1.
Which of the following are part of the 5 functions of the respiratory system? (Check all that apply)
Correct Answer(s)
B. Acid Base Balance
D. Metabolism
E. pHonation
Explanation
The respiratory system is responsible for several functions, including acid-base balance, metabolism, and phonation. Acid-base balance refers to the regulation of the body's pH levels through the exchange of gases in the lungs. Metabolism involves the exchange of oxygen and carbon dioxide to support cellular respiration and energy production. Phonation refers to the production of sound through the movement of air in the respiratory system. Therefore, the correct answer options are Acid Base Balance, Metabolism, and Phonation.
2.
The inhalation of air from the atmosphere into the lungs is known as…
Correct Answer
A. Ventilation
Explanation
Ventilation refers to the process of inhaling air from the atmosphere into the lungs. It involves the movement of air through the respiratory system, specifically the nose or mouth, down the trachea, and into the lungs. This process allows oxygen to enter the lungs and carbon dioxide to be expelled. External respiration, on the other hand, refers to the exchange of gases between the lungs and the bloodstream, while internal respiration refers to the exchange of gases between the bloodstream and the cells of the body.
3.
What is Internal Respiration?
Correct Answer
B. The exchange of gases between the blood and the cells
Explanation
Internal respiration refers to the exchange of gases between the blood and the cells. During this process, oxygen is transported from the bloodstream into the cells, while carbon dioxide, a waste product of cellular metabolism, is transported from the cells into the bloodstream to be eliminated from the body. This exchange of gases occurs in the capillaries, where oxygen diffuses from the blood into the cells, and carbon dioxide diffuses from the cells into the blood. This process is essential for cellular respiration and maintaining proper oxygen and carbon dioxide levels in the body.
4.
What is the proper technique for a nasal intubation?
Correct Answer
C. With the nose pushed superiorly insert the tube with steady gentle pressure parallel to the roof of the mouth.
Explanation
The correct technique for a nasal intubation is to insert the tube with the nose pushed superiorly, applying steady gentle pressure, and keeping it parallel to the roof of the mouth. This technique helps to ensure proper placement of the tube and minimize the risk of complications.
5.
Which of the following is a risk associated with prolonged nasal intubations?
Correct Answer
D. Intracranial Infection
Explanation
Prolonged nasal intubations can increase the risk of intracranial infection. This is because the nasal passages are connected to the sinuses and the skull base, which are in close proximity to the brain. If the nasal intubation is not properly managed or if there is a breach in the nasal mucosa, bacteria can enter the nasal passages and potentially cause an infection in the intracranial space. This can lead to serious complications, including meningitis or brain abscess. Therefore, it is important to monitor and manage nasal intubations carefully to minimize the risk of intracranial infection.
6.
What is the function of the pharynx?
Correct Answer
A. Serve as a conduit for air and food and to provide a resonating chamber for speech sounds
Explanation
The pharynx serves as a conduit for air and food, allowing them to pass from the mouth to the esophagus or trachea. It also acts as a resonating chamber for speech sounds, helping to produce and modify sound waves produced by the vocal cords. This explanation highlights the main functions of the pharynx without explicitly stating that it is the correct answer.
7.
Which of the following is NOT part of the pharynx?
Correct Answer
B. TracheopHarynx
Explanation
The tracheopharynx is not part of the pharynx. The pharynx is a muscular tube that connects the nasal cavity and mouth to the esophagus and larynx. It is divided into three parts: the nasopharynx, oropharynx, and laryngopharynx. The nasopharynx is located behind the nasal cavity, the oropharynx is located behind the mouth, and the laryngopharynx is located behind the larynx. The tracheopharynx, however, does not exist anatomically and is not a recognized part of the pharynx.
8.
Why is it that adults need cuffed tubes and children do not?
Correct Answer
C. Cricoid cartilage can form a seal against an ETT tube in children, making cuffed tubes uneccessary.
Explanation
The cricoid cartilage in children can create a tight seal around an endotracheal tube (ETT), eliminating the need for a cuff. This seal helps to prevent air leaks and ensures proper ventilation. In contrast, adults have wider vocal cords, making it more difficult to maintain a secure seal without a cuff. The cuff in adult ETTs helps to prevent air leaks and accidental extubation. Therefore, children do not require cuffed tubes due to the natural seal created by the cricoid cartilage.
