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Physiology 412G > Respiratory -- Practice Questions > Flashcards

Respiratory -- Practice Questions Flashcards

1
Q

Which of the following statements about the need for O2 in aerobic metabolism is true?
A) Aerobic metabolism takes place in the cytosol.
B) It includes multiple mitochondrial pathways.
C) O2 is needed to oxidize ADP to ATP.
D) It is independent of mitochondrial content.

A

It includes multiple mitochondrial pathways.

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2
Q

The process of gas exchange between the lungs and the cardiovascular system depends on:
A) Bulk air flow from alveoli to capillaries.
B) High O2 content in the cardiovascular system.
C) CO2 production by the peripheral tissues.
D) Gas exchange depends on diffusion only.

A

Gas exchange depends on diffusion only.

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3
Q

Which of the following structures are needed for normal speech?
A) Vocal folds.
B) Nasal sinuses.
C) All are correct.
D) Mouth.

A

All are correct.

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4
Q

The following structures are part of the respiratory zone, except:
A) terminal bronchioles.
B) respiratory bronchioles.
C) alveolar sacs.
D) alveoli.

A

terminal bronchioles.

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5
Q

During quiet breathing, muscle activity is needed for:
A) inspiration.
B) expiration.
C) both.
D) neither.

A

inspiration.

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6
Q

We say the conducting zone is a low-resistance pathway because its branching:
A) increases total airway surface area.
B) decreases total airway resistance.
C) decreases the resistance of each airway.
D) all options are correct.

A

decreases total airway resistance.

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7
Q

At rest (end of expiration), the lungs are ”attached” to the chest wall because:
A) the parietal pleura attaches to the lung.
B) the chest wall and lungs are close.
C) the intrapleural space is closed.
D) the pleural fluid joins the pleuras.

A

The intrapleural space is closed.

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8
Q

At the end of a quiet breath (expiration), what is the direction of the recoil
forces acting on the respiratory system?
A) Lung recoil out, chest recoil in.
B) Lung recoil out, chest recoil out.
C) Lung recoil in, chest recoil in.
D) Lung recoil in, chest recoil out.

A

Lung recoil in, chest recoil out.

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9
Q

If transpulmonary pressure increases from 3 to 10 cm H2O:
A) lung volume increases.
B) lung volume decreases.
C) lung compliance decreases.
D) lung compliance increases.

A

lung volume increases

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10
Q

In the complete absence of muscle activity, the respiratory system:
A) is at residual volume (RV).
B) is at functional residual capacity (FRC).
C) has total elastic recoil out.
D) is furthest away from total lung capacity (TLC).

A

Is at functional residual capacity (FRC)

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11
Q

The disease process in COPD may include significant loss of alveolar walls.
Because of this, we predict that:
A) total lung compliance decreases.
B) alveolar surface tension decreases.
C) quiet expirations are not passive.
D) quiet inspirations are not passive.

A

quiet expirations are not passive

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12
Q

A normal subject is testing an experimental O2-containing low-density liquid.
During the experiment, the subject is completely immersed in this liquid,
and breathing this liquid in and out. Assuming gas exchange is normal,
what is likely to change during the experiment?
A) Lung compliance will increase.
B) Surface tension will increase.
C) Surfactant production will increase.
D) The lungs will be difficult to expand.

A

Lung compliance will increase

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13
Q

What results from airway branching into the lungs?
A) Resistance of the airway below a branching is higher.
B) Air velocity increases and flow becomes laminar.
C) Resistance is proportional to the number of branches.
D) Air resistance increases with laminar air flow.

A

Resistance of the airway below a branching is higher

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14
Q

How does lung volume change airway resistance?
A) Resistance increases with airway branching.
B) Resistance is proportional to transpulmonary pressure.
C) Resistance is inversely proportional to lung volume.
D) Resistance is proportional to lateral traction.

