Chapter 22 A&P

72) Inspiratory reserve volume.

A

82) Pharynx.

A

80) Define anatomical dead space. What is the relationship between anatomical and alveolar dead space? Which value is likely to increase during lung pathology?

Anatomical dead space is the space in the conducting respiratory passageways. Alveolar dead space is the space in nonfunctional alveoli. Anatomical dead space and alveolar dead space together make up the total dead space. Alveolar dead space will increase during lung pathology.

66 ) Distinguish among anemic , ischemic ( stagnant ) , histotoxic , and hypoxemic hypoxia .

Anemic hypoxia reflects poor oxygen delivery resulting from too few RBCs or RBCs that contain abnormal or too little Hb. Ischemic (stagnant) hypoxia results when blood circulation is impaired or blocked. Histotoxic hypoxia occurs when body cells are unable to use 02 even though adequate amounts are delivered. Hypoxemia hypoxia is indicated by reduced arterial P02.

67) Larynx.

B

69) Tidal volume.

B

3 ) Select the correct statement about oxygen transport in blood . A ) During normal activity , a molecule of hemoglobin returning to the lungs carries one molecule of 02 . B ) Increased BPG levels in the red blood cells enhance oxygen - carrying capacity . C ) A 50 % oxygen saturation level of blood returning to the lungs might indicate an activity level higher than normal . D ) During conditions of acidosis , hemoglobin is able to carry oxygen more efficiently .

C ) A 50 % oxygen saturation level of blood returning to the lungs might indicate an activity level higher than normal .

36 ) Which of the following is correct regarding acclimatization ? A ) At high altitudes , hemoglobin's affinity for 02 is increased because BPG concentrations increase . B ) Decreases in arterial P02 cause the peripheral chemoreceptors to become less responsive to increases in PC02 . C ) High - altitude conditions always result in lower - than - normal hemoglobin saturation levels because less 02 is available to be loaded . D ) When blood O2 levels decline , the kidneys produce more erythropoietin , which stimulates breakdown of red blood cells in the spleen

C ) High - altitude conditions always result in lower - than - normal hemoglobin saturation levels because less 02 is available to be loaded .

33 ) Which of the following anchor ( s ) the vocal folds ? A ) cuneiform cartilages B ) cricoid cartilage C ) arytenoid cartilages D ) corniculate cartilages

C ) arytenoid cartilages

51 ) Which of the following incorrectly describes mechanisms of CO2 transport ? A ) as bicarbonate ions in plasma B ) just over 20 % of CO2 is carried in the form of carbaminohemoglobin C ) attached to the heme part of hemoglobin D ) 7-10 % of CO2 is dissolved directly into the plasma

C ) attached to the heme part of hemoglobin

24 ) Most inspired particles such as dust fail to reach the lungs because of the A ) action of the epiglottis B ) abundant blood supply to nasal mucosa C ) ciliated mucous lining in the nose D ) porous structure of turbinate bones

C ) ciliated mucous lining in the nose

21 ) Which of the disorders below is characterized by destruction of the walls of the alveoli producing abnormally large air spaces that remain filled with air during exhalation ? A ) tuberculosis B ) pneumonia C ) emphysema D ) coryza

C ) emphysema

14 ) Tidal volume is air A ) forcibly expelled after normal expiration B ) inhaled after normal inspiration C) exchanged during normal breathing D ) remaining in the lungs after forced expiration

C ) exchanged during normal breathing

6 ) The major nonelastic source of resistance to air flow in the respiratory passageways is A ) surface tension B ) surfactant C ) friction D ) air pressure

C ) friction

30 ) Which respiratory - associated muscles would contract or relax during forced expiration , for example blowing up a balloon ? A ) diaphragm would contract , internal intercostals would relax B ) diaphragm would contract , external intercostals would relax C ) internal intercostals and abdominal muscles would contract D ) external intercostals would contract and diaphragm would relax

