2013 Physiology Exam 4 Review Dr. Dessem Respiration

1. 2013 Physiology Exam 4 ReviewDr. DessemRespiration

2. 1 • (former National Board Question) A marked fall from normal in the oxygen tension in arterial blood would stimulate the receptors in the: • central nervous system chemoreceptors • aortic arch and the carotid sinus • aortic and carotid bodies • walls of the great veins • respiratory center

3. 1 • (former National Board Question) A marked fall from normal in the oxygen tension in arterial blood would stimulate the receptors in the: • central nervous system chemoreceptors • aortic arch and the carotid sinus • aortic and carotid bodies* • walls of the great veins • respiratory center • (regulation of respiration)

4. 2 • The total quantity of air that can be expelled from the lungs following a maximal inspiration is the: • A. tidal volume • B. expiratory reserve volume • C. functional residual volume • D. vital capacity • E. inspiratory reserve volume

5. 2 • The total quantity of air that can be expelled from the lungs following a maximal inspiration is the: • A. tidal volume • B. expiratory reserve volume • C. functional residual volume • D. vital capacity* • E. inspiratory reserve volume • (pulmonary ventilation)

6. 3 • A patient breathes at a rate of 25 breaths per minute. Her tidal volume is 500ml. Her anatomical dead space is 150ml. What is her respiratory minute volume (Vt)? • A. 1.25 liters/min • B. 3.75 linters/min • C. 7.5 liters/min • D. 12.5 liters/min • E. 75 liters/min

7. 3 • A patient breathes at a rate of 25 breaths per minute. Her tidal volume is 500ml. Her anatomical dead space is 150ml. What is her respiratory minute volume (Vt)? • A. 1.25 liters/min • B. 3.75 linters/min • C. 7.5 liters/min • D. 12.5 liters/min* • E. 75 liters/min • (measurement of pulmonary function)

8. 4 • The Hering-Breuer inflation reflex: • A. is an underlying mechanism of normal respiratory rhythmicity • B. is primarily initiated via chemoreceptors in the lung • C. limits tidal volume during states of high (>1 liter) lung inflation • D. is mediated via the glossopharyngeal nerve • E. when activated immediately triggers inspiration

9. 4 • The Hering-Breuer inflation reflex: • A. is an underlying mechanism of normal respiratory rhythmicity • B. is primarily initiated via chemoreceptors in the lung • C. limits tidal volume during states of high (>1 liter) lung inflation* • D. is mediated via the glossopharyngeal nerve • E. when activated immediately triggers inspiration • (control of respiration)

10. 5 • During forced expiration, actively contracting muscles include the: • A. diaphragm • B. abdominal muscles • C. external intercostal muscles • D. diaphragm and external intercostals muscles • E. abdominal muscles and internal intercostalsmuscles

11. 5 • During forced expiration, actively contracting muscles include the: • A. diaphragm • B. abdominal muscles • C. external intercostal muscles • D. diaphragm and external intercostals muscles • E. abdominal muscles and internal intercostals muscles* • (mechanics of ventilation)

12. 6 • The conduction zone of the lungs is characterized by which of the following: • A. gas exchange • B. a complete respiratory membrane • C. a relatively rapid forward velocity of gas during inspiration • D. diffusion • E. the lowest total resistance of the airway

13. 6 • The conduction zone of the lungs is characterized by which of the following: • A. gas exchange • B. a complete respiratory membrane • C. a relatively rapid forward velocity of gas during inspiration* • D. diffusion • E. the lowest total resistance of the airway • (mechanics of ventilation)

14. 7 • Stimulation of breathing in response to low O2 tension is brought about primarily by low O2 tension acting upon: • A. pneumotaxic center in the pons • B. central respiratory centers • C. peripheral chemoreceptors • D. neurons in the expiratory area of the medulla • E. chemoreceptors in the central respiratory centers

15. 7 • Stimulation of breathing in response to low O2 tension is brought about primarily by low O2 tension acting upon: • A. pneumotaxic center in the pons • B. central respiratory centers • C. peripheral chemoreceptors* • D. neurons in the expiratory area of the medulla • E. chemoreceptors in the central respiratory centers • (regulation of respiration)

16. 8 • The central respiratory chemoreceptors are: • A. located near the dorsal surface of the medulla • B. part of a positive feedback control loop for the control of respiration • C. activated by changes in extracellular H+ concentration • D. part of the pneuomotaxic respiratory center • E. located in the dorsal respiratory group

17. 8 • The central respiratory chemoreceptors are: • A. located near the dorsal surface of the medulla • B. part of a positive feedback control loop for the control of respiration • C. activated by changes in extracellular H+ concentration* • D. part of the pneuomotaxic respiratory center • E. located in the dorsal respiratory group • (regulation of respiration)

