chapter 1: the anatomy and physiology of the respiratory
TRANSCRIPT
Chapter 1: The Anatomy and Physiology of the Respiratory System
TRUE/FALSE
1. The palatine tonsils and the pharyngeal tonsils are thought to be types of lymphoid tissues.
ANS: T
Feedback
Correct The palatine and pharyngeal tonsils are lymphoid tissues and are believed to
serve certain immunologic defense functions. Incorrect The palatine and pharyngeal tonsils are lymphoid tissues and are believed to
serve certain immunologic defense functions.
PTS: 1
2. The eustachian tubes serve to equalize pressure in the middle ear.
ANS: T
Feedback
Correct The eustachian tubes connect the nasopharynx to the middle ear and serve to
equalize pressure in the middle ear. Incorrect The eustachian tubes connect the nasopharynx to the middle ear and serve to
equalize pressure in the middle ear.
PTS: 1
3. The oropharynx is located between the hard palate, superiorly, and the base of the tongue, inferiorly.
ANS: F
Feedback
Correct The oropharynx is located between the soft palate, superiorly, and the base of the
tongue, inferiorly. Incorrect The oropharynx is located between the soft palate, superiorly, and the base of the
tongue, inferiorly.
PTS: 1
4. The pharyngeal reflex is also known as the swallowing reflex.
ANS: T
Feedback
Correct When stimulated, the muscles and nerves work together to produce the
pharyngeal reflex, also known as the gag or swallowing reflex. Incorrect When stimulated, the muscles and nerves work together to produce the
pharyngeal reflex, also known as the gag or swallowing reflex.
PTS: 1
5. An endotracheal tube is used to bypass the lower airway.
ANS: F
Feedback
Correct An endotracheal tube is used to bypass the upper airway and must be
appropriately warmed and humidified. Incorrect An endotracheal tube is used to bypass the upper airway and must be
appropriately warmed and humidified.
PTS: 1
6. The visceral pleura is attached to the inner surface of the lungs.
ANS: F
Feedback
Correct The visceral pleura is attached to the outer surface of each lung. The parietal
pleura lines the inside of the thoracic walls. Incorrect The visceral pleura is attached to the outer surface of each lung. The parietal
pleura lines the inside of the thoracic walls.
PTS: 1
7. The lungs have a natural tendency to collapse.
ANS: T
Feedback
Correct The lungs have a natural tendency to collapse, and the thorax has a natural
tendency to expand. Incorrect The lungs have a natural tendency to collapse, and the thorax has a natural
tendency to expand.
PTS: 1
8. The thorax has a natural tendency to expand.
ANS: T
Feedback
Correct The thorax has a natural tendency to expand, and the lungs have a natural
tendency to collapse. Incorrect The thorax has a natural tendency to expand, and the lungs have a natural
tendency to collapse.
PTS: 1
9. Twelve thoracic vertebrae form the posterior midline border of the thoracic cage.
ANS: T
Feedback
Correct Twelve thoracic vertebrae form the posterior midline border of the thoracic cage. Incorrect Twelve thoracic vertebrae form the posterior midline border of the thoracic cage.
PTS: 1
10. The anterior tendon is the area where the two hemidiaphragms merge together.
ANS: F
Feedback
Correct The two hemidiaphragms merge in an area called the central tendon. Incorrect The two hemidiaphragms merge in an area called the central tendon.
PTS: 1
11. The purpose of cilia is to propel mucus toward the nasopharynx.
ANS: T
Feedback
Correct The purpose of cilia is to propel mucus toward the nasopharynx. Incorrect The purpose of cilia is to propel mucus toward the nasopharynx.
PTS: 1
12. The receptors for sense are located in the olfactory region.
ANS: T
Feedback
Correct The receptors for sense are located in the olfactory region. Incorrect The receptors for sense are located in the olfactory region.
