Raabia Ansari GMS5605 Respiratory System

At 4 weeks of development, the respiratory system begins as an outgrowth of the foregut. This
outgrowth is referred to as the respiratory diverticulum. The ____ lining the respiratory diverticulum
gives rise to the epithelium and glands of the trachea, bronchi, and alveoli.
A. Lung bud
B. Ectoderm
C. Endoderm
D. Neural crest tissue

The answer is C, Endoderm. The endoderm lining the respiratory diverticulum (also known as the lung
bud) gives rise to the epithelium and glands of the trachea, bronchi, and alveoli.
The splanchnic mesoderm and neural crest tissue surrounding the lung bud gives rise to connective
tissue, cartilage, and smooth muscles of the trachea, bronchi, and alveoli.
A is not correct because this is the respiratory diverticulum.
B is not correct because it is the endoderm, not the ectoderm, that gives rise to the epithelium and
glands of the trachea, bronchi, and alveoli.
D is not correct because the neural crest tissue gives rise to the connective tissue, cartilage, and smooth
muscles of the trachea, bronchi, and alveoli.

Which of the following regarding the lungs is true?

A. The left lung has 3 lobes and the right lung has 2 lobes.
B. The right lung has a cardiac notch to accommodate the position of the heart.
C. The left lung is shorter than the left lung to accommodate the liver.
D. The left lung is about 10% smaller than the right lung.

The answer is D, the left lung is about 10% smaller than the right lung. The right lung is thicker and
broader but is also somewhat shorter than the left lung because the diaphragm is higher on the right
side to accommodate the liver.
The right lung has 3 lobes and the left lung has 2 lobes.
The left lung as a cardiac notch to accommodate the position of the heart.
The right lung is shorter than the left, to accommodate the liver (as previously stated above).

----------------------------------

Jacklyn Nave 3-1 MCQ

Questions

1. When the arytenoid cartilage is abducting, it is _________________.

a. Decreasing the Rima glottidis space
b. Increasing the Rima glottidis space
c. Moving the vocal cords apart
d. Moving the vocal cords together
 e. Both A & D
f. Both B & C

2. A child patient presents with having inhaled a dime. Likely, the foreign object is where?
a. The esophagus
b. The inferior vena cava
c. The left primary bronchus
d. The right primary bronchus

Rationale

1. The correct answer is (f)

When the arytenoid cartilage is abducting, the cartilage is pivoting away from each other (moving
laterally). This means the vocal cords are moving a art or away from each other. This also means the
Rima glottidis space is going to increase. When the arytenoid cartilage is adducting, the vocal cords are
moving together (medially) and the Rima glottidis space is closing, essentially closing the airway.

2. The correct answer is (d)

The right primary bronchus is vertical and wide in structure, as compared to the left primary bronchus
which is horizontal and narrow. If a foreign object is inhaled, the object will therefore be more likely to
be lodged in the right primary bronchus due to its anatomical structure. The esophagus is part of the
digestive system, and likely would not be involved in this situation. The inferior vena cave is part of the
cardiovascular system, and is not connected to the nasal cavity or respiratory system.

MCQ 3-1 Kathryn Kennedy

1. What cartilage is the only one that encircles the airway completely?
a. Corniculate cartilage
b. Thyroid cartilage
c. Arytenoid Cartilage
d. Cricoid Cartilage

Answer: D

Rationale: The thyroid cartilage only makes a “U” shape around the anterolateral portions of the larynx.
The arytenoid cartilage helps with vocal cord attachment posteriorly. The corniculate cartilage is horn-
shaped and is above the arytenoid cartilage. The cricoid cartilage encircles the larynx/airway completely.

2. Which of these is not part of the parietal pleura?

 a. Hilum Pleura
b. Mediastinal Pleura
c. Diaphragmatic Pleura
d. Cervical Pleura

Answer: A

Rationale: Medistinal, diaphragmatic, and cervical are all part of the parietal pleura. The
hilum is the place through which blood vessels, lymphatic vessels, and nerves enter and
exit the lungs.

