Chapter 22: Respiratory System

Test Bank

MULTIPLE CHOICE

1. Which structure is called the windpipe and is supported by rings of

cartilage?
a. Bronchus
b. Alveolus
c. Pharynx
d. Trachea
ANS: D

2. Which of the following respiratory tubes are primarily composed of

smooth muscle and determine the flow of air to the alveoli?
a. Trachea
b. Bronchi
c. Bronchioles
d. Nares
ANS: C

3. The trachea branches into the right and left

a. alveoli.
b. bronchi.
c. nares.
d. pulmonary arteries.
ANS: B

4. The lungs are located within the

a. mediastinum.
b. dorsal cavity.
c. spinal cavity.
d. thoracic cavity.
ANS: D

5. Oxygen diffuses from the alveoli into the

a. bronchioles.
b. trachea.
c. pulmonary capillaries.
d. eustachian tube.
ANS: C
 6. Which nerve innervates the diaphragm?
a. Intercostal nerve
b. Sciatic
c. Phrenic
d. Cranial nerve XI
ANS: C

7. The diaphragm
a. is smooth muscle that forms the
bronchioles.
b. is skeletal muscle.
c. contracts in response to the
firing of the vagus nerve.
d. forms the outer lining of the
lungs.
ANS: B

8. The pleural membranes

a. line the respiratory passages.
b. form the bronchioles.
c. are serous membranes.
d. are confined to the mediastinum.
ANS: C

9. Which respiratory muscles are located between the ribs?

a. Diaphragm
b. Bronchiolar smooth muscle
c. Intercostals
d. Sternocleidomastoids
ANS: C

10. Contraction of the diaphragm and the external intercostal muscles

a. stimulates the phrenic and
intercostal nerves.
b. decreases thoracic volume.
c. causes air to move out of the
lungs.
d. is responsible for inhalation.
ANS: D

11. Stimulation of the phrenic and intercostal nerves causes the release of
 which neurotransmitter into the neuromuscular junction?
a. Adrenaline
b. Norepinephrine
c. Acetylcholine
d. Myosin
ANS: C

12. Dyspnea means

a. “puffed up” alveoli.
b. pneumonia.
c. cyanosis.
d. difficulty breathing.
ANS: D

13. The Adam’s apple is

a. cartilage.
b. the epiglottis.
c. the primary site of gas exchange.
d. the pharynx.
ANS: A

14. Frontal, maxillary, sphenoidal, and ethmoidal

a. refer to the bones of the thorax.
b. are saliva-secreting glands.
c. are paranasal sinuses.
d. are lined with serous membrane.
ANS: C

15. What happens when the diaphragm and the intercostal muscles relax?
a. air moves out of the lungs.
b. inhalation occurs.
c. ventilation ceases.
d. chest volume increases.
ANS: A

16. Which of the following best describes eupnea?

a. Kussmaul respirations
b. Vital capacity
c. Normal, quiet breathing
d. Hypoxemia
ANS: C
17. The respiratory passages are lined with
a. pleura.
b. mucous membrane.
c. serous membrane.
d. muscle.
ANS: B

18. How is most oxygen transported through the blood?

a. attached to hemoglobin.
b. as bicarbonate.
c. as a surfactant.
d. as a lysozyme.
ANS: A

19. Which of the following is the dome-shaped muscle that is the chief
muscle of inhalation?
a. Diaphragm
b. Epiglottis
c. Mediastinum
d. Pericardium
ANS: A

20. Bronchiolar constriction is most likely to cause

a. pneumothorax.
b. pulmonary edema.
c. wheezing.
d. laryngitis.
ANS: C

21. Surfactants are found within the

a. pulmonary capillaries.
b. trachea.
c. alveoli.
d. intrapleural space.
ANS: C

22. Which of the following is the major regulator of respiratory activity?

a. PO2
b. PCO2
c. Bicarbonate
d. Albumin
 ANS: B

23. Which of the following structures controls respirations?

a. Medulla oblongata
b. Basal ganglia
c. Postcentral gyrus
d. Limbic system
ANS: A

24. As plasma PCO2 increases,

a. hemoglobin synthesis increases.
b. ventilation increases.
c. vital capacity increases.
d. respirations cease.
ANS: B