A

Resistance is inversely proportional to lung volume

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15
Q

Which of the following factors LIMITS inspiratory flow in a flow-volume loop?
A) Increased airway resistance
B) Increased lung recoil
C) Increased muscle force
D) All options are correct

A

Increased lung recoil

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16
Q

What would a patient with COPD show in both a flow-volume loop and a spirogram?
A) Increased inspiratory flow
B) Decreased total lung capacity
C) Increased residual volume
D) Decreased expiratory flow

A

Decreased expiratory flow

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17
Q

In a normal subject, which of the following factors limits expiratory flow during a forceful expiratory maneuver?
A) Decreasing lateral traction
B) Increasing intrapleural pressure
C) Increasing muscle force
D) Decreasing vascular resistance

A

Decreasing lateral traction

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18
Q

The work of breathing accounts for elastic and resistive forces in the respiratory
system. During quiet tidal breathing, what factor accomplishes the work during
expiration?
A) Total airway resistance
B) Expiratory muscle activity
C) Respiratory system recoil
D) Inspiratory muscle relaxation

A

Respiratory system recoil

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19
Q

According to the alveolar ventilation equation, when the metabolic production of CO2 doubles:
A) alveolar ventilation decreases by 50%
B) alveolar Pco2 decreases by 50%
C) alveolar ventilation increases by 100%
D) alveolar Pco2 increases by 100%

A

Alveolar ventilation increases by 100%

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20
Q

You are about to measure the distribution of ventilation in a normal subject lying on his back (supine position). Based on your understanding of the respiratory system, which lung region will receive the most ventilation?
A) Apex
B) Back
C) Front
D) Base

A

Back

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21
Q

You will measure pulmonary blood flow while the subject is on his back (supine). Which of the following is a likely consequence of posture?
A) The lungs will be mostly zone 3: Parterial > Pvenous > Palveolar
B) The lungs will be mostly zone 2: Parterial > Palveolar > Pvenous
C) The lungs will be mostly zone 1: Palveolar > Parterial > Pvenous
D) It cannot be predicted from the information given

A

The lungs will be mostly zone 3: Parterial > Pvenous > Palveolar

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22
Q

The alveolar-arterial O2 difference arises because of:
A) a physiological shunt.
B) faster CO2 diffusion.
C) faster O2 diffusion.
D) an anatomical shunt

A

an anatomical shunt

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23
Q

A physiological shunt may develop when regional airways collapse and become obstructed. As a consequence, regional V/Q will:
A) decrease.
B) increase.
C) not change.
D) cannot be determined.

A

decrease

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24
Q

A patient with an anatomical shunt is placed on supplemental O2. You expect arterial O2 content to:
A) increase because O2 diffusion improves.
B) decrease because O2 diffusion worsens.
C) not change because it is not a diffusion problem.
D) not change because there is local vasodilation.

A

Not change because it is not a diffusion problem

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25
Q

Which of the following factors makes the exchange of carbon monoxide (CO) between the lungs and the circulation diffusion-limited?
A) CO is fairly insoluble in blood.
B) Hemoglobin binds CO with high affinity.
C) Alveolar CO equilibrates with blood CO.
D) CO easily crosses from alveolus to capillary.

A

Hemoglobin binds CO with high affinity

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26
Q

O2 and CO2 are relatively insoluble in the alveolar-capillary interface. However, both gases are PERFUSION-LIMITED because:
A) Both gases are insoluble in blood too.
B) Both gases equilibrate with blood in >0.7s
C) O2 and CO2 equilibrate fast in blood.
D) All the options are incorrect.

A

O2 and CO2 equilibrate fast in blood (less than 0.75s)

27
Q

2,3-Diphosphoglycerate (2,3-DPG) concentration increases a lot during exposure to altitude (low ambient Po 2). When ambient Po2 is very low, the change in 2,3-DPG can be:
A) good because it improves O2 unloading to the tissues.
B) bad because it makes O2 unloading more difficult.
C) good because more O2 binds to Hgb in the lungs.
D) bad because less O2 binds to Hgb in the lungs.

