Year 1 Case 6 Revision

How many fissures are present within the right lung?

• One

• Two

• Three

• Four

• Five

A healthy 6 year old takes a very deep breath in while preparing to blow her birthday candles out. Her lungs are momentarily hyperinflated. Select the statement which correctly describes the behaviour of her lungs in this state.

• Interpleural pressure is relatively close to 0

• Decreasing the interpleural pressure will cause deflation of the lungs

• The lung tissue is nearing its elastic limit

• The lung tissue has a relatively high compliance compared to a normal level of inflation

• Interpleural pressure may reach +2kPa

Identify the function of the cells labelled X in the respiratory epithelium

• Phagocytose pathogens as part of the mononuclear phagocyte system

• Provide regenerative potential to the respiratory epithelium

• Secrete mucus that protects the respiratory epithelium

• Produce surfactant to allow alveolar expansion

• Act as a conduit for blood vessels that allow warming of the respiratory tract

Select the statement that correctly describes the mechanisms to reduce V/Q discrepancies between individual alveoli.

• Hypercapnic pulmonary vasoconstriction restores optimal V/Q when there is relative overperfusion

• The Hering-Breuer reflex reduces respiratory rate to prevent overventilation which would give too high a V/Q

• Hypoxia-induced bronchoconstriction restores optimal V/Q when there is relative overventilation

• The pontine respiratory group induces phase-switching to expiration to prevent overventilation which would give too high a V/Q

• The last in-first out principle increases oxygen delivery to relatively more obstructed alveoli

Select the name of the structure most responsible for detection of hypoxia.

• Type I glomus cells in the carotid bodies

• Type II glomus cells in the carotid bodies

• Central chemoreceptors in the medulla oblongata

• Type I glomus cells in the aortic bodies

• Type II glomus cells in the aortic bodies

Select the correct statement describing rib 11.

• It articulates with thoracic vertebrae 10 and 11 via costovertebral and costotransverse joints

• It indirectly articulates with the sternum via interchondral joints

• A branch of the musculophrenic artery runs in its costal groove anteriorly

• A direct branch of the aorta runs in its costal groove posteriorly

• An anterior intercostal vein runs in its costal groove anteriorly

Select the answer which is NOT a known risk factor for the development of pulmonary embolism.

• Immobility

• Malignancy

• Pregnancy

• Oestrogen therapy

• BMI of 25.0 kg/m2 ('overweight')

Pulmonary embolism is a conditioned characterised by occlusion of blood vessels in the lung. Similar conditions in other organs often lead to tissue necrosis. Select the best reason why pulmonary embolism does not often cause necrosis.

• The lung tissue can be supplied with oxygen directly from inhaled air

• The lung tissue is also supplied by other blood vessels

• The emboli typically do not fully occlude the blood vessels

• There is collateral blood supply to the lung tissue

• The emboli typically lodges in a vein, meaning there is a limited effect on oxygen delivery to the lung tissue

Where is surfactant secreted from?

• Type I pneumocytes

• Pleural cells

• Alveolar macrophages

• Chief cells

• Type II pneumocytes

Select the statement that correctly describes the morphological changes seen in bronchiectasis.

• Changes are typically seen in the lung apices

• Honeycombing is typically seen

• Loss of alveolar tethering is characteristically seen

• Inflammatory changes are very often seen

• The changes seen are almost always bilateral