TopHat Respiratory System Questions

A 7-year-old boy is brought to the clinic by his mother because she has noticed that he has been having trouble breathing. She says that this has not been constant, but that she really noticed it earlier in the spring, and it seems to come back up whenever he plays with his friends. She is concerned that he has anxiety and has tried to limit the amount of time he spends around groups of children. She notes that while he plays, he seems to have difficulty breathing, takes frequent breaks from running, and has coughing spells. During a medical history, the boy states that he enjoys being around his friends, but he gets winded easily making it difficult to keep up with others. He also notes that he coughs something up when he starts feeling like he can't breathe. When questioned about what he was coughing up, he describes a clear sputum with white dots. On physical examination, the physician detects wheezing in both basilar lung fields on auscultation, but no rales or stridor. The heart and abdominal sounds are normal. There is no fever and no lymphadenopathy. What is the likely problem the patient is suffering from? a. upper respiratory infection b. lung cancer c. exercise-induced asthma d. anxiety

c. exercise-induced asthma This is a classic case of exercise-induced asthma in a young patient. Lung cancers are very rare in someone this age, and he didn't present with a bloody sputum. There was no evidence of infection. The little white dots are called Curschmann's spirals, microscopic mucus plugs that come from the bronchioles, and are usually diagnostic for asthma.

Which of the below describe external and internal respiration? a. air entering the lungs and gas exchange across the lungs b. oxygen moving one way across lung tissues and carbon dioxide moving the other way c. gas exchange in the lungs and gas exchange in the systemic tissues of the body, respectively d. breathing through the mouth and nose, respectively

c. gas exchange in the lungs and gas exchange in the systemic tissues of the body, respectively External respiration is the exchange of respiratory gases between your blood and the air you breath (from the external environment). Internal respiration is the exchange of respiratory gases between your blood and the tissues of your body (the internal environment).

Carbaminohemoglobin is _____________. a. an alteration of adult hemoglobin, similar to fetal hemoglobin b. hemoglobin with carbon monoxide bound to it c. hemoglobin with carbon dioxide bound to it d. hemoglobin that is devoid of oxygen

c. hemoglobin with carbon dioxide bound to it Hemoglobin interacts with more than just oxygen; it can also bind to and carry a small amount of carbon dioxide. Carbaminohemoglobin forms when CO2 binds to the protein chains of Hb, which are distinct from the iron atoms to which O2 binds.

If the volume occupied by a gas decreases by 1/3 (i.e. to 2/3 of original volume), what will happen to the pressure of the gas? a. increase by 1/3 b. decrease by 1/3 c. increase by 50% d. decrease by 50%

c. increase by 50% Reducing the volume by 1/3, increases pressure by 50%. Think of it this way, changing the volume to 2/3 its original value, changes the pressure to 3/2 (150%) its original value.

What would happen without the chloride shift? a. less carbon dioxide would be bound to Hb b. less carbon dioxide would be dissolved c. less carbon dioxide would be transformed to bicarbonate d. less carbon dioxide would be produced by tissues

c. less carbon dioxide would be transformed to bicarbonate The conversion of carbon dioxide into bicarbonate and hydrogen ions is a reversible reaction. By removing these ions from the cell (in part by the chloride shift), it favors the continuation of the reaction in the direction of bicarbonate.

The partial pressure gradient for carbon dioxide across the respiratory membrane is ________ than that for oxygen. The rate of diffusion of carbon dioxide across the respiratory membrane is _________ than that of oxygen. a. less; less b. more; more c. less; more d. more; less

c. less; more Despite its partial pressure gradient being lower, carbon dioxide still diffuses more rapidly than oxygen due to it having a higher solubility.

What would happen if a mixture of gas is composed of 50% O2 and 50% CO2, and a beaker of water is placed in the mixture? a. the same amount of O2 and CO2 will dissolve in the beaker of water b. more O2 than CO2 will dissolve in the beaker of water c. more CO2 than O2 will dissolve in the beaker of water d. neither O2 nor CO2 will dissolve in the beaker of water

c. more Co2 than O2 will dissolve in the beaker of water Carbon dioxide is more soluble in water than oxygen, so more carbon dioxide will dissolve.

When the airways constrict, the most likely value to be affected is the _________. a. tidal volume b. functional residual capacity c. peak expiratory flow d. inspiratory reserve volume

c. peak expiratory flow Constriction of airways does not change the size of the lungs, so volumes and capacities are unchanged. It does, however, increase resistance to flow.