C ) internal intercostals and abdominal muscles would contract

20 ) Which of the following is the leading cause of cancer death for both men and women in North America ? A ) esophageal B ) skin C ) lung D ) colorectal

C ) lung

64 ) Which of the following does NOT influence hemoglobin saturation ? A ) partial pressure of carbon dioxide B ) BPG C ) nitric oxide D ) temperature

C ) nitric oxide

26 ) In the plasma , the quantity of oxygen in solution is A ) not present except where it is combined with carrier molecules B ) about equal to the oxygen combined with hemoglobin C ) only about 1.5 % of the oxygen carried in blood D ) greater than the oxygen combined with hemoglobin

C ) only about 1.5 % of the oxygen carried in blood

38 ) The Bohr effect refers to the unloading of . in a RBC due to declining blood pH . A ) chloride ions B ) BPG C ) oxygen D ) carbon dioxide

C ) oxygen

13 ) The larynx contains A ) a cricoid cartilage also called the Adam's apple B ) an upper pair of avascular mucosal folds called true vocal folds C ) the thyroid cartilage D ) lateral cartilage ridges called false vocal folds

C ) the thyroid cartilage

32 ) Inspiratory capacity is A ) air inspired after a tidal inhalation . B ) functional residual capacity C ) the total amount of air that can be inspired after a tidal expiration D ) the total amount of exchangeable air

C ) the total amount of air that can be inspired after a tidal expiration

49 ) Possible causes of hypoxia include A ) obstruction of the esophagus B ) taking several rapid deep breaths C ) too little oxygen in the atmosphere D ) getting very cold

C ) too little oxygen in the atmosphere

2 ) Which pressure actually keeps the lungs from collapsing ? A ) intrapleural pressure B ) atmospheric pressure C ) transpulmonary pressure D ) intrapulmonary pressure

C ) transpulmonary pressure

35 ) The local matching of blood flow with ventilation is , A ) chloride shifting B ) the Bohr effect C ) ventilation - perfusion coupling D ) the Haldane effect

C ) ventilation - perfusion coupling

23 ) Factors that influence the rate and depth of breathing include A ) temperature of alveolar air B ) thalamic control C ) voluntary cortical control D ) stretch receptors in the alveoli

C ) voluntary cortical control

77) Air that does not participate in the exchange of gases.

D

83) Main (primary) bronchus.

D

84) Residual volume.

D

9 ) The relationship between gas pressure and gas volume is described by A) Dalton's law B ) Henry's law C ) Charles ' law D ) Boyle's law

D ) Boyle's law

42 ) The statement , " in a mixture of gases , the total pressure is the sum of the individual partial pressures of gases in the mixture " paraphrases . A ) Henry's law B ) Boyle's law C ) Charles law D ) Dalton's law

D ) Dalton's law

41 ) Which of the following is true regarding normal quiet expiration of air ? A ) It depends on the complete lack of surface tension on the alveolar wall . B ) It requires contraction of abdominal wall muscles . C ) It is driven by increased blood CO2 levels . D ) It is a passive process that depends on the recoil of elastic fibers that were stretched during inspiration .

D ) It is a passive process that depends on the recoil of elastic fibers that were stretched during inspiration .

43 ) Which of the following counteracts the movement of bicarbonate ions from the RBC ? A ) the Haldane effect B ) the Bohr effect C ) release of hydrogen ion D ) chloride shifting

D ) chloride shifting

54 ) The Bohr effect describes the tendency for hemoglobin to more readily unload oxygen under which conditions ? A ) decreased pH and PC02 B ) increased pH and decreased PC02 C ) increased pH and PC02 D ) decreased pH and increased PC02

D ) decreased pH and increased PC02

60 ) Air moves out of the lungs when the pressure inside the lungs is A ) less than the pressure in the atmosphere . B ) equal to the pressure in the atmosphere . C ) greater than the intra - alveolar pressure D ) greater than the pressure in the atmosphere

