Ch 22 - The Respiratory System Flashcards
1
Q
Secrete a fluid containing surfactant
A
Type II cells
2
Q
Where the respiratory zone of the lungs begin
A
Respiratory bronchioles
3
Q
Composed of simple squamous epithelium
A
Type I cells
4
Q
Terminates in alveoli
A
Alveolar duct
5
Q
Composed of cuboidal cells
A
Type II cells
6
Q
The respiratory membrane is composed of fused basement membrane of the capillary walls and ________
A
Type I cells
7
Q
True or false? The roof of the nasal cavity is formed by parts of the frontal bone
A
False
8
Q
True or false? The olfactory mucosal lining of the nasal cavity contains the receptors for the sense of smell.
A
True
9
Q
True or false? The functions of the nasal conchae are to enhance the air turbulence in the cavity and to increase the mucosal surface area exposed to the air
A
True
10
Q
True or false? Paranasal sinuses seem to have NO useful function.
A
False
11
Q
True or false? The pleura is a thin, single-layered serosa that divides into parietal and visceral pleura
A
False
12
Q
True or false? Intrapleural pressure is normally about 4 mm Hg less than the pressure in the alveoli
A
True
13
Q
True or false? During normal quiet breathing, approximately 750 mL of air moves into and out of the lungs with each breath
A
False
14
Q
True or false? The alveolar ventilation rate is the best index of effective ventilation
A
True
15
Q
True or false? In chronic bronchitis, mucus production is decreased and this leads to the inflammation and fibrosis of the mucosal lining of the bronchial tree
A
False
16
Q
True or false? Labored breathing is termed dyspnea
A
True
17
Q
True or false? The largest amount of carbon dioxide is transported in the bloodstream, in the form of carbonic anhydride
A
False
18
Q
True or false? Each lung has an indention, the pelvis, through which blood vessels enter an leave the lung
A
False
19
Q
No exchange of gases occurs here
A
Segmental bronchi
20
Q
True or false? Increased temperature results in decreased O2 unloading from hemoglobin.
A
False
21
Q
True or false? The epiglottis is a smooth muscle that covers the glottis during swallowing.
A
False
22
Q
True or false? Valsalvaʹs maneuver involves closing off the glottis (preventing expiration) while contracting the muscles of expiration, causing an increase in intra-abdominal pressure.
A
True
23
Q
True or False? Smoking diminishes ciliary action and eventually destroys the cilia.
A
True
24
Q
True or False? Tracheal obstruction is life threatening.
A
True
25
True or False? The paired lungs are located in the mediastinum.
False
26
True or False? The parietal pleura lines the thoracic wall.
True
27
True or False? The average individual has 500 ml of residual volume in his lungs.
False
28
True or False? Atelectasis (lung collapse) renders the lung useless for ventilation.
True
29
True or False? The Hering-Breuer reflex is a potentially dangerous response that may cause overinflation of the lung.
False
30
True or False? Strong emotions and pain acting through the limbic system activate sympathetic centers in the hypothalamus, thus modulating respiratory rate and depth by sending signals to the respiratory centers.
True
31
True or False? As carbon dioxide enters systemic blood, it causes more oxygen to dissociate from hemoglobin (the Haldane effect), which in turn allows more CO2 to combine with hemoglobin and more
bicarbonate ion to be generated (the Bohr effect).
False
32
True or False? Daltonʹs law states that the total pressure exerted by a mixture of gases is the sum of the pressures exerted independently by each gas in the mixture.
True
33
True or False? Oxygenated hemoglobin releases oxygen more readily when the pH is more basic.
False
34
True or False? Nasal conchae mainly work on inhalation to warm and moisten air. They serve minor functions for exhalation.
False
35
True or False? Under certain conditions, the vocal folds act as a sphincter that prevents air passage.
True
36
True or False? Apneustic breathing is characterized by prolonged inspirations.
True
37
Air and food are routed into the proper channels by the ________.