25. Intra-alveolar surface tension is caused by

a. acid.
b. mucus.
c. water.
d. bicarbonate.
ANS: C

26. Hypoventilation decreases the respiratory excretion of

a. oxygen.
b. water.
c. carbon dioxide.
d. albumin.
ANS: C

27. Hypoventilation can cause

a. bleeding and hypotension.
b. alkalosis and Kussmaul
respirations.
c. hypoxemia and acidosis.
d. hyperglycemia and acidosis.
ANS: C

28. Which of the following is most likely to cause hypoxemia?

a. Kussmaul respirations
b. Hyperventilation
 c. Medullary depression
d. Brain stem stimulation
ANS: C

29. Boyle’s law forms the basis of

a. ventilation.
b. chemical regulation of breathing.
c. oxygen transport in the blood.
d. carbon dioxide transport in the
blood.
ANS: A

30. Boyle’s law states the relationship between volume and

a. O2.
b. CO2.
c. pressure.
d. H2O.
ANS: C

31. Which of the following is necessary for the lungs to remain expanded?
a. The alveolar cells must secrete
surfactant.
b. The intrapulmonic pressure must
be negative.
c. The glottis must be closed.
d. The intrapleural pressure must
be negative.
ANS: D

32. The nares, nostrils, and nasal septum

a. are concerned with gas
exchange.
b. are located in the upper
respiratory tract.
c. contain gustatory organs.
d. are parts of the bronchial tree.
ANS: B

33. Which of the following is most related to the transport of the

respiratory gases by the blood?
a. Inhalation, exhalation
b. Oxyhemoglobin,
 carbaminohemoglobin
c. Inspiration, expiration
d. Breathing in, breathing out
ANS: B

34. Which of the following contributes to the wheezing of asthma?

a. Constriction of the bronchiolar
smooth muscle
b. Edema of the esophagus
c. Inflammation of the trachea and
pharynx
d. Pneumothorax
ANS: A

35. Anatomical dead air space is most associated with which structure?
a. Frontal sinus
b. Alveoli
c. Trachea
d. Esophagus
ANS: C

36. The water molecule is polar, meaning that each end of the molecule
has an electrical charge. Because of this characteristic, water
a. has a high surface tension.
b. can only dissolve lipids.
c. is a poor solvent.
d. is lipid-soluble.
ANS: A

37. Which of the following structures is located in the lungs?

a. Pharynx
b. Epiglottis
c. Alveoli
d. Larynx
ANS: C

38. Which of the following is most related to the relaxation of the

diaphragm and the intercostal muscles?
a. Results from the firing of the
inspiratory neurons
b. Caused by the firing of the
phrenic and intercostal nerves
 c. Decreased thoracic volume
d. Causes air to move into the lungs
ANS: C

39. What is the transport mechanism necessary for the movement of

oxygen from the alveoli across the pulmonary capillary membranes
into the blood?
a. Osmosis
b. Filtration
c. Diffusion
d. Active transport pump
ANS: C

40. What is the effect of an overdose of an opioid (narcotic)?

a. Alters the shape of the
hemoglobin so that it cannot bind
to oxygen
b. Depresses the medulla oblongata
and depresses ventilation
c. Causes spasm of the epiglottis
resulting in an upper airway
obstruction
d. Causes hyperventilation and
alkalosis
ANS: B

41. Which substance greatly reduces the attractive forces among the
water molecules lining the alveoli?
a. Lysozyme
b. Converting enzyme
c. Mucus
d. Surfactant
ANS: D

42. What is the effect of curare?

a. Depresses the inspiratory
neurons in the medulla oblongata
b. Changes the shape of the
hemoglobin so that it cannot bind
to oxygen
c. Interferes with the activation of
the diaphragm and the
intercostal muscles by their
 motor nerves
d. Inactivates acetylcholinesterase
ANS: C

43. The epiglottis

a. is innervated by the phrenic
nerve.
b. prevents air from entering the
esophagus.
c. prevents food from entering the
trachea.
d. is the Adam’s apple.
ANS: C

44. The trachea is

a. “the problem” in asthma.
b. the site of gas exchange.
c. composed primarily of smooth
muscle.
d. a large airway that splits into two
bronchi.
ANS: D