Yaseen Makhzan

The paired laryngeal cartilages that, along with intrinsic laryngeal muscles, move the vocal folds
(true vocal cords) in speech production are the ________ cartilages.

a. cricoid
b. thyroid
c. arytenoid
d. epiglottic

Rationale: Answer is C. This is because the cricoid, thyroid, and epiglottic cartilages are all
singular cartilages and unpaired.

2. The cardiac notch is a feature of the:

a. Right lung
b. Left lung
c. heart
d. diaphragm

Rationale: Answer is B because the heart pushes into the left lung causing it to be smaller
than the right lung. This is the only definition of cardiac notch meaning the other answers
cannot be correct.
Raul Anaya Jr.
Question 1
Which cartilage has more height posteriorly than its anterior aspect; ring-shaped?
a. Epiglottis
b. Thyroid
c. Corniculate
d. Cricoid

Question 2
The respiratory consists of ____ parts. The _____ zone, consists of tubes and tissue within the
lungs where gas exchange occurs
a. 3 ; Lung
b. 2 ; Conducting
c. 4 ; Respiratory
d. 2 ; Respiratory

Question 1
 A is incorrect because this is leaf shaped
 B is incorrect because this consists of two fused plates
 C is incorrect because this is the tiny piece of cartilage that sits on top of arytenoid
 D is correct because it is the only cartilage that completes a full ring

Question 2
 A is incorrect because I made this up
 B is incorrect because conducting zone filters, warms, and moistens air
 C is incorrect because there are 2 parts
 D is correct because there are 2 parts and this zone uses the main sites of gas
exchange between air and blood

MCQ 3-1 GMS 5605 Tammy Gillespie

Which of the following structures does not increase surface area within the nasal cavity for
warming, moistening, and filtering air?
a. choanae
b. conchae
c. nasal septum
d. meatuses

Rationale: Choanae, or internal nares, are the openings on each side of the nasal septum for air
to pass from the nasal cavity into the nasopharynx. The conchae, or turbinate bones, are
curved shelves of bone, covered in mucous membranes, in the nasal cavity for surface area.
The meatuses are the canals formed under the conchae for the air flow. The nasal septum
divides the nasal cavity in half to increase the surface area, as well.

Which of the following is the proper order of structures of the bronchial tree off of the trachea?
a. segmental bronchi, lobar bronchi, main bronchi, bronchioles
b. bronchioles, segmental bronchi, lobar bronchi, main bronchi
c. main bronchi, lobar bronchi, segmental bronchi, bronchioles
d. bronchioles, main bronchi, lobar bronchi, segmental bronchi

Rationale: coming off of the trachea are the main, or primary, bronchi. Then the secondary, or
lobar, bronchi, are next, followed by the tertiary, or segmental, bronchi. The bronchioles are
found at the ends of the segmental bronchi.

H Horn
1. Which of the following structures is not part of the conducting zone of the
respiratory system?
a. Trachea
b. Bronchi
c. Pharynx
d. Alveoli

2. Which of the following is not one of the three basic steps of respiration?
a. Pulmonary Ventilation
 b. Internal Respiration
c. External Respiration
d. Systemic Respiration

Question 1 Rationale: D. The Alveoli are part of the respiratory zone, while answers A-C are a
part of the conducting zone.
Question 2 Rationale: D Systemic Respiration is not part of the 3 basic steps.
David Baza Fuentes
GMS 5605
MCQ 3-1

1. Which of the following is not a component of the lower respiratory system?

a. Larynx
b. Pharynx
c. Bronchi
d. Lungs

Correct answer: B
Rationale: The correct answer is C the pharynx. The pharynx is a component of the upper
respiratory system, which also includes the nose, pharynx and associated structures. Answer
choices A, C, and D are structures that make up the lower respiratory system.

