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FISDAP Airway Exam Practice Test and Study
Guide 2025: Master Airway Management for EMT &
Paramedic Success
Question 1: From the atmosphere, what structures does air pass through during ventilation? A. Atmosphere → pharynx → larynx → trachea → bronchi → bronchioles → alveoli → nose B. Atmosphere → trachea → larynx → pharynx → nose → bronchi → bronchioles → alveoli C. Atmosphere → nose → nasopharyngeal space/oropharyngeal space (if mouth breather) → pharynx → larynx → trachea → bronchi → bronchioles → alveoli D. Atmosphere → mouth → larynx → pharynx → trachea → bronchi → bronchioles → alveoli Correct Answer: C Rationale: Air typically enters through the nose (or mouth), passes through the nasopharynx (or oropharynx if breathing through the mouth), then the pharynx, larynx, trachea, bronchi, bronchioles, and finally reaches the alveoli for gas exchange. Question 2: What is the primary purpose of the nasal passages and nasopharynx? A. To facilitate the exchange of oxygen and carbon dioxide. B. To filter out large particulate matter from the air. C. To warm and humidify the air as it passes through. D. To regulate the pressure of air entering the lungs. Correct Answer: C Rationale: The nasal passages and nasopharynx are lined with mucous membranes and cilia that warm and humidify the inhaled air, making it more suitable for the delicate tissues of the lower respiratory tract. They also filter out larger particles, but warming and humidification are their primary roles in preparing the air. Question 3: What is the fundamental difference between respiration and ventilation? A. Respiration is the movement of air, while ventilation is the exchange of gases.
B. Respiration occurs in the upper airway, while ventilation occurs in the lower airway. C. Respiration is a passive process, while ventilation is an active process. D. Respiration refers to the exchange of gases in the alveoli, ventilation refers to the movement of air into the lungs. Correct Answer: D Rationale: Ventilation is the mechanical process of moving air into and out of the lungs. Respiration, on the other hand, is the physiological process of gas exchange occurring at the alveolar level (external respiration) and at the cellular level (internal respiration). Respiration is essential for oxygen delivery, carbon dioxide removal, and blood pH regulation. Question 4: Which of the following structures are part of the upper airway? A. Trachea, bronchi, bronchioles, alveoli B. Larynx, trachea, bronchi C. Nose, mouth, tongue, jaw, pharynx, and larynx D. Pharynx, larynx, trachea Correct Answer: C Rationale: The upper airway consists of structures superior to the larynx, including the nose, mouth, tongue, jaw, pharynx (nasopharynx, oropharynx, laryngopharynx), and the larynx itself is sometimes considered the dividing line, with structures above it being strictly upper airway. Question 5: What anatomical structure serves as a key landmark dividing the upper airway from the lower airway? A. The pharynx B. The trachea C. The larynx D. The bronchi Correct Answer: C Rationale: The larynx is generally considered the dividing point between the upper and lower airways. Structures above the larynx (pharynx, nose, mouth) are part of the upper
Rationale: False. The right lung has three lobes (superior, middle, inferior), while the left lung has only two lobes (superior, inferior) to accommodate the heart. Additionally, the right main bronchus is typically shorter, wider, and more vertically oriented than the left main bronchus. Question 9: What is the correct order of structures within the lungs that air passes through during ventilation? A. Alveoli, bronchioles B. Bronchioles, alveoli C. Bronchi, alveoli D. Alveoli, bronchi Correct Answer: B Rationale: During ventilation, air travels down the bronchi, branching into smaller bronchioles, and finally reaches the alveoli, where gas exchange takes place. Therefore, the order is bronchioles followed by the alveoli. Question 10: True or false: The lungs use muscles found in the lateral lobes to expand and contract. A. True B. False Correct Answer: B Rationale: False. The lungs themselves are passive, elastic organs and do not contain muscles for expansion and contraction. Lung expansion occurs due to the contraction of the diaphragm and the intercostal muscles, which increases the volume of the thoracic cavity, creating^1 a negative pressure that draws air into the lungs. Expiration is typically a passive process resulting from the relaxation of these muscles. Question 11: True or false: Air rushes into the lungs because of negative pressure created by the expansion of the thoracic cavity. A. True B. False Correct Answer: A
