Organ Systems: Quiz 3 Quiz Questions

Front 1

You are about to do a swimming race. You take 6 TLC breaths. Why?

Back 1

To decrease PCO2 and increase O2 levels in the blood. pH would increase in this case. The opposite happens in hyperventilation

Front 2

The SO2 curve for a patient with anemia will have what difference?

Back 2

The values on the right y-axis will be lower due to decrease concentration of O2 in the blood.

Front 3

Your patient had a war related injury that diminished the capacity of his phrenic nerve to fire. Will he become hypoxemic when he exercises?

Back 3

True.

Front 4

Your out of shape patient climbs the two flights of stairs to your third floor brownstone office. As he enters your office the status of his breathing will be? What is the status of his blood?

Back 4

Hyperventilating
1. pH and PO2 is decreased
2. PCO2 is increased

Front 5

Your out of shape patient continued to breathe rapidly for a long time and this slowed your patient flow. You think next time "I will give him gases to help him" You will give him?

Back 5

Increased O2 and decreased CO2 to speed up his recovery.

Front 6

A patients lungs have an area of constricted alveoli and the patient has bronchiole constrictions and mucous plugs that severely constrict his airways. This results in PAO2 of 55. Are his peripheral chemoreceptors responding to his PaO2?

Back 6

Yes they are. Anything less than 60 they will be responding and firing feedback signals telling the brain we need more oxygen. This would cause the person to hyperventilate to bring more O2 into the body

Front 7

Your patient has a genetic disease that limits his surfactant production. How will this affect compliance and his work of breathing?

Back 7

Compliance would decrease and Work of breathing would increase.

Front 8

If blood lacked RBCs, but the lungs were functioning normally. The arterial PO2 would be?

Back 8

normal. Although it wouldn't be enough oxygen to carry our metabolic needs it would still be normal. That's why RBCs are needed to carry the additional PO2 needed.

Front 9

Your patient has hemolytic anemia (increased destruction of red blood cells.) She is always tired and cannot exercise. What accounts for her total oxygen content being reduced?

Back 9

Decreased Hb content in blood.

Front 10

Your extremely nervous patient begins to hyperventilate in the chair. You decide to give her nitrous oxide. To be most effective you tell her to?

Back 10

relax and take deep breaths. Shallow breaths won't work because of dead space.

Front 11

A patient with left heart failure may experience?

Back 11

Pulmonary Edema

Front 12

A patient with right heart failure may experience?

Back 12

engorged neck veins

Front 13

In cardiac shock there is a decrease in?

Back 13

MAP and a decrease in coronary flow --> a weak heart and a decrease in Cardiac Output.

Front 14

Sudden onset ventricular fibrillation decreases?

Back 14

cardiac output

Front 15

Resistance in blood vessels is inversely related to?

Back 15

radius

Front 16

Movement of molecules across a capillary bed is by?

Back 16

1. Diffusion down concentration gradients
2. Filtration down pressure gradients
3. Absorption due to osmotic pressure differences

Front 17

Both systemic and pulmonary circulations have the same?

Back 17

flow rate

Front 18

Decreasing which of the following will result in an increase in cardiac output:
1. Heart Rate
2. Contractility
3. End diastolic ventricular volume
4. Systemic blood pressure
5. 3 and 4

Back 18

4. Systemic Blood Pressure

Front 19

T/F The peripheral chemo receptor ONLY responds to changes in blood PO2. The Central Chemoreceptor responds ONLY to changes in blood PCO2

Back 19

The first statement is false and the 2nd is true

Front 20

In the actual vs. Theoretical lung, PaO2 will be less than PAO2 because right to left shunts will allow more oxygenated blood to mix with blood coming from pulmonary circulation.

Back 20

Statement is right, but reason is wrong

Front 21

A subject has a tidal volume of 500 ml. Dead space is 150 mls and a respiratory rate of 18 per minute. What is his alveolar ventilation in liters?

Back 21

18 x (500-150) = 6300/1000 = 6.3 L

Front 22

What causes some degree of blood acidosis?

Back 22

strenuous exercise

Front 23

If a patient's peripheral chemoreceptors are functioning properly, which reflects the feedback control mechanisms that might occur through a peripheral chemoreceptor?