2. For inhalation to occur the air pressure in the lungs must be what?
a. Be equal to atmospheric pressure
b. Higher than atmospheric pressure
c. Lower than atmospheric pressure
d. Pressure must equal 760 mmHg

Correct answer: C
Rationale: The correct answer is C. For air to flow into the lungs the pressure in the lungs must
be lower than atmospheric pressure. This is achieved by increasing the size of the lung.
MCQ 3-1 Karen V. Goodwin

1. This area of the upper respiratory airway serves only as an air passageway.
A. The nasopharynx
B. The oropharynx
C. The laryngopharynx
D. The thyropharynx

2. Which is the correct order of structures from PROXIMAL to DISTAL?

A. Trachea—respiratory bronchioles—terminal bronchioles—main bronchi—segmental
bronchi—lobar bronchi—alveolar ducts—alveolar sacs
B. Trachea—main bronchi—segmental bronchi—lobar bronchi—terminal bronchioles—
respiratory bronchioles—alveolar ducts—alveolar sacs
C. Trachea—main bronchi—lobar bronchi—segmental bronchi—terminal bronchioles—
respiratory bronchioles—alveolar ducts—alveolar sacs
D. Trachea—main bronchi—lobar bronchi—segmental bronchi—respiratory bronchioles—
terminal bronchioles—alveolar ducts—alveolar sacs

RATIONALE:
1. ANSWER: A. The nasopharynx serves only as an air passageway. The oropharynx (B)
serves also in swallowing food. The laryngopharynx (C) serves also in voice production.
Answer D, thyropharynx, is not a real structure and is only a detractor answer choice.
2. ANSWER: C. The correct order of respiratory tree passages is: Trachea—main bronchi—
lobar bronchi—segmental bronchi—terminal bronchioles—respiratory bronchioles—
alveolar ducts—alveolar sacs. No other order demonstrated in the remaining answer
choices can be considered correct.
Robert S. Richardson
GMS 5605
3-1 Questions

1. Name the structures that would be in the nasopharynx.

a. opening of the pharyngotympanic (auditory) tube
b. pharyngeal tonsil
c. palatine tonsil
d. choices a) and b)
e. choices b) and c)

2. Which type of epithelium makes up the alveolar ducts and alveoli?

a. pseudostratified ciliated columnar
b. nonkeratinized stratified squamous
c. simple squamous
d. simple cuboidal

Rationale for question 1

Choice a): The opening of the pharyngotympanic (auditory) tube would be included within the
nasopharynx.
Choice b): The pharyngeal tonsil would be included within the nasopharynx.
Choice c): The palatine tonsil would not be included within the nasopharynx. The palatine tonsil
would be included within the oropharynx.
Choice d): Yes, the opening of the pharyngotympanic (auditory) tube and the pharyngeal
tonsil would both be within the nasopharynx.
Choice e): The pharyngeal tonsil is included in the nasopharynx. The palatine tonsil is not
included in the nasopharynx because it is included in the oropharynx.

Rationale for question 2

Choices a): Would not be a good answer. Pseudostratified ciliated columnar would be found in
the mucosa of the nasopharynx, trachea, main bronchi, lobar bronchi, and segmental bronchi.
Pseudostratified ciliated columnar would not be thin enough for efficient gas exchange to take
place.
Choice b): Would not be a good answer. Nonkeratinized stratified squamous would be found in
the oropharynx, laryngopharynx, and part of the larynx. Stratified layers would not be good for
efficient gas exchange.
Choice c): Would be the correct answer. The alveolar sacs should have as thin as cells as
possible to get the best gas exchange capabilities. The simple squamous epithelium would
be the most efficient for gas exchange.
Choice d): Would not be a good answer. The simple cuboidal cells would not be thin enough for
gas exchange to take place.
Valentina Saracino
MCQ3-1

1. While going for a run, a bug flew directly into your right eye and stimulated your
lacrimal gland causing your eye to tear. The nasolacrimal duct that carries these
tears from the lacrimal sac of the eye into the nasal cavity opens underneath the
______.
a. Inferior nasal concha
b. Puncta
c. Superior nasal concha
d. Internal auditory meatus

Rationale: (a) inferior nasal concha is the correct answer because the nasolacrimal duct
opens underneath the inferior nasal concha and if you have excess tears, they will actually
go into the the tear system that goes into the nasal cavity. (b) puncta is incorrect because
this drains into the lacrimal system and drains inferiorly into the nasal cavity via the
nasolacrimal duct. The nasolacriminal duct does not open underneath this structure. (c)
superior nasal concha is a tempting answer, but is incorrect because it is too superior in
location and its main function is that as air passes through, it provides warmth, moisture,
and cleaning. (d) internal auditory meatus is incorrect and provides a passage for the
vestibulocochlear nerve and the facial nerve and the nasolacrimal duct and does not open
underneath this structure.