Larynx
38
The loudness of a personʹs voice depends on the force with which air rushes across the ________.
Vocal folds
39
The walls of the alveoli are composed of two types of cells, type I and type II. The function of type II is ________.
To secrete surfactant
40
After the segmental (tertiary) bronchus, the next smaller branch of the respiratory passageway is (are) the ________.
Terminal bronchioles
41
The smallest macroscopic subdivision of the lung is the ________.
Lobule
42
The pleurae are vital to the integrity of the lungs because they produce a ________, allowing the lungs to glide over the thorax wall during breathing
Lubricating serous secretion
43
Intrapulmonary pressure is the pressure within the _________ of the lungs
Alveoli
44
The relationship between the pressure and volume of gases is given by ________.
Boyleʹs law
45
The statement, ʺin a mixture of gases, the total pressure is the sum of the individual partial pressures of gases in the mixtureʺ paraphrases ________.
Daltonʹs law
46
Surfactant helps to prevent the alveoli from collapsing by ________, thereby reducing the surface tension of alveolar fluid
Interfering with the cohesiveness of water molecules
47
For gas exchange to be efficient, the respiratory membrane must be ________.
0.5 to 1 micrometer thick
48
With the Bohr effect, more oxygen is released because a decrease in pH (acidosis) ________.
Weakens the hemoglobin-oxygen bond
49
The most powerful respiratory stimulus for breathing in a healthy person is ________.
Increase of carbon dioxide
50
Nerve impulses from ________ will result in inspiration.
The ventral respiratory group
51
In the plasma, the quantity of oxygen in solution is only about ________ carried in dissolved form.
1.5% of the oxygen
52
Which of the following statements is incorrect?
A) During fetal life, lungs are filled with fluid.
B) Respiratory rate is lowest in newborn infants.
C) Descent of the diaphragm results in abdominal breathing.
D) The chest wall becomes more rigid with age.
B) Respiratory rate is lowest in newborn infants.
53
Another name for the inflation reflex is ________.
Hering-Breuer
54
Which of the following does not influence the increase in ventilation that occurs as exercise is
initiated?
A) psychic stimuli
B) decrease in lactic acid levels
C) proprioceptors
D) simultaneous cortical motor activation of the skeletal muscles and respiratory center
B) decrease in lactic acid levels
55
```
Which of the following is not a form of lung cancer?
A) adenocarcinoma
B) Kaposiʹs sarcoma
C) small cell carcinoma
D) squamous cell carcinoma
```
B) Kaposiʹs sarcoma
56
```
Which of the following is not an event necessary to supply the body with O2 and dispose of
CO2?
A) pulmonary ventilation
B) blood pH adjustment
C) internal respiration
D) external respiration
```
B) blood pH adjustment
57
Which of the following is not true of the respiratory tract from the medium bronchi to the aveoli?
A) Cartilage gradually decreases and disappears at the bronchioles.
B) Resistance to air flow increases due to the increase in cross-sectional diameter.
C) Proportionally, smooth muscle decreases uniformly.
D) Lining of the tubes changes from ciliated columnar to simple squamous epithelium in the alveoli.
B) Resistance to air flow increases due to the increase in cross-sectional diameter.
58
```
Which of the following determines lung compliance?
A) airway opening
B) flexibility of the thoracic cage
C) muscles of inspiration
D) alveolar surface tension
```
D) alveolar surface tension
59
Tidal volume is air ________.
A) remaining in the lungs after forced expiration
B) exchanged during normal breathing
C) inhaled after normal inspiration
D) forcibly expelled after normal expiration
B) exchanged during normal breathing
60
The ideal vital capacity of an individual is around ________.
4800 mL
61
Possible causes of hypoxia include ________.
Too little oxygen in the atmosphere
62
The lung volume that represents the total volume of exchangeable air is the ________.
Vital capacity
63
Since the lungs are filled with fluid during fetal life, which of the following statements is true regarding respiratory exchange?