9.
Which of the following is one of the single cartilage formations of the larynx?
Correct Answer
D. Cricoid
Explanation
The cricoid is one of the single cartilage formations of the larynx. It is a ring-shaped cartilage located at the base of the larynx, below the thyroid cartilage. The cricoid cartilage provides support and stability to the larynx, and it also plays a role in regulating airflow during breathing and phonation.
10.
When you swallow food, what cartilage of the larynx guards the laryngeal entrance and protects you from aspiration?
Correct Answer
A. Epiglottis
Explanation
The epiglottis is a flap of cartilage located at the base of the tongue that prevents food and liquid from entering the trachea (windpipe) when swallowing. It acts as a protective barrier by covering the laryngeal entrance, ensuring that food goes down the esophagus and into the stomach instead of the lungs. This helps to prevent aspiration, which can lead to choking or respiratory issues. The other options listed, such as vocal cords, cricoid, and arytenoid, are also parts of the larynx but do not specifically guard the laryngeal entrance like the epiglottis does.
11.
The chief support for the larynx is provided by…
Correct Answer
B. Hyoid Bone
Explanation
The hyoid bone is the correct answer because it is the only option that directly supports the larynx. The pharynx is a passageway for air and food, but it does not provide support for the larynx. The thyroid cartilage and cricoid cartilage are both part of the larynx itself, rather than providing support for it. Therefore, the hyoid bone is the chief support for the larynx.
12.
You are the SRNA for Mr. Becker today. During the middle of the ENT case the surgeon moves the patients head down, so that his chin is to his chest. Your preceptor asks how this will effect your ETT, what do you tell him?
Correct Answer
C. The ETT will be pushed further into the trachea, pt at risk for tube to hit carina or go into Right mainstem bronchus.
Explanation
When the patient's head is moved down, with the chin to the chest, it causes a flexion of the neck. This flexion can lead to the ETT (endotracheal tube) being pushed further into the trachea. As a result, there is a risk that the tube may hit the carina (the point where the trachea splits into the bronchi) or even enter the right mainstem bronchus. This can cause complications and compromise the patient's airway. Therefore, it is important to be aware of this risk and take necessary precautions to prevent any potential harm to the patient.
13.
Which Cartilage is attached to the posterior ends of the vocal cords and serves as their focal point for movement?
Correct Answer
D. Arytenoid
Explanation
The arytenoid cartilage is attached to the posterior ends of the vocal cords and serves as their focal point for movement. It is responsible for controlling the tension and position of the vocal cords, allowing for changes in pitch and voice production. The epiglottis is a flap of cartilage that covers the opening of the larynx during swallowing to prevent food from entering the airway. The periglottic cartilage is not a specific cartilage structure in the larynx. The corniculate cartilages are small, horn-shaped cartilages located on top of the arytenoid cartilages, assisting in closing the glottis during swallowing and producing sound.
14.
Which laryngeal cartilage corresponds to the beginning of the trachea?
Correct Answer
A. Cricoid
Explanation
The cricoid cartilage corresponds to the beginning of the trachea. It is a ring-shaped cartilage located at the lower part of the larynx and forms the inferior part of the laryngeal skeleton. It sits on top of the trachea and provides support and protection to the airway. The cricoid cartilage also plays a role in vocal cord movement and helps regulate airflow during breathing and phonation.
15.
Which of the following is true regarding the trachea?
Correct Answer
B. Distance from incisors to carina is roughly 26 cm
16.
As the bronchial branching becomes more extensive in the bronchial tree the epithelium changes from _______________ to _____________ in the terminal bronchioles.
Correct Answer
C. Pseudostratified ciliated, simple cuboidal
Explanation
As the bronchial branching becomes more extensive in the bronchial tree, the epithelium changes from pseudostratified ciliated to simple cuboidal in the terminal bronchioles. This change in epithelium is due to the decrease in the amount of cartilage and smooth muscle present in the smaller airways. The pseudostratified ciliated epithelium is found in the larger bronchi and helps to move mucus and trapped particles out of the respiratory tract. In the terminal bronchioles, which are smaller and have less need for mucus clearance, the epithelium transitions to simple cuboidal, which is better suited for gas exchange.