18. 9 • In restrictive disorders of respiration: • A. lung or chest wall compliance is decreased and FEV1 is decreased • B. lung or chest wall compliance is decreased and FEV1 is increased • C. airway resistance is increased and FEV1 is decreased • D. airway resistance is increased and FEV1 is increased • E. airway resistance is increased and FEV1 is unchanged

19. 9 • In restrictive disorders of respiration: • A. lung or chest wall compliance is decreased and FEV1 is decreased* • B. lung or chest wall compliance is decreased and FEV1 is increased • C. airway resistance is increased and FEV1 is decreased • D. airway resistance is increased and FEV1 is increased • E. airway resistance is increased and FEV1 is unchanged • (mechanics of ventilation)

20. 10 • During normal quiet breathing, the factor most important in regulating respiratory activity is the: • A. baroreceptor reflex • B. CO2 level of arterial blood • C. chemoreceptor reflex • D. pH of arterial blood • E. O2 level of arterial blood

21. 10 • During normal quiet breathing, the factor most important in regulating respiratory activity is the: • A. baroreceptor reflex • B. CO2 level of arterial blood* • C. chemoreceptor reflex • D. pH of arterial blood • E. O2 level of arterial blood • (regulation or respiration)

22. 11 • Which of the following is characteristic of obstructive lung disease? • A. decreased frequency of breathing and decreased tidal volume • B. increased frequency of breathing and decreased tidal volume • C. decreased frequency of breathing and increased tidal volume • D. increased frequency of breathing and increased tidal volume • E. decreased frequency of breathing and normal tidal volume

23. 11 • Which of the following is characteristic of obstructive lung disease? • A. decreased frequency of breathing and decreased tidal volume • B. increased frequency of breathing and decreased tidal volume • C. decreased frequency of breathing and increased tidal volume* • D. increased frequency of breathing and increased tidal volume • E. decreased frequency of breathing and normal tidal volume • (mechanic of ventilation)

24. 12 • Lung compliance is: • A. defined as the change in transpulmonary pressure divided by the change in lung volume • B. defined as the change in transpulmonary pressure multiplied by the change in lung volume • C. increased by fibrosis of the lung • D. partly dependent upon the surface tension of the fluid which lines the walls of the alveoli • E. decreased by emphysema

25. 12 • Lung compliance is: • A. defined as the change in transpulmonary pressure divided by the change in lung volume • B. defined as the change in transpulmonary pressure multiplied by the change in lung volume • C. increased by fibrosis of the lung • D. partly dependent upon the surface tension of the fluid which lines the walls of the alveoli* • E. decreased by emphysema • (mechanics of ventilation)

26. 13 • A deficiency of pulmonary surfactant would decrease? • A. the surface tension in the alveoli • B. airway conductance • C. lung compliance • D. the work of breathing • E. the change in intrapleural pressure required to achieve a given tidal volume

27. 13 • A deficiency of pulmonary surfactant would decrease? • A. the surface tension in the alveoli • B. airway conductance • C. lung compliance* • D. the work of breathing • E. the change in intrapleural pressure required to achieve a given tidal volume • (mechanics of ventilation)

28. 14 • Which of the following cannot be measured using spirometry? • A. inspiratory reserve volume • B. expiratory reserve volume • C. residual volume • D. all of the others can be measured using spirometry

29. 14 • Which of the following cannot be measured using spirometry? • A. inspiratory reserve volume • B. expiratory reserve volume • C. residual volume* • D. all of the others can be measured using spirometry • (measurement of pulmonary ventiliation)

30. 15 • Which of the following muscles participate in normal quiet expiration? • A. external intercostal muscles • B. internal intercostal muscles • C. rectus abdominis • D. none of these muscle participate in normal quiet expiration

31. 15 • Which of the following muscles participate in normal quiet expiration? • A. external intercostal muscles • B. internal intercostal muscles • C. rectus abdominis? • D. none of these muscle participate in normal quiet expiration • (mechanics of respiration)

32. 16 • Total cross-sectional area of the respiratory airways is largest in the: • A. trachea • B. primary bronchi • C. secondary bronchi • D. respiratory bronchioles • E. alveolar ducts and alveolar sacs

33. 16 • Total cross-sectional area of the respiratory airways is largest in the: • A. trachea • B. primary bronchi • C. secondary bronchi • D. respiratory bronchioles* • E. alveolar ducts and alveolar sacs • (pulmonary ventiliation)

34. 17 • Which of the following is/are true about peripheral neural inputs to respiratory centers? • A. activation of muscle and joint receptors stimulate ventilation • B. juxta-capillary receptors are part of the sympathetic nervous system • C. activation of pulmonary irritant receptors elicit the Hering-Breuer reflex • D. they are mediated through the hypoglossal nerve • E. they synapse directly in the ventral respiratory group