Back 23

decreased PaO2 is sensed leading to increased Vdot that leads to decreased PaCO2

Front 24

Athlete takes a drug that causes a shift to the right in the Hb-O2 curve. He loses all of his races. Why?

Back 24

The right shift caused a decrease in the affinity for oxygen and so there was not enough bound to Hb to meet his needs.

Front 25

Which of the following is INCORRECT on the effects of gravity on ventilation-perfusion ratio.
A. decreased compliance in lung apex, zone 1
B. decreased compliance in lung base, zone 3
C. increased blood flow in lung base, zone 3
D. decreased blood flow in lung apex, zone 1

Back 25

B. decreased compliance in lung base, zone 3

Front 26

If your patient has interstitial edema in the lung, diffusion will MOSTLY be affected because:
A. the diffusion distance will have increased
B. the delta (Δ) PO2/PCO2 will be increased
C. edema will affect the solubility of the gas D. the surface area of alveoli will be increased

Back 26

A.

Front 27

The pathogenesis of bronchitis and emphysema are associated with:
A. Corticosteroid medications
B. High blood pressure
C. Cigarette smoking
D. Chronic anemia

Back 27

C.

Front 28

Which of the following might be an adverse affect of the medications used for the management of bronchitis and emphysema?
A. Increased risk of bleeding following oral surgery
B. Decreased salivary flow
C. Increased risk of infection
D. All of the above

Back 28

D. All of the above

Front 29

Which statement about pulmonary circulation is TRUE?
A. it has high vascular pressure
B. blood flows uniformly throughout the lung
C. shunts deliver blood to the pulmonary artery
D. it receives the entire cardiac output
E. its oxygen status is similar to systemic circulation

Back 29

D. it receives the entire cardiac output

Front 30

Select the INCORRECT statement concerning the olfactory mucosa.
A. Epithelium is taller than the rest of the nasal mucosa. B. Completely lacks ciliated epithelial cells.
C. Contains a stem cell population throughout life.
D. Has serous glands but lacks mucous glands.
E. Located on the roof of the nasal cavity.

Back 30

B

Front 31

A tertiary bronchus feeds an entire:
A. lung
B. lobe
C. segment
D. lobule
E. acinus

Back 31

C. segment

Front 32

The cell of the alveolus that does not make contact with the alveolar basement membrane is the:
A. type I pneumocyte
B. septal cell
C. type II pneumocyte
D. great alveolar cell
E. type III pneumocyte

Back 32

E. type III pneumocyte

Front 33

Select the INCORRECT statement concerning the respiratory system.
A. The Clara cell is a secretory cell.
B. The secondary bronchus is located both extrapulmonarilly and intrapulmonarilly.
* C. All bronchioles are lined by pseudostratified columnar epithelium.
D. Lambert’s sinuses are shunts between adjacent acini in the lung.
E. Respiratory bronchioles have alveoli in their walls.

Back 33

C.

Front 34

What senses O2?

Back 34

Carotid Body

Front 35

Expansion of the lung inhibits?

Back 35

inspiration

Front 36

Temporary alkalosis can be caused by?

Back 36

Hyperventialtion

Front 37

A person with emphysema has ___________________ FRC and ___________________ Compliance.

Back 37

increased and increased

Front 38

1. Chronic bronchitis and emphysema are classified as
a. Forms of tuberculosis
b. Chronic obstructive pulmonary disease
c. Pneumonia
d. Different forms of asthma

Back 38

b. Chronic obstructive pulmonary disease

Front 39

2. The olfactory epithelium differs from the rest of the epithelium of the naal cavity in all of the following ways EXCEPT that the olfactory epithelium
a. Lacks goblet cells
b. Lacks mucous glands
c. Lacks cilia
d. Has a basement membrane
e. Is a taller epithelium

Back 39

d. has a basement membrane

Front 40

3. The component of the conducting portion of the respiratory system that has a simple cuboidal epithelium with clara cells; and lacks goblet cells, glands, cartilage, and alveoli is the:
a. Tertiary bronchus
b. Primary bronchiole
c. Secondary bronchiole
d. Terminal bronchiole
e. Respiratory bronchiole

Back 40

d. Terminal bronchiole

Front 41

4. Select the INCORRECT statement concerning the respiratory system
a. False vocal cords are covered with stratified squamous epithelium
b. Both the trachea and the primary bronchus have c-shaped cartilage rings
c. The mucosa of the nasal cavity has a large vascular bed
d. Both the external nares and the vestibule have hairs
e. All levels of bronchi have hyaline cartilage in their walls

Back 41

A.