Rationale: True. When the diaphragm and intercostal muscles contract, the thoracic cavity expands, increasing its volume. According to Boyle's Law (pressure and volume are inversely related), this increase in volume leads to a decrease in pressure within the thoracic cavity (becoming negative relative to atmospheric pressure). This pressure gradient causes air to rush from the higher-pressure atmosphere into the lower- pressure lungs until equilibrium is reached. Question 12: True or false: The parietal pleura lines the lungs, and the visceral pleura lines the body cavity. The space between is called the anterior pleura. A. True B. False Correct Answer: B Rationale: False. The visceral pleura is the membrane that directly lines the surface of the lungs. The parietal pleura lines the inner surface of the thoracic cavity (body cavity in this context). The space between the visceral and parietal pleura is called the pleural space, not the anterior pleura. This space contains a small amount of pleural fluid that reduces friction during breathing. Question 13: Which of the following groups of muscles are primarily involved in the process of inhalation? A. Diaphragm and abdominal muscles B. Intercostals and pectoral muscles C. Diaphragm and intercostals D. Cervical muscles and abdominal muscles Correct Answer: C Rationale: The primary muscles responsible for quiet inhalation are the diaphragm (which contracts and flattens, increasing the vertical dimension of the thoracic cavity) and the external intercostal muscles (which elevate the rib cage, increasing the anterior-posterior and lateral dimensions). Other muscles like cervical, abdominal, and pectoral muscles may assist during forced or labored breathing. Question 14: Which of the following is true regarding the muscles involved in passive expiration? A. The diaphragm contracts to expel air.
Correct Answer: B Rationale: Hypoxic drive is a secondary control mechanism for respiration that relies on chemoreceptors in the aorta and carotid arteries to detect significantly low levels of oxygen in the blood. It is less sensitive than the primary CO2/pH-driven system and typically only becomes a major stimulus for breathing in chronic conditions with persistently low oxygen levels. Question 17: Which two main areas of the brainstem are critically involved in the control of respiration? A. Cerebrum and cerebellum B. Thalamus and hypothalamus C. Medulla oblongata and pons D. Midbrain and reticular formation Correct Answer: C Rationale: The medulla oblongata and the pons, located in the brainstem, are the primary control centers for respiration. The medulla sets the basic rhythm of breathing, initiates inspiration, and stimulates the diaphragm via the phrenic nerve. The pons influences the rate and depth of breathing, helping to smooth out the transitions between inhalation and exhalation. Question 18: True or false: Arteries typically carry oxygenated blood away from the heart to organs and capillaries. A. True B. False Correct Answer: A Rationale: True, with one notable exception. In the systemic circulation, arteries carry oxygenated blood from the left ventricle of the heart to the rest of the body's tissues and organs. The exception is the pulmonary arteries, which carry deoxygenated blood from the right ventricle to the lungs for oxygenation. What is the tidal volume? - - correct ans- - amount of air moved in/out of lungs in single breath. Usually 500 ml in adult
What is inspiratory reserve volume? - - correct ans- - Deepest breath you can take after normal respiration What is expiratory reserve volume/Vital Capacity? - - correct ans- - maximum amount you can breathe out after normal breath. What is residual volume? - - correct ans- - Remaining gas in lungs after exhalation. This is to keep lungs inflated What is dead space? What structures are considered part of dead space? - - correct ans- - Part of respiratory system not involved in active respiration. Air moves through here but little to no respiration occurs. Mouth, trachea, bronchi and bronchioles considered dead space What is minute volume? What does it measure? - - correct ans- - Minute volume = RR x tidal volume. Volume of air moving through lungs in 1 minute. Can be estimated quickly. Count RR rate. If normal check to see chest rise and fall (tidal volume). If chest rise and fall is weak and/or little air coming out of nose, then the person has small minute volume. Alveolar Minute Volume - - correct ans- - Volume of air moved through lungs in 1 minute minus the dead space. Alveolar Minute Volume = (tidal volume - dead space) x RR Alveolar Ventilation - - correct ans- - Volume of air that reaches alveoli. Alveolar ventilation = tidal volume - dead space Name the characteristics of normal breathing - - correct ans- - 1. Normal rate (12-20)
- regular pattern of inhalation/exhalation
- clear bilateral lung sounds
Where are the alpha-1 receptors located? What is their effect? - - correct ans- - location- blood vessels constricted blood vessels, skin is pale, cool, clammy They essentially increase BP Where are the Beta-1 receptors located? What is their effect? - - correct ans- - location- heart effect- increased HR, increased force of contraction They essentially increase CO since CO = HR x SV Where are the Beta-2 receptors located? What is their effect? - - correct ans- - location - lungs (beta-2 is beta-tube) effect - bronchodilation (more air enters lungs) Where are the muscarinic receptors located? What is their effect? - - correct ans- - location - heart effect - decreased HR, decreased force of contraction Muscarinic is parasympathetic system and do complete opposite of Beta-1 which is sympathetic What hormones activate the sympathetic nervous system? - - correct ans- - Epineprhine and norepineprhine, which are released from he adrenal gland after stimulation by the sympathetic nervous system. These hormones stimulate heart and blood vessels.