A benefit of humidifying air prior to its arrival in the respiratory division: a. promotes gas exchange b. is necessary for air to pass through the bronchioles c. prevents dryness of the lung tissue d. kills microorganisms

c. prevents dryness of the lung tissue Dryness of lung tissue can cause irritation and coughing, thereby interfering with ventilation. Therefore maintaining a sufficient amount of humidity in the air is beneficial.

Surfactant is necessary for ______. a. delivering blood to the alveoli b. keeping bronchi open c. reducing surface tension in the alveoli d. forming the alveolar pores

c. reducing surface tension in the alveoli By interfering with hydrogen bonding, surfactant reduces the surface tension created by water molecules that line the inner surface of the alveoli.

Transpulmonary pressure is the pressure measured across __________. a. the ends of the bronchioles b. the conducting division c. the visceral pleura d. the parietal pleura

c. the visceral pleura Transpulmonary pressure is the difference between alveolar pressure and intrapleural pressure. The visceral pleura covers the surface of the lung, between it and the space within the pleural cavity.

Approximately how many hemoglobin molecules are in a red blood cell? a. 1 b. 4 c. 1 million d. 250 million

d. 250 million Recall that the cytoplasm of red blood cells has a high density of hemoglobin, with each red cell containing 250-300 million hemoglobin molecules. Each hemoglobin can carry up to four oxygen molecules.

The respiratory center is located in the __________. a. cerebellum b. cerebral cortex c. aortic arch and carotid bodies d. brainstem

d. brainstem The respiratory center is located in the medulla and pons of the brainstem.

Coughing and sneezing both attempt to _________. a. force air quickly through the vocal cords in order to make an alarming sound b. open alveoli that have collapsed c. move humidified air from the lungs to the upper respiratory tract d. clear irritants from the airways

d. clear irritants from the airways Coughing clears irritants from the airways via forceful, rapid air movement.

Neurological injury can result in a variety of abnormal breathing patterns. Predict which structures, when injured, might lead to altered breathing. For each, discuss the type of breathing pattern that might result from the injury.

Damage to the brainstem can dramatically change breathing patterns depending on which areas are affect.

There are a number of professional athletes that sleep in either hypo- or hyper-baric chambers. Discuss the pros and cons of using such devices.

Hyperbaric chambers have been shown to reduce swelling, promoters wound healing, fights infections and increase blood O2 levels. Hypobaric chambers have been shown to increase capillary density within muscle, and to increase the efficiency of mitochondria in O2 usage.

Is ventilation controlled by the autonomic nervous system? Which aspects of ventilation seem to argue for, and which against, being autonomically controlled?

Respiration can be controlled by changes in CSF pH, Po2 in arterial blood and mechanoreceptors in the airways and lungs, all at an autonomic level. The control of respiration by the medulla is also at an autonomic level, which can be over-ridden by inputs from the cortex.

Sort these structure in the order that air would pass through them during inhalation. Alveolar sac Respiratory bronchiole Alveoli Alveolar duct

Respiratory bronchiole Alveolar duct Alveolar sac Alveoli During inhalation, air is delivered to a respiratory bronchiole by a terminal bronchiole. From here, air is carried by alveolar ducts to alveolar sacs comprised of the tiny alveoli.

Populations that live at altitude (such as the Sherpas of Tibet) are better adapted to the low oxygen levels than those that travel from lower climates and acclimatize for several months at higher elevation. Predict possible reasons, including physiological benefits, that might explain how these high-altitude dwellers can thrive in their native environment.

Sherpas of Tibet have the following changes: more efficient mitochondria, producing more energy with less O2; vascular changes to small blood vessels keeping them open during low O2 levels and a lot-shifted hemoglobin:O2 binding curve.

Select the frontal sinuses.

The frontal sinuses are above the eyes, in the frontal bone.

If a person has one lung lobe removed (due to lung cancer, for example), to what extent would you expect this to impact gas exchange and ventilatory volumes? What types of respiratory compensation would you expect after the surgery?

This would decrease the ability of the lungs to supply oxygen and remove carbon dioxide. This would be most notable when exercising or walking up stairs. It would generally decrease all ventilatory volumes. Compensation would likely be an increase rate of breathing - hypercapnia.

An increase in altitude leads to a ___________. Select all that apply. a. decrease in atmospheric pressure b. decrease in fraction of oxygen in the air c. decrease in inhaled Po2

a, c At increased altitude, atmospheric pressure drops. This leads to a decrease in inhaled oxygen.

Match the definition with the term. a. amount of air left in the lung after a complete exhale b. amount of air inhaled and exhaled during normal breathing c. amount of air that can be inhaled "on top of" a normal inhale d. the total amount of air that a person can move into, or out of, their lungs 1) residual volume 2) tidal volume 3) inspiratory reserve volume 4) vital capacity

a. 1 b. 2 c. 3 d. 4 Inspiratory reserve volume is the volume of air that can be inspired beyond a normal inspiration. Residual volume is the amount of air trapped in the lungs. Tidal volume is the amount of air moved during a normal breath. Vital capacity is the total amount of air you can move.