17.
The names of two layers of serous membranes that enclose and protect the lungs are … (Two Answers)
Correct Answer(s)
C. Parietal
D. Visceral
Explanation
The pleural membranes consist of two layers: the parietal pleura and the visceral pleura. The parietal pleura lines the inner surface of the chest wall and the diaphragm, while the visceral pleura covers the surface of the lungs. Together, these two layers form a protective sac around the lungs, allowing them to move smoothly during breathing while also providing lubrication. The surfactant, on the other hand, is a substance produced by the lungs that helps reduce surface tension and prevents the collapse of the alveoli. However, it is not a layer of serous membrane that encloses and protects the lungs.
18.
Which lung contains the greater proportion of lung capacity?
Correct Answer
A. Right
Explanation
The right lung contains the greater proportion of lung capacity. This is because the right lung has three lobes, while the left lung only has two lobes. The additional lobe in the right lung allows it to have a larger volume and therefore a greater proportion of the total lung capacity.
19.
The cardiac notch is contained within which lung?
Correct Answer
B. Left
Explanation
The cardiac notch is a concave space on the left lung that accommodates the heart. It is not present in the right lung. Therefore, the correct answer is left.
20.
Which lung contains a hilus?
Correct Answer
C. Both
Explanation
Both lungs contain a hilus. The hilus is a region on each lung where the bronchi, blood vessels, and nerves enter and exit. It is located on the medial side of each lung and serves as a point of connection between the lung and other structures in the thoracic cavity. Therefore, both the right and left lungs have a hilus.
21.
Due to pulmonary anatomy, a risk associated with inserting subclavian lines is…
Correct Answer
D. Pneumothorax
Explanation
Pneumothorax is a risk associated with inserting subclavian lines due to the pulmonary anatomy. The subclavian vein is located close to the lung, and during the insertion of the line, there is a possibility of unintentional puncture or damage to the lung tissue, leading to the accumulation of air in the pleural space, causing a pneumothorax. This can result in lung collapse and difficulty in breathing. Therefore, pneumothorax is a potential complication that healthcare professionals should be cautious about when performing subclavian line insertions.
22.
What is the function of the alveolar capillary membrane?
Correct Answer
A. Diffusion of gases
Explanation
The alveolar capillary membrane is responsible for the diffusion of gases. This membrane is very thin and allows for the exchange of oxygen and carbon dioxide between the alveoli and the capillaries. Oxygen from the inhaled air diffuses across this membrane into the bloodstream, while carbon dioxide, a waste product, diffuses from the bloodstream into the alveoli to be exhaled. This diffusion process is essential for the exchange of gases and is crucial for respiration.
23.
Which form of cellular metabolism produces the greatest amount of ATP?
Correct Answer
B. Aerobic Metabolism
Explanation
Aerobic metabolism produces the greatest amount of ATP. During aerobic metabolism, glucose is broken down in the presence of oxygen to produce ATP through a series of reactions called cellular respiration. This process occurs in the mitochondria and is highly efficient, producing a total of 36-38 ATP molecules per glucose molecule. In contrast, glycolysis, which occurs in the cytoplasm, only produces a net gain of 2 ATP molecules per glucose molecule. Anaerobic metabolism, such as fermentation, also occurs in the cytoplasm and produces a small amount of ATP. Therefore, aerobic metabolism is the most efficient in terms of ATP production.
24.
General anesthesia will have what effects of cellular metabolism?
Correct Answer
C. Reducing both O2 consumption and CO2 production by ~ 15% each.
Explanation
General anesthesia reduces both oxygen (O2) consumption and carbon dioxide (CO2) production by approximately 15% each. This means that under general anesthesia, the body's cellular metabolism slows down, resulting in a decrease in the amount of oxygen consumed and the amount of carbon dioxide produced. This is important because it helps to maintain a stable balance of gases in the body and ensures proper functioning of various organs and systems.
25.
What is the primary function of the Tracheobronchial tree?