A

bad because less O2 binds to Hgb in the lungs

28
Q

Patients with severe anemia may have tachycardia at rest. This is likely:
A) an attempt to increase O2 delivery.
B) due to lack of O2 in the heart.
C) a consequence of tissue stress.
D) a sign that the lungs are hypoxic.

A

an attempt to increase O2 delivery

29
Q

Which of the following statements about CO2 transport is true?
A) Most of the CO2 is transported as carbamino-Hgb.
B) CO2 is converted to H2CO3 in the plasma.
C) Most of the CO2 is transported as HCO3- .
D) Pco2 does not determine the amount of dissolved CO2.

A

Most of the CO2 is transported as HCO3-

30
Q

In respiratory acidosis, the primary problem is ______ because ___________.
A) low arterial Po2 — CO2 is converted to HCO3- .
B) high arterial Pco2 — CO2 is converted to H2CO3.
C) low arterial Po2 — O2 is a metabolic acid.
D) high arterial Pco2 — O2 is a major pH buffer.

A

high arterial Pco2 — CO2 is converted into H2CO3

31
Q

Which of the following statements about the respiratory pacemaker is correct?
A) It works independently from other CNS centers.
B) It has neurons with rhythmic pacemaker potentials.
C) It senses distension of the chest wall and lungs.
D) It includes clusters of neurons in the medulla.

A

It includes clusters of neurons in the medulla

32
Q

One difference between peripheral and central chemoreceptors is that:
A) peripheral chemoreceptors sense Pco2 only.
B) central chemoreceptors sense metabolic acids.
C) peripheral chemoreceptors sense metabolic acids.
D) central chemoreceptors sense low Po2 in CSF.

A

peripheral chemoreceptors sense metabolic acids

33
Q

Which of the following conditions shifts the ventilatory response to Pco2 down and to the right?
A) metabolic acidosis
B) sleep
C) hypoxia
D) Exercise

A

sleep

34
Q

Which of the following situations is likely to result in the greatest response to arterial hypoxemia?
A) Arterial pH = 7.1 and Pco2 = 50 mm
B) Arterial pH = 7.3 and Po2 = 70 mm Hg
C) Venous pH = 6.9 and Pco2 = 60 mm Hg
D) Venous pH = 7.1 and Po2 = 70 mm Hg

A

Arterial pH = 7.1 and Pco2 = 50 mmHg

35
Q

What is the key difference between central and obstructive sleep apnea?
A) Greater ventilatory drive in obstructive apnea.
B) Higher chemoreceptor activity in central apnea.
C) Higher chemoreceptor activity in obstructive apnea.
D) Lower ventilatory drive in obstructive apnea.

A

Greater ventilatory drive in obstructive apnea

36
Q

Once the anaerobic threshold is reached during exercise, ___________ because ____________.
A) ventilation increases —- arterial Pco2 decreases
B) ventilation increases —- arterial Po2 increases
C) ventilation increases —- arterial Pco2 increases
D) ventilation increases —- arterial pH decreases

A

ventilation increases — arterial pH decreases

37
Q

In what metabolic reaction is most of the O 2 provided by the respiratory system used?
a. O2 is reduced to water.
b. O2 reduces glucose to CO 2 .
c. O2 regulates intracellular pH.
d. O2 is used to produce lactic acid

A

O2 is reduced to water

38
Q

Which of the following is true about type 2 alveolar cells?
a. Their cilia move foreign particles.
b. They are not very abundant.
c. They produce pulmonary surfactant.
d. All the answers are correct.

A

They produce pulmonary surfactant

39
Q

Which of the following is a function of the respiratory system?
a. It increases the production of angiotensin 1.
b. It participates in the regulation of aldosterone secretion.
c. It serves to generate positive inspiratory pressures.
d. It regulates the concentration of metabolic acids in blood.

