1
Q
What structure is the superior part of the Pharynx? A. Oropharynx B. Larynx C. Nasal cavity D. Nasopharynx E. Laryngopharynx
A
D. Nasopharynx
2
Q
The nasopharynx ends and the oropharynx begins at the level of the \_\_\_\_\_\_\_? A. Epiglottis B. Glottis C. Uvula D. Vallecula
A
C. Uvula
3
Q
The oropharynx extends to the level of the \_\_\_\_? A. Epiglottis B. Glottis C. hypopharynx D. Uvula
A
A. Epiglottis
4
Q
The laryngopharynx extends from the tip of the ______ to the _______ and _______?
A. Larynx, esophagus, Trachea
B. Epiglottis, glottis, esophagus
C. Glottis, epiglottis, esophagus
D. Epiglottis, trachea, esophagus
A
B. Epiglottis, glottis, esophagus
5
Q
The laryngopharynx opens into the ____, and lies in the _____ part of the neck.
A. Pharynx, anterior
B. Pharynx, posterior
C. Larynx, anterior
D. Larynx, superior
A
A. larynx, anterior
6
Q
An important landmark in the _________ is the ________.
**Hint: this landmark is used to identify where the curved blade of the laryngoscope is placed during endotracheal intubation.
A. Oropharynx, larynx B. Laryngopharynx, uvula C. Trachea, vallecula D. Oropharynx, uvula E. Laryngopharynx, vallecula
A
E. Laryngopharynx, vallecula
7
Q
How many cartilages does the larynx have?
A. 6
B. 7
C. 9
D. 12
A
C. 9
8
Q
Which cartilage of the larynx is the largest and MOST superior?
A. Thyroid cartilage (unpaired) B. Thyroid cartilage (paired) C. Cricoid cartilage D. Cuneiform cartilage E. Epiglottis
A
A. Thyroid cartilage (unpaired)
9
Q
Which is the only complete cartilage ring in the larynx?
A. Thyroid cartilage
B. Cricoid cartilage
C. Arytenoid cartilage
D. Cuneiform cartilage
A
B. Cricoid cartilage
**This is the MOST inferior cartilage of the larynx.
10
Q
Where is the U-shaped Hyoid bone located?
A. Inferior to the mandible
B. Beneath the maxilla
C. Above the mandible
D. Superior to the maxilla
A
A. inferior to the mandible
11
Q
What is the purpose for the Hyoid bone?
A. Helps support the airway by attaching ligaments to
the jaw
B. Helps support the airway by anchoring muscles to
the jaw
C. Helps support the mandible
D. Helps support the floor of the mandible
A
A. Helps support the airway by anchoring muscles to the
jaw
12
Q
Which cartilage is the Hyoid bone attached to?
A. Cuneiform cartilage B. Corniculate cartilage C. Cricoid cartilage D. Thyroid cartilage E. Epiglottis
A
D. Thyroid cartilage
13
Q
Which structure are the true and false vocal cords contained in?
A. Larynx
B. Pharynx
C. Trachea
D. Esophagus
A
A. Larynx
14
Q
This structure is a recess located on either side of the larynx, and foreign materials that are swallowed may become lodged here.
A. Glottis
B. Trachea
C. Right main bronchus
D. Piriform sinus
A
D. Piriform sinus
15
Q
Where is the trachea in comparison to the esophagus?
A. Anterior
B. Posterior
C. Inferior
D. Superior
A
A. Anterior
16
Q
What structure marks the beginning of the trachea?
A. Carina
B. Cricoid cartilage
C. Epiglottis
D. Main bronchus
A
B. Cricoid cartilage
17
Q
What structure is located at the opening of the main bronchus where it bifurcates?
A. Hyoid bone
B. Cricoid cartilage
C. Trachea
D. Carina
A
D. Carina
18
Q
What is the cause for bronchodilation of the bronchial smooth muscles when injected with epinephrine?
Stimulation to : A. Beta 2 adrenergic receptor B. Baroreceptors C. Chemoreceptors D. Vagus nerve
A
A. Beta 2 adrenergic receptor
19
Q
The _____ are/is functional units of the respiratory system.
A. Lungs B. Oral and nasal cavity C. respiratory membrane D. Alveoli E. Bronchial tree
A
D. Alveoli
20
Q
Most of the lung tissue is made up of?