45. Which of the following is most likely to cause pulmonary edema?

a. Bronchitis
b. Coryza
c. Exercise-induced asthma
d. Left ventricular heart failure
ANS: D

46. Kussmaul respirations

a. cause hypoxemia.
b. increase PCO2.
c. refer to an acidosis-induced
increased respiratory activity.
d. are caused by a decrease in the
plasma [H+].
ANS: C

47. In reference to a normally expanded lung, the

a. intrapulmonic pressure is less
than intrapleural pressure.
 b. intrapleural pressure is greater
than atmospheric pressure.
c. intrapulmonic pressure is greater
than intrapleural pressure.
d. intrapleural, intrapulmonic, and
atmospheric pressures are equal.
ANS: C

48. In which structure is the PO2 104 mm Hg?

a. Pulmonary artery
b. Alveolus
c. Right ventricle
d. Vena cava
ANS: B

49. Across which structure(s) does most gas exchange occur?

a. Trachea
b. Bronchus
c. Bronchioles
d. Alveoli
ANS: D

50. The Hering-Breuer reflex

a. prevents overinflation of the
lungs.
b. is a chemical reflex; no nerves
are involved.
c. is important only in disease
states.
d. is concerned only with sneezing
and coughing.
ANS: A

51. The central chemoreceptors are primarily sensitive to blood levels of

a. oxygen.
b. carbon dioxide and [H+].
c. sodium.
d. potassium.
ANS: B

52. Which structure has the thinnest wall?

a. Trachea
 b. Bronchi
c. Larynx
d. Alveoli
ANS: D

53. Which event occurs first?

a. The diaphragm contracts.
b. Air moves into the lungs.
c. The phrenic nerve fires.
d. The inspiratory neurons in the
medulla fire.
ANS: D

54. What is the effect of phrenic nerve stimulation?

a. Expiration
b. Relaxation of the diaphragm and
the intercostals
c. Inhalation
d. A decrease in chest diameter
ANS: C

55. Which of the following events occurs last?

a. Contraction of the diaphragm
and the intercostals
b. Movement of air into the lungs
c. Firing of the inspiratory neurons
in the medulla
d. Firing of the phrenic and
intercostal nerves
ANS: B

56. The phrenic nerve fires. Which event occurs next?

a. The inspiratory neurons fire.
b. The diaphragm contracts.
c. Air moves into the lungs.
d. Thoracic volume decreases.
ANS: B

57. Which respiratory structure is distal to the trachea and proximal to the
alveoli?
a. Pharynx
b. Larynx
 c. Bronchus
d. Glottis
ANS: C

58. Laryngospasm is most likely to cause

a. emphysema.
b. pneumothorax.
c. acute respiratory obstruction.
d. asthma.
ANS: C

59. Atelectasis
a. decreases the surface area for
gas exchange.
b. causes pneumothorax.
c. causes acute respiratory
obstruction.
d. is best treated with antibiotics.
ANS: A

60. Activation of the beta2-adrenergic receptors of the airway

a. causes laryngospasm.
b. constricts the bronchioles.
c. restricts air flow.
d. causes bronchodilation.
ANS: D

61. The collection of mucus in the lower airways is most likely to cause
a. laryngospasm.
b. pneumothorax.
c. atelectasis.
d. pharyngitis.
ANS: C

62. Which of the following is most likely to stimulate coughing that may be
accompanied by a life-threatening bradycardia?
a. Suctioning of the lower airways
b. Administration of albuterol (a
beta2-adrenergic agonist) via
inhalation
c. Administration of O2 via nasal
cannula
 d. Performance of a thoracentesis
ANS: A

63. A preterm infant is most likely to develop respiratory distress because

of
a. bacterial pneumonia.
b. a deficiency of surfactant.
c. excess mucus zin the upper
airways.
d. an inability of the immature
diaphragm to contract.
ANS: B

64. Which group is incorrect?

a. Pulmonary volumes: tidal,
inspiratory reserve, expiratory
reserve
b. Structures of the bronchial tree:
bronchi, bronchioles, alveoli
c. Respiratory gases: oxygen,
carbon dioxide
d. Parts of the pharynx: oropharynx,
nasopharynx, laryngopharynx,
bronchiopharynx
ANS: D

