Chapter 22 Respiratory Flashcards
(92 cards)
1
Q
The main site of gas exchange is
A
Alveoli
2
Q
The loudness of a persons voice depends on the
A
Force with which air rushes across the vocal cords
3
Q
The walls of the alveoli are composed of two types of cells type one and type two alveolar cells the function of type two alveolar cells is to
A
Secrete surfactant
4
Q
Complete the following statement using the choices below. Air moves out of the lungs when the pressure inside the lungs is
A
Greater than the pressure in the atmosphere
5
Q
Which of the following is true regarding normal quiet expiration of air
A
What is a passive process that depends on the recoil of elastic fibers that were stretched during inspiration
6
Q
Intrapulmonary pressure is the
A
Pressure within the alveoli of the lungs
7
Q
The relationship between gas pressure in gas volume is described by
A
Boyles law
8
Q
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
Dalton’s law
9
Q
Surfactant helps to prevent the alveoli from collapsing by
A
Interfering with the cohesiveness of water molecules, thereby reducing the surface tension of alveolar fluid
10
Q
For gas exchange to be efficient the respiratory membrane must be
A
.5 to 1 micrometer thick
11
Q
With the Bohr effect, more oxygen is released because a
A
It decreases in pH (acidosis) weakens the hemoglobin to oxygen bond
12
Q
The most powerful respiratory stimulus for breathing and a healthy person is
A
Increase of carbon dioxide
13
Q
The Local matching of blood flow with ventilation is
A
Ventilation perfusion coupling
14
Q
In the plasma the quantity of oxygen in solution is
A
Only about 1.5% of the oxygen is carried in blood
15
Q
Which of the following is the leading cause of cancer death for both men and women in North America
A
Lung
16
Q
Which of the choices below describes the forces that acts to pull the ones away from the thorax wall and thus collapse lungs
A
The natural tendency for the lungs to recoil in the surface tension of the alveolar fluid
17
Q
Which of the following counteracts the movement of bicarbonate ions from the red blood cells
A
Chloride shifting
18
Q
Which of the following is not a form of lung cancer
A
Kaposis sarcoma
19
Q
Which of the following refers to the movement of air into and out of the lungs
A
Pulmonary ventilation
20
Q
The major nonelastic source of resistance to airflow in the respiratory passageways is
A
Friction
21
Q
Which of the following determines lung compliance
A
Alveolar surface tension
22
Q
Tidal volume is air
A
Exchanged during normal breathing
23
Q
Which of the following choices below determines the direction of respiratory gas movement
A
Partial pressure gradient
24
Q
Possible causes of hypoxia include
A
Too little oxygen in the atmosphere
25
How long volume that represents the total volume of exchangeable air is the
Vital capacity
26
Which of the following is correct regarding acclimatization
High altitude conditions always result in lower than normal hemoglobin saturation levels because it’s less oxygen is available to be loaded
27
Which of the following is not a stimulus for breathing
Rising blood pressure
28
Respiratory control centers are located in the
Medulla and pons
29
The amount of air that can be inspired above the tidal volume is called
Inspiratory reserve volume
30
Which statement about carbon dioxide is false
More CO2 dissolves in the blood plasma that is carried in the RBCs
31
Oxygen and carbon dioxide are exchanged in the lungs and through all the cell membranes by
Diffusion
32
Select the correct statement about the pharynx
The pharyngotympanic (auditory) blends posteriorly into the nasopharynx
33
The larynx contains
The thyroid cartilage
34
Which respiratory associated muscles would contract or relax during forced expiration, for example blowing up a balloon
Internal intercostals and abdominal muscles would contract
35
Which of the choices below is NOT A roll of the pleurae
Assassin blood flow to and from the heart because the heart sits between the lungs
36
Which of the following in correctly describes the mechanisms of carbon dioxide transport
Attached to the heme part of hemoglobin
37
Factors that influence the rate and depth of breathing include
Voluntary cortical control
38
Which of the following provides the greatest surface area for gas exchange
Alveoli
39
The respiratory membrane is a combination of
Alveolar capillary walls and their fused basement membranes
40
The symptoms of hypo ventilation may be averted by breathing into a paper bag because it
Help contain carbon dioxide in the blood
41
Inspiratory capacity is
It’s all amount of air that can be inspired after a tidal expiration
42
Which center is located in the pons
Pontine respirator group (RPG)
43
The nose serves all of the following functions except
a direct initiator of the coughing refex
44
