphragm, external and internal intercostals, and abdominals.

Question 4

What is the term that describes the presence of fluid in the pleural space as a result of inflammation?&#10;A) Pleural effusion&#10;B) Thoracentesis&#10;C) Pleural rub&#10;D) Pneumothorax&#10;

Accepted Answer

If the pleural membranes become inflamed by disease, fluid may form in the pleural space, creating what is called a pleural effusion.

Question 5

Approximately three-fourths of all parasympathetic fibers are in which cranial nerve?&#10;A) IX&#10;B) X&#10;C) XI&#10;D) XII&#10;

Accepted Answer

Approximately three-fourths of all parasympathetic fibers are in the vagus nerve, which sends out many branches to the visceral orgAnswer.

Question 6

Which of the following statements are true of the phrenic nerves?
I.They originate from spinal nerves C3 to C5.
II.They enter the chest in front of the scalenus muscle.
III.They are sandwiched between subclavian arteries and veins.
IV.Nerve injury is associated with paralysis of the diaphragm.

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

Accepted Answer

The paired phrenic nerves supply motor innervation to the diaphragm. They originate from the right and left cervical nerve plexuses as branches of cervical spinal nerves C3 to C5 (Figure 2-5). Phrenic nerves cross in front of the scalenus anterior muscles of the neck and enter the chest, sandwiched between subclavian arteries and veins. Thoracic surgery, neck trauma, and cancerous tumors sometimes injure or compress the phrenic nerve, causing paralysis of the diaphragm. However, breathing may still be possible if intercostal nerves and muscles are intact.

Question 7

Which of the following are explanations for the left hemidiaphragmatic surface being slightly lower than the right?
I.The heart rests on the left half of the diaphragm, pushing it downward.
II.The presence of air in the stomach acts as a vacuum, pulling the diaphragm downward.
III.The liver, directly below the right half of the diaphragm, props up this area.

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

Accepted Answer

The left diaphragmatic surface is slightly lower than the right because 
(1) the heart rests on the left half of the diaphragm, pushing it downward, and 
(2) the liver, directly below the right half of the diaphragm, props up this area (see Figure 2-1).

Question 8

Which of the following is the source of innervation for the lung?&#10;A) Somatic nervous system&#10;B) Cranial nerves&#10;C) Autonomic nervous system&#10;D) Visceral nerves&#10;

Accepted Answer

The somatic system provides only motor innervation to the ventilatory muscles; the autonomic system supplies both motor (efferent) and sensory (afferent) nerves to the lung.

Question 9

Which of the following forms of nitric oxide (NO₂) is useful in identifying early stages of asthma exacerbation? A) bNO₂ B) nNO₂ C) iNO₂ D) eNO₂

Accepted Answer

Because asthma is an inflammatory disease of the airways, increased iNO₂ would be expected to elevate the concentration of NO₂in the exhaled gas of asthmatics. Indeed, asthmatics do have higher concentrations of exhaled NO₂ than normal individuals, especially during exacerbations of the disease. Thus, monitoring exhaled NO₂ has been proposed as a way to identify early stages of asthma exacerbations.

Question 10

The presence of irritants such as noxious gases elicits reflex bronchoconstriction to limit penetration of injurious substances into the lungs.This reflex is produced by stimulation of which of the following structures?

A) Bronchial smooth muscle
B) Gag receptors
C) Rapidly adapting receptors
D) Cough receptors

Accepted Answer

Stimulation of RARs causes reflex bronchoconstriction, expiratory narrowing of the larynx, cough, deep inspiration, and mucous secretion. These receptors are protective mechanisms in healthy humAnswer because they elicit bronchospasm, limiting penetration of injurious substances into the lung.

Question 11

Which of the following are the main neurotransmitters of the autonomic system?
I.Norepinephrine
II.Acetylcholine
III.Dopamine
IV.Adrenaline

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

Accepted Answer

The answer of Which of the following are the main...

Question 12

What is the best explanation for the anticholinergics being less useful than adrenergic bronchodilators in treating small airway constriction?&#10;A) Cholinergic innervation is greatest in the large airways.&#10;B) Adrenergic innervation is greatest in the large airways.&#10;C) Cholinergic innervation is greatest in the small airways.&#10;D) Cholinergics require a higher dose than the adrenergics to elicit the same effect.&#10;

Accepted Answer

The answer of What is the best explanation for the...

Question 13

What substance is responsible for the only natural mechanism for sympathetic bronchodilation in humans?&#10;A) Norepinephrine&#10;B) Epinephrine&#10;C) Acetylcholine&#10;D) Dopamine&#10;

Accepted Answer

The answer of What substance is responsible for the only...

