exam 5 Flashcards
surfactant is produced by
type 2 cells
oxyhemoglobin shift to the right
decreased affinity for oxygen
oxyhemoglobin shift to the left
increased affinity for oxygen
is asthma reversible
yes
Abnormal permanent enlargement of the gas-exchange airways accompanied by the destruction of the alveolar walls without obvious fibrosis
Emphysema
in the bladder the _____ nerves help with emptying
parasympathetic
nephrons are lost with ____
age
constricts resistant vessels increase systemic vascular resistance
stimulates sodium transport for reabsorption in renal absorption
helps release aldosterone
vasopressin
increases fluid retention
stimulates thirst centers
cardiac and vascular hypertrophy
angiotensin
Primary function is to establish a hyperosmotic state within the medullary interstitial fluid.
Loop of Henle
RIFLE
AKI
Risk; Injury; Failure; Loss; End-stage disease
hyperkalemia is associated with what condition
AKI
- What pulmonary defense mechanism propels a mucous blanket that entraps particles moving
toward the oropharynx?\
a. Nasal turbinates
b. Alveolar macrophages
c. Cilia
d. Irritant receptors on the nares
c. Cilia
Which term is used to identify the movement of gas and air into and out of the lungs?
a. Perfusion
b. Ventilation
c. Respiration
d. Diffusion
b. Ventilation
When an individual aspirates food particles, where would the healthcare professional expect to hear decreased or absent breath sounds?
a. Left lung
b. Right lung
c. Trachea
d. Carina
b. Right lung
Air passage among alveoli is collateral and evenly distributed because of the function of which structures?
a. Type I alveolar cells
b. Pores of Kohn
c. Acinus pores
d. Alveolar pores
b. Pores of Kohn
. Where in the lung does gas exchange occur?
a. Trachea
b. Segmental bronchi
c. Alveolocapillary membrane
d. Main bronchus
c. Alveolocapillary membrane
Surfactant produced by type II alveolar cells facilitates alveolar distention and ventilation by which mechanism?
a. Decreasing thoracic compliance
b. Attracting water to the alveolar surface
c. Decreasing surface tension in the alveoli
d. Increasing surface tension in the alveoli
c. Decreasing surface tension in the alveoli
Which part of the brainstem provides basic automatic rhythm of respiration by sending efferent impulses to the diaphragm and intercostal muscles?
a. Dorsal respiratory group (DRG)
b. Ventral respiratory group (VRG)
c. Pneumotaxic center
d. Apneustic center
b. Ventral respiratory group (VRG)
Which structures secrete surfactant?
a. Type I alveolar cells
b. Type II alveolar cells
c. Alveolar macrophages
d. Stretch receptors
b. Type II alveolar cells
Which describes the pressure in the pleural space?
a. Atmospheric
b. Below atmospheric
c. Above atmospheric
d. Variable
b. Below atmospheric
A healthcare professional wants to determine the adequacy of a person’s alveolar ventilation. What assessment finding is most important for the professional to consider?
a. Respiratory rate of 12 breaths/min
b. Ventilatory pattern is regular and rhythmic.
c. Respiratory effort is strained with muscle involvement.
d. Arterial blood gas shows a PaCO2 of 44 mmHg
d. Arterial blood gas shows a PaCO2 of 44 mmHg
Which normal physiologic change occurs in the aging pulmonary system?
a. Decreased flow resistance
b. Fewer alveoli
c. Stiffening of the chest wall
d. Improved elastic recoil
c. Stiffening of the chest wall
How is most of the oxygen in the blood transported?
a. Dissolved in plasma
b. Bound to hemoglobin
c. In the form of carbon dioxide (CO2)
d. Bound to protein
b. Bound to hemoglobin
Stretch receptors and peripheral chemoreceptors send afferent impulses regarding ventilation to
which location in the brain?