A) Respiratory exchanges are made through the ductus arteriosus.
B) Respiratory exchanges are not necessary.
C) Respiratory exchanges are made through the placenta.
D) Since the lungs develop later in gestation, fetuses do not need a mechanism for respiratory exchange.
C) Respiratory exchanges are made through the placenta.
64
Which of the following is not a stimulus for breathing?
A) rising carbon dioxide levels
B) rising blood pressure
C) arterial Po2 below 60 mm Hg
D) arterial pH resulting from CO2 retention
B) rising blood pressure
65
Respiratory control centers are located in the ________.
Medulla and pons
66
The amount of air that can be inspired above the tidal volume is called ________.
Inspiratory capacity
67
Which statement about CO2 is incorrect?
A) Its concentration in the blood is decreased by hyperventilation.
B) Its accumulation in the blood is associated with a decrease in pH.
C) More CO2 dissolves in the blood plasma than is carried in the RBCs.
D) CO2 concentrations are greater in venous blood than arterial blood.
C) More CO2 dissolves in the blood plasma than is carried in the RBCs.
68
Oxygen and carbon dioxide are exchanged in the lungs and through all cell membranes by ________.
Diffusion
69
Select the correct statement about the pharynx.
A) The pharyngeal tonsil is located in the laryngopharynx.
B) The auditory tube drains into the nasopharynx.
C) The laryngopharynx blends posteriorly into the nasopharynx.
D) The palatine tonsils are embedded in the lateral walls of the nasopharynx.
B) The auditory tube drains into the nasopharynx.
70
The larynx contains the________.
Thyroid cartilage
71
Which respiratory-associated muscles would contract if you were to blow up a balloon?
Internal intercostals and abdominal muscles would contract
72
The oropharynx does NOT include ________.
Pharyngeal tonsils
73
```
Which of the following is not found on the right lobe of the lung?
A) middle lobe
B) cardiac notch
C) horizontal fissure
D) oblique fissure
```
B) cardiac notch
74
Impairments of oxygen transport include ________, a form of hypoxemic hypoxia
Carbon monoxide poisoning
75
Which of the following correctly describes mechanisms of CO2 transport?
A) 20% of CO2 is dissolved directly into the plasma.
B) 7-8% of CO2 is carried in the form of carbaminohemoglobin.
C) The chloride shift mechanism enhances CO2 transport.
D) Carbonic anhydrase is responsible for bonding CO2 to hemoglobin.
C) The chloride shift mechanism enhances CO2 transport.
76
Factors that influence the rate and depth of breathing include ________.
Voluntary cortical control
77
```
Which of the following provide the greatest surface area for gas exchange?
A) alveolar sacs
B) alveoli
C) respiratory bronchioles
D) alveolar ducts
```
B) alveoli
78
The respiratory membrane is a combination of ________ and their fused basement membranes
Alveolar and capillary walls
79
Gas emboli may occur because ________.
A diver holds his breath upon ascent
80
Inspiratory capacity is ________ that can be inspired after a tidal expiration
The total amount of air
81
Which center is located in the pons?
Pontine respirator group (PRG)
82
```
The nose serves all the following functions except ________.
A) as a passageway for air movement
B) as the initiator of the cough reflex
C) warming and humidifying the air
D) cleansing the air
```
B) as the initiator of the cough reflex
83
A premature baby usually has difficulty breathing. However, the respiratory system is developed enough for survival by ________.
28 weeks
84
Which of the following statements is true regarding the respiratory rate of a newborn?
A) The respiratory rate of a newborn is slow.
B) The respiratory rate of a newborn varies between male and female infants.
C) The respiratory rate of a newborn is approximately 30 respirations per minute.
D) The respiratory rate of a newborn is, at its highest rate, approximately 40-80 respirations per minute.
D) The respiratory rate of a newborn is, at its highest rate, approximately 40-80 respirations per minute.