According to the oxygen hemoglobin disassociation curve,PO2 in the lungs of 100 mm Hg results in Hb being 98% saturated. At high altitude, there is less oxygen. At a PO2 in the lungs of 80 mm Hg, Hb would be ______ Saturated
95%
45
Which of the following is an appropriate response to carbon monoxide poisoning
Hyperbaric oxygen chamber to increase PO2 and clear carbon monoxide from the body
46
Select the correct statement about the neural mechanisms of respiratory control
The pond is thought to be instrumental in the smooth transition from inspiration to expiration
47
Which of the following choices is not a factor that promotes oxygen binding to and dissociation from hemoglobin
Number of red blood cells
48
Which of the following is responsible for holding the lungs to the thorax wall are
Surface tension from pleural fluid and negative pressure in the pleural cavity
49
The erythrocyte (RBC) Count increases after a while when an individual goes from a low to high altitude because the
Concentration of oxygen and/or total atmospheric pressure is lower at high altitude’s
50
Most inspired particles such as dust to reach the lungs because of the
Ciliated mucous lining in the nose
51
Which of the following is incorrect
Pressure gradient equals gas flow over resistance
52
Select the correct statement about the physical factors influencing Pulmonary ventilation
As alveolar surface tension increases additional muscle action will be required
53
Select the correct Statement about oxygen transport in blood
If 50% oxygen saturation level of blood returning to the lungs might indicate an activity level higher than normal
54
Which of the following disorders below is characterized by destruction of the walls of the alveoli producing abnormally large air spaces remain filled with air during exhalation
Emphysema
55
Which of the following does not influence hemoglobin saturation
Nitric oxide
56
For inspiration of air which of the following happens first
Diaphragm just sounds in rib cages rise
57
Spirometry results reveal a vital capacity of 2 L which is well below the predicted value of 5 L this suggest what disorder
Restrictive disease
58
The law that flies to the amount of carbon dioxide you could dissolve In a soda is called
Henrys law
59
Which structure is lined with simple squamous epithelium
Alveolus
60
Using spirometry, patient discovers are forced expiratory volume after the first second is 40%. What does this suggest
Restrictive disease
61
Which of the following anchor is the vocal cords
Arytenoid cartilages
62
Which of the following is a conducting zone structure
Terminal bronchioles
63
How is alveolar gas exchange affected by emphysema and pneumonia
Pneumonia-Thickness of the exchange membrane may increase drastically
Emphysema-The lungs become progressively less elastic and more fibrous
64
NO exchange of gases occur here
segmental (tertiary) bronchi
65
Secrete a fluid containing surfactant
Type 2 alveolar cells
66
Where the respiratory zone of the lungs begins
Respiratory bronchioles
67
Composed of simple squamous epithelium
Type 1 alveolar cells
68
Terminates in alveoli
alveolar duct
69
Composed of cuboidal cells
Type 2 alveolar cells
70
The respiratory membrane is composed of fused basement membrane of the capillary walls and ________.
Type 1 alveolar cells
71
TV + IRV + ERV + RV
Total lung capacity
72
ERV + RV
Functional residual capacity
73
TV + IRV + ERV
Vital Capacity
74
TV + IRV
Inspiratory capacity
75
During normal quiet breathing, approximately 750ml of air moves into and out of the lungs with each breath. False, why?
approximately 500ml*
76
In chronic bronchitis, mucus production is decreased and this leads to the inflammation and fibrosis of the mucosal lining of the bronchial tree. False, why?
mucus production is increased*
77
The largest amount of carbon dioxide is transported in the bloodstream in the form of carbonic anhydrase. False, why?
in the form of bicarbonate ions*
78
Increased temperature results in decreased O2 unloading from hemoglobin. False, why?
increased O2*
79
The paired lungs occupy the mediastinum of the thoracic cavity. False, why?
pleural cavities of the thoracic cavity*
80
The average individual has 500 ml of residual volume in his lungs. False, why?
1200ml*
81
The inflation (Hering-Breuer) reflex is a potentially dangerous response that may cause overinflation of the lung. False, why?
that prevents overinflation of the lung*
82
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 O2 even though adequate amounts are delivered. Hypoxemia hypoxia is indicated by reduced arterial PO2.
83
Timothy has been having difficulty breathing since he had pneumonia last month. Recently he had severe pain in his chest and back, and his breathing was extremely irregular. The doctor at the emergency room told him that one of the lobes of his lung had collapsed. How could this happen?