What is pathophysiology? - - correct ans- - Study of how normal physiologic processes are affected by disease What is respiratory compromise? - - correct ans- - Inability of body to move gas effectively. Can result in decreased O2 (hypoxia) and increased CO2 (hypercarbia) What factors can impair ventilation? - - correct ans- - 1. Obstruction a. foreign objects - toys, food, teeth tongue etc b. physiological - induced by asthma, allergic rxns, infection
- Impairment a. brain injury - to medulla/pons b. breathing muscles - diaphragm, c. nerves - neuromuscular disease like cerebral palsy can affect phrenic nerve
- Other factors a. drugs - opioids can reduce RR b. loss of consciousness - can cause impaired ventilation c. trauma to chest wall - impair expansion of lungs What factors can impair respiration? - - correct ans- - 1. air (too little O2, too much CO2, toxins like CO)
- impaired movement of gas across cell membrane (due to fluid in alveoli, mucus or other secretions)
- Blood vessels become clogged (pulmonary embolism) What is the V/Q ratio? - - correct ans- - How much gas is being moved effectively, versus how much blood is flowing around the alveoli where gas exchange (perfusion occurs)
In oxygen rich lungs, PO2 > PO2 oxygen poor blood. O2 diffuses across alveoli into blood. In CO2 rich blood, PCO2 > PCO2 of lungs so CO2 diffuses from blood to lungs, and then is exhaled out What does it mean if someone says they are "keeping the airways patent"? - - correct ans- - Keeping airway patent = maintaining open airway so air can enter/leave lungs freely How is regulation of breathing different in those with COPD? What does research indicate about assisting in respiration with COPD sufferers? - - correct ans- - COPD sufferers have difficulty removing CO2 from body. Overtime, respiratory control centers in brain adjust to this new baseline of CO2. In late stage COPD hypoxic drive is activated. Some research suggests that providing high flow O2 could negatively affect body's drive to breathe. What is Dyspnea? - - correct ans- - Shortness of breath Signs and symptoms of Hypoxia? - - correct ans- - Early
- Restlessness
- Irritability
- apprehension
- tachycardia
- anxiety Late
- mental status changes
- weak (thready) pulse
- cyanosis
- Dyspnea
Cellular respiration (Metabolism)? - - correct ans- - Cells take energy from nutrients through series of chemical processes. What is the difference between external and internal respiration? - - correct ans- - External - process of breathing fresh air into respiratory system and exchanging O2 and CO2 between alveoli and blood in pulmonary capillaries internal - exchange of oxygen and CO2 between systemic circulatory systems and cells of body What are the critical periods in which a cell needs O2? - - correct ans- - 0 - 1 minute: cardiac irritability 0 - 4 minute: brain damage not likely 4 - 6 minute: brain damage possible 6 - 10 minute: brain damage likely more than 10: irreversible brain damage What is intrapulmonary shunting? What is the cause of it? - - correct ans- - It's when blood enters lungs from right side of heart bypasses alveoli and return to left side of heart in unoxygenated state. Can be caused by nonfunctional alveoli due to diseases What factors can lead to hypoxia due to circulatory compromise? - - correct ans- - 1. obstruction of blood flow due to a. pulmonary embolism b. pneumothorax c. heart failure d. cardiac tamponade
- Decreased ability of blood to carry O
- Palpate radial pulse to ensure accuracy and correlation w/ pulse ox Normal reading between 98-100. Less than 90% pt requires treatment unless chronic condition. Oxygen applied when SPO2 drops below 94% What can cause an inaccurate pulse ox? - - correct ans- - 1. Hypovolemia
- Severe peripheral vasoconstriction (chronic hypoxia, smoking or hypothermia)