PTS: 1
MULTIPLE CHOICE
1. Which of the following is not a primary function of the upper airway?
a. to humidify and warm inspired air
b. to help with speech and smell
c. to conduct air
d. to house the teeth
ANS: D
Feedback
A The primary functions of the upper airway are to conduct air, to humidify and warm
inspired air, to prevent foreign materials from entering the tracheobronchial tree, and to
serve as an important part of smell and speech. B The primary functions of the upper airway are to conduct air, to humidify and warm
inspired air, to prevent foreign materials from entering the tracheobronchial tree, and to
serve as an important part of smell and speech.
C The primary functions of the upper airway are to conductor air, to humidify and warm
inspired air, to prevent foreign materials from entering the tracheobronchial tree, and to
serve as an important part of smell and speech. D The teeth are housed in the oral cavity, not the upper airway.
PTS: 1
2. What forms the floor of the nasal cavity?
a. the palatine process of the maxilla and the palatine bones
b. the frontal process of the maxilla and the cribriform plate of the ethmoid bone
c. the vomer and the perpendicular plate of the ethmoid bone
d. the hard and soft palates of the roof of the mouth
ANS: A
Feedback
A The palatine process of the maxilla and the palatine bones create the floor of the nasal
cavity. These also form the hard palate of the roof of the mouth. B The frontal process of the maxilla and the cribriform plate of the ethmoid bone form the
roof of the nasal cavity. C The vomer and the perpendicular plate of the ethmoid bone form the posterior nasal
septum. D The hard palate forms the floor of the nasal cavity, but the soft palate does not.
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3. What part of the nose represents the tracheobronchial tree’s first line of defense?
a. nostrils
b. vibrissae
c. stratified squamous epithelium (nonciliated)
d. vestibule
ANS: B
Feedback
A The nostrils are where air first enters the nasal cavity. B Vibrissae, or hair follicles, are housed in the vestibule of the nose and are the first line
of defense. C Nonciliated stratified squamous epithelium lines the anterior one-third of the nasal
cavity but plays no role in the tracheobronchial tree’s first line of defense. D The vestibule houses the vibrissae but in itself plays no role in the tracheobronchial
tree’s first line of defense.
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4. What type of epithelium lines the oral cavity?
a. nonciliated pseudostratified columnar epithelium
b. nonciliated stratified squamous epithelium
c. ciliated pseudostratified columnar epithelium
d. ciliated stratified squamous epithelium
ANS: B
Feedback
A Nonciliated pseudostratified columnar epithelium does not line any part of the airway. B Nonciliated stratified squamous epithelium lines the anterior third of the nasal cavity,
the oral cavity, the oropharynx, and the area above the vocal cords. C Ciliated pseudostratified columnar epithelium lines the posterior two-thirds of the nasal
cavity, the nasopharynx, and the area below the vocal cords. D Ciliated stratified squamous epithelium does not line any part of the airway.
PTS: 1
5. What is the area between the base of the tongue and the epiglottis called?
a. Adam’s apple
b. thyroid cartilage
c. hyoid bone
d. vallecula
ANS: D
Feedback
A The Adam’s apple is another name for the thyroid cartilage. B Another name for the thyroid cartilage is the Adam’s apple. C The hyoid bone is not part of the larynx and is a horseshoe-shaped bone that is
suspended from the upper portion of the thyroid cartilage. D The vallecula is formed by mucous membrane folds between the base of the tongue and
the epiglottis.
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6. Alveolar type II cells produce what substance?
a. mucus
b. pulmonary surfactant
c. antibodies
d. saliva
ANS: B
Feedback
A Mucus is produced by goblet cells and bronchial glands. B Alveolar type II cells produce surfactant, which decreases surface tension. C Antibodies are produced when an antigen is introduced to the body. They are not
produced by alveolar type II cells. D Saliva is produced by salivary glands in the oral cavity.