During expiration, how does alveolar pressure compare to atmospheric pressure? a. alveolar pressure is higher b. the pressures are the same c. alveolar pressure is lower

a. alveolar pressure is higher Alveolar pressure is greater than atmospheric pressure during exhalation, driving air out of the lungs.

Atmospheric pressure is ______________. a. determined as the mathematical sum of all the partial gas pressures that make it up b. due solely to nitrogen c. due solely to oxygen d. the partial pressure of nitrogen plus two times the partial pressure of oxygen, minus the partial pressure of water

a. determined as the mathematical sum of all the partial gas pressures that make it up Air is comprised of several gases. Atmospheric pressure is determined by the sum of their partial pressures.

Input from the chemoreceptors (aortic and carotid bodies) enters the respiratory centers via the ____________. a. dorsal respiratory group b. Botzinger area c. caudal center d. apneustic center

a. dorsal respiratory group The dorsal respiratory group (DRG) uses information it collects from chemoreceptors to influence the activity of the ventral respiratory group (VRG).

Which structure is most responsible for producing sound? a. glottis b. vestibular folds c. epiglottis d. corniculate structure

a. glottis The vocal folds of the glottis vibrate to produce sound.

Fetal hemoglobin binds oxygen with ________ than adult hemoglobin. a. greater affinity b. the same affinity c. less affinity

a. greater affinity Fetal hemoglobin is able to take oxygen from adult hemoglobin due its higher affinity.

If a greater pressure difference is generated between the atmosphere and the lungs, and the airways maintain their diameter, the flow rate of air entering the lungs will ______? a. increase b. decrease c. remain the same

a. increase Flow is directly related to ΔP. So if the difference in pressure increases, so does the flow rate.

The number of primary bronchi matches the number of _____ that we have. a. lungs b. lung lobes c. bronchopulmonary segments d. lung lobules

a. lungs There are two lungs, so there are two primary bronchi.

The ability of a gas to dissolve in water is dependent on which of the following? a. partial gas pressure, chemical solubility, and temperature b. partial gas pressure and chemical solubility, but not temperature c. total gas pressure (sum of all partial pressures), chemical solubility, and temperature d. total gas pressure (sum of all pressures), chemical solubility, but not temperature

a. partial gas pressure, chemical solubility, and temperature The ability of gas to dissolve in water (amount and rate) depends on its ability to interact with water molecules (solubility), the difference in partial pressures, and the temperature.

The region of the brainstem thought to be most responsible for generating a basic pattern of breathing is the ___________. a. pre-Botzinger complex b. Botzinger area c. caudal center d. dorsal respiratory group

a. pre-Botzinger complex The main stimulus for breathing originates from the pre-Bötzinger complex, a sub-region of the VRG.

Match each of the following structures with their anatomical classification. a. nose b. trachea c. bronchi d. pharynx 1) lower respiratory tract 2) lower respiratory tract 3) upper respiratory tract 4) upper respiratory tract

a. upper b. lower c. lower d. upper The nose and pharynx are above the larynx so are in the upper respiratory tract; the trachea and bronchi are below the larynx so are in the lower respiratory tract.

At a partial pressure of oxygen of 60 mmHg, hemoglobin is ________ percent saturated. a. 100 b. 90 c. 60 d. 40

b. 90 Despite a relatively large drop in partial pressure of oxygen, hemoglobin is still 90% saturated!

Diffusion results from ________. a. a difference in total pressures b. a difference in concentration c. changing temperature d. enclosed spaces

b. a difference in concentration Diffusion can be thought of as a spreading out of small particles. They move from areas of high concentration toward areas of low concentration.

Which of the following pressures are less than atmospheric pressure (760 mmHg)? a. alveolar pressure during exhalation b. alveolar pressure during inhalation c. pressure inside the lungs between breaths

b. alveolar pressure during inhalation Assuming the airways are open, air will flow from the higher pressure outside of the body to the lower pressure in the alveoli and allow for inhalation. During exhalation, alveolar pressure is higher than atmospheric. Between breaths air does not move because pressure inside the lungs is equal to atmospheric pressure.

Which structure is responsible for the large surface area of the nasal cavity? a. bridge b. conchae c. septum d. sinuses

b. conchae Nasal conchae create a series of mucous membrane covered "shelves" in the wall of the nasal cavity that increase surface area.

