Chapter 22 Respiratory System

A deficiency of surfactants in the neonate a. makes it difficult to expand the lungs. b. decreases alveolar surface tension. c. causes epiglottal swelling and laryngospasm. d. causes upper airway irritation.

A

A tracheostomy is performed in order to a. ensure an open airway. b. humidify inhaled air. c. administer high dose oxygen into the laryngopharynx. d. introduce food and water into the esophagus and stomach.

A

Atelectasis a. decreases the surface area for gas exchange. b. causes pneumothorax. c. causes acute respiratory obstruction. d. is best treated with antibiotics.

A

Boyle's law forms the basis of a. ventilation. b. chemical regulation of breathing. c. oxygen transport in the blood. d. carbon dioxide transport in the blood.

A

Cartilaginous rings a. prevent the collapse of the trachea. b. surround each alveolus. c. are innervated by the phrenic nerve. d. attach the diaphragm to the thoracic wall.

A

Clubbing" of the fingers is a response to a. chronic hypoxemia. b. CO2 retention and acidosis. c. acute hyperventilation in response to metabolic acidosis. d. chronic dry hacking cough.

A

Contraction and relaxation of the diaphragm and intercostal muscles a. change thoracic volume. b. close the glottis. c. occur in response to firing of the vagus nerve. d. All of the above are true.

A

How is most oxygen transported through the blood? a. attached to hemoglobin. b. as bicarbonate. c. as a surfactant. d. as a lysozyme.

A

Hyperventilation is most apt to induce a. alkalosis. b. hypoxemia. c. a decline in blood pH. d. metabolic acidosis.

A

Inspiratory and expiratory neurons a. are located within the respiratory control center in the brain stem. b. are sensitive primarily to PO2. c. line the breathing tubes, especially the bronchioles. d. All of the above are true.

A

Respirations are primarily controlled by the a. medulla oblongata. b. cerebellum. c. spinal cord. d. frontal lobe.

A

Severing the phrenic nerve a. stops ventilation. b. impairs exhalation but has no effect on inhalation. c. causes hyperventilation and respiratory alkalosis. d. does all of the above.

A

Surfactants a. are secreted by cells within the alveoli. b. increase surface tension. c. transport oxygen across the alveolar-pulmonary capillary membrane. d. relax the epiglottis so as prevent upper respiratory obstruction.

A

Surfactants a. prevent collapse of the alveoli. b. induce anaphylaxis. c. cause upper respiratory obstruction. d. decrease thoracic volume.

A

The Adam's apple is a. cartilage. b. the epiglottis. c. the primary site of gas exchange. d. the pharynx.

A

The Hering-Breuer reflex a. prevents overinflation of the lungs. b. is a chemical reflex; no nerves are involved. c. is important only in disease states. d. is concerned only with sneezing and coughing.

A

The trachea a. contains C-shaped cartilaginous rings. b. encircles the pulmonary artery, where gas exchange occurs. c. is lined with surfactant-secreting cells. d. is located within the pleural cavity.

A

The water molecule is polar, meaning that each end of the molecule has an electrical charge. Because of this characteristic, water a. has a high surface tension. b. can only dissolve lipids. c. is a poor solvent. d. is lipid-soluble.

A

What happens when the diaphragm and the intercostal muscles relax? a. air moves out of the lungs. b. inhalation occurs. c. ventilation ceases. d. chest volume increases.

A

When the muscles of respiration relax, a. thoracic volume decreases and air moves out of the lungs. b. thoracic volume increases and air moves out of the lung. c. thoracic volume decreases and air moves into the lungs. d. thoracic volume decreases and intrapulmonic pressure decreases.

A

Which group is incorrect? a. Structures of the bronchial tree: trachea, bronchi, bronchioles, alveoli b. Paranasal sinuses: frontal, maxillary, sphenoidal, ethmoidal c. Structures of the upper respiratory tract: trachea, pharynx, larynx d. Parts of the pharynx: oropharynx, nasopharynx, laryngopharynx

A

Which of the following contributes to the wheezing of asthma? a. Constriction of the bronchiolar smooth muscle b. Edema of the esophagus c. Inflammation of the trachea and pharynx d. Pneumothorax

A

Which of the following is most likely to stimulate coughing that may be accompanied by a life-threatening bradycardia? a. Suctioning of the lower airways b. Administration of albuterol (a beta2-adrenergic agonist) via inhalation c. Administration of O2 via nasal cannula d. Performance of a thoracentesis