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7. What does the stimulated sympathetic nervous system cause to occur in the bronchial smooth muscle?
a. bronchoconstriction
b. vasodilation
c. bronchodilation
d. vasoconstriction
ANS: C
Feedback
A Sympathetic nervous system stimulation causes the bronchial smooth muscle to dilate
not constrict. B The prefix vaso- means “vessel”; the term vasodilation means “blood vessels dilate.” C The sympathetic nervous system is the fight-or-flight system and causes bronchodilation
to prepare the body for action. D The term vaso- means “vessel”; the term vasoconstriction means “blood vessels
constrict.”
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8. Anteriorly, the base of the lungs extends down to approximately where?
a. eleventh rib
b. base of the scapula
c. sixth rib
d. body of the manubrium
ANS: C
Feedback
A The base of the lung extends to the eleventh rib, posteriorly. B The scapula is on the posterior side of the thorax. C Anteriorly, the base of the lung extends to the sixth rib, or the level of the xiphoid
process. D The manubrium does not extend down far enough.
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9. What nerve innervates each hemidiaphragm?
a. optic
b. facial
c. glossopharyngeal
d. phrenic
ANS: D
Feedback
A The optic nerve innervates the eye. B The facial nerve innervates the muscles of the face. C The glossopharyngeal nerve innervates the posterior third of the tongue. D The phrenic nerve innervates each hemidiaphragm, which causes diaphragmatic
contraction.
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10. Which of the following does not slow the rate of mucociliary transport?
a. humidity
b. cigarette smoke
c. hypoxia
d. dehydration
ANS: A
Feedback
A Proper humidity will increase the rate of the mucociliary transport. B Cigarette smoke will decrease the rate of mucociliary transport.
C Hypoxia will decrease the rate of mucociliary transport. D Dehydration will decrease the rate of mucociliary transport.
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11. The bifurcation of the trachea is known as the:
a. hilum
b. carina
c. aortic arch
d. glottis
ANS: B
Feedback
A The hilum is the area of the lung where the blood vessels, nerves, lymph vessels, and
main stem bronchi enter and exit the lungs. B The carina is the bifurcation of the trachea into the right and left main stem bronchi. C The aortic arch is where the aorta leaves the heart and turns downward and to the left,
creating an arch. D The glottis is the opening between the true vocal cords.
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12. Approximately, how many alveoli are in one primary lobule?
a. 2000
b. 130,000
c. 300 million
d. 20
ANS: A
Feedback
A There are about 2000 alveoli in each primary lobule. B There are about 130,000 primary lobules in the lung. C An average adult male has about 300 million alveoli in the lung. D There are between 15 and 20 alveolar sacs for each alveolar duct.
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13. What is the purpose of the vibrissae?
a. to filter the inspired air
b. to warm the filtered air
c. to humidify the filtered air
d. to clean the inspired air
ANS: A
Feedback
A The vibrissae filter inspired air. B The vibrissae filter inspired air. C The vibrissae filter inspired air. D The vibrissae filter inspired air.
PTS: 1
14. What type of epithelium lines the anterior one-third of the nasal cavity?
a. stratified squamous
b. pseudostratified ciliated
c. stratified nonciliated
d. columnar
ANS: A
Feedback
A Stratified squamous epithelium lines the anterior one-third of the nasal cavity. B Stratified squamous epithelium lines the anterior one-third of the nasal cavity. C Stratified squamous epithelium lines the anterior one-third of the nasal cavity. D Stratified squamous epithelium lines the anterior one-third of the nasal cavity.
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15. What type of epithelium lines the posterior two-thirds of the nasal cavity?
a. pseudostratified squamous
b. pseudostratified ciliated columnar
c. ciliated squamous
d. nonciliated columnar
ANS: B
Feedback
A Pseudostratified ciliated columnar epithelium lines the posterior two-thirds of the nasal
cavity. B Pseudostratified ciliated columnar epithelium lines the posterior two-thirds of the nasal
cavity. C Pseudostratified ciliated columnar epithelium lines the posterior two-thirds of the nasal
cavity. D Pseudostratified ciliated columnar epithelium lines the posterior two-thirds of the nasal
cavity.