a. Pneumotaxic center in the pons
b. Apneustic center in the pons
c. Dorsal respiratory group (DRG) in the medulla oblongata
d. Ventral respiratory group (VRG) in the medulla oblongata
c. Dorsal respiratory group (DRG) in the medulla oblongata
If a patient develops acidosis, the nurse would expect the oxyhemoglobin dissociation curve to react in which manner?
a. Shift to the right, causing more oxygen (O2) to be released to the cells
b. Shift to the left, allowing less O2 to be released to the cells
c. Show no change, allowing the O2 concentration to remain stable
d. Show dramatic fluctuation, allowing the O2 concentration to increase
a. Shift to the right, causing more oxygen (O2) to be released to the cells
The sternocleidomastoid and scalene muscles are referred to as which group?
a. Diaphragmatic muscles
b. Muscles of expiration
c. Intercostal muscles
d. Accessory muscles of inspiration
d. Accessory muscles of inspiration
A newborn has alveolar collapse, decreased lung expansion, increased work of breathing, and severe gas-exchange abnormalities and the student asks the healthcare professional for an explanation of what is happening. What response by the professional is best?
a. A decrease in lung compliance from the trauma of a long childbirth process
b. A traumatic pneumothorax from a prolonged and difficult labor
c. Damage done to the alveoli from exposure to supplemental oxygen at birth
d. Lack of surfactant leading to increased alveolar surface tension and fluid collection
d. Lack of surfactant leading to increased alveolar surface tension and fluid collection
The student asks the professor to explain what characteristic is demonstrated by lungs with decreased compliance?
a. Difficult deflation
b. Easy inflation
c. Stiffness
d. Inability to diffuse oxygen
c. Stiffness
The lung is innervated by the parasympathetic nervous system via which nerve?
a. Vagus
b. Phrenic
c. Brachial
d. Pectoral
a. Vagus
What event is characteristic of the function in Zone 1 of the lung?
a. Blood flow through the pulmonary capillary bed increases in regular increments.
b. Alveolar pressure is lesser than venous and arterial pressures.
c. The capillary bed collapses, and normal blood flow ceases.
d. Blood flows through Zone 1, but it is impeded by alveolar pressure.
c. The capillary bed collapses, and normal blood flow ceases.
Hypoventilation that results in the retention of carbon dioxide will stimulate which receptors in an attempt to maintain a normal homeostatic state?
a. Irritant receptors
b. Central chemoreceptors
c. Peripheral chemoreceptors
d. Stretch receptors
b. Central chemoreceptors
What is the most important cause of pulmonary artery constriction?
a. Low alveolar partial pressure of arterial oxygen (PaO2)
b. Hyperventilation
c. Respiratory alkalosis
d. Epinephrine
a. Low alveolar partial pressure of arterial oxygen (PaO2)
A healthcare professional tells the student that a properly placed endotracheal tube for mechanical ventilation is 5 to 7 cm above the tracheal bifurcation. Where does this bifurcation occur?
a. Larynx
b. Bronchi
c. Carina
d. Nasopharynx
c. Carina
How low must the partial pressure of arterial oxygen (PaO2) drop before the peripheral chemoreceptors influence ventilation?
a. Below 100 mmHg
b. Below 80 mmHg
c. Below 70 mmHg
d. Below 60 mmHg
c. Below 70 mmHg
Which receptors are located in the smooth muscles of airways?
a. Central chemoreceptors
b. Stretch receptors
c. Peripheral chemoreceptors
d. J-receptors
b. Stretch receptors
Which receptors are located near the respiratory center?
a. Peripheral chemoreceptors
b. Stretch receptors
c. Central chemoreceptors
d. J-receptors
c. Central chemoreceptors
Which receptors are located in the aortic bodies, aortic arch, and carotid bodies?
a. Central chemoreceptors
b. Stretch receptors
c. J-receptors
d. Peripheral chemoreceptors
d. Peripheral chemoreceptors
A patient is having a spirometry measurement done and asks the healthcare professional to explain this test. What response by the professional is best?