Question 14

A patient is being evaluated for postextubation laryngeal edema.A dose of racemic epinephrine has been ordered.What type of agent is this medication? A) β₂ agonist B) Alpha-adrenergic C) Anticholinergic D) Parasympathomimetic

Accepted Answer

The answer of A patient is being evaluated for postextubation...

Question 15

Which of the following is the right sequence of events for generating a cough?
I.The glottis suddenly opens, explosively releasing compressed gas.
II.The diaphragm contracts, causing a deep inspiration.
III.The muscles in the larynx close the glottis, sealing the upper airway.
IV.A slight inspiratory pause occurs.
V.The abdominal expiratory muscles contract forcefully.

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

Accepted Answer

The answer of Which of the following is the right...

Question 16

Which of the following reflexes causes smooth muscle relaxation and bronchodilation after a deep inspiration?&#10;A) Herring-Breuer reflex&#10;B) Gag reflex&#10;C) Corneal reflex&#10;D) Brudzinski reflex&#10;

Accepted Answer

The answer of Which of the following reflexes causes smooth...

Question 17

A well-known asthmatic individual has been admitted to the ED complaining of difficulty breathing.The physician is asking for a bronchodilator.Which of the following agents should be considered?
I.β₂ agonists
II.Anticholinergics
III.Parasympathomimetics
IV.Sympathomimetics

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

Accepted Answer

The answer of A well-known asthmatic individual has been admitted...

Question 18

Which of the following are typical locations for the pulmonary β₂ receptors?
I.Airway smooth muscle
II.Alveolar interstitium
III.Vascular smooth muscle
IV.Submucosal glands

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

Accepted Answer

The answer of Which of the following are typical locations...

Question 19

Which of the following structures in the lung are innervated by the parasympathetic postganglionic fibers?
I.Smooth airway muscle
II.Mucous glands
III.Pulmonary blood vessels
IV.Lung parenchyma

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

Accepted Answer

The answer of Which of the following structures in the...

Question 20

How many ribs articulate with thoracic vertebrae?&#10;A) 12&#10;B) 11&#10;C) 7&#10;D) 2&#10;

Accepted Answer

The answer of How many ribs articulate with thoracic vertebrae?&#10;A)...

Question 21

Which of the following mechanisms is by far the most significant cause of thoracic cavity enlargement during inspiration?&#10;A) Downward movement of the diaphragm&#10;B) Upward movement of the diaphragm&#10;C) Abdominal muscle contraction&#10;D) Abdominal muscle relaxation&#10;

Accepted Answer

The answer of Which of the following mechanisms is by...

Question 22

Which of the following are the only accessory muscles of expiration?&#10;A) Diaphragm&#10;B) Intercostal muscles&#10;C) Pectoralis major&#10;D) Abdominal muscles&#10;

Accepted Answer

The answer of Which of the following are the only...

Question 23

Which of the following is the primary muscle of respiration that is active during quiet breathing?&#10;A) Diaphragm&#10;B) Intercostal muscle&#10;C) Pectoralis major&#10;D) Abdominal muscle&#10;

Accepted Answer

The answer of Which of the following is the primary...

Question 24

If the lungs fail to empty normally during exhalation, because of either weakened elastic recoil forces or high resistance to airflow, the retained volume causes what change in the chest radiograph?&#10;A) Flattening of the diaphragm&#10;B) Bullae formation&#10;C) Pneumothorax&#10;D) Pleural effusion&#10;

Accepted Answer

The answer of If the lungs fail to empty normally...

Question 25

Which of the following are considered accessory muscles of respiration?
I.Sternomastoids
II.Pectoralis major
III.Trapezius
IV.Abdominals

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

Accepted Answer

The answer of Which of the following are considered accessory...

Question 26

Strong inspiratory efforts may create enough subatmospheric pressure in the thoracic cavity to suck the intercostals muscles inward.This physical finding is called:&#10;A) Paradoxical breathing&#10;B) Intercostal retractions&#10;C) Flail chest&#10;D) Rigid chest&#10;

Accepted Answer

The answer of Strong inspiratory efforts may create enough subatmospheric...

Question 27

During cardiopulmonary resuscitation involving cardiac compressions, care must be taken not to compress which part of the sternum because its fracture may damage underlying organs?&#10;A) Manubrium&#10;B) Xiphoid process&#10;C) Angle of Louis&#10;D) Body&#10;

Accepted Answer

The answer of During cardiopulmonary resuscitation involving cardiac compressions, care...

Question 28

The junction of the manubrium, the body of the sternum, and the second rib is known as an anatomical landmark for the level of the carina.What is the name of this part of the sternum?&#10;A) Manubrium&#10;B) Xiphoid process&#10;C) Angle of Louis&#10;D) Body&#10;

Accepted Answer

The answer of The junction of the manubrium, the body...

Deck 2: The Lungs and Chest Wall