A. Respiratory membrane
B. Alveoli
C. Pseudostratified columnar epithelium
D. Goblet cells
A
B. Alveoli
21
Q
Each alveolus is vascular; made up of a fine network of capillaries
A. True
B. False
A
A. True
22
Q
The purpose of the alveoli being coated with surfactant is to _________
A. Deflect foreign material from entering
B. Provide nutrients to each alveolus
C. Prevents atelectasis
D. separate the tiny air sacs
A
C. Prevents atelectasis
23
Q
Pulmonary veins carry ________, whereas pulmonary arteries carry_________
A. Nitrogen (N2) , carbon dioxide (CO2)
B. Deoxyhemoglobin, oxyhemoglobin
C. Deoxygenated blood, oxygenated blood
D. Oxygenated blood, deoxygenated blood
A
D. Oxygenated blood, deoxygenated blood
24
Q
Each lobe of the lung is divided into lobules. The left lobe has____ lobules, and the right lobe has ______ lobules.
A. 6, 4
B. 2, 3
C. 9, 10
D. 8, 9
A
C. 9, 10
25
The most inner layer of the pleural cavity surrounding the lung?
A. Parietal layer
B. Visceral layer
C. pleural membrane
D. lymphatic tissue
B. Visceral layer
26
The fluid that separates the 2 pleural layers and acts as a lubricant?
A. Surfactant
B. Pleural fluid
C. Visceral fluid
D. Serious fluid
D. Serious fluid
27
The primary function of the lungs is ______?
A. Respiration
B. Ventilation
A. Respiration
28
The gas exchange of oxygen and carbon dioxide between an organism and the environment is called?
```
A. Ventilation
B. Lung compliance
C. Eupnea
D. Pulmonary elimination
E. Respiration
```
E. Respiration
29
The lungs are separated by this structure.
```
A. Heart
B. Mediastinum
C. Rib cage
D. Thoracic cavity
E. Stratified squamous epithelium
```
B. Mediastinum
30
The mechanical movement of air into and out of the lung is called?
```
A. Respiration
B. External respiration
C. Internal respiration
D. Ventilation
E. Gas exchange
```
D. Ventilation
31
The supporting structures of the airway include the ....
A. Thoracic rib cage, and the mediastinum
B. Thoracic rib cage, phrenic nerve, and the
mediastinum
C. Trachea, lungs, and the thoracic rib cage
D. Larynx, trachea, and the sternum
B. Thoracic rib cage, phrenic nerve, and the
| mediastinum
32
The thoracic vertebrae consists of ______ pairs of ribs.
A. 8
B. 14
C. 6
D. 12
D. 12
33
The inferior 5 ribs are called ______, and they DO NOT attach directly to the sternum.
A. False ribs
B. Primary ribs
C. Floating ribs
D. Accessory ribs
A. False ribs
34
The sternum is divided into 3 parts called?
A. Manubrium, the body, xiphoid process
B. The body, xiphoid process, rib cage
C. Manubrium, xiphoid process, rib cage
D. Manubrium, the body, rib cage
A. Manubrium, the body, xiphoid process
35
The superior margin of the manubrium, known as the _________.
A. Sternal angle
B. Jugular notch
C. Vertebral arch
D. Superior notch
B. Jugular notch
36
Which is the MOST important muscle used for ventilation?
A. Pectoralis minor
B. Intercostal muscles
C. Diaphragm
D. External intercostal muscles
C. Diaphragm
37
When the diaphragm contracts, the abdominal contents are pushed downward and the intercostal muscles move the ribs upward and outward.
A. True
B. False
A. True
38
During inhalation the diaphragm contracts to ______ the volume and _____ the pressure in the thoracic cavity.
A. Decrease, increase
B. Increase, decrease
B. Increase, decrease
39
You find your patient laying on the ground and due to the M.O.I you suspect a spinal injury. You note your patient is cyanosed and not breathing.
You suspect the primary reason for your patients respiratory arrest is due to.....
A. Thoracic spine fracture
B. Spinal cord injury at the C5 level
C. Spinal cord injury at the C3 level
D. Injury to the medulla and pons
C. Spinal cord injury at the C3 level
*The phrenic nerve originates between C3 and C5. Any spinal injury at the C3 level or above eliminates phrenic nerve function of all the intercostal muscles in the chest wall, which makes it impossible for the pt. to initiate contractions of the diaphragm.