2. When working in the emergency department, you performed a CT scan and saw an
abnormality that you suspect may be cancer in the region where the trachea
bifurcates into the left and right primary bronchus. The vertebral level that you are
looking at is _______.
a. L4-L5
b. T4-T5
c. C1-C2
d. S2-S3
Rationale: (b) T4-T5 is the correct answer because this is the location of the sternal angle
that articulates with the second rib where the trachea divides into the left and right
primary bronchus. (c) C1-C2 is incorrect and is the Atlanto-axial joint and is too superior in
location to be where the trachea bifurcates into the left and right primary bronchus. (a) L4-
L5 is incorrect because this is too inferior to the location of the bifurcation of the trachea
and this is where a physician would perform a spinal tap. (d) S2-S3 is incorrect because this
too inferior and is for example the location of where the meningeal layers end.

GMS5605 Assignment: MCQ 3-1 (Joe Payyapilly)

1. The dorsal respiratory group (DRG) of the medullary respiratory center stimulate the diaphragm via
the:
a. Pulmonary nerves
b. Phrenic nerves
c. Vagus nerve
d. Recurrent laryngeal nerve
2. ______________ develop from the respiratory diverticulum.
a. Trachea
b. Esophagus
c. Pharynx
d. Nasal cavity
Answer Keys:
1. Rationale: The correct choice is b. Phrenic nerves. During normal quiet breathing, neurons of the
dorsal respiratory group (DRG) of the medullary respiratory center generate impulses to the diaphragm
via the phrenic nerves and the external intercostal muscles via the intercostal nerves. All other options are
related to nerve innervation for the lungs, such as the vagus nerve; pulmonary nerves, a branch of the
vagus nerve innervate the bronchial tree and the visceral pleura, and the recurrent laryngeal nerve
recurrent laryngeal nerve (RLN), a branch of the vagus nerve supplies all the intrinsic muscles of the
larynx.
2. Rationale: The correct choice is a. Trachea. The endoderm lining the respiratory diverticulum gives
rise to the epithelium and glands of the trachea, bronchi, and alveoli. As the respiratory diverticulum
elongates, its distal end enlarges to form a globular tracheal bud, which gives rise to the trachea. All other
options are incorrect.
Meri Gonashvili

GMS5605 Assignment: MCQ 3-1

Shelf like projections on the lateral wall of the nasal cavity called?

a. Nasal septum
b. Nasal vestibules
c. Conchae
d. Uvula
e. None of the above

Rationale: The correct choice is C. There are three shelves called superior, middle and inferior nasal
conchae on each lateral wall of the nasal cavity. Conchae reaching the nasal septum and subdivide each
part of the nasal cavity into superior, middle and inferior nasal meatuses. The arrangement of the
meatuses and conchae increases the surface of the nasal cavity and prevent it from dehydration. On the
other hand, nasal septum divides the external node into right and left chambers. Additionally, the
opening of the external nares leads into cavities named nasal vestibules. Finally, the uvula is found is in
the oral cavity as a hanging finger like muscular structure from the border of the soft palate.

The point where the parietal pleura connects to the visceral pleura called?

a. Hilum
b. Cardiac notch
c. Apex of the lungs
d. Costal surface of the lung

Rationale: The correct choice is A. Each lung is surrounded by a double-layered serous membrane
called pleural membrane (parietal pleura and visceral pleura). The space between these layers is called
the pleural cavity. The medial surface of each lung contains an area the hilum-the only site where the
parietal pleura connects to the visceral pleura and pulmonary blood vessels, bronchi, lymphatic vessels,
and nerves enter and exit via that area.
_____________________________________________________________________________________
Santiago Bernal

GMS5605 Assignment: MCQ 3-1

1. This portion of the pharynx extends to the plane of the soft palate:

a. Nasopharynx

b. Oropharynx

c. Laryngopharynx

d. Hypopharynx

Rationale: The correct answer is a. The nasopharynx is the portion of the pharynx that lies posterior to
the nasal cavity and extends to the plane of the soft palate. The oropharynx lies posterior to the oral
cavity and extends from the soft palate inferiorly to the level of the hyoid bone. The laryngopharynx
begins at the level of the hyoid bone. The hypopharynx is a synonym of the laryngopharynx.