65. Which group is incorrect?

a. Structures of the bronchial tree:
trachea, bronchi, bronchioles,
alveoli
b. Paranasal sinuses: frontal,
maxillary, sphenoidal, ethmoidal
c. Structures of the upper
respiratory tract: trachea,
pharynx, larynx
d. Parts of the pharynx: oropharynx,
nasopharynx, laryngopharynx
ANS: A

66. The respiratory tract

a. includes the mouth, pharynx,
trachea, and esophagus.
b. contains conductance,
 resistance, and exchange
structures.
c. is lined with serous pleural
membranes and cilia.
d. begins with the nose and mouth
and ends at the bronchioles.
ANS: B

67. Contraction and relaxation of the diaphragm and intercostal muscles

a. change thoracic volume.
b. close the glottis.
c. occur in response to firing of the
vagus nerve.
d. All of the above are true.
ANS: A

68. Cartilaginous rings

a. prevent the collapse of the
trachea.
b. surround each alveolus.
c. are innervated by the phrenic
nerve.
d. attach the diaphragm to the
thoracic wall.
ANS: A

69. Which of the following statements is true of the right bronchus?

a. Food and small objects are more
likely to be aspirated into the
right bronchus because it is more
vertical and larger than the left
bronchus.
b. The right bronchus has an
opening to the pleural cavity.
c. Oxygen content is higher in the
right bronchus than the left
bronchus.
d. The right bronchus is bigger than
the left bronchus, so it has higher
levels of carbon dioxide.
ANS: A

70. The lungs contain the

 a. inspiratory and expiratory
neurons.
b. structures of the bronchial tree.
c. pharynx, larynx, and trachea.
d. pleural membranes.
ANS: B

71. Which of the following best describes the visceral and parietal pleura?
a. Line the inner wall of the trachea
and bronchi
b. Line the mediastinum
c. Are serous membranes that line
the pleural cavity
d. Are surfactant-secreting
membranes
ANS: C

72. Surfactants
a. prevent collapse of the alveoli.
b. induce anaphylaxis.
c. cause upper respiratory
obstruction.
d. decrease thoracic volume.
ANS: A

73. Which of the following occurs on inhalation?

a. Air moves into the intrapulmonic
space.
b. Thoracic volume increases.
c. The diaphragm contracts.
d. All of the above occur.
ANS: D

74. Which of the following occurs on exhalation?

a. Respiratory expiratory neurons
fire.
b. The diaphragm relaxes.
c. Thoracic volume decreases.
d. All of the above occur.
ANS: D

75. Which of the following describes Boyle’s law?

 a. An increase in thoracic volume
causes an increase in
intrapulmonic pressure.
b. There is no relationship between
intrapulmonic pressure and
thoracic volume.
c. An increase in thoracic volume
decreases intrapulmonic
pressure.
d. An increase in thoracic volume
forces air out of the lungs.
ANS: C

76. Severing the phrenic nerve

a. stops ventilation.
b. impairs exhalation but has no
effect on inhalation.
c. causes hyperventilation and
respiratory alkalosis.
d. does all of the above.
ANS: A

77. Most CO2 is transported in the blood

a. by the hemoglobin, as
carbaminohemoglobin.
b. by megakaryocytes.
c. loosely bound to the iron
molecule in heme.
d. as bicarbonate.
ANS: D

78. Respirations are primarily controlled by the

a. medulla oblongata.
b. cerebellum.
c. spinal cord.
d. frontal lobe.
ANS: A

79. The pneumotaxic center and apneustic center are located within the
a. aortic bodies.
b. alveoli.
c. pons.
 d. spinal cord.
ANS: C

80. Inspiratory and expiratory neurons

a. are located within the respiratory
control center in the brain stem.
b. are sensitive primarily to PO2.
c. line the breathing tubes,
especially the bronchioles.
d. All of the above are true.
ANS: A

81. Which of the following is an upper respiratory structure?

a. Alveoli
b. Larynx
c. Bronchi
d. Bronchioles
ANS: B

82. Which of the following represents a correct air flow?

a. Bronchus to trachea to
bronchioles
b. Trachea to bronchioles to alveoli
c. Bronchi to bronchioles to alveoli
d. Nasopharynx to larynx to
bronchioles to bronchi
ANS: C