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MULTIPLE RESPONSE
1. Which of the following is/are function(s) of the larynx?
a. It is a passageway for air between the pharynx and the trachea.
b. It helps with the sense of smell.
c. It helps protect against aspiration.
d. It helps with phonation.
ANS: A, C, D
Feedback
Correct The larynx is a passageway for air between the pharynx and the trachea, it helps
protect against aspiration, and it helps with phonation. Incorrect The upper airway is involved with the sense of smell; the larynx is not.
PTS: 1
2. Which of the following represent the single cartilages of the larynx?
a. corniculate
b. thyroid
c. epiglottis
d. cricoid
ANS: B, C, D
Feedback
Correct The thyroid cartilage, the epiglottis, and the cricoid cartilage are all single
cartilages of the larynx. Incorrect The corniculate cartilage is a paired cartilage.
PTS: 1
3. Which of the following produces mucus in the tracheobronchial tree?
a. lamina propria
b. goblet cells
c. submucosal, or bronchial, glands
d. basement membrane
ANS: B, C
Feedback
Correct Goblet cells and submucosal, or bronchial, glands produce mucus, but the
bronchial glands produce the majority of the mucus in the tracheobronchial tree. Incorrect The lamina propria is part of the epithelial layer of the tracheobronchial tree and
is where the submucosal glands are located. The basement membrane is part of
the epithelial layer of the tracheobronchial tree and separates the basal cells from
the smooth muscle.
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4. When a mast cell degranulates, which of the following is released?
a. histamine
b. IgE
c. SRS-A
d. antigen
ANS: A, C
Feedback
Correct Histamine, SRS-A, heparin, PAF, and ECF-A are some of the chemical
mediators that are released from a mast cell when it degranulates. Incorrect IgE is the substance that binds to the mast cell. An antigen is the foreign
substance that causes IgE to be released.
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5. Which of the following are included in the cartilaginous airways?
a. terminal bronchi
b. segmental bronchi
c. lobar bronchi
d. trachea
ANS: B, C, D
Feedback
Correct The trachea, main stem bronchi, lobar bronchi, segmental bronchioles, and
subsegmental bronchioles contain cartilage and are therefore considered
cartilaginous airways. Incorrect The terminal bronchioles are noncartilaginous airways.
PTS: 1
6. What are the names of the two airways that make up the noncartilaginous airways?
a. alveolar ducts
b. bronchioles
c. subsegmental airways
d. terminal bronchioles
ANS: B, D
Feedback
Correct The bronchioles and the terminal bronchioles are noncartilaginous. Incorrect The alveolar ducts are part of the area for gas exchange. The subsegmental
airways are part of the cartilaginous airways.
PTS: 1
7. A primary lobule is composed of which of the following?
a. respiratory bronchioles
b. alveolar ducts
c. terminal bronchioles
d. alveolar clusters
ANS: A, B, D
Feedback
Correct A primary lobule is composed of the respiratory bronchioles, alveolar ducts, and
alveolar clusters that originate from a single terminal bronchiole. Incorrect The terminal bronchioles are not part of the sites for gas exchange but are part of
the noncartilaginous airways.
PTS: 1
8. Which of the following are part of the layers of the arteries?
a. tunica intima
b. tunica media
c. tunica adventitia
d. tunica outer
ANS: A, B, C
Feedback
Correct The tunica intima is the innermost layer, the tunica media is the middle layer, and
the tunica adventitia is the outer layer of an artery. Incorrect There is no term tunica outer.
PTS: 1
9. Which of the following are accessory muscles of expiration?
a. trapezius
b. pectoralis major
c. internal intercostal
d. rectus abdominis
ANS: C, D
Feedback
Correct The rectus abdominis, external abdominis obliquus, internal abdominis obliquus,
transversus abdominis, and internal intercostal muscles are accessory muscles of
expiration. Incorrect The trapezius, pectoralis major, scalene, sternocleidomastoid, and external
intercostal muscles are muscles of inspiration.