a. To evaluate the cause of hypoxia
b. To measure the volume and flow rate during forced expiration
c. To measure the gas diffusion rate at the alveolocapillary membrane
d. To determine pH and oxygen and carbon dioxide concentrations
b. To measure the volume and flow rate during forced expiration
Which structures belong to the upper conduction airway? (Select all that apply.)
a. Oropharynx
b. Larynx
c. Nasopharynx
d. Trachea
e. Bronchi
a. Oropharynx
c. Nasopharynx
What does the pathophysiology student learn about the respiratory process referred to as remodeling? (Select all that apply.)
a. Remodeling involves the vascular walls.
b. Scarring and thickening occurs during this process.
c. Remodeling results in a permanent change.
d. Pulmonary artery hypotension results.
e. Remodeling increases blood flow resistance.
a. Remodeling involves the vascular walls.
b. Scarring and thickening occurs during this process.
c. Remodeling results in a permanent change.
e. Remodeling increases blood flow resistance.
A healthcare professional who works in a senior center knows about the effects of aging on the
pulmonary system, which include which of these? (Select all that apply.)
a. Decreased chest wall compliance
b. Decreased lung recoil
c. Reduced ventilatory reserve
d. Decreased partial pressure of arterial oxygen (PaO2)
e. Reduced respiratory rate
a. Decreased chest wall compliance
b. Decreased lung recoil
c. Reduced ventilatory reserve
d. Decreased partial pressure of arterial oxygen (PaO2)
Which of these cause the airway epithelium to constrict? (Select all that apply.)
a. Histamines
b. Prostaglandins
c. Alveolar alkalosis
d. Alveolar acidosis
e. Serotonin
a. Histamines
b. Prostaglandins
c. Alveolar alkalosis
e. Serotonin
Oxyhemoglobin association and dissociation
Shift to the left depicts the hemoglobin’s________ affinity for oxygen, which promotes association in the lungs and inhibits dissociation in the tissues.
increased
Oxyhemoglobin association and dissociation
Shift to the right depicts the hemoglobin’s _______ affinity for oxygen or an increase in the ease with which oxyhemoglobin dissociates and oxygen moves into the cells.
decreased
Which immunoglobulin (Ig) may contribute to the pathophysiologic characteristics of asthma?
a. IgA
b. IgE
c. IgG
d. IgM
b. IgE
A healthcare professional is educating a patient about asthma. The professional states that good control is necessary due to which pathophysiologic process?
a. Norepinephrine causes bronchial smooth muscle contraction and mucus secretion but it also causes high blood pressure.
b. Uncontrolled inflammation leads to increased bronchial hyperresponsiveness and eventual scarring.
c. The release of epinephrine leads to development of cardiac dysrhythmias.
d. Immunoglobulin G causes smooth muscle contraction which will eventually weaken the respiratory muscles.
b. Uncontrolled inflammation leads to increased bronchial hyperresponsiveness and eventual scarring.
A healthcare professional is educating a patient on asthma. The professional tells the patient that the most successful treatment for chronic asthma begins with which action?
a. Avoidance of the causative agent
b. Administration of broad-spectrum antibiotics
c. Administration of drugs that reduce bronchospasm
d. Administration of drugs that decrease airway inflammation
a. Avoidance of the causative agent
The student learns that which inflammatory mediators are produced in asthma? (Select all that apply.)
a. Histamine
b. Bradykinin
c. Leukotrienes
d. Prostaglandins
e. Neutrophil proteases
a. Histamine
b. Bradykinin
c. Leukotrienes
d. Prostaglandins
What is the area of the kidneys that contains the glomeruli and portions of the tubules called?
a. Medulla
b. Cortex
c. Pyramids
d. Columns
b. Cortex
What is the functional unit of the kidney called?
a. Glomerulus
b. Nephron
c. Collecting duct
d. Pyramid
b. Nephron
What is the only surface inside the nephron where cells are covered with microvilli to increase the reabsorptive surface area called?