2. These triangular pieces of cartilage are located at the posterior, superior border of the cricoid
cartilage; these pieces of cartilage influence the position and tension of the vocal folds:

a. Thyroid cartilages

b. Arytenoid cartilages

c. Corniculate cartilages

d. Supracricoid cartilages

Rationale: The correct answer is b. The arytenoid cartilages influence the position and tension of the
vocal folds, and are located at the posterior, superior border of the cricoid cartilages. The thyroid
cartilages form the upper anterior and lateral walls of the larynx. The corniculate cartilages are located
at the apex of each arytenoid cartilages. The supracricoid cartilages do not exist.
GMS 5605 MCQ 3-1 Kathryn Behrns

1. Which structure is not part of the conducting portion of the respiratory system?
A. Nose
B. Nasal Cavity
C. Pharynx
D. Respiratory Bronchioles

Rationale:

The correct answer is D) respiratory bronchioles. The nose, nasal cavity, pharynx, larynx, trachea,
bronchi, and bronchioles are all part of the conducting portion of the respiratory system. The
respiratory bronchioles are not included in the conducting system.

2. What is the correct air molecules take through the nose?

A. external nares → nasal vestibule → nasal cavity → internal nares
B. external nares → nasal cavity → nasal vestibule → internal nares
C. external nares → internal nares → nasal cavity → nasal vestibule
D. external nares → nasal vestibule → internal nares → nasal cavity

Rationale:

The correct answer is A) external nares → nasal vestibule → nasal cavity → internal nares. The external
nares are the opening to the external nose. Which then leads to the nasal vestibule followed by the
nasal cavity that is deeper in the skull. Finally, there are the internal nares which is how the nose
communicates with the pharynx.

Melissa Layton - Assignment: MCQ 3-1

1. All of the following statements regarding the divisions of the pharynx are true EXCEPT
A. the nasopharynx extends from the nasal cavity to the soft palate
B. there are five openings to the nasopharynx
C. the oropharynx is the only region of the pharynx that has both respiratory and digestive functions.
D. the laryngopharynx has a posterior opening that leads to the esophagus and an anterior opening that
leads to the larynx
2. You travel to an area of high altitude for the first time. In your excitement, you run to get a better
view of the area and discover that “thin air” is a real thing. The _____ sends nerve impulses to your
sternocleidomastoid, scalene, and pectoralis minor muscles to help force the inhalation of air into your
lungs.
A. dorsal respiratory group (DRG)
B. ventral respiratory group (VRG)
C. pontine respiratory group (PRG)
D. pneumotaxic center

Q1 Rationale: Option C is the false statement. Both the oropharynx and the laryngopharynx serve as
passageway for food and drinks as well as air.

Q2 Rationale: Option B is the correct answer. The VRG does not play a role in normal breathing, but
does work with the DRG during forceful inhalation and exhalation experienced during exercise, playing a
wind instrument, or trying to catch your breath. The VRG works by activating accessory muscles.
Option A is incorrect because the DRG controls our normal, quiet breathing. The DRG continues to
function during forceful breathing, but requires assistance from the VRG. Options C and D refer to the
same thing. The pontine respiratory group (PRG) allows us to modify our breathing for speaking,
exercising or sleeping.

GMS5605: Medical Anatomy, Summer A/C 2018

MCQ’s 3-1
Benjamin T. Heggie

OBJECTIVE: The following MCQs are meant to challenge ones understanding of the respiratory
system in medical human anatomy.

1. Which of the following structures are not found in the oropharynx region of the
pharynx?

A. Fauces (anterior opening)

B. Palatine tonsils
C. Adenoid
D. Lingual tonsils
E. None of the above

2. Which of the following does not function within the conducting zone of the respiratory
system?

A. Nose
B. Trachea
C. Bronchi
D. Terminal bronchioles
E. Alveolar ducts

Question 1: Answer and rationale (Tortora, pg. 732)

The correct answer to question 1 is option C, adenoid, also known as the pharyngeal tonsil. The
pharyngeal tonsil is located along the upper posterior wall of the nasopharynx. The remaining
structures (fauces, palatine tonsils and lingual tonsils) are found in the oropharynx.