83. Which of the following is true of the lower respiratory tract?

a. Contains the respiratory organs
in the chest
b. Contains all respiratory organs
c. Contains all respiratory
structures lined with mucous
membrane
d. Contains all organs distal to the
larynx
ANS: A

84. The olfactory receptors

a. are located on the tongue.
b. are located within the nasal
 cavities and nasal septum.
c. are also called taste buds.
d. carry sensory information to the
brain via CN II.
ANS: B

85. As part of the respiratory structures, the oropharynx and

laryngopharynx
a. carry only air.
b. are located distal to the larynx.
c. carry food and water to the
esophagus.
d. carry air to respiratory structures
distal to the pharynx.
ANS: C

86. Which of the following represents a correct anatomical sequence?

a. Larynx, laryngopharynx, trachea
b. Oropharynx, laryngopharynx,
larynx
c. Larynx, pharynx, bronchi
d. Voice box, windpipe, alveoli
ANS: B

87. Which of the following structures prevents entrance of food and water
into the respiratory passages?
a. Larynx
b. Glottis
c. Epiglottis
d. Thyroid cartilage
ANS: C

88. Which of the following structures is located both in the thoracic cavity
and mediastinum but not in the pleural cavities?
a. Lungs
b. Heart
c. Alveoli
d. Bronchioles
ANS: B

89. The epiglottis, glottis, and vocal cords

a. vibrate on exhalation, causing
 sound.
b. prevent the entrance of food and
water into the respiratory
passages.
c. are structures of the larynx.
d. are composed of tough cartilage.
ANS: C

90. Identify the names of the following: voice box, throat, and windpipe.
a. Larynx, vocal cords, trachea
b. Larynx, laryngopharynx, bronchi
c. Larynx, pharynx, trachea
d. Laryngopharynx, pharynx, alveoli
ANS: C

91. A tracheostomy is performed in order to

a. ensure an open airway.
b. humidify inhaled air.
c. administer high dose oxygen into
the laryngopharynx.
d. introduce food and water into the
esophagus and stomach.
ANS: A

92. What causes a boy’s voice to “break” or change at the onset of

puberty?
a. Rapid growth of the throat region
stretches the vocal cords.
b. Testosterone causes the vocal
cords to thicken.
c. Testosterone closes the glottis
permanently.
d. Testosterone enlarges the thyroid
cartilage (Adam’s apple).
ANS: B

93. What is the primary concern with laryngospasm and swelling of the lips
and tongue?
a. Interruption of the negative
pressure within the intrapleural
space
b. Indication of accumulation of
 water in the alveoli as in
pulmonary edema
c. Acute upper airway obstruction
d. Indication of damage of the
phrenic nerve
ANS: C

94. “Clubbing” of the fingers is a response to

a. chronic hypoxemia.
b. CO2 retention and acidosis.
c. acute hyperventilation in
response to metabolic acidosis.
d. chronic dry hacking cough.
ANS: A

95. Which of the following is a structure located within the lungs?

a. Visceral pleura
b. Primary bronchi
c. Parietal pleura
d. Intrapleural space
ANS: B

96. Which of the following is the first step in inhalation?

a. Phrenic nerve stimulation
b. Activation of the NM receptors
(neuromuscular junction of the
phrenic nerve and diaphragm)
c. Firing of the medullary
inspiratory neurons
d. Contraction of the diaphragm
ANS: C

97. Where is blood oxygenated?

a. Within the left ventricle
b. Within the left anterior
descending artery
c. Within the coronary sinus
d. Across the alveolus/pulmonary
capillary membrane
ANS: D

98. Central and peripheral chemoreceptors (aortic and carotid bodies)

 a. are responsive only to
hypoxemia.
b. are both sensitive to [H+]
concentrations.
c. can regulate the rate and depth
of respirations.
d. More than one of the above are
true.
ANS: D

99. Which of the following are the accessory muscles of respiration (used
in forced exhalation)?
a. Intercostals and diaphragm
b. Sternocleidomastoid and
trapezius
c. Internal intercostals and the
abdominal muscles
d. Pectoralis major and serratus
anterior
ANS: C