a. Proximal convoluted tubules
b. Distal tubules
c. Ascending loop of Henle
d. Descending loop of Henle
a. Proximal convoluted tubules
What part of the kidney controls renal blood flow, glomerular filtration, and renin secretion?
a. Macula densa
b. Visceral epithelium
c. Juxtaglomerular apparatus (JGA)
d. Filtration slits
c. Juxtaglomerular apparatus (JGA)
Innervation of the bladder and internal urethral sphincter is supplied by which nerves?
a. Peripheral nerves
b. Parasympathetic fibers
c. Sympathetic nervous system
d. Tenth thoracic nerve roots
b. Parasympathetic fibers
How much urine accumulates in the bladder before the mechanoreceptors sense bladder fullness?
a. 75 to 100 mL
b. 100 to 150 mL
c. 250 to 300 mL
d. 350 to 400 mL
c. 250 to 300 mL
What is the trigone?
a. A smooth muscle that comprises the orifice of the ureter
b. The inner mucosal lining of the kidneys
c. A smooth triangular area between the openings of the two ureters and the urethra
d. One of the three divisions of the loop of Henle
c. A smooth triangular area between the openings of the two ureters and the urethra
The glomerular filtration rate is directly related to which factor?
a. Perfusion pressure in the glomerular capillaries
b. Diffusion rate in the renal cortex
c. Diffusion rate in the renal medulla
d. Glomerular active transport
a. Perfusion pressure in the glomerular capillaries
On average, what percent of cardiac output do the kidneys receive?
a. 10% to 20%
b. 15% to 20%
c. 20% to 25%
d. 30% to 35%
c. 20% to 25%
What are blood vessels of the kidneys innervated by?
a. Vagus nerve
b. Sympathetic nervous system
c. Somatic nervous system
d. Parasympathetic nervous system
b. Sympathetic nervous system
When renin is released, it is capable of which action?
a. Inactivation of autoregulation
b. Direct activation of angiotensin II
c. Direct release of antidiuretic hormone (ADH)
d. Formation of angiotensin I
d. Formation of angiotensin I
A student asks the professor to explain what effect natriuretic peptides have during heart failure when the heart dilates. Which response by the professor is best?
a. Stimulates antidiuretic hormones
b. Inhibits antidiuretic hormones
c. Stimulates renin and aldosterone
d. Inhibits renin and aldosterone
d. Inhibits renin and aldosterone
What is the direct action of atrial natriuretic hormone?
a. Sodium retention
b. Sodium excretion
c. Water retention
d. Water excretion
b. Sodium excretion
What term is used to identify the movement of fluids and solutes from the tubular lumen to the peritubular capillary plasma?
a. Tubular secretion
b. Ultrafiltration
c. Tubular reabsorption
d. Tubular excretion
c. Tubular reabsorption
A patient’s urinalysis came back positive for glucose. What does the healthcare professional expect the patient’s blood glucose to be at a minimum?
a. 126 mg/dL
b. 150 mg/dL
c. 180 mg/dL
d. 200 mg/dL
c. 180 mg/dL
Which hormone is required for water to be reabsorbed in the distal tubule and collecting duct?
a. Antidiuretic hormone
b. Aldosterone
c. Cortisol
d. Adrenocorticotropic hormone
a. Antidiuretic hormone
Which glycoprotein protects against urolithiasis?
a. Uromodulin
b. Nephrin
c. Urodilatin
d. Cystatin
a. Uromodulin
What is the end product of protein metabolism that is excreted in urine?
a. Glucose
b. Ketones
c. Bile
d. Urea
d. Urea
What is the action of urodilatin?
a. Urodilatin causes vasoconstriction of afferent arterioles.
b. It causes vasodilation of the efferent arterioles.
c. Urodilatin inhibits antidiuretic hormone secretion.
d. It inhibits salt and water reabsorption
d. It inhibits salt and water reabsorption
The concentration of the final urine is determined by antidiuretic hormone (ADH), which is secreted by which gland?