A

Which of the following is the dome-shaped muscle that is the chief muscle of inhalation? a. Diaphragm b. Epiglottis c. Mediastinum d. Pericardium

A

Which of the following is true of the lower respiratory tract? a. Contains the respiratory organs in the chest b. Contains all respiratory organs c. Contains all respiratory structures lined with mucous membrane d. Contains all organs distal to the larynx

A

Which of the following statements is true of the right bronchus? a. Food and small objects are more likely to be aspirated into the right bronchus because it is more vertical and larger than the left bronchus. b. The right bronchus has an opening to the pleural cavity. c. Oxygen content is higher in the right bronchus than the left bronchus. d. The right bronchus is bigger than the left bronchus, so it has higher levels of carbon dioxide.

A

Which of the following structures controls respirations? a. Medulla oblongata b. Basal ganglia c. Postcentral gyrus d. Limbic system

A

A preterm infant is most likely to develop respiratory distress because of a. bacterial pneumonia. b. a deficiency of surfactant. c. excess mucus in the upper airways. d. an inability of the immature diaphragm to contract.

B

As plasma PCO2 increases, a. hemoglobin synthesis increases. b. ventilation increases. c. vital capacity increases. d. respirations cease.

B

Hypoventilation is most apt to a. increase blood pH. b. induce acidosis. c. cause ketosis. d. cause hyperglycemia.

B

In which structure is the PO2 104 mm Hg? a. Pulmonary artery b. Alveolus c. Right ventricle d. Vena cava

B

Laryngospasm and epiglottal swelling is most apt to cause a. pulmonary edema. b. upper airway obstruction. c. pleural effusion. d. pneumothorax.

B

The alveoli a. are supported by C-shaped cartilaginous rings. b. are the primary site of respiratory gas exchange. c. contract and relax, thereby determining resistance to air flow through the respiratory passages. d. are composed primarily of smooth muscle.

B

The central chemoreceptors are primarily sensitive to blood levels of a. oxygen. b. carbon dioxide and [H+]. c. sodium. d. potassium.

B

The diaphragm a. is smooth muscle that forms the bronchioles. b. is skeletal muscle. c. contracts in response to the firing of the vagus nerve. d. forms the outer lining of the lungs.

B

The lungs contain the a. inspiratory and expiratory neurons. b. structures of the bronchial tree. c. pharynx, larynx, and trachea. d. pleural membranes.

B

The nares, nostrils, and nasal septum a. are concerned with gas exchange. b. are located in the upper respiratory tract. c. contain gustatory organs. d. are parts of the bronchial tree.

B

The olfactory receptors a. are located on the tongue. b. are located within the nasal cavities and nasal septum. c. are also called taste buds. d. carry sensory information to the brain via CN II.

B

The phrenic nerve fires. Which event occurs next? a. The inspiratory neurons fire. b. The diaphragm contracts. c. Air moves into the lungs. d. Thoracic volume decreases.

B

The respiratory passages are lined with a. pleura. b. mucous membrane. c. serous membrane. d. muscle.

B

The respiratory tract a. includes the mouth, pharynx, trachea, and esophagus. b. contains conductance, resistance, and exchange structures. c. is lined with serous pleural membranes and cilia. d. begins with the nose and mouth and ends at the bronchioles.

B

The trachea branches into the right and left a. alveoli. b. bronchi. c. nares. d. pulmonary arteries.

B

What causes a boy's voice to "break" or change at the onset of puberty? a. Rapid growth of the throat region stretches the vocal cords. b. Testosterone causes the vocal cords to thicken. c. Testosterone closes the glottis permanently. d. Testosterone enlarges the thyroid cartilage (Adam's apple).

B

What is the effect of an overdose of an opioid (narcotic)? a. Alters the shape of the hemoglobin so that it cannot bind to oxygen b. Depresses the medulla oblongata and depresses ventilation c. Causes spasm of the epiglottis resulting in an upper airway obstruction d. Causes hyperventilation and alkalosis

B

Which event occurs in response to an increase in thoracic volume? a. The respiratory control center is activated. b. Air moves into and through the respiratory passages. c. Intrapleural pressure becomes greater than intrapulmonic pressure. d. Air is exhaled.