Front 42

5. Which statement about a right shift in the Hb-O2 saturation curve is INCORRECT
a. Will occur if pH decreases
b. Reflects lower affinity for O2
c. Will occur if Pco2 increases
d. Is independent of Hb content
e. Will occur at increased temperature

Back 42

d. Is independent of Hb content

Front 43

6. In the real lung, reasons for P(AO2) >P (aO2) include all of the following except:
a. Diffusion limitations
b. Capillary transit time increasing to 1.5 sec
c. A tumor restricting alveolar capillary blood flow
d. Shunts
e. Mismatch of ventilation-perfusion

Back 43

b. Capillary transit time increasing to 1.5 sec

Front 44

7. Hyperventilation leads to:
a. Increased P(AO2), decreased P(aCO2), decreased blood pH
b. Increased P (Ao2), decreased P (aCO2), increased blood pH
c. Decreased P (AO2), increased P(aCO2), increased blood pH
d. Decreased P (AO2), decreased P(aCO2), decreased blood pH
e. Increased P(AO2), increased P(aCO2), increased blood pH

Back 44

b. Increased P (Ao2), decreased P (aCO2), increased blood pH

Front 45

9. Lung compliance is increased:
a. When surfactant levels decrease
b. In patients with emphysema
c. When airway resistance is increased
d. In pulmonary fibrosis
e. w/ a genetic syndrome that increases the elastin content of lung tissue

Back 45

b. In patients with emphysema

Front 46

10. Hyboxemia produces hyperventilation by a direct effect on the:
a. Phrenic nerve
b. J receptors
c. Lung stretch receptors
d. Central chemoreceptor
e. Carotid and aortic bodies

Back 46

e. Carotid and aortic bodies

Front 47

11. Which of the following is NOT part of the control of breathing?
a. Can be voluntarily controlled
b. Rhythm seet by central pattern generator
c. Regulated contraction of diaphragm
d. Positive feedback systems
e. PO2 sensing

Back 47

d. Positive feedback systems

Front 48

12. “c-shaped” cartilaginous rings used to keep the conducting portion of the respiratory passageways patent at the end of expiration are found in the:
a. Terminal bronchioles
b. Respiratory bronchioles
c. Trachea
d. Alveolar ducts
e. All of the above

Back 48

c. Trachea

Front 49

13. Branchings of the bronchiole tree are accompanied by branching of the
a. Pulmonary artery
b. Bronchial artery
c. Pulmonary vein
d. Bronchial vein
e. All of the above

Back 49

A. pulmonary artery

Front 50

14. The blood-air barrier across which the gaseous exchange occurs DOES NOT include the:
a. Capillary blood plasma
b. RBC membrane
c. Basal lamina of the type 1 pneumocyte
d. Type 2 pneumocyte membrane
e. Surfactant

Back 50

d. Type 2 pneumocyte membrane

Front 51

15. An asthmatic patient has a V(T) 500 ml, dead space of 250 ml, breathing rate of 20/min, vital capacity of 4000 ml and uses 275 ml of O2/min. His total ventilation is:
a. 10 L/min
b. 5 L/min
c. 80 L/min
d. 5.5 L/min
e. 3 L/min

Back 51

A. 10 L/min

Front 52

16. Which statement best describes Hypoxic Pulmonary Vasoconstriction (HPV)? It:
a. Is caused by a decrease in P (CO2) in bronchioles
b. Is due to increased P (CO2) sensed by peripheral chemoreceptors
c. Is vasoconstriction of arterioles due to low P (o2)
d. Results in increased blood flow to the lung
e. Is closure of trachea due to noxious fumes

Back 52

c. Is vasoconstriction of arterioles due to low P (o2)

Front 53

17. Which relationship best accounts for why a mountain climber would carry oxygen with him when climbing Mt Everest?
a. The Henderson-Hasselbalch equation
b. The compliance formula
c. The Law of La Place for surface tension
d. Dalton’s law for partial pressure
e. The equation that describes laminar flow

Back 53

D.