PTS: 1
10. What are the names of the areas that make up the pharynx?
a. oropharynx
b. nasopharynx
c. laryngopharynx
d. oral cavity
ANS: A, B, C
Feedback
Correct The oropharynx, nasopharynx, and laryngopharynx make up the pharynx. Incorrect The oral cavity is the area located anteriorly to the oropharynx.
PTS: 1
11. You are called to assess a patient who has increased work of breathing (WOB) on inspiration. You
could expect to see what accessory muscles being used?
a. trapezius
b. rectus abdominis
c. external oblique
d. pectoralis major
ANS: A, D
Feedback
Correct The trapezius, pectoralis major, sternocleidomastoid, scalene, and external
intercostal muscles are accessory muscles of inspiration. Incorrect The rectus abdominis, external abdominis obliquus, internal abdominis obliquus,
transversus, and internal intercostal muscles are accessory muscles of expiration.
PTS: 1
12. What three parts compose the sternum?
a. clavicle
b. xiphoid process
c. body of sternum
d. manubrium
ANS: B, C, D
Feedback
Correct The manubrium is the top part of the sternum. The body of the sternum is the
middle and largest part of the sternum. The xiphoid process is the small
projection of bone at the bottom of the sternum. Incorrect The clavicle attaches to the manubrium of the sternum.
PTS: 1
13. What two layers make up the mucous blanket?
a. cilia
b. gel
c. sol
d. basal cells
ANS: B, C
Feedback
Correct The gel layer is the top layer and more viscous; the sol layer is the bottom layer. Incorrect The cilia move the sol layer in a wavelike fashion. The cilia are attached to the
basal cells.
PTS: 1
14. Which of the following make up the cartilaginous airways?
a. subsegmental bronchi
b. segmental bronchi
c. main stem bronchi
d. lobar bronchi
ANS: A, B, C, D
Feedback
Correct All of the answers are part of the cartilaginous airways. Incorrect There are no incorrect answers for this question.
PTS: 1
15. Which of the following make up the noncartilaginous airways?
a. trachea
b. bronchioles
c. respiratory bronchioles
d. terminal bronchioles
ANS: B, D
Feedback
Correct The bronchioles and terminal bronchioles make up the noncartilaginous airways. Incorrect The trachea is part of the cartilaginous airways, and the respiratory bronchioles
are part of the sites of gas exchange.
PTS: 1
16. Which of the following are part of the sites of gas exchange?
a. alveolar sacs
b. alveolar ducts
c. bronchioles
d. respiratory bronchioles
ANS: A, B, D
Feedback
Correct The alveolar sacs, alveolar ducts, and the respiratory bronchioles are part of the
sites of gas exchange. Incorrect The bronchioles are noncartilaginous airways.
PTS: 1
17. What forms the roof of the nasal cavity?
a. nasal bones
b. palatine bones
c. frontal process of the maxilla
d. cribriform plate of the ethmoid bone
ANS: A, C, D
Feedback
Correct The nasal bones, frontal process of the maxilla, and the cribriform plate of the
ethmoid bone form the roof of the nasal cavity. Incorrect The palatine bones form the floor of the nasal cavity.
PTS: 1
18. What forms the upper third of the nose?
a. cribriform plate of the ethmoid bone
b. lateral nasal cartilage
c. nasal bones
d. frontal process of the maxilla
ANS: C, D
Feedback
Correct The nasal bones and the frontal process of the maxilla form the upper third of the
nose. Incorrect The cribriform plate of the ethmoid bone and the lateral nasal cartilage do not
make up the upper third of the nose.
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COMPLETION
1. There are ____________________ lobes in the right lung.
ANS:
three
3
PTS: 1
2. The space between the true vocal cords is called the ____________________.
ANS: glottis
PTS: 1
3. The potential space between the parietal and visceral pleura is called the
______________________________.
ANS: pleural space
PTS: 1
4. The ____________________ muscles allow people to shrug their shoulders and are considered
accessory muscles of inspiration.