a. Posterior pituitary
b. Thyroid
c. Parathyroid
d. Anterior pituitary
a. Posterior pituitary
What does the healthcare professional understand about urodilatin?
a. Urodilatin inhibits sodium chloride and water reabsorption in the medullary part of the collecting duct.
b. It inhibits antidiuretic hormone (ADH) to prevent water reabsorption in the medullary part of the collecting duct.
c. Urodilatin is stimulated by a rise in blood pressure and an increase in extracellular volume.
d. It is stimulated by a fall in blood pressure and a decrease in extracellular volume
c. Urodilatin is stimulated by a rise in blood pressure and an increase in extracellular volume.
What substance stimulates renal hydroxylation in the process of producing vitamin D?
a. Erythropoietin
b. Thyroid hormone
c. Calcitonin
d. Parathyroid hormone
d. Parathyroid hormone
Which hormone is synthesized and secreted by the kidneys?
a. Antidiuretic hormone
b. Aldosterone
c. Erythropoietin
d. Angiotensinogen
c. Erythropoietin
The student wants information about a patient’s renal function. What test does the healthcare professional tell the student to evaluate?
a. Glomerular filtration rate
b. Hourly urine output
c. Serum blood urea nitrogen and creatinine
d. The specific gravity of the solute concentration of the urine
a. Glomerular filtration rate
Which renal change is found in older adults?
a. Sharp decline in glomerular filtration rate
b. Sharp decline in renal blood flow
c. Decrease in the number of nephrons
d. Decrease in urine output
c. Decrease in the number of nephrons
A healthcare professional is caring for an older adult. Understanding age-related renal changes, what urinalysis finding would the professional view as normal for an older patient?
a. pH 5.2
b. Moderate protein
c. Specific gravity 1.003
d. Positive for white cell casts
c. Specific gravity 1.003
What process allows the kidney to respond to an increase in workload?
a. Glomerular filtration
b. Secretion of 1,25-dihydroxyvitamin D3
c. Increased heart rate
d. Compensatory hypertrophy
d. Compensatory hypertrophy
Which process makes it possible for ureters to be transplanted successfully?
a. Compensatory hypertrophy
b. Erythropoietin secretion
c. Peristalsis
d. Collateral circulation
c. Peristalsis
Which structures are parts of the nephron? (Select all that apply.)
a. Loop of Henle
b. Renal corpuscle
c. Proximal convoluted tubule
d. Calyx
e. Collecting duct
a. Loop of Henle
b. Renal corpuscle
c. Proximal convoluted tubule
e. Collecting duct
Which forces create passive transport of water in the proximal tubule? (Select all that apply.)
a. Peritubular capillary hydrostatic pressure
b. Peritubular capillary oncotic pressure
c. Interstitial hydrostatic pressure
d. Interstitial osmotic pressure
e. Peritubular capillary osmotic pressure
b. Peritubular capillary oncotic pressure
e. Peritubular capillary osmotic pressure
Which hormones are produced by the kidney? (Select all that apply.)
a. Renin
b. Erythropoietin
c. 1,25-Dihydroxyvitamin D3
d. Calcitonin
e. Aldosterone
a. Renin
b. Erythropoietin
c. 1,25-Dihydroxyvitamin D3
What information does the pathophysiology student learn about renal circulation? (Select all that apply.)
a. The interlobar arteries travel down into the renal columns.
b. The arcuate arteries branch to form the interlobar arteries.
c. The arcuate arteries arch over the base of the pyramids.
d. The interlobar arteries run parallel to the surface of the kidneys.
e. The interlobar arteries run between the pyramids.
a. The interlobar arteries travel down into the renal columns.
b. The arcuate arteries branch to form the interlobar arteries.
e. The interlobar arteries run between the pyramids.
A patient has been diagnosed with a renal stone. Based on knowledge of common stone types,
what self-care measure does the healthcare professional plan to teach the patient when stone
analysis has returned?
a. Increase water intake.
b. Decrease soda intake.
c. Restrict animal protein in the diet.
d. Ingest 1000 mg of calcium a day.
d. Ingest 1000 mg of calcium a day.