B

Which of the following events occurs last? a. Contraction of the diaphragm and the intercostals b. Movement of air into the lungs c. Firing of the inspiratory neurons in the medulla d. Firing of the phrenic and intercostal nerves

B

Which of the following is a structure located within the lungs? a. Visceral pleura b. Primary bronchi c. Parietal pleura d. Intrapleural space

B

Which of the following is an upper respiratory structure? a. Alveoli b. Larynx c. Bronchi d. Bronchioles

B

Which of the following is most related to the transport of the respiratory gases by the blood? a. Inhalation, exhalation b. Oxyhemoglobin, carbaminohemoglobin c. Inspiration, expiration d. Breathing in, breathing out

B

Which of the following is the major regulator of respiratory activity? a. PO2 b. PCO2 c. Bicarbonate d. Albumin

B

Which of the following represents a correct anatomical sequence? a. Larynx, laryngopharynx, trachea b. Oropharynx, laryngopharynx, larynx c. Larynx, pharynx, bronchi d. Voicebox, windpipe, alveoli

B

Which of the following structures is located both in the thoracic cavity and mediastinum but not in the pleural cavities? a. Lungs b. Heart c. Alveoli d. Bronchioles

B

Which of the following will cause the intrapulmonic pressure to become less than atmospheric pressure? a. Relaxation of the respiratory muscles b. Increase in thoracic volume c. Secretion of surfactants d. 95% oxygen saturation

B

Anatomical dead air space is most associated with which structure? a. Frontal sinus b. Alveoli c. Trachea d. Esophagus

C

As part of the respiratory structures, the oropharynx and laryngopharynx a. carry only air. b. are located distal to the larynx. c. carry food and water to the esophagus. d. carry air to respiratory structures distal to the pharynx.

C

Boyle's law states the relationship between volume and a. O2. b. CO2. c. pressure. d. H2O.

C

Bronchiolar constriction is most likely to cause a. pneumothorax. b. pulmonary edema. c. wheezing. d. laryngitis.

C

Firing of the intercostal and phrenic nerves a. activates the respiratory control center in the medulla oblongata. b. causes relaxation of the muscles of respiration. c. causes a skeletal muscle response that increases thoracic volume. d. dilates the bronchioles.

C

Frontal, maxillary, sphenoidal, and ethmoidal a. refer to the bones of the thorax. b. are saliva-secreting glands. c. are paranasal sinuses. d. are lined with serous membrane.

C

Hypoventilation can cause a. bleeding and hypotension. b. alkalosis and Kussmaul respirations. c. hypoxemia and acidosis. d. hyperglycemia and acidosis.

C

Hypoventilation decreases the respiratory excretion of a. oxygen. b. water. c. carbon dioxide. d. albumin.

C

Identify the names of the following: voicebox, throat, and windpipe. a. Larynx, vocal cords, trachea b. Larynx, laryngopharynx, bronchi c. Larynx, pharynx, trachea d. Laryngopharynx, pharynx, alveoli

C

In reference to a normally expanded lung, the a. intrapulmonic pressure is less than intrapleural pressure. b. intrapleural pressure is greater than atmospheric pressure. c. intrapulmonic pressure is greater than intrapleural pressure. d. intrapleural, intrapulmonic, and atmospheric pressures are equal.

C

Intra-alveolar surface tension is caused by a. acid. b. mucus. c. water. d. bicarbonate.

C

Kussmaul respirations a. cause hypoxemia. b. increase PCO2. c. refer to an acidosis-induced increased respiratory activity. d. are caused by a decrease in the plasma [H+].

C

Laryngospasm is most likely to cause a. emphysema. b. pneumothorax. c. acute respiratory obstruction. d. asthma.

C

Oxygen diffuses from the alveoli into the a. bronchioles. b. trachea. c. pulmonary capillaries. d. eustachian tube.

C

Stimulation of the phrenic and intercostal nerves causes the release of which neurotransmitter into the neuromuscular junction? a. Adrenaline b. Norepinephrine c. Acetylcholine d. Myosin

C

Surfactants are found within the a. pulmonary capillaries. b. trachea. c. alveoli. d. intrapleural space.

C

The collection of mucus in the lower airways is most likely to cause a. laryngospasm. b. pneumothorax. c. atelectasis. d. pharyngitis.

C

The epiglottis a. is innervated by the phrenic nerve. b. prevents air from entering the esophagus. c. prevents food from entering the trachea. d. is the Adam's apple.