D ) greater than the pressure in the atmosphere

47 ) The amount of air that can be inspired above the tidal volume is called A ) vital capacity B ) reserve air C ) expiratory capacity D ) inspiratory reserve volume

D ) inspiratory reserve volume

53 ) Surfactant helps to prevent the alveoli from collapsing by A ) protecting the surface of alveoli from dehydration and other environmental variations B ) warming the air before it enters C ) humidifying the air before it enters D ) interfering with the cohesiveness of water molecules , thereby reducing the surface tension of alveolar fluid

D ) interfering with the cohesiveness of water molecules , thereby reducing the surface tension of alveolar fluid

25 ) Inspiration occurs when the is less than the A ) tidal volume ; vital capacity B ) intrapleural pressure ; transpulmonary pressure C ) thoracic cavity volume ; lung volume D ) intrapulmonary pressure ; atmospheric pressure

D ) intrapulmonary pressure ; atmospheric pressure

58 ) Which center is located in the pons ? A ) inspiratory center B ) pacemaker neuron center C ) expiratory center D ) pontine respirator group ( PRG )

D ) pontine respirator group ( PRG )

50 ) Using spirometry , a patient discovers their forced expiratory volume ( FEV ) after the first second is 40 % . What does this suggest ? A ) exposure to asbestos B ) healthy lungs C ) obstructive pulmonary disease D ) restrictive disease

D ) restrictive disease

68) What is the chloride shift and why does it occur?

The chloride shift is an ionic exchange process whereby chloride ions move from the plasma into the erythrocytes to counterbalance the net positive charge left within the erythrocytes by the rapid outrush of negative bicarbonate ions whenever blood CO2 rises.

71) Infant respiratory distress syndrome (IRDS) is a condition peculiar to premature babies. In IRDS insufficient surfactant is produced. What does this cause and how is it treated?

Too little surfactant results in increased surface tension that can collapse the alveoli. Great effort is required to completely reinflate the alveoli during each inspiration. IRDS is treated by spraying natural or synthetic surfactant into the newborn's respiratory passageways. Also, devices that maintain positive airway pressure throughout the respiratory cycle can keep the alveoli open between breaths. Severe cases require mechanical ventilators.

100 ) Tracheal obstruction is life threatening .

True

86 ) The functions of the nasal conchae are to enhance the air turbulence in the cavity and to increase the mucosal surface area exposed to air for greater efficiency .

True

88 ) The lingual tonsil is found on the posterior surface of the root of the tongue

True

91 ) Ventilation perfusion coupling means that more blood flows past functional alveoli than past nonfunctional alveoli .

True

97 ) Atelectasis ( lung collapse ) renders the lung useless for ventilation .

True

70) How is it possible to change the pitch of our voice from high to low?

Usually, the tenser the vocal folds, the faster they vibrate and the higher the pitch. To produce deep tones, the gl widens, and to produce high-pitched tones, the glottis becomes a slit. Intrinsic laryngeal muscles control the true folds and the size of the glottis.

78) The contraction of the diaphragm and the external intercostal muscles begins inspiration. Explain exactly what happens, in terms of volume and pressure changes in the lungs, when these muscles contract.

With contraction of the diaphragm, the height of the thoracic cavity increases. Contraction of the external intercostal muscles expands the diameter of the thorax. With an increase in volume of the thorax, the intrapulmonary volume increases, causing a drop in pressure relative to atmospheric pressure. Air rushes into the lungs along this pressure gradient until intrapulmonary and atmospheric pressures are equal.

34 ) According to the oxygen - hemoglobin dissociation curve , P02 in the lungs of 100 mm Hg results in Hb being 98 % saturated . At high altitude , there is less 02. At a P02 in the lungs of 80 mm Hg , Hb would be saturated . A ) 95 % B ) 100 % C ) 98 % D ) less than 50 %

A ) 95 %

29 ) Select the correct statement about the physical factors influencing pulmonary ventilation . A ) As alveolar surface tension increases , additional muscle action will be required B A decrease in compliance causes an increase in ventilation . C ) Surfactant helps increase alveolar surface tension . D ) A lung that is less elastic will require less muscle action to perform adequate ventilation .