35. 17 • Which of the following is/are true about peripheral neural inputs to respiratory centers? • A. activation of muscle and joint receptors stimulate ventilation* • B. juxta-capillary receptors are part of the sympathetic nervous system • C. activation of pulmonary irritant receptors elicit the Hering-Breuer reflex • D. they are mediated through the hypoglossal nerve • E. they synapse directly in the ventral respiratory group • (regulation of ventilation)

36. 18 • Which of the following is true concerning the distribution of ventilation in the lung? • A. ventilation is uniformly distributed throughout the lung • B. ventilation is greater at the top of the lung • C. the distribution of ventilation can be measured with spirometry • D. ventilation is greater at the bottom of the lung

37. 18 • Which of the following is true concerning the distribution of ventilation in the lung? • A. ventilation is uniformly distributed throughout the lung • B. ventilation is greater at the top of the lung • C. the distribution of ventilation can be measured with spirometry • D. ventilation is greater at the bottom of the lung* • (pulmonary ventilation)

38. 19 • A patient suffers total paralysis of her intercostal muscles. For this patient, which of the following values would still be expected to be essentially normal? • A. inspiratory reserve volume (IRV) • B. expiratory reserve volume (ERV) • C. total lung capacity (TLC) • D. vital capacity (VC) • E. none of the other answers are correct

39. 19 • A patient suffers total paralysis of her intercostal muscles. For this patient, which of the following values would still be expected to be essentially normal? • A. inspiratory reserve volume (IRV) • B. expiratory reserve volume (ERV) • C. total lung capacity (TLC) • D. vital capacity (VC) • E. none of the other answers are correct* • ( external intercostal muscles contribute to inspiration thus IRV, TLC and VC would be reduced. Internal intercostal muscles are involved in forced expiration thus ERV, TLC, VC would be reduced.)

40. 20 • Alveolar surfactant acts to increase pulmonary? • A. surface tension • B. compliance • C. airway resistance • D. vascular resistance • E. edema

41. 20 • Alveolar surfactant acts to increase pulmonary? • A. surface tension • B. compliance * • C. airway resistance • D. vascular resistance • E. edema • ( surfactant reduces surface tension and thus increases lung compliance)

42. 21 • Contraction of the abdominal muscles is important in • A. normal quiet breathing • B. forced maximal inspiration • C. normal quiet expiration • D. forced (maximum) expiration • E. none of the other answers are correct

43. 21 • Contraction of the abdominal muscles is important in • A. normal quiet breathing • B. forced maximal inspiration • C. normal quiet expiration • D. forced (maximum) expiration * • E. none of the other answers are correct • (decreases thoracic volume by pushing the abdominal viscera cranial)

44. 22 • The afferent (sensory) endings for the Hering-Breuer reflex are stretch receptors in the ______ transmitted via ________ • A. aortic arch, vagus nerve • B. carotid sinus, vagus nerve • C. lungs, vagusnerve • D. heart, glossopharyngeal nerve • E. diaphragm, vagus nerve

45. 22 • The afferent (sensory) endings for the Hering-Breuer reflex are stretch receptors in the ______ transmitted via ________ • A. aortic arch, vagus nerve • B. carotid sinus, vagus nerve • C. lungs, vagus nerve* • D. heart, glossopharyngeal nerve • E. diaphragm, vagus nerve • (mechanoreceptors in the lungs activated by large lung inflations)

46. 23 • If John's vital capacity is 4.5L and his tidal volume is 525ml, then what is his inspiratory reserve volume? • A. 3975ml • B. 2075ml • C. 1050ml • D. 4500ml • E. cannot be determined from the information given

47. 23 • If John's vital capacity is 4.5L and his tidal volume is 525ml, then what is his inspiratory reserve volume? • A. 3975ml • B. 2075ml • C. 1050ml • D. 4500ml • E. cannot be determined from the information given * • (need to know expiratory reserve volume also)

48. 24 • What test measures the amount of gas expelled when one inspires maximally and exhales maximally and rapidly? • A. forced expiratory volume in some second test (FEV1) • B. forced vital capacity test • C. forced residual capacity test • D. forced internal thoracic volume assessment • E. nitrogen washout test

49. 24 • What test measures the amount of gas expelled when one inspires maximally and exhales maximally and rapidly? • A. forced expiratory volume in some second test (FEV1) • B. forced vital capacity test* • C. forced residual capacity test • D. forced internal thoracic volume assessment • E. nitrogen washout test • (FVC - amount of air a person can expel after maximum inhalation )

50. 25 • Total lung capacity is equal to: • A. vital capacity x tidal volume • B. functional residual capacity + expiratory reserve volume • C. anatomical dead space + alveolar dead space • D. residual volume + vital capacity • E. inspiratory capacity + residual volume