Question 2: Answer and rationale (Tortora, pg. 728)

The correct answer to question 2 is option E, alveolar ducts, which is a main site for gas
exchange between air and blood. Therefore, the appropriate part of the respiratory system
alveolar ducts serve in is the respiratory zone. The remaining passageways (nose, trachea,
bronchi, and terminal ducts) function to filter, warm, and moisten air and conduct it into the
lungs.
 MCQ: 3-1 (Ayah)
Q1:
A 5-year-old boy, presented with diminution of hearing. His mother gave history of recurrent
bilateral earache, mouth breathing and snoring. Otoscopy showed retracted dull both tympanic
membranes, and the plain x-ray (lateral view on nasopharynx) showed narrow nasopharyngeal
air column. The hypertrophy to which of the following lymphoid tissues was sufficient to produce
the boy symptoms?

A. Platine tonsils.
B. Adenoid tonsil.
C. Pharyngeal tonsil.
D. Both B and C.

Q2:
A two-year-old girl was playing with her toy, laughing and happy, suddenly she started to cough
as she was chocking with a whistling sound produced from her chest, the small toy was
disappeared.
While examining and attempting to remove it, the child cried excessively, and the foreign body
dislodged downward into lower airway.
After managing her case at the hospital, it was successfully removed from the middle lobar
bronchi, which main bronchus did the toy lodge in this case?

A. Right main bronchus

B. Left main bronchus
C. Superior bronchus
D. Inferior bronchus
Q1:Key words

recurrent bilateral earache, mouth breathing and snoring. (lateral view on nasopharynx)
showed narrow nasopharyngeal air column.

Correct answer is D

Adenoid causing bilateral secretory otitis media.

The pharynx lies just posterior to the nasal and oral cavities, superior to the larynx and esophagus, and
just anterior to the cervical vertebrae.

The pharynx can be divided into three anatomical regions

1. Nasopharynx
2. Oropharynx
3. Laryngopharynx

(1) The nasopharynx extends from the skull base to the palate.

-It is behind the nose(choana)

 Roof: It contains sub- epithelial lymphoid tissue ,called Adenoid tonsil (Pharyngeal tonsil)Answer
B,C,D
 Opening of Eustachian tube.
 Tubal elevation or torous tubarius: cause by eustachian tube
 Pharyngeal recess or fossa of Rosen muller.

(2) The oropharynx:

-It extends from the palate to the tip of epiglottis.

-Behind the oral cavity

 It contains the palatine tonsils (answer A) present on each side of the oropharynx between the
pillars of fauces.

(3) Laryngopharynx : It extends from the tip of epiglottis to the lower border of cricoid cartilage.

 Pyrifrom Fossa
 Postcricoid area
 Posterior pharyngeal wall.

Clinical Anatomy: Snoring, sleep apnea, and moth breathing and the effect of recurrent infection of the
adenoid that might causes sinusitis otitis media, pharyngitis are the symptoms of adenoid tonsil.
 Q2: it was successfully removed from the middlelobar bronchi, which mainbronchus did the toy
lodge in this case?
Correct answer is A

Explanation:
Bronchial tree Anatomy:
The trachea is flexible tube, where it bifurcates in the mediastinum into right and left main bronchus.
Each main bronchus enters the root of a lung and passes through the hilum into the lung itself; Right and
left.

The right main bronchus (answer A) gives raise to three lobar bronchicalled:

 The superior
 Middle
 Inferior

The left main bronchus gives rise to two lobar bronchicalled:

 Superior
 Inferior bronchi.

Note: the left bronchus has no middle lobar bronchi answer(B)

Answers C, and D , are not a main bronchus, as seen above.

The Right main bronchus is wider and takes a more vertical course through the root of the hilum than
the left main bronchus. Therefore, inhaled foreign bodies tend to lodge more frequently on the right
side than on the left.