A ) As alveolar surface tension increases , additional muscle action will be required .

5 ) Which law describes the relationship between the pressure and volume of a gas ? A ) Boyle's law B ) Charles ' law C ) Henry's law D ) Dalton's law

A ) Boyle's law

45 ) Which of the following maintains the patency ( openness ) of the trachea ? A ) C - shaped cartilage rings B ) surfactant production C ) surface tension of water D ) pseudostratified ciliated epithelium

A ) C - shaped cartilage rings

56 ) Hemoglobin has a much greater affinity for carbon monoxide than oxygen . Which principle explains why a hyperbaric chamber ( containing high levels of oxygen ) can treat carbon monoxide poisoning ? A ) Henry's law B ) Boyle's law C ) Charles ' law . D ) Dalton's law

A ) Henry's law

15 ) Which of the following is INCORRECT ? A ) Pressure gradient equals gas flow over resistance . B ) Resistance equals pressure gradient over gas flow . C ) Gas flow equals pressure gradient over resistance . D ) The amount of gas flowing in and out of the alveoli is directly proportional to the difference in pressure or pressure gradient between the external atmosphere and the alveoli .

A ) Pressure gradient equals gas flow over resistance .

65 ) The left lung differs from the right in that the left lung has A) a cardiac notch B ) three lobes C ) a wider and more vertical primary bronchus D ) an oblique fissure

A ) a cardiac notch

12 ) Which of the following determines lung compliance ? A) alveolar surface tension B ) muscles of inspiration C ) flexibility of the thoracic cage D ) airway opening

A ) alveolar surface tension

55 ) Which structure is lined with simple squamous epithelium ? A ) alveolus B ) trachea C ) oropharynx D ) nasopharynx

A ) alveolus

8 ) The loudness of a person's voice depends on the A ) force with which air rushes across the vocal folds B ) length of the vocal folds C ) strength of the intrinsic laryngeal muscles D ) thickness of vestibular folds

A ) force with which air rushes across the vocal folds

52 ) Which of the following is an appropriate response to carbon monoxide ( CO ) poisoning ? A ) hyperbaric oxygen chamber to increase P02 and clear CO from the body B ) slow breathing into a paper bag C ) immediate application of bicarbonate ions to facilitate removal of CO from Hb D ) hyperventilation to exhale CO from the body

A ) hyperbaric oxygen chamber to increase P02 and clear CO from the body

19 ) The most powerful respiratory stimulus for breathing in a healthy person is A ) increase of carbon dioxide B ) loss of oxygen in tissues C ) acidosis D ) alkalosis

A ) increase of carbon dioxide

7 ) Which of the choices below determines the direction of respiratory gas movement ? A ) partial pressure gradient B ) the temperature C ) molecular weight and size of the gas molecule D ) solubility in water

A ) partial pressure gradient

1 ) Which of the following is NOT a stimulus for breathing ? A ) rising blood pressure B ) arterial Po2 below 60 mm Hg C ) acidosis resulting from CO2 retention D ) rising carbon dioxide levels

A ) rising blood pressure

37 ) Which of the following is a conducting zone structure ? A ) terminal bronchiole B ) respiratory bronchiole C ) alveolar duct D ) alveolar sac

A ) terminal bronchiole

46 ) Which of the choices below describes the forces that act to pull the lungs away from the thorax wall and thus collapse the lungs ? A ) the natural tendency for the lungs to recoil and the surface tension of the alveolar fluid B ) the natural tendency for the lungs to recoil and transpulmonary pressures C ) compliance and transpulmonary pressures D ) compliance and the surface tension of the alveolar fluid

A ) the natural tendency for the lungs to recoil and the surface tension of the alveolar fluid

48 ) Which of the following is NOT part of the respiratory membrane of the lungs ? A ) alveolar epithelium B ) single layer of smooth muscle cells C ) basement membrane D ) capillary endothelium

B) single layer of smooth muscle cells

73) Briefly differentiate between atmospheric pressure, intrapulmonary pressure, and intrapleural pressure. Which of these is always negative in a healthy individual during normal breathing? What happens if intrapleural pressure becomes equal to atmospheric pressure?