Correct Answer
B. To conduct gas flow to and from the alveoli
Explanation
The primary function of the Tracheobronchial tree is to conduct gas flow to and from the alveoli. This means that it serves as a pathway for air to enter and exit the lungs, allowing for the exchange of oxygen and carbon dioxide in the alveoli. The tracheobronchial tree consists of the trachea, bronchi, and bronchioles, which progressively branch out and become smaller as they reach the alveoli. This arrangement ensures that air reaches the deepest parts of the lungs where gas exchange occurs.
26.
The Tracheobronchial Tree is composed of how many different dichotomous divisions?
Correct Answer
D. 23
Explanation
The Tracheobronchial Tree is composed of 23 different dichotomous divisions. This means that the tree branches off into two smaller branches at each division, resulting in a total of 23 divisions. Each division represents a branching point in the respiratory system, allowing for the passage of air into smaller and smaller airways.
27.
At what level of tracheobronchial division does flat epithelium begin to appear?
Correct Answer
A. 17-19
Explanation
Flat epithelium begins to appear at the level of tracheobronchial division 17-19.
28.
Which of the following is true regarding Aleveoli?
Correct Answer
B. Size of alveoli is a function of gravity and lung volume.
Explanation
The size of alveoli is influenced by both gravity and lung volume. When a person is in an upright position, the largest alveoli are found at the bases of the lungs due to the effect of gravity. Additionally, as lung volume increases, the size of the alveoli also increases. This is because the expansion of the lungs stretches the alveoli, allowing for more surface area for gas exchange. Therefore, the size of alveoli is indeed a function of both gravity and lung volume.
29.
Why are Cervical injuries above the level of C5 incompatible with spontaneous ventilation?
Correct Answer
C. Due to both pHrenic and intercostals nerves being disrupted.
Explanation
Cervical injuries above the level of C5 are incompatible with spontaneous ventilation because both the phrenic and intercostal nerves, which are responsible for controlling the muscles involved in breathing, are disrupted. The phrenic nerve controls the diaphragm, the main muscle involved in breathing, while the intercostal nerves control the muscles between the ribs that assist in breathing. Without the proper functioning of these nerves, the individual would be unable to breathe on their own.
30.
Vagal Activity in the lungs is responsible for Broncho_______ and it ______ secretions.
Correct Answer
D. Constriction, Increases
Explanation
Vagal activity refers to the stimulation of the vagus nerve, which plays a role in controlling various bodily functions. In the lungs, vagal activity can cause bronchoconstriction, which is the narrowing of the airways. This constriction can lead to difficulty in breathing. Additionally, vagal activity can also increase secretions in the lungs, such as mucus production. Therefore, the correct answer is "Constriction, Increases".
31.
During spontaneous ventilation the gradients for gas exchange are created by…
Correct Answer
A. Changes in intrathoracic pressure
Explanation
During spontaneous ventilation, the gradients for gas exchange are created by changes in intrathoracic pressure. As the diaphragm contracts and relaxes, it causes changes in the volume of the thoracic cavity, leading to changes in intrathoracic pressure. These pressure changes result in the movement of air in and out of the lungs, facilitating gas exchange. Intermittent positive pressure in the airway, on the other hand, is associated with positive pressure ventilation, not spontaneous ventilation. Diaphragmatic relaxation is not directly involved in creating the gradients for gas exchange.
32.
Inhalational agents affect the respiratory pattern by resulting in slow, deep breaths during anesthesia.
Correct Answer
B. False
Explanation
Inhalational agents do not necessarily result in slow, deep breaths during anesthesia. The effect of these agents on the respiratory pattern can vary depending on the specific agent used and the individual patient. Some inhalational agents may cause respiratory depression, leading to shallow and slow breaths, while others may have minimal impact on the respiratory pattern. Therefore, it is not accurate to say that inhalational agents always result in slow, deep breaths during anesthesia.
33.
In the supine position, abdominal breathing predominates.
Correct Answer
A. True
Explanation
In the supine position, which is lying flat on the back, abdominal breathing is the natural and preferred breathing pattern. This is because when lying on the back, the diaphragm can move more freely, allowing for deeper breaths that primarily engage the abdominal muscles. This type of breathing promotes relaxation and is commonly used in practices such as yoga and meditation. Therefore, the statement that abdominal breathing predominates in the supine position is true.