A

It participates in the regulation of aldosterone secretion

40
Q

The resistance of the conducting airways is influenced by all of the following, except:
a. autonomic activity.
b. lateral tissue traction.
c. endocrine/paracrine factors.
d. venous compliance.

A

venous compliance

41
Q

Smoking impairs the movement of the cilia on the luminal side of the airway epithelium. This effect may result in:
a. decreased airway resistance.
b. accelerated mucociliary clearance.
c. increased risk of infection.
d. increased mucus production.

A

Increased risk of infection

42
Q

John Doe underwent emergency neck surgery last week after a severe car accident. During the operation, the surgeons found that both phrenic nerves were cut and the diaphragm was completely paralyzed. What lung volumes and capacities will be affected the most?
a. Residual volume.
b. Functional residual capacity.
c. Expiratory reserve volume.
d. Inspiratory reserve volume.

A

Inspiratory reserve volume

43
Q

Consider the pressure/volume relationships for the chest wall and lungs. Under what conditions are the recoil forces of the chest and lungs the same magnitude but opposite direction?
a. When a pneumothorax occurs.
b. At functional residual capacity.
c. At residual volume
d. That never happens.

A

At functional residual capacity

44
Q

What are likely functional consequences of decreased lung compliance?
a. Stiffer chest wall – Respiratory muscle fatigue and failure.
b. Decreased airway resistance – Tidal volume increases.
c. Loss of lung volume – Expiration becomes active.
d. Increased lung elastic recoil – Total lung volume decreases.

A

Increased lung elastic recoil – Total lung volume decreases

45
Q

Imagine 4 bronchioles that originate from the same airway. Each bronchiole has resistance of 4 resistance units. Based on your understanding of the functional consequences of airway branching, what is the likely total resistance of the 4 bronchioles?
a. 1 resistance unit
b. 4 resistance units
c. 16 resistance units
d. It cannot be determined.

A

1 resistance unit

46
Q

Chronic obstructive pulmonary disease (COPD) is a complex disease with a variable mix of airway inflammation (bronchitis) and lung parenchyma destruction (emphysema). As you might guess from its name, COPD is characterized by increased airway resistance. Which of the following factors contributes to the increased airway resistance in COPD?
a. Decreased mucus production.
b. Loss of lateral tissue traction.
c. Increased intraalveolar compression.
d. Increased sympathetic stimulation.

A

Loss of lateral tissue traction

47
Q

In a flow-volume loop like the one above, what factors explain the early peak airflow during expiration?
a. Lower transpulmonary pressure, and high airway resistance.
b. Greater inspiratory muscle force, and high respiratory system recoil.
c. Lower airway resistance, and high respiratory system recoil.
d. Greater respiratory muscle force, and dynamic airway compression.

A

Lower airway resistance, and high respiratory system recoil

48
Q

A member of the UK swim team decides to use a snorkel to improve her competition time. After a few laps around the pool, she feels more “winded” than normal. A probable cause of this is:
a. decreased anatomical dead space.
b. decreased area for gas exchange.
c. increased airway resistance.
d. increased ventilation/perfusion ratio.

A

increased airway resistance

49
Q

According to the alveolar ventilation equation (above), when metabolic CO2 production (Vco2 ) increases, alveolar Pco2 __________, unless alveolar ventilation ____________.
a. Depends on O2 consumption.
b. decrease — increases
c. increases — decreases
d. increases — increases

A

increases – increases

50
Q

A decrease in perfusion to a small lung region is followed by a local:
a. decrease in alveolar Pco2 .
b. decrease in alveolar Po2 .
c. increase in ventilation.
d. decrease in vascular resistance.

A

Decrease in alveolar Pco2

51
Q

The hemoglobin dissociation curve shifts to the right under certain conditions, for example when blood Pco2 increases. This shift means that:
a. The P50 decreases.
b. Affinity for O2 increases.
c. O2 diffusion decreases.
d. More O2 is unloaded.