Atmospheric pressure is the pressure exerted by gases of the atmosphere. Intrapulmonary pressure is the pressure within the alveoli of the lungs. Intraple ural pressure is the pressure within the intrapleural space. Intrapleural pressure is negative relative to the other two during normal inspiration/expiration. Equalization of the intrapleural pressure with atmospheric pressure or intrapulmonary pressure immediately causes lung collapse.

63 ) Which statement about CO2 is FALSE ? A ) Its accumulation in the blood is associated with a decrease in pH . B ) More CO2 dissolves in the blood plasma than is carried in the RBCs . C ) CO2 concentrations are greater in venous blood than arterial blood . D ) Its concentration in the blood is decreased by hyperventilation .

B ) More CO2 dissolves in the blood plasma than is carried in the RBCs .

16 ) Which of the following provide the greatest surface area for gas exchange ? A ) alveolar ducts B ) alveoli C) alveolar sacs D ) respiratory bronchioles

B ) alveoli

61 ) How is the bulk of carbon dioxide transported in blood ? A ) chemically combined with the heme portion of hemoglobin B ) as bicarbonate ions in plasma after first entering the red blood cells C ) as carbonic acid in the plasma D ) chemically combined with the amino acids of hemoglobin as carbaminohemoglobin in the red blood cells

B ) as bicarbonate ions in plasma after first entering the red blood cells

11 ) The nose serves all of the following functions EXCEPT A ) cleansing the air B ) as the direct initiator of the cough reflex C ) warming and humidifying the air D ) as a passageway for air movement

B ) as the direct initiator of the cough reflex

44 ) Which of the choices below is NOT a role of the pleurae ? A ) allow the lungs to glide easily over the thorax wall during breathing movements B ) assist in blood flow to and from the heart because the heart sits between the lungs C ) help divide the thoracic cavity into three chambers D ) help limit the spread of local infections

B ) assist in blood flow to and from the heart because the heart sits between the lungs

59 ) The erythrocyte ( red blood cell ) count increases after a while when an individual goes from a low to a high altitude because the A ) concentration of oxygen and / or total atmospheric pressure is higher at higher altitudes B ) concentration of oxygen and / or total atmospheric pressure is lower at high altitudes C ) temperature is lower at higher altitudes D ) basal metabolic rate is higher at high altitudes

B ) concentration of oxygen and / or total atmospheric pressure is lower at high altitudes

31 ) The symptoms of hyperventilation may be averted by breathing into a paper bag because it A ) lowers blood pH levels B ) helps retain carbon dioxide in the blood C ) reduces brain perfusion by constricting cerebral blood vessels D ) helps retain oxygen in the blood

B ) helps retain carbon dioxide in the blood

22 ) As the tension of vocal folds in the larynx increase , the voice becomes A ) louder B ) higher in pitch C ) more distinct D ) lower in pitch

B ) higher in pitch

18 ) Respiratory control centers are located in the A ) midbrain and medulla B ) medulla and pons C ) upper spinal cord and medulla D pons and midbrain

B ) medulla and pons

17 ) Which of the choices below is NOT a factor that promotes oxygen binding to and dissociation from hemoglobin ? A ) partial pressure of oxygen B ) number of red blood cells C ) temperature D ) partial pressure of carbon dioxide

B ) number of red blood cells

39 ) Intrapulmonary pressure is the A ) difference between atmospheric pressure and respiratory pressure B ) pressure within the alveoli of the lungs C ) pressure within the pleural cavity D ) negative pressure in the intrapleural space