40
The contents within the mediastinum are...
A. Heart, trachea, esophagus
B. Heart, trachea, esophagus, Larynx, blood and lymphatic vessels
C. Blood vessels, lymphatic tissue and lymphatic vessels
D. Both A and C
D. Both A and C
41
External respiration is diffusion of O2 and CO2 between inspired air and pulmonary capillaries, and internal respiration is diffusion of O2 and CO2 between the capillary RBC and tissue cells?
A. False
B. True
B. True
42
Atmospheric pressure is .....
A. 761mm Hg
B. 765mm Hg
C. 650mm Hg
D. 760mm Hg
D. 760mm Hg
43
During expiration, elastic recoil causes the thorax and lung space to decrease in size, which ___________ the intrapulmonic pressure about _____mm Hg above the pressure of the atmosphere.
A. Decreases, 1mm Hg
B. Decreases, 761mm Hg
C. Increases, 1mm Hg
D. Increases, 761mm Hg
C. Increases, 1mm Hg
44
At the END of expiration, the intrapulmonic pressure, and the atmospheric pressure become _______, which stimulates the gas movement out of the lungs to stop.
A. Greater
B. Opposing
C. Equal
D. Decreased
C. Equal
45
During inspiration, the diaphragm and intercostal muscles contact, the volume in the chest ________, and _______ pressure occurs; air enters the lungs.
A. Decreases ,positive
B. Increases, negative
C. Balances, negative
D. Increases, positive
B. Increases, negative
46
On inspiration the diaphragm contacts and the dome of the diaphragm takes on a ______ shape.
A. Flat
B. U-shape
C. Curved
D. Downward
A. Flat
47
On inspiration the internal and external intercostal muscles contracts, which _____ the ______ and increases the chest cavity.
A. Raises, diaphragm
B. Lowers, ribs
C. Lowers, lungs
D. Raises, ribs
D. Raises, ribs
48
Expiration is usually a active motion?
A. True
B. False
B. False
*Expiration is usually a PASSIVE motion
49
The ease in which the lungs and thorax expand during inspiration is known as ___________?
A. Compliance
B. Resistance
C. Tension
D. Reliance
A. Compliance
*The greater the compliance the easier the expansion
50
Examples of diseases that reduce compliance are_______
A. Asthma, pulmonary embolism
B. Pulmonary edema, Bronchitis
C. Asthma, bronchitis, pulmonary edema
D. Both A and B
C. Asthma, bronchitis, pulmonary edema
51
Other disease like _______ increase lung compliance by breaking down the elastic fibers that surround lung tissue causing "air trapping"
A. Flail chest
B. Aspiration pneumonia
C. Emphysema
D. None of the above
C. Emphysema
*The tissue breakdown may be the result of overstretching of the fibers from chronic coughing. These patients have no problem inflating their lungs, but have extreme difficulty exhaling.
52
Health people usually use about 5% of their body expenditure for energy to quiet breath. What factors increase the amount of energy needed for ventilation?
A. Loss of pulmonary surfactant, increased airway resistance
B. decrease in pulmonary pressure
C. None of the above
D. Both A and B
D. Both A and B
53
Alveoli have a tendency to collapse; surfactant lowers the surface tension by intermingling with the water molecules. How does this prevent atelectasis?
A. Helps reduce the cohesive force of the water molecules
B. Helps increase the intrapulmonary pressure
C. Helps reduce the cohesive force of the surface tension
D. None of the above
A. Helps reduce the cohesive force of the
water molecules
*The surface tension is created because water molecules are attracted to each other in the alveolar membrane.
54
The collapse (or diminished volume) of all or part of the lung can be caused by obstruction (such as a foreign body, tumor or mucus), and can also be caused by compression (pneumothorax), or a deficiency in surfactant.
A. Tension pneumothorax
B. Atelectasis
C. Cardiac tamponade
D. Flail chest
B. Atelectasis
55
The angle of Louis is found where the manubrium joins the body of the sternum.
A. True
B. False
A. True
56
Flail chest may occur when two or more adjacent ribs are fractured.
A. True
B. False
B. False
* A flail chest may occur when three or
more adjacent ribs are fractured.
57
Subcutaneous emphysema would most commonly be associated with a?