100. At which point in the respiratory cycle is thoracic volume the smallest?
a. At end-inhalation
b. With contraction of the
diaphragm
c. With contraction of the external
intercostals
d. At end of exhalation
ANS: D

101. The trachea

a. contains C-shaped cartilaginous
rings.
b. encircles the pulmonary artery,
where gas exchange occurs.
c. is lined with surfactant-secreting
cells.
d. is located within the pleural
cavity.
ANS: A

102. Firing of the intercostal and phrenic nerves

a. activates the respiratory control
 center in the medulla oblongata.
b. causes relaxation of the muscles
of respiration.
c. causes a skeletal muscle
response that increases thoracic
volume.
d. dilates the bronchioles.
ANS: C

103. The diaphragm

a. is the chief muscle of inhalation.
b. is innervated by the phrenic
nerve.
c. increases thoracic volume when
contracted.
d. All of the above are true.
ANS: D

104. Which event occurs in response to an increase in thoracic volume?

a. The respiratory control center is
activated.
b. Air moves into and through the
respiratory passages.
c. Intrapleural pressure becomes
greater than intrapulmonic
pressure.
d. Air is exhaled.
ANS: B

105. When the muscles of respiration relax,

a. thoracic volume decreases and
air moves out of the lungs.
b. thoracic volume increases and air
moves out of the lung.
c. thoracic volume decreases and
air moves into the lungs.
d. thoracic volume decreases and
intrapulmonic pressure
decreases.
ANS: A

106. Laryngospasm and epiglottal swelling is most apt to cause

a. pulmonary edema.
 b. upper airway obstruction.
c. pleural effusion.
d. pneumothorax.
ANS: B

107. Ventilation
a. refers to the regulation of blood
pH by the lungs.
b. refers to loading and unloading
of oxygen by hemoglobin.
c. has two phases: inhalation and
exhalation.
d. is exclusively responsive to pCO2.
ANS: C

108. Which of the following will cause the intrapulmonic pressure to become
less than atmospheric pressure?
a. Relaxation of the respiratory
muscles
b. Increase in thoracic volume
c. Secretion of surfactants
d. 95% oxygen saturation
ANS: B

109. What will happen under the following conditions: the pO2 is 95 mm Hg
(arterial blood) and 40 mm Hg (tissue)?
a. Oxygen diffuses from the tissues
into the blood.
b. Blood pH shifts from an acid to
an alkaline range.
c. Carbon dioxide diffuses from the
blood to the tissues.
d. Oxygen diffuses from the blood
to the tissues.
ANS: D

110. A stab wound to the chest causes the lung to collapse because
a. of a sudden increase in surface
tension.
b. intrapulmonic pressure becomes
less than atmospheric pressure.
c. intrapulmonic pressure becomes
 higher than intrapleural pressure.
d. intrapleural pressure becomes
greater than intrapulmonic
pressure.
ANS: D

111. The alveoli

a. are supported by C-shaped
cartilaginous rings.
b. are the primary site of
respiratory gas exchange.
c. contract and relax, thereby
determining resistance to air flow
through the respiratory
passages.
d. are composed primarily of
smooth muscle.
ANS: B

112. Surfactants
a. are secreted by cells within the
alveoli.
b. increase surface tension.
c. transport oxygen across the
alveolar-pulmonary capillary
membrane.
d. relax the epiglottis so as prevent
upper respiratory obstruction.
ANS: A

113. A deficiency of surfactants in the neonate

a. makes it difficult to expand the
lungs.
b. decreases alveolar surface
tension.
c. causes epiglottal swelling and
laryngospasm.
d. causes upper airway irritation.
ANS: A

114. Because of their smooth muscle content, _____________ are the primary
determinants of air flow.
a. trachea
 b. bronchi
c. alveoli
d. bronchioles
ANS: D

115. Hyperventilation is most apt to induce

a. alkalosis.
b. hypoxemia.
c. a decline in blood pH.
d. metabolic acidosis.
ANS: A

116. Hypoventilation is most apt to

a. increase blood pH.
b. induce acidosis.
c. cause ketosis.
d. cause hyperglycemia.
ANS: B

117. Pleural membranes

a. line the inside of the lungs.
b. secrete surfactants.
c. secrete mucus and other viscous
secretions to minimize friction
between the pleural membranes.
d. are serous membranes.
ANS: D