How does progressive nephron injury affect angiotensin II activity?
a. Angiotensin II activity is decreased.
b. Angiotensin II activity is elevated.
c. Angiotensin II activity is totally suppressed.
d. Angiotensin II activity is not affected
b. Angiotensin II activity is elevated.
The student asks the professor to explain the role of pyrophosphate, potassium citrate, and magnesium in the formation of kidney stones. What response by the professor is best?
a. They inhibit crystal growth.
b. They stimulate the supersaturation of salt.
c. They facilitate the precipitation of salts.
d. They enhance crystallization of salt crystals
a. They inhibit crystal growth.
Hypercalciuria is primarily attributable to which alteration?
a. Defective renal calcium reabsorption
b. Intestinal hyperabsorption of dietary calcium
c. Bone demineralization caused by prolonged immobilization
d. Hyperparathyroidism
b. Intestinal hyperabsorption of dietary calcium
A healthcare professional is assessing a patient who could have either pyelonephritis or cystitis. Which differentiating sign would assist the professional in making this diagnosis?
a. Difficulty starting the stream of urine
b. Spasmodic pain that radiates to the groin
c. Increased glomerular filtration rate
d. Urinalysis confirmation of white blood cell casts
d. Urinalysis confirmation of white blood cell casts
Which abnormal laboratory value is found in glomerular disorders?
a. Elevated creatinine concentration
b. Low blood urea nitrogen (BUN)
c. Elevated immunoglobulin A (IgA)
d. Low serum complement
a. Elevated creatinine concentration
Creatinine is primarily excreted by glomerular filtration after being constantly released from what type of tissue?
a. Nervous system
b. Kidneys
c. Muscle
d. Liver
c. Muscle
A professor has taught a student about skeletal alterations seen in chronic kidney disease. Which
statement by the student indicates the professor needs to give more information?
a. Parathyroid hormone is no longer effective in maintaining serum phosphate levels.
b. The parathyroid gland is no longer able to secrete sufficient parathyroid hormone.
c. The synthesis of 1,25-vitamin D3, which reduces intestinal absorption of calcium,
is impaired.
d. The effectiveness of calcium and phosphate resorption from bone is impaired.
b. The parathyroid gland is no longer able to secrete sufficient parathyroid hormone.
A patient who has chronic kidney disease has hemoglobin of 7.2 mg/dL. What treatment does the
healthcare professional prepare the patient for?
a. Intrinsic factor
b. Vitamin B12
c. Vitamin D
d. Erythropoietin
d. Erythropoietin
When the right kidney is obstructed, how will the glomeruli and tubules in the left kidney compensate?
a. Increase in number
b. Increase in size
c. Develop collateral circulation
d. Increase speed of production
b. Increase in size
In glomerulonephritis, what damages the epithelial cells resulting in proteinuria? (Select all that apply.)
a. Ischemia
b. Lysosomal enzymes
c. Compression from edema
d. Activated complement
e. Altered membrane permeability
d. Activated complement
e. Altered membrane permeability
Besides dyspnea, what is the most common characteristic associated with pulmonary disease?
a. Chest pain
b. Digit clubbing
c. Cough
d. Hemoptysis
c. Cough
A patient reports needing to sit up at night in order to breathe. What term does the healthcare professional document about this condition?
a. Hyperpnea
b. Orthopnea
c. Apnea
d. Atelectasis
b. Orthopnea
Kussmaul respirations as a respiratory pattern may be associated with which characteristic(s)?
a. Alternating periods of deep and shallow breathing
b. Increased work of breathing
c. Inadequate alveolar ventilation in relation to metabolic demands
d. Slightly increased ventilatory rate, large tidal volumes, and no expiratory pause
d. Slightly increased ventilatory rate, large tidal volumes, and no expiratory pause
Respirations that are characterized by alternating periods of deep and shallow breathing are a result of which respiratory mechanism?