Timothy suffered a pneumothorax, or lung collapse, most likely caused by a rupture of the visceral pleura as a result of coughing during his bout with pneumonia. The pneumothorax was large enough to cause atelectasis, or collapse, of one of his lobes, but not the remainder of his lung.
84
While having a physical examination, a young male informed his doctor that at age 8 he had lobar pneumonia and pleurisy in his left lung. The physician decided to measure his VC. Describe the apparatus and method used for taking this measurement. Define the following terms used in the description of lung volumes: TV, IRV, ERV, RV, and VC.
His vital capacity (VC) was measured using a spirometer. As he breathed into a handheld device, the speed and volume of air flow was calculated from the output of a pressure transducer. Tidal volume (TV) is the amount of air that moves into and out of the lungs with normal breathing. Inspiratory reserve volume (IRV) is the amount of air that can be forcibly inhaled beyond a tidal inspiration. The expiratory reserve volume (ERV) is the amount of air that can be evacuated from the lungs over and above a tidal expiration. Residual volume (RV) is the amount of air that remains in the lungs even after the most strenuous expiration. Vital capacity (VC) is the total amount of exchangeable air.
85
Jane had been suffering through a severe cold and was complaining of a frontal headache and a dull, aching pain at the side of her face. What regions are likely to become sites of secondary infection following nasal infection?
Following nasal infection, the paranasal sinuses can become infected.
86
A smoker sees his doctor because he had a persistent cough for months and is short of breath after very little exertion. What diagnosis will the doctor make and what can the person expect if he does not quit smoking?
The person is suffering from chronic bronchitis, which causes the dyspnea and coughing. If he does not stop smoking, he can expect frequent pulmonary infections, more coughing, and progressively worse dyspnea (all symptoms of chronic obstructive pulmonary disease). Ultimately, he can expect to develop hypoxemia, CO2 retention, and respiratory acidosis. He may develop emphysema or lung cancer.
87
After a long scuba diving session on a Caribbean reef, Carl boards a plane to Dallas. He begins to feel pain in his elbow on the flight back to Dallas. What is happening to him?
Carl is experiencing decompression sickness, "the bends," due to several problems: (1) Applying Boyle's law, a lot of gas was forced into Carl's bloodstream during the dive and there was not sufficient time to decompress the excess before he boarded the plane. (2) The plane is not pressurized to sea level, which further reduced atmospheric pressure holding the gases in suspension (Henry's law). Carl should be to be transported to a hyperbaric chamber to be repressurized. This will reduce the volume of the gas bubbles in his arm so that normal circulation can resume.
88
A patient was admitted to the hospital with chronic obstructive pulmonary disease. His PO2 was 55 and PCO2 was 65. A new resident orders 54% oxygen via the venturi mask. One hour later, after the oxygen was placed, the nurse finds the patient with no respiration or pulse. She calls for a Code Blue and begins cardiopulmonary resuscitation (CPR). Explain why the patient stopped breathing.
In people who retain carbon dioxide because of pulmonary disease, arterial PCO2 is chronically elevated and chemoreceptors become unresponsive to this chemical stimulus. In such cases, declining PO2 levels act on the oxygen-sensitive peripheral chemoreceptors and provide the principle respiratory stimulus, or the so-called hypoxic drive. Pure oxygen will stop a person's breathing, because his respiratory stimulus (low PO2 levels) would be removed.
89
While dining out in a restaurant a man suddenly chokes on a piece of meat. The waitress is also a student nurse and comes to the man's aid. She asks him if he can talk. The man responds by shaking his head no and grabbing at his neck. What is the significance of the man's inability to talk?
Speech involves the intermittent release of expired air and opening and closing of the glottis. Because the man is unable to speak, this indicates that he is choking on a piece of food that suddenly closed off air at or below the glottis.
90
How will the lungs compensate for an acute rise in the partial pressure of CO2 in arterial blood?
Respiratory rate will increase.
91
A patient with tuberculosis is often noncompliant with treatment. Explain why this may happen.
Noncompliance may occur because of the length of treatment. Treatment entails a 12-month course of antibiotics. Once the patient begins to feel better and the clinical symptoms dissipate, the patient may stop taking the medication.
92
John has undergone surgery and has developed pneumonia. He also has a history of emphysema. Which symptoms and signs would the nurse expect to find?
1. The patient may have dyspnea.
2. The patient may have hypoxemia because of increased secretions in the lungs.
3. The patient may use his accessory muscles to assist breathing.
4. The patient may have a productive cough.
5. The patient's breath sounds may have rales (crackles).