C

The epiglottis, glottis, and vocal cords a. vibrate on exhalation, causing sound. b. prevent the entrance of food and water into the respiratory passages. c. are structures of the larynx. d. are composed of tough cartilage.

C

The pleural membranes a. line the respiratory passages. b. form the bronchioles. c. are serous membranes. d. are confined to the mediastinum.

C

The pneumotaxic center and apneustic center are located within the a. aortic bodies. b. alveoli. c. pons. d. spinal cord.

C

Ventilation a. refers to the regulation of blood pH by the lungs. b. refers to loading and unloading of oxygen by hemoglobin. c. has two phases: inhalation and exhalation. d. is exclusively responsive to pCO2.

C

What is the effect of curare? a. Depresses the inspiratory neurons in the medulla oblongata b. Changes the shape of the hemoglobin so that it cannot bind to oxygen c. Interferes with the activation of the diaphragm and the intercostal muscles by their motor nerves d. Inactivates acetylcholinesterase

C

What is the effect of phrenic nerve stimulation? a. Expiration b. Relaxation of the diaphragm and the intercostals c. Inhalation d. A decrease in chest diameter

C

What is the primary concern with laryngospasm and swelling of the lips and tongue? a. Interruption of the negative pressure within the intrapleural space b. Indication of accumulation of water in the alveoli as in pulmonary edema c. Acute upper airway obstruction d. Indication of damage of the phrenic nerve

C

What is the transport mechanism necessary for the movement of oxygen from the alveoli across the pulmonary capillary membranes into the blood? a. Osmosis b. Filtration c. Diffusion d. Active transport pump

C

Which nerve innervates the diaphragm? a. Intercostal nerve b. Sciatic c. Phrenic d. Cranial nerve XI

C

Which of the following are the accessory muscles of respiration (used in forced exhalation)? a. Intercostals and diaphragm b. Sternocleidomastoid and trapezius c. Internal intercostals and the abdominal muscles d. Pectoralis major and serratus anterior

C

Which of the following best describes eupnea? a. Kussmaul respirations b. Vital capacity c. Normal, quiet breathing d. Hypoxemia

C

Which of the following best describes the visceral and parietal pleura? a. Line the inner wall of the trachea and bronchi b. Line the mediastinum c. Are serous membranes that line the pleural cavity d. Are surfactant-secreting membranes

C

Which of the following describes Boyle's law? a. An increase in thoracic volume causes an increase in intrapulmonic pressure. b. There is no relationship between intrapulmonic pressure and thoracic volume. c. An increase in thoracic volume decreases intrapulmonic pressure. d. An increase in thoracic volume forces air out of the lungs.

C

Which of the following is most likely to cause hypoxemia? a. Kussmaul respirations b. Hyperventilation c. Medullary depression d. Brain stem stimulation

C

Which of the following is most related to the relaxation of the diaphragm and the intercostal muscles? a. Results from the firing of the inspiratory neurons b. Caused by the firing of the phrenic and intercostal nerves c. Decreased thoracic volume d. Causes air to move into the lungs

C

Which of the following is the first step in inhalation? a. Phrenic nerve stimulation b. Activation of the NM receptors (neuromuscular junction of the phrenic nerve and diaphragm) c. Firing of the medullary inspiratory neurons d. Contraction of the diaphragm

C

Which of the following represents a correct air flow? a. Bronchus to trachea to bronchioles b. Trachea to bronchioles to alveoli c. Bronchi to bronchioles to alveoli d. Nasopharynx to larynx to bronchioles to bronchi

C

Which of the following respiratory tubes are primarily composed of smooth muscle and determine the flow of air to the alveoli? a. Trachea b. Bronchi c. Bronchioles d. Nares

C

Which of the following structures is located in the lungs? a. Pharynx b. Epiglottis c. Alveoli d. Larynx

C

Which of the following structures prevents entrance of food and water into the respiratory passages? a. Larynx b. Glottis c. Epiglottis d. Thyroid cartilage

C

Which respiratory muscles are located between the ribs? a. Diaphragm b. Bronchiolar smooth muscle c. Intercostals d. Sternocleidomastoids

C

Which respiratory structure is distal to the trachea and proximal to the alveoli? a. Pharynx b. Larynx c. Bronchus d. Glottis

C

A stab wound to the chest causes the lung to collapse because a. of a sudden increase in surface tension. b. intrapulmonic pressure becomes less than atmospheric pressure. c. intrapulmonic pressure becomes higher than intrapleural pressure. d. intrapleural pressure becomes greater than intrapulmonic pressure.