ANS: trapezius
PTS: 1
5. The ____________________ fissure separates the left upper lobe from the left lower lobe.
ANS: oblique
PTS: 1
6. The ____________________ is the area of the mediastinal border where the main stem bronchi, blood
vessels, lymph vessels, and various nerves enter and leave the lungs.
ANS: hilum
PTS: 1
7. No lymphatic vessels are found in the walls of the ____________________.
ANS: alveoli
PTS: 1
8. The capillaries are composed of a single layer of ____________________ epithelial cells.
ANS: squamous
PTS: 1
9. ______________________________ are small holes in the walls of the interalveolar septa that permit
air to pass between adjacent alveoli.
ANS: Pores of Kohn
PTS: 1
10. The end of the endotracheal tube should be positioned ____________________ cm above the carina.
ANS:
two
2
PTS: 1
11. If an endotracheal tube is inserted too far into the trachea, it will most likely enter the
____________________ main stem bronchi.
ANS: right
PTS: 1
12. There are approximately ___________________________________ alveoli in an adult male lung.
ANS:
300,000,000
300 million
three hundred million
PTS: 1
13. The ____________________ arteries arise from the aorta and nourish the tracheobronchial tree as far
as the terminal bronchioles.
ANS: bronchial
PTS: 1
14. About one-third of bronchial venous blood returns to the right atrium via the ____________________
vein, the ____________________ vein, and the ____________________ vein.
ANS:
azygos, hemiazygos, intercostal
azygos, intercostal, hemiazygos
hemiazygos, azygos, intercostal
hemiazygos, intercostal, azygos
intercostal, azygos, hemiazygos
intercostal, hemiazygos, azygos
PTS: 1
15. As air travels down the tracheobronchial tree, the total cross-sectional area ____________________.
ANS: increases
PTS: 1
16. There are about ____________________ cilia per ciliated cell.
ANS:
200
two hundred
PTS: 1
17. The average diameter of the terminal bronchioles is about ____________________ mm.
ANS:
0.5
one-half
one half
1/2
PTS: 1
18. In the internal portion of the nose, a partition, the ______________________________, separates the
nasal cavity into two approximately equal chambers.
ANS: nasal septum
PTS: 1
19. The openings of the nasal cavity, in which air flows into the nasal cavity, are called
____________________.
ANS:
nares
nostrils
PTS: 1
20. As air passes through the nares, it passes through a slightly dilated area called the
____________________.
ANS: vestibule
PTS: 1
SHORT ANSWER
1. List the ten branches of the tracheobronchial tree in order.
ANS:
trachea
main stem bronchi
lobar bronchi
segmental bronchi
subsegmental bronchi
bronchioles
terminal bronchioles
respiratory bronchioles
alveolar ducts
alveolar sacs
PTS: 1
2. Explain what happens when a mast cell is activated.
ANS:
When a mast cell is activated, it releases numerous substances, such as histamine, SRS-A, heparin,
PAF, and ECF-A. These chemicals cause increased vascular permeability, smooth muscle contraction,
increased mucus secretion, and vasodilation with edema.
PTS: 1
3. Explain what the alveolar-capillary interstitium is composed of?
ANS:
The interstitium is a gel-like substance composed of molecules that are held together by a weblike
network of collagen fibers. The interstitium has two major components, the tight space and the loose
space. The tight space is the area between the alveolar epithelium and the capillaries. This is where gas
exchange occurs. The loose space is the areas that surrounds the bronchioles, respiratory bronchioles,
alveolar ducts, and alveolar sacs.
PTS: 1
4. What happens to the bronchial smooth muscle when the sympathetic nervous system is stimulated?
ANS:
The bronchial smooth muscles dilate or relax when the sympathetic nervous system is stimulated.
PTS: 1
5. List and explain the parts of the sternum.
ANS:
There are three parts of the sternum: the body, which is the middle portion; the xiphoid process, which
is the small piece of bone at the bottom of the sternum; and the top part, which is called the
manubrium sterni.
PTS: 1