B ) pressure within the alveoli of the lungs

28 ) Which of the following refers to the movement of air into and out of the lungs ? A ) external respiration B ) pulmonary ventilation C) gas exchange D ) internal respiration

B ) pulmonary ventilation

62 ) Spirometry results reveal a vital capacity of two liters which is well below the predicted value of five liters . This suggests which disorder ? A ) asthma B ) restrictive disease C ) emphysema D ) obstructive pulmonary disease

B ) restrictive disease

4 The walls of the alveoli are composed of two types of cells , type I and type II alveolar cells . The function of type II alveolar cells is to A ) protect the lungs from bacterial invasion B ) secrete surfactant C ) replace mucus in the alveoli D ) trap dust and other debris

B ) secrete surfactant

10 ) Which of the following is responsible for holding the lungs to the thorax wall ? A ) the visceral pleurae and the changing volume of the lungs B ) surface tension from pleural fluid and negative pressure in the pleural cavity C ) the smooth muscles of the lung D ) the diaphragm and the intercostal muscles alone

B ) surface tension from pleural fluid and negative pressure in the pleural cavity

27 Which bone does NOT contain paranasal sinuses ? A ) ethmoid B ) temporal C) frontal D ) maxillary

B ) temporal

57 ) The lung volume that represents the total volume of exchangeable air is the A ) tidal volume B ) vital capacity C ) expiratory reserve volume D ) inspiratory capacity .

B ) vital capacity

40 ) For inspiration of air , which of the following happens first ? A ) thoracic cavity volume decreases B ) diaphragm descends , thoracic volume begins to increase , and rib cage rises C ) intrapulmonary pressure drops D ) air ( gases ) flows into lungs

B) diaphragm descends , thoracic volume begins to increase , and rib cage rises

74) Expiratory reserve volume

C

75) Trachea.

C

76) Carina of trachea.

E

79) The partial pressure gradient for oxygen (in the body) is much steeper than that for carbon dioxide. Explain how equal amounts of these two gases can be exchanged (in a given time interval) in the lungs and at the tissues.

Equal amounts of 02 and CO2 can be exchanged in the lungs and at the tissues because CO2 solubility in plasma and alveolar fluid is 20 times greater than that of 02

85 ) The Heimlich maneuver is a procedure in which air in the lungs is used to expel a piece of food lodged in the esophagus .

False

87 ) The paired lungs occupy the mediastinum of the thoracic cavity .

False

89 ) In chronic bronchitis , mucus production is decreased and this leads to the inflammation and fibrosis of the mucosal lining of the bronchial tree .

False

90 ) Oxygenated hemoglobin releases oxygen more readily when the pH is more basic

False

92 ) During normal quiet breathing , males breathe 25 % more than females .

False

93 ) A drop in blood pH is likely to cause a slower breathing rate

False

94 ) The inflation ( Hering - Breuer ) reflex is a potentially dangerous response that may cause overinflation of the lung .

False

95 ) Increased temperature results in decreased 02 unloading from hemoglobin .

False

98 ) The largest amount of carbon dioxide is transported in the bloodstream in the form of carbonic anhydrase

False

99 ) The average individual has 500 ml of residual volume in his lungs .

False

Haldane effect ) , which in turn allows more CO2 to combine with hemoglobin and more 96 ) As carbon dioxide enters systemic blood , it causes more oxygen to dissociate from hemoglobin ( the bicarbonate ions to be generated ( the Bohr effect ) .

False

81) How is alveolar gas exchange affected by emphysema and pneumonia?

In pneumonia, gas exchange is impaired due to the thickening of the walls of the alveoli, shared basement membrane and capillary wall. It may even reduce the vital capacity. In emphysema, the progressive destruction of alveoli leads to a reduction in the cross-sectional area of gas exchange, resulting in having to supplement with oxygen the air that these patients breathe. Additionally, due to a reduction in elastic connective tissue and normal tissue parenchyma, the compliance will also be reduced.