D

Across which structure(s) does most gas exchange occur? a. Trachea b. Bronchus c. Bronchioles d. Alveoli

D

Activation of the beta2-adrenergic receptors of the airway a. causes laryngospasm. b. constricts the bronchioles. c. restricts air flow. d. causes bronchodilation.

D

At which point in the respiratory cycle is thoracic volume the smallest? a. At end inhalation b. With contraction of the diaphragm c. With contraction of the external intercostals d. At end of exhalation

D

Because of their smooth muscle content, _____________ are the primary determinants of air flow. a. trachea b. bronchi c. alveoli d. bronchioles

D

Central and peripheral chemoreceptors (aortic and carotid bodies) a. are responsive only to hypoxemia. b. are both sensitive to [H+] concentrations. c. can regulate the rate and depth of respirations. d. More than one of the above are true.

D

Contraction of the diaphragm and the external intercostal muscles a. stimulates the phrenic and intercostal nerves. b. decreases thoracic volume. c. causes air to move out of the lungs. d. is responsible for inhalation.

D

Dyspnea means a. "puffed up" alveoli. b. pneumonia. c. cyanosis. d. difficulty breathing.

D

Most CO2 is transported in the blood a. by the hemoglobin, as carbaminohemoglobin. b. by megakaryocytes. c. loosely bound to the iron molecule in heme. d. as bicarbonate.

D

Pleural membranes a. line the inside of the lungs. b. secrete surfactants. c. secrete mucus and other viscous secretions to minimize friction between the pleural membranes. d. are serous membranes.

D

The diaphragm a. is the chief muscle of inhalation. b. is innervated by the phrenic nerve. c. increases thoracic volume when contracted. d. All of the above are true.

D

The lungs are located within the a. mediastinum. b. dorsal cavity. c. spinal cavity. d. thoracic cavity.

D

The trachea is a. "the problem" in asthma. b. the site of gas exchange. c. composed primarily of smooth muscle. d. a large airway that splits into two bronchi.

D

What will happen under the following conditions: the pO2 is 95 mm Hg (arterial blood) and 40 mm Hg (tissue)? a. Oxygen diffuses from the tissues into the blood. b. Blood pH shifts from an acid to an alkaline range. c. Carbon dioxide diffuses from the blood to the tissues. d. Oxygen diffuses from the blood to the tissues.

D

Where is blood oxygenated? a. Within the left ventricle b. Within the left anterior descending artery c. Within the coronary sinus d. Across the alveolus/pulmonary capillary membrane

D

Which event occurs first? a. The diaphragm contracts. b. Air moves into the lungs. c. The phrenic nerve fires. d. The inspiratory neurons in the medulla fire.

D

Which group is incorrect? a. Pulmonary volumes: tidal, inspiratory reserve, expiratory reserve b. Structures of the bronchial tree: bronchi, bronchioles, alveoli c. Respiratory gases: oxygen, carbon dioxide d. Parts of the pharynx: oropharynx, nasopharynx, laryngopharynx, bronchiopharynx

D

Which of the following is most likely to cause pulmonary edema? a. Bronchitis b. Coryza c. Exercise-induced asthma d. Left ventricular heart failure

D

Which of the following is necessary for the lungs to remain expanded? a. The alveolar cells must secrete surfactant. b. The intrapulmonic pressure must be negative. c. The glottis must be closed. d. The intrapleural pressure must be negative.

D

Which of the following occurs on exhalation? a. Respiratory expiratory neurons fire. b. The diaphragm relaxes. c. Thoracic volume decreases. d. All of the above occur.

D

Which of the following occurs on inhalation? a. Air moves into the intrapulmonic space. b. Thoracic volume increases. c. The diaphragm contracts. d. All of the above occur.

D

Which structure has the thinnest wall? a. Trachea b. Bronchi c. Larynx d. Alveoli

D

Which structure is called the windpipe and is supported by rings of cartilage? a. Bronchus b. Alveolus c. Pharynx d. Trachea

D

Which substance greatly reduces the attractive forces among the water molecules lining the alveoli? a. Lysozyme b. Converting enzyme c. Mucus d. Surfactant

D