85
Select the correct statement about the neural mechanisms of respiratory control.
A) The pons is thought to be instrumental in the smooth transition from inspiration to expiration.
B) The dorsal respiratory group neurons depolarize in a rhythmic way to establish the pattern of breathing.
C) The pontine respirator group (PRG) continuously stimulates the medulla to provide inspiratory drive.
D) The ventral respiratory group is contained within the pons.
A) The pons is thought to be instrumental in the smooth transition from inspiration to expiration.
86
Which of the following statements is correct?
A) H+ acts directly on central chemoreceptors to decrease the rate and depth of breathing.
B) Low arterial pH is the most powerful stimulator of respiration.
C) Arterial pH does not affect central chemoreceptors directly.
D) H+ has little effect on the blood pH.
C) Arterial pH does not affect central chemoreceptors directly.
87
The factors responsible for holding the lungs to the thorax wall are ________ from pleural fluid and ________ in the pleural cavity.
Surface tension; negative pressure
88
The erythrocyte count increases after a while when an individual goes from a low to a high altitude because the concentration of oxygen and/or total atmospheric pressure is ________.
Lower at high altitudes
89
Most inspired particles such as dust fail to reach the lungs because of the ________ in the nose.
Ciliated mucous lining
90
Which of the following is not possible?
A) Gas flow equals pressure gradient over resistance.
B) Pressure gradient equals gas flow over resistance.
C) Resistance equals pressure gradient over gas flow.
D) The amount of gas flowing in and out of the alveoli is directly proportional to the difference in pressure or pressure gradient between the external atmosphere and the alveoli.
B) Pressure gradient equals gas flow over resistance.
91
Select the correct statement about the physical factors influencing pulmonary ventilation.
A) A decrease in compliance causes an increase in ventilation.
B) A lung that is less elastic will require less muscle action to perform adequate ventilation.
C) As alveolar surface tension increases, additional muscle action will be required.
D) Surfactant helps increase alveolar surface tension.
C) As alveolar surface tension increases, additional muscle action will be required.
92
Select the correct statement about oxygen transport in blood:
A) During normal activity, a molecule of hemoglobin returning to the lungs carries one molecule of O2
B) During conditions of acidosis, hemoglobin is able to carry oxygen more efficiently
C) Increased BPG levels in the red blood cells enhance oxygen-carrying capacity
D) A 50% oxygen saturation level of blood returning to the lungs might indicate an activity level higher than normal
D) A 50% oxygen saturation level of blood returning to the lungs might indicate an activity level higher than normal
93
```
Which of these is not a characteristic of emphysema?
A) bronchial edema
B) destruction of alveolar walls
C) loss of lung elasticity
D) air trapping
```
A) bronchial edema
94
Type II alveolar cells secrete ________.
Surfactant
95
______________ is called the law of partial pressure.
Dalton's Law
96
________ law would apply to the amount of CO2 you could dissolve in a Pepsi.
Henry's
97
Oxygen unloading in a RBC due to declining pH is called the ________.
Bohr effect
98
The ________ regulates smoothing of transitions from inspiration to expiration.
Pontine respiratory group (PRG)
99
________ is the most common lethal genetic disease in the United States.
Cystic fibrosis
100
The cartilaginous flap that closes the trachea during swallowing is called the ________.
Epiglottis
101
The archway in the back of the throat is called the ________.
Fauces
102
The trachea is lined with ________ epithelium.
Ciliated pseudostratified columnar
103
Terminal bronchioles are lined with ________ epithelium.
Cuboidal
104
How is alveolar gas exchange affected by emphysema and pneumonia?
With pneumonia, if the lungs become edematous, the thickness of the exchange membrane may increase dramatically, restricting gas exchange, and body tissues begin to suffer from hypoxia. With emphysema, the lungs become progressively less elastic and more fibrous, which hinders both inspiration and expiration. Gas exchange remains adequate initially, but muscular activity must be enlisted to expire. Additionally, a symptom of emphysema is fusion of alveoli, resulting in less surface area for gas exchange.