A

More O2 is unloaded

52
Q

CO2 is transported in blood mainly as:
a. bicarbonate
b. carbamino-Hgb
c. free CO2 in plasma
d. carbonic acid

A

Bicarbonate

53
Q

One of your classmates hyperventilates uncontrollably after getting an “A” in a final exam. What is a likely consequence?
a. decreased alveolar Po2 .
b. increased arterial Pco2 .
c. decreased arterial Po2 .
d. decreased alveolar Pco2

A

Decreased alveolar Pco2

54
Q

Which of the following statements about the peripheral chemoreceptors is not correct?
a. They are located in the dorsal surface of the pons.
b. They respond to changes in arterial Po2 .
c. They respond to changes in plasma pH.
d. They are innervated by afferent fibers.

A

They are located in the dorsal surface of the pons

55
Q

The equilibration of blood Po2 in alveolar capillaries with alveolar gas Po2 is:

significantly slower in mild anemia.
complete after less than 90% of the alveolar capillary length.
significantly faster in pulmonary fibrosis.
dependent on active O2 transport from alveoli to blood.

A

complete after less than 90% of the alveolar capillary length

56
Q

Smoking may lead to chronic obstructive pulmonary disease (COPD), which is characterized by pulmonary emphysema (destruction of elastic tissue and alveolar walls) and chronic bronchitis (airway inflammation and increased mucus production). COPD patients often have breathing difficulties and chronic cough. What do you think is one explanation for their labored breathing?

Alveolar wall destruction decreases lung compliance.
Abundant secretions increase airway resistance.
The airway resistance is too low.
Lateral traction is stronger and collapses the airways.

A

Abundant secretions increase airway resistance

57
Q

Which of the following is true about type 2 alveolar cells?

Their cilia move foreign particles up the airways.
All the answers are correct.
They are not very abundant.
They produce surfactant.

A

They produce surfactant

58
Q

Which of the following is true about lung compliance?

It is determined by the lung tissues.
It is the change in pressure as volume increases.
It is lower in pulmonary emphysema.
It is higher in pulmonary fibrosis.

A

It is determined by lung tissues

59
Q

Intrapleural pressure is usually negative (less than atmospheric pressure), except:

when the chest wall has a greater elastic recoil.
when there is a pneumothorax.
during mid-inspiration.
at the end of expiration.

A

When there is a pneumothorax

60
Q

An acute decrease in the perfusion of a small lung region is followed by:

all answers are correct.
local increase in alveolar Po2.
bronchodilation in the underperfused region.
local increase in alveolar Pco2

A

Local increase in alveolar Po2

61
Q

The mechanical ventilators used for critically ill patients work through a tube placed inside the trachea. Positive pressure (above atmospheric pressure) is used to inflate the lungs during inspiration. How does this approach compare to the way the healthy respiratory system works during a normal quiet breath?

There is no difference.
It is the opposite: intrapleural pressure becomes less negative during a normal inspiration.
It is the opposite: alveolar pressure is negative during a normal inspiration.

A

It is the opposite: alveolar pressure is negative during a normal inspiration

62
Q

The main factor that determines the respiratory compensation to metabolic acidosis is:

plasma Pco2 is higher than normal.
alveolar Po2 is lower than normal.
increased firing rate of central chemoreceptors.
increased firing rate of peripheral chemoreceptors

A

Increased firing rate of peripheral chemoreceptors

63
Q

The function of hemoglobin in red blood cells is to:

increase blood O2 content.
increase alveolar Pco2 above venous Pco2.
transport all the CO2 produced by the tissues.
increase arterial Po2 above alveolar Po2.

A

Increase blood O2 content

64
Q

During quiet breathing, airflow during expiration ends when:

alveolar and atmospheric pressures are the same.
transpulmonary pressure becomes more negative.
inspiratory muscles relax.
expiratory muscles relax.

A

Alveolar and atmospheric pressures are the same.

Physiology 412G (7 decks)

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