As blood moves along the length of the pulmonary capillary, the partial pressure gradient of oxygen ________. a. decreases b. increases c. stays the same

b. increases Oxygen is diffusing into blood from air, so as blood makes its way through the pulmonary capillaries the partial pressure gradient is decreasing.

During the process of internal respiration, oxygen diffuses ________ systemic cells and carbon dioxide diffuses _______ systemic cells. a. into; into b. into; out of c. out of; out of d. out of; into

b. into; out of Oxygen is required for cellular respiration, so it is diffusing into systemic cells. Carbon dioxide is produced as a waste product of cellular respiration, so it is diffusing out of systemic cells.

Using the oxyhemoglobin dissociation curve in figure 20.29, what is the approximate oxygen saturation at a pO2 of 30 mmHg? a. 5% b. 20% c. 50% d. 75%

c. 50% Hemoglobin is 50% saturated at an oxygen partial pressure of 30 mm Hg.

Administering high levels of oxygen to a person with chronically high PCO2 levels would likely lead to _________ in ventilation. a. no change b. an increase c. a decrease

c. a decrease Elevated carbon dioxide would typically cause increased ventilation. However, if that elevation is chronic, the body can become less sensitive to its presence. Thus, the impact of increasing oxygen levels is more likely to have an impact, decreasing ventilation.

Dead space air is best described as __________. a. air that fills the alveoli b. air that passes through the larynx for sound generation c. air that does not participate in gas exchange d. atmospheric air that has not yet been inhaled

c. air that does not participate in gas exchange Lack of blood perfusion prevents the air in dead space from participating in gas exchange.

A 4-year-old male is brought to the emergency department just before one in the morning because of violent coughing after eating peanuts. On physical examination, his lips look cyanotic (blue) and he continues to cough. After talking to him for a short time, the attending physician was able to determine that, at some point, the young boy had begun to wonder how many peanuts he could fit his nose. What is the likely problem the patient is suffering from? a. acute allergy to peanuts b. peanuts lodged within his nose c. foreign material in his throat d. foreign material in his lungs

d. foreign material in his lungs The peanuts have moved through his nasopharynx into his lungs, which is responsible for the violent coughing and the peripheral hypoxia - causing the cyanosis in his lips. An acute allergy to peanuts would cause a systemic response akin to anaphylactic shock. Foreign material in his throat would be loosened by his coughing.

Zones of blood flow through the lungs are most directly determined by which of the following? a. the person's arterial blood pressure b. the height of a person c. the septa dividing regions fed by specific bronchi d. the relationship between alveolar pressure and capillary pressure

d. the relationship between alveolar pressure and capillary pressure When/where blood pressure inside a capillary is less than the pressure inside an alveolus, the vessel will collapse.

A normal resting breath is also called the ________. a. residual volume b. inspiratory reserve volume c. lung capacity d. tidal volume

d. tidal volume Reserve volumes describe the volume of air that can be moved beyond a normal breath. Residual volume is the amount of air trapped in the lungs that cannot be expired. Tidal volume is the amount of air moved during a normal breath. Total lung capacity is the entire volume of the lungs.

If a beaker of water with an initial PO2 of 0 mmHg is placed into a gas mixture with a PO2 of 100 mmHg, what is the resulting PO2 in the water (after equilibrium)? a. 100 mmHg b. 50 mmHg c. 0 mmHg d. undetermined with the given parameters

d. undetermined with the given parameters In order to determine the resulting partial pressure, you would need to know the volume of water and the volume of the gas mixture.

Sort these lung structures/segments in order from largest to smallest. lobe lobule bronchopulmonary segment

lobe bronchopulmonary segment lobule Lobes are subdivided into bronchopulmonary segments, which are comprised of smaller lobules. The right lung is divided into three lobes that consist of ten bronchopulmonary segments while the left lung has two lobes that consist of eight to nine bronchopulmonary segments.

Sort the following structures from superior to inferior. nasopharynx laryngopharynx oropharynx

nasopharynx oropharynx laryngopharynx The nasopharynx is posterior to the nasal cavity, the oropharynx is posterior to the oral cavity, and the laryngopharynx is adjacent to the larynx.

Sort these segments of the pulmonary circulation from proximal to distal. lobar artery pulmonary capillaries right pulmonary artery pulmonary trunk

pulmonary trunk right pulmonary artery lobar artery pulmonary capillaries The pulmonary trunk is the large artery into which the right ventricle ejects blood. The right pulmonary artery is the branch of the pulmonary trunk that carries blood to the right lung. Lobar arteries branch from pulmonary arteries to deliver blood to lung lobes and eventually (after more branching) give rise the pulmonary capillaries.