Front 54

18. Which would NOT be related to the work of breathing
a. Inertia of lung and chest walls
b. Frictional resistance of tissue
c. Airflow resistance
d. Increased lung compliance
e. Increased chest wall elastance

Back 54

b. Frictional resistance of tissue

Front 55

19. Identical twins, Joe and Jim, visit pulmonologist. Medical tests are performed and, in one test, their lungs are artificially inflated so the volume increases by 20%. It is found that it takes twice the pressure to inflate Jim’s lung as compared to Joe’s. Which statement best describes this?
a. Jim’s V(T) is less than Joes
b. Jim has decreased compliance
c. Joe has increased elastance
d. Joe and Jim’s lungs have equal compliance
e. Jim must have a deficiency in DPPC

Back 55

b. Jim has decreased compliance

Front 56

20. Which statement about Infant Respiratory Distress Syndrome is incorrect?
a. Surface tension is increased
b. Occurs in premature births
c. Alveoli tend to collapse
d. Lungs have decreased compliance
e. Caused by increased secretion of surfactants

Back 56

e. Caused by increased secretion of surfactants

Front 57

21. Which statement best describes what happens when HbO2 buffers a H+ ion
a. H+ combines with bicarbonate and yields Co2 + H2O
b. HbO2 loses its affinity for O2
c. HbO2 binds more oxygen molecules
d. pH decreases
e. A carbamino compound is formed

Back 57

b. HbO2 loses its affinity for O2

Front 58

22. A fire burns in a building and a young boy breathes the fumes, which results in a systemic left shift in his Hb-O saturation curve. Which is most likely to occur?
a. The boy will hypoventilate
b. He will have decreased Co2 tension in the lung
c. Blood flow will decrease to compensate
d. There will be decreased delivery of O2 to tissues
e. P(aCO2) will increase

Back 58

d. There will be decreased delivery of O2 to tissues

Front 59

23. Which does NOT account for the continuous drop of P(O2) throughout the respiratory system?
a. Solubility of O2 in plasma
b. Humidity of inspired air
c. Right to left shunts
d. Thebesian veins emptying into left heart
e. Use of O2 by mitochondria

Back 59

a. Solubility of O2 in plasma

Front 60

24. The Hering-Bruer reflex involves:
a. Stimulation of nasal chemoreceptors producing a sneeze
b. Constriction of bronchioles due to low P(o2)
c. Stretch receptors in the lung terminating inspiration
d. Contraction of the diaphragm in response to P (CO2)
e. Closure of the glottis in response to cytokines

Back 60

c. Stretch receptors in the lung terminating inspiration

Front 61

25. If the ventilation : perfusion ratio of an alveolus approaches infinity, it could signify:
a. Normal ventilation
b. A blocked alveolus
c. Decreased ventilation
d. Blocked blood flow
e. Increased ventilation and slight decrease in perfusion

Back 61

d. Blocked blood flow

Front 62

26. Sensing decreased blood pH that leads to increased ventilation that, in turn, leads to increased blood pH is a regulatory system based on:
a. Positive feedback control
b. Regulatory control
c. Passive control
d. Negative feedback control
e. None of the above

Back 62

d. Negative feedback control

Front 63

27. Which of the following does not apply to the left lung?
a. Oblique fissure
b. Horizontal fissure
c. Lingual
d. Pulmonary artery above bronchus at hilum
e. Bronchial arteries

Back 63

b. Horizontal fissure

Front 64

28. Pulmonary edema could occur if:
a. Capillary hydrostatic P > interstitial hydrostatic P
b. Capillary hydrostatic P < interstitial hydrostatic P
c. Capillary osmotic pressure > interstitial osmotic pressure
d. Interstitial osmotic pressure decreased from normal values
e. Blood flow decreases while PO2 increases