A. Closed pneumothorax
B. Hemothorax
C. Open pneumothorax
D. Tension pneumothorax
D. Tension pneumothorax
58
You suspect your patient is developing a tension pneumothorax. Of the following, which would be considered a late sign of this injury?
A. Diminished breath sounds on the injured side
B. Increased dyspnea
C. Tracheal deviation
D. Unequal expansion of the chest
C. Tracheal deviation
59
A tension pneumothorax that develops in a patient with closed chest trauma must be relieved through thoracic needle decompression. When performing this technique, the needle should be inserted just above the rib at the chosen site.
A. True
B. False
A. True
60
The term traumatic asphyxia is used to describe a severe crushing injury to the chest and abdomen that results from a(n)
A. Accumulation of blood in the pleural space
B. Air leaking into the pleural space
C. Increase in intrathoracic pressure that forces blood from the right
side of the heart into the veins of the upper thorax, neck, and face
D. Pressure accumulation in the pleural space on one side of the
chest due to a closed pneumothorax
C. Increase in intrathoracic pressure that forces blood from the right
side of the heart into the veins of the upper thorax, neck, and face
61
Beck's triad, which consists of jugular vein distension, muffled heart sounds, and hypotension, is associated with which chest injury?
A. Myocardial contusion
B. Pericardial tamponade
C. Tension pneumothorax
D. Traumatic asphyxia
B. Pericardial tamponade
62
One possible finding in pericardial tamponade may be pulsus paradoxus, which is defined as a systolic blood pressure that drops more than 10 to 15 mm Hg during inspiration compared with expiration.
A. True
B. False
A. True
63
Sudden compression of the abdomen followed by abdominal pain, SOB, and decreased breath sounds are indications of?
A. Diaphragmatic rupture
B. Pneumothorax
C. Tension pneumothorax
D. Traumatic pneumothorax
A. Diaphragmatic rupture
64
If the paramedic suspects a venous injury, the patient should be kept in the ______ position to prevent an air embolism.
A. Semi sitting
B. Recumbent
C. Prone
D. Supine
D. Supine
65
____ _______ is described as an increased systolic pressure, widened pulse pressure, and decrease in the pulse and respiratory rate, which result from increased intracranial pressure.
A. Pulsus paradoxus
B. Pericardial tamponade
C. Cushing's triad
D. Orthopnea
C. Cushing's triad
66
You are caring for a 16-year-old female who may have ingested prescription narcotics as a suicide gesture. Her blood pressure is normal, pulse rate is 132, and respiratory rate is 8 and shallow. She is most likely in:
A. Metabolic acidosis.
B. Metabolic alkalosis.
C. Respiratory acidosis.
D. Respiratory alkalosis.
C. Respiratory acidosis
*Respiratory acidosis is caused by a decrease in tidal volume or respiratory rate.
67
You arrive to find a 42-year-old woman just beginning to have difficulty breathing and itching hives after a single sting by a hornet. At the cellular level, what has occurred?
A. An anaerobic metabolism has begun at the local level and is now
moving into the vasculature.
B. The cells begin a hypermetabolic state associated with the
patient's increased activity level after the sting.
C. The mast cells are retaining the vasoactive amines resulting in a
localized response to the sting.
D. The mast cells have degranulated, releasing serotonin and
histamines into the general circulation.
A. An anaerobic metabolism has begun at
the local level and is now moving into
the vasculature.
*When tissue is injured, as in a sting from a
bee, the mast cells discharge
their granules (degranulation) as part of
the inflammatory response that results in
a hypersensitivity reaction (allergic
reaction).
68
A compromised airway or an airway in a patient with no gag reflex must be secured manually.
A. True
B. False
A. True
*The airway of an unconscious patient or a patient without a gag reflex or cough reflex must be secured immediately. A compromised airway must be secured manually or with adjunct equipment.
69
You and your partner are working aboard a police boat. A 24-year-old woman has been pulled from the water and the crew has initiated ventilation with a bag valve mask. They report that it has become increasingly difficult to get air into the patient. These changes in thoracic and inspiratory pressures are:
A. Foreign body obstruction
B. Ventilation/perfusion mismatch. (V/Q mismatch)
C. Atelectasis.
D. Compliance.
D. Compliance
*The ease with which the lungs and thorax expand during pressure changes is known as compliance. Better compliance means easier pulmonary expansion.
70
Simply put, oxygen moves into the general circulation because?