105
Briefly differentiate between atmospheric pressure, intrapulmonary pressure, and intrapleural pressure. Which of these is always negative in a healthy individual during normal breathing? What happens if intrapleural pressure becomes equal to atmospheric pressure?
Atmospheric pressure is the pressure exerted by gases of the atmosphere. Intrapulmonary pressure is the pressure within the alveoli of the lungs. Intrapleural pressure is the pressure within the intrapleural space. Intrapleural pressure is negative relative to the other two during normal inspiration/expiration. Equalization of the intrapleural pressure with atmospheric pressure or intrapulmonary pressure immediately causes lung collapse.
106
The contraction of the diaphragm and the external intercostal muscles begins inspiration. Explain exactly what happens, in terms of volume and pressure changes in the lungs, when these muscles contract.
With contraction of the diaphragm, the height of the thoracic cavity increases. Contraction of the intercostal muscles expands the diameter of the thorax. With an increase in volume of the thorax, the intrapulmonary volume increases, causing a drop in pressure relative to atmospheric pressure. Air rushes into the lungs along this pressure gradient until intrapulmonary and atmospheric pressures are equal.
107
What is the chloride shift and why does it occur?
The chloride shift is an ionic exchange process whereby chloride ions move from the plasma into the erythrocytes to counterbalance the net positive charge left within the erythrocytes by the rapid outrush of negative bicarbonate ions.
108
If a baby is born at 28 weeksʹ gestation, what major problem will the doctors look for?
The type II alveolar cells may not have fully developed; therefore, there is the possibility of lung collapse.
109
How is it possible to change the pitch of our voice from high to low?
Usually, the tenser the vocal folds, the faster they vibrate and the higher the pitch. To produce deep tones, the glottis widens, and to produce high-pitched tones, the glottis becomes a slit. Intrinsic laryngeal muscles control the true vocal folds and the size of the glottis.
110
The partial pressure gradient for oxygen (in the body) is much steeper than that for carbon dioxide. Explain how equal amounts of these two gases can be exchanged (in a given time interval) in the lungs and at the tissues.
Equal amounts of O2 and CO2 can be exchanged in the lungs and at the tissues because CO2 solubility in plasma and alveolar fluid is 20 times greater than that of O2.
111
Define anatomical dead space. What is the relationship between anatomical and alveolar dead space? Which value is likely to increase during lung pathology?
Anatomical dead space is the space in the conducting respiratory passageways. Alveolar dead space is the space in nonfunctional alveoli. Anatomical dead space and alveolar dead space together make up the total dead space. Alveolar dead space will increase during lung pathology.
112
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 atelectasis, or lung collapse, most likely caused by air entering the pleural cavity due to a rupture of the visceral pleura. The rupture could have happened as a result of coughing during his bout with pneumonia.
113
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 mouthpiece, a hollow bell, inverted over water, was displaced, giving a graphic recording on a rotating drum. 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 the tidal volume. 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.
114
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.
115
A smoker sees his doctor because he has a persistent cough 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, CO 2 retention, and respiratory acidosis. He may develop emphysema or lung cancer.
116
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 the bends due to several problems: (1) Applying Boyleʹs law, a lot of gas was forced into Carlʹs 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 (Henryʹs law). Carl will have 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.
117
A patient was admitted to the hospital with chronic obstructive pulmonary disease. His PO2was 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 personʹs breathing, because his respiratory stimulus (low PO2 levels) would be removed.
118
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 manʹs 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 manʹs 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 the glottis in the larynx.
119
How will the lungs compensate for an acute rise in the partial pressure of CO2 in arterial blood?
Respiratory rate will increase.
120
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.
121
John has undergone surgery and has developed pneumonia. He also has a history of emphysema. Which assessment parameters 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 patientʹs breath sounds may have crackles.