34.
During general anesthesia Expiration will become…
Correct Answer
B. Active
Explanation
During general anesthesia, expiration will become active. This is because general anesthesia causes muscle relaxation, including the muscles involved in breathing. As a result, the patient is unable to maintain normal breathing patterns on their own. Therefore, the process of expiration becomes active, requiring the patient to consciously and actively push air out of their lungs.
35.
The Chest wall has a tendency to _____, while the lungs have a tendency to _____.
Correct Answer
C. Expand, Collapse
Explanation
The chest wall has a tendency to expand, while the lungs have a tendency to collapse. During inhalation, the muscles between the ribs contract, causing the chest wall to expand and create more space in the thoracic cavity. This expansion creates negative pressure, which allows the lungs to expand and fill with air. On the other hand, during exhalation, the muscles relax and the chest wall recoils, causing the lungs to collapse and push air out. This natural tendency of the chest wall to expand and the lungs to collapse helps in the process of breathing.
36.
Alveoli collapse is directly proportional to…
Correct Answer
D. Surface Tension
Explanation
When alveoli collapse, it is primarily due to the surface tension within the alveoli. Surface tension is the force that causes the liquid molecules within the alveoli to attract each other, creating a tendency for the alveoli to collapse. Therefore, the collapse of alveoli is directly proportional to the surface tension.
37.
What substance within the alveoli serves to decrease surface tension?
Correct Answer
A. Surfactant
Explanation
Surfactant is the substance within the alveoli that serves to decrease surface tension. Surface tension is the force that causes the liquid molecules at the surface of a liquid to be pulled together, creating a cohesive force. In the alveoli, surfactant reduces surface tension, allowing the alveoli to expand and preventing them from collapsing. This is important for efficient gas exchange in the lungs. Angiotensin Converting Enzyme is not related to surface tension in the alveoli. Carbon dioxide is a waste product that is exchanged in the alveoli, but it does not decrease surface tension. Pleural WD40 is not a substance found in the alveoli and does not serve to decrease surface tension.
38.
The ease at which the lungs and thoracic wall can be expanded is known as what?
Correct Answer
B. Compliance
Explanation
Compliance refers to the ease at which the lungs and thoracic wall can be expanded. It is a measure of the lung's ability to stretch and expand in response to changes in pressure. High compliance indicates that the lungs are easily expandable, while low compliance suggests stiffness or resistance to expansion. This property is important for efficient breathing and allows the lungs to fill with air during inhalation and deflate during exhalation.
39.
Which of the following is not true regarding functional residual capacity?
Correct Answer
C. Composed of Expiratory reserve volume + Inspiratory reserve volume
Explanation
Functional residual capacity (FRC) is the volume of air that remains in the lungs after a normal exhalation. It is composed of the expiratory reserve volume (ERV), which is the amount of air that can still be exhaled after a normal exhalation, and the inspiratory reserve volume (IRV), which is the amount of air that can still be inhaled after a normal inhalation. Therefore, the statement that FRC is composed of ERV + IRV is true. The other statements are also true, as FRC is indeed defined as the lung volume at the end of normal exhalation, it is about 2300 ml in a normal adult, and it is directly related to patient height.
40.
What is Closing Capacity?
Correct Answer
D. Volume at which small airways close in dependent parts of lungs
Explanation
Closing capacity refers to the volume at which the small airways in the dependent parts of the lungs close. This occurs due to the decrease in lung elastic recoil and increased airway resistance in these areas. It is an important measurement in assessing lung function and can help identify abnormalities in the small airways.
41.
You are assessing lung volumes on a patient today. You ask your patient to take a very deep breath (as much as he can) and then to promptly exhale as much as he can. What are you measuring?
Correct Answer
A. Vital Capacity
Explanation
By asking the patient to take a very deep breath and then exhale as much as they can, the healthcare professional is measuring the vital capacity. Vital capacity is the maximum amount of air a person can exhale after taking the deepest breath possible. It is a measure of the overall lung function and can help assess respiratory health.
42.
Vital Capacity is NOT dependent on which of the following?