A. The partial pressure of oxygen and the partial pressure of carbon
dioxide in the bloodstream are equal, causing oxygen to move into
the bloodstream.
B. The partial pressure of oxygen in the lungs is greater than the
partial pressure of oxygen dissolved in the bloodstream.
C. The partial pressure of carbon dioxide returning to the pulmonary
bed is sufficient to displace oxygen into the bloodstream.
D. The partial pressure of oxygen in the lungs is less than the partial
pressure of carbon dioxide displacing the oxygen into the
bloodstream.
B. The partial pressure of oxygen in the
lungs is greater than the partial
pressure of oxygen dissolved in the
bloodstream.
*Oxygen diffuses from the lungs to
the blood (higher area of concentration,
to a lower area of concentration)
71
You approach the driver of a car in a single vehicle accident. You note the smell of alcohol as you approach. The driver is not wearing a seatbelt and no airbags have deployed. You note blood in his mouth, though his teeth are all intact, and he is hoarse when he answers your questions. You should suspect:
A. Foreign body airway obstruction.
B. An allergic reaction.
C. Acute alcohol intoxication.
D. Laryngeal fracture.
D. Laryngeal fracture
*The MOST common cause of laryngeal
fracture is a MVA. Signs and symptoms
will reveal difficulty with speech and
coughing up blood.
72
_______ is generally used to describe patients who have chronic airway obstruction. Chronic is defined as occurring on most days for at least three months in the
year, for at least two successive years.
A. Chronic bronchitis
B. COPD
C. Emphysema
D. Chronic upper resp. infection
B. COPD
73
________ is defined as a condition of the lung characterized by abnormal, permanent
enlargement of the air spaces distal to the terminal bronchiole, accompanied by destruction of
their walls.
A. COPD
B. Chronic bronchitis
C. Asthma
D. Emphysema
D. Emphysema
74
________ is defined as chronic or recurrent excess mucous secretion, in most instances accompanied by cough.
A. Emphysema
B. Bronchitis
C. Upper airway infection
D. Asthma
B. Bronchitis
75
______ is defined as a chronic inflammatory disease of the airways with hyperreactivity of the
trachea and bronchi to various stimuli and manifested by widespread narrowing of the airways
that changes in severity either spontaneously or as a result of therapy.
A. Asthma
B. Bronchitis
C. COPD
D. Both B and C
A. Asthma
76
_____ is the MOST common fracture caused by a MVA.
A. Clavicular
B. Skull
C. Larynx
D. Periorbital
C. Larynx
77
The MOST common region for trauma on the trachea is the area that boarders?
A. Glottis
B. 3rd tracheal ring
C. Cricoid cartilage
D. Both B and C
D. Both B and C
78
Tracheal trauma is usually NOT an isolated event. The trauma is usually associated with injuries of the ______ and ________.
A. Cervical spine
B. Esophagus
C. Larynx, esophagus
D. Both A and B
D. Both A and B
79
The MOST common area to fracture in pediatrics is?
A. Skull
B. Clavicular
C. Tib/Fib
D. Ulna/radial
B. Clavicular
80
Which ribs are the MOST common to fracture in adults?
A. 3 to 8
B. 4 to 6.
C. 4 to 8
A. 3 to 8
*because these are your false ribs (not attached)
81
A pulmonary embolism is a clot in the _____.
A. Pulmonary vein
B. Bronchial tree
C. Pulmonary artery
D. Lungs
C. Pulmonary artery
*This is a perfusion issue!!
****Any issue that happens suddenly is usually a
perfusion issue
82
You are at risk of a pulmonary embolism if....
A. History of COPD
B. Ventricular fibrillation
C. Tall and thin
D. Atrial fibrillation
D. Atrial fibrillation
83
The MOST common sign/symptom of a pulmonary embolism is?
A. Tachypnea
B. Swelling in the lower extremities
C. Dyspnea
D. Decreased BP
C. Dyspnea
84
Upper respiratory infection is ______.
A. The most common of ALL illnesses
B. The most common illness in winter
C. The most common in pediatrics
D. The most common in the elderly
A. The most common of ALL illnesses
85
Spontaneous pneumothorax is caused by a ______.
A. Chronic respiratory infections
B. Bleb
C. Both A and B
D. Chest trauma
B. Bleb
Paramedic Theory: Respiratory
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