- Time delay in detecting respiratory insufficiency
- Dark/metallic nail polish
- Dirty fingers
- CO poisoning You encounter an unconscious pt. They have a pulse but inadequate breathing. What should you do if they are a) found in their bed or b) found underneath a tree? - - correct ans- - You need to open the airway. If head trauma is suspected, use a jaw thrust. If head trauma is not suspected, use a head-tilt-chin-lift maneuver You encounter an unconscious pt. They have a pulse but inadequate respirations. You open the airway and find vomit. What should you do? - - correct ans- - You should suction the pt using How do you use suction equipment? - - correct ans- - Can use rigid (Yankauer/tonsil tips) or nonrigid (french/whistle-tip). Use rigid unless you are suctioning a stoma or suctioning nose/liquid at back of mouth. Make sure to measure for proper size. Don't touch back of throat, don't want to activate gag reflex. Turn on to at least 300 mmHg. Attach appropriate tubing. Suction for no more than 15 seconds for adults, 10 seconds for children, and 5 seconds for infants. Rinse with water. Asthma Signs and Symptoms? - - correct ans- - 1. wheezing on inspiration/expiration
- Bronchospasm
Anaphylaxis Signs and Symptoms? - - correct ans- - 1. Flushed skin/hives (urticaria)
- Generalized edema
- hypotension
- laryngeal edema w/ dyspnea
- wheezing/stridor Most rxns occur w/in 30 mins, administer epi using epipen. O2 also helps Bronchiolitis signs and symptoms? - - correct ans- - 1. Dyspnea
- wheezing
- Coughing
- fever
- dehydration
- Tachypnea
- Tachycardia Often due to RSV infection, severe bronchiole inflammation. Occurs most frequently in infants, especially boys. Provide O2 therapy, allow pt to remain in comfortable position. Reassess frequently and be prepared to manage airway/positive pressure ventilation Bronchitis Signs and Symptoms - - correct ans- - 1. Chronic cough w/ sputum production
- Wheezing
- cyanosis
- Tachypnea Type of COPD, can be due to tobacco. When excess mucus created. Carbon Monoxide Poisoning - - correct ans- - 1. flu like symptoms
Treat w/ humidified O Diphtheria - - correct ans- - 1. difficulty breathing/swallowing
- sore throat
- thick gray buildup in throat/nose
- fever Emphysema - - correct ans- - 1. barrel chest
- pushed lip breathing (pink puffers)
- dyspnea on exertion
- cyanosis
- wheezing/decreased breath sounds Most common form of COPD. Loss of elastic material in lungs Epiglottitis - - correct ans- - 1. Dyspnea
- High fever
- stridor
- drooling
- difficulty swallowing
- severe sore throat
- tripod/sniffing position Life threatening, caused by bacterial infection of epiglottis in children, risk of complete airway obstruction. Try to keep them from crying. Do not put anything in mouths. Provide quick transport to ER, focus on maintaining patent airway Flu - - correct ans- - 1. cough
- fever
- sore throat
- fatigue Hay Fever - - correct ans- - coldlike symptoms, caused by allergic response. Hyperventilation - - correct ans- - over breathing to the point of arterial CO2 falls below normal. Alkalosis of blood occurs.
- anxiety
- dizziness
- numbness
- tingling of hands/feet
- painful spasms of hand/feet
- Pt's feel they cannot catch breathe occurs when someone experiences psychological distress. Maybe be as high as 40 breaths/min or low as 20. Verbally instruct pt to slow breathing, and if that doesn't work, give supplemental O2 and provide transport Pertussis - - correct ans- - 1. coughing spells
- whooping sound
- fever airborne bacterial infection, coughing spells can last for a minute where pt turns red. May vomit/want to avoid eat/drink Pleural Effusion - - correct ans- - collection of fluid outside lung on one or both sides that compresses lung/lungs and causes dyspnea.