Back 64

a. Capillary hydrostatic P > interstitial hydrostatic P

Front 65

29. The first element of the bronchiole tree that provides for the gaseous exchange is the:
a. Intrapulmonary bronchus
b. Tertiary bronchus
c. Terminal bronchus
d. Alveolar duct
e. Respiratory bronchiole

Back 65

e. Respiratory bronchiole

Front 66

30. Which is NOT related to compliance?
a. Extra work of breathing in patients with fibrosis
b. Increased FRC in patients with emphysema
c. Lack of surfactants making the lung more difficult to inflate
d. Bronchioles contracting in the presence of low PO2
e. A baby with RDS will have problems breathing

Back 66

d. Bronchioles contracting in the presence of low PO2

Front 67

31. Hyperventilation leads to:
1. Increased P(Ao2)
2. Decreased P(ao2)
3. Increased blood pH
4. Decreased blood pH
5. Decreased P (ACO2)
a. 1, 4
b. 2, 4, 5
c. 1, 3, 5
d. 2, 5
e. 1, 4, 5

Back 67

c. 1, 3, 5

Front 68

32. Which of the following is NOT a characteristic of the pulmonary circulation system?
a. Its blood flow is affected by gravity
b. Blood flows under low pressure
c. Oxygenation status differs systemic circulation
d. Receives 80 % of cardiac output
e. Blood flow increases from apex to base

Back 68

d. Receives 80 % of cardiac output

Front 69

33. Which of the following would NOT be associated with hypoxemia?
a. Edema in lungs
b. Increase in change of P(o2) across alveolus/capillary
c. Peripheral chemoreceptors becoming insensitive to P(O2)
d. A blocked artery
e. Increase in shunt volumes

Back 69

b. Increase in change of P(o2) across alveolus/capillary

Front 70

34. Work of breathing is associated with all of the following except
a. Inertia of chest wall
b. Elasticity of lung and chest
c. Airway resistance
d. Overcoming decreased lung compliance
e. Expiration during V(T) breathing

Back 70

e. Expiration during V(T) breathing

Front 71

35. An out of shape dental student decides to climb Mount Everest. He will need to use and oxygen mask when:
a. P(aCo2) > P (Aco2)
b. P (Ao2)>P(ao2)
c. P(Ao2) <P(ao2)
d. His altitude limits diffusion of CO2
e. Pulmonary vein P(vO2)>Pulmonary artery P(aO2)

Back 71

c. P(Ao2) <P(ao2)

Front 72

36. A pt w/ emphysema comes into your dental office. His V(T) is 350 ml, his TLC is 5100 ml, his dead space is 150 ml. while sitting in your dental chair, relaxed and not worrying, his normal ventilatory needs are V(A) = 4 L/min. What is his rate of breathing
a. 20/min
b. 11/min
c. 8/min
d. 50/min
e. Not enough information to determine

Back 72

a. 20/min

Front 73

37. The segment of the bronchial tree supplying a single bronchopulmonary segment is a
a. Main bronchus
b. Secondary bronchus
c. Tertiary bronchus
d. Terminal bronchus
e. Respiratory bronchiole

Back 73

c. Tertiary bronchus

Front 74

1. The rate of diffusion is inversely proportional to


a) surface area

b) solubility


c) partial pressure gradient


d) thickness

Back 74

d) thickness*

Front 75

2. Which cells secrete the aqueous hypolayer of pulmonary surfactant?


a) type I pneumocytes


b) type II pneumocytes


c) type III pneumocytes


d) Clara cells

Back 75

d) Clara cells*

Front 76

3. The major histological difference between a bronchus and a primary bronchiole is that the bronchiole lacks


a) cartilage
b) smooth muscle


c) lymphatics?

Back 76

a) cartilage

Front 77

4. The olfactory mucosa differs from the mucosa of the nasal cavity in all of the following aspects EXCEPT that the olfactory mucosa


a) has taller epithelium


b) has stratified epithelium


c) lacks goblet cells


d) lacks mucous glands


e) has motile and non-motile cilia

Back 77

.

Front 78

9. A person's tidal volume is 500 mL, dead space is 150 mL, breathing rate is 18 L/min. What is their total ventilation in liters?

Back 78

- 9 L/min – do not subtract dead space!