Correct Answer
B. Gender
Explanation
Vital capacity is the maximum amount of air that can be forcefully exhaled after a maximum inhalation. It is dependent on factors such as body habitus (physical build), respiratory muscle strength, and chest-lung compliance (the ability of the lungs and chest wall to expand and contract). However, gender does not have a significant impact on vital capacity. While there may be slight differences between males and females due to variations in body size and lung volumes, gender alone does not determine vital capacity.
43.
What would be a normal Vital Capacity for a female who is 5’4” and 60 kg?
Correct Answer
C. 3600 ml
Explanation
Vital capacity is the maximum amount of air a person can exhale after taking a deep breath. It is influenced by factors such as height, weight, age, and gender. In general, males tend to have a higher vital capacity than females. However, the given question does not provide the age of the female, which can also affect vital capacity. Therefore, without additional information, it is difficult to determine the exact normal vital capacity for a female who is 5'4" and 60 kg.
44.
Gas flow in the lungs is…
Correct Answer
D. A mix of laminar and turbulent
Explanation
Gas flow in the lungs is a mix of laminar and turbulent. Laminar flow occurs in the smaller airways, where the flow is smooth and streamlined. Turbulent flow occurs in the larger airways, where the flow is chaotic and irregular. This mix of flow patterns allows for efficient gas exchange in the lungs, as the laminar flow promotes diffusion while the turbulent flow helps to mix the gases and maintain a constant concentration gradient.
45.
The work of breathing is performed primarily by what?
Correct Answer
A. DiapHragm
Explanation
The diaphragm is the main muscle responsible for the work of breathing. It is a dome-shaped muscle located at the base of the lungs, separating the chest cavity from the abdominal cavity. When we inhale, the diaphragm contracts and moves downward, allowing the lungs to expand and fill with air. When we exhale, the diaphragm relaxes and moves upward, pushing the air out of the lungs. The intercostal muscles, abdominal muscles, and accessory muscles also play a role in breathing, but the diaphragm is the primary muscle involved.
46.
Patients with increased airflow resistance will have a rapid, shallow breathing pattern.
Correct Answer
B. False
Explanation
Patients with increased airflow resistance will actually have a slow, deep breathing pattern. This is because increased resistance in the airways makes it harder for air to flow in and out of the lungs, so the body compensates by taking slower and deeper breaths to increase the amount of air entering the lungs. Therefore, the statement is false.
47.
After inducing a patient for general anesthesia you can expect that their FRC will be…
Correct Answer
B. Decreased
Explanation
After inducing a patient for general anesthesia, their FRC (Functional Residual Capacity) will decrease. General anesthesia causes relaxation of the muscles, including the diaphragm, which leads to a decrease in lung volume. This reduction in lung volume results in a decrease in the FRC, which is the volume of air remaining in the lungs after a normal expiration.
48.
What is the minute volume for a patient breathing 12 breaths per minutes at 450 ml tidal volume?
Correct Answer
C. 5.4 L
Explanation
The minute volume is calculated by multiplying the respiratory rate (breaths per minute) by the tidal volume (volume of air per breath). In this case, the patient is breathing 12 breaths per minute at a tidal volume of 450 ml. Therefore, the minute volume would be 12 breaths/minute x 450 ml/breath = 5400 ml/minute. Since 1 liter is equal to 1000 ml, the minute volume can be converted to liters by dividing by 1000. Therefore, the minute volume is 5.4 L.
49.
Gases in non-respiratory airways are known as what?
Correct Answer
D. Anatomic Dead Space
Explanation
Anatomic Dead Space refers to the portion of the respiratory system where gases are present but not involved in gas exchange. It includes the airways such as the trachea, bronchi, and bronchioles, where no gas exchange occurs. This dead space is important for the conditioning of inhaled air, but it does not contribute to the exchange of oxygen and carbon dioxide between the lungs and the bloodstream.
50.
How will systemic vasoconstriction effect pulmonary blood volume?
Correct Answer
A. Will increase pulmonary blood volume
Explanation
Systemic vasoconstriction refers to the narrowing of blood vessels throughout the body. This constriction increases the resistance to blood flow, causing an increase in blood pressure. In response to this increased pressure, the body compensates by redistributing blood to areas with lower resistance, such as the lungs. As a result, pulmonary blood volume increases.