a. Decreased blood flow to the medulla oblongata
b. Increased partial pressure of arterial carbon dioxide (PaCO2)
c. Stimulation of stretch or J-receptors
d. Fatigue of the intercostal muscles and diaphragm
a. Decreased blood flow to the medulla oblongata
A hospitalized patient is complaining of shortness of breath, but the student does not notice cyanosis. The patient’s hemoglobin is 9 g/dL, so the student asks the healthcare professional to explain. The professional tells the student that what amount of hemoglobin must be desaturated before cyanosis occurs?
a. 3
b. 5
c. 7
d. 9
b. 5
What does the student learn about ventilation?
a. Hypoventilation causes hypocapnia.
b. Hypoventilation causes alkalosis.
c. Hyperventilation causes hypocapnia.
d. Hyperventilation causes acidosis.
c. Hyperventilation causes hypocapnia.
A patient has long-standing pulmonary disease and chronic hypoxia. The student assesses the patient’s fingertips and notices bulbous enlargement of the distal segment of the digits. How does the student document this finding?
a. Edema
b. Clubbing
c. Angling
d. Osteoarthropathy
b. Clubbing
The student asks the healthcare professional to explain how pulmonary edema and pulmonary
fibrosis cause hypoxemia. What description by the professional is best?
a. Creates alveolar dead space
b. Decreases the oxygen in inspired gas
c. Creates a right-to-left shunt
d. Impairs alveolocapillary membrane diffusion
d. Impairs alveolocapillary membrane diffusion
High altitudes may produce hypoxemia through which mechanism?
a. Shunting
b. Hypoventilation
c. Decreased inspired oxygen
d. Diffusion abnormalities
c. Decreased inspired oxygen
Which condition is capable of producing alveolar dead space?
a. Pulmonary edema
b. Pulmonary emboli
c. Atelectasis
d. Pneumonia
b. Pulmonary emboli
Which condition involves an abnormally enlarged gas-exchange system and the destruction of the lung’s alveolar walls?
a. Transudative effusion
b. Emphysema
c. Exudative effusion
d. Abscess
b. Emphysema
the portion of the respiratory system where tidal volume doesn’t participate in gas exchange: it is ventilated but not perfused.
Dead space
Which factor contributes to the production of mucus associated with chronic bronchitis?
a. Airway injury
b. Pulmonary infection
c. Increased Goblet cell size
d. Bronchospasms
c. Increased Goblet cell size
Movement of air into and out of the lungs
Ventilation:
Movement of gases between air spaces in the lungs and the bloodstream
Diffusion:
Movement of blood into and out of the capillary beds of the lungs to body organs and tissues
Perfusion:
Carries out the first two processes
Pulmonary system:
Pulmonary artery divides and enters the lung at the ____
hilus
Neural impulses from the respiratory center travel to the diaphragm by way of the right and left ______
phrenic nerves
Sets the basic automatic rhythm.
Receives impulses from peripheral chemoreceptors in the carotid and aortic bodies: Detects the Paco2 and the amount of oxygen in the arterial blood.
Dorsal respiratory group (DRG):
Respiratory center Is located in the _____
brainstem.
Contains inspiratory and expiratory neurons.
Becomes active when increased ventilatory effort is required.
Ventral respiratory group(VRG):
Are located in the pons.
Modifiers of the inspiratory depth and rate are established by the medullary centers.
Pneumotaxic and apneustic centers:
Lung receptors
Are sensitive to noxious substances.
When stimulated cause cough, bronchoconstriction, and increase respiratory rate.
Irritant receptors:
Lung receptors
Protect against excess lung inflation.
Decrease respiratory rate and volume.
Stretch receptors:
Lung receptors
Are sensitive to increased pulmonary capillary pressure
Juxtapulmonary capillary (J) receptors:
Reflects Paco2.
Is stimulated by hydrogen (H+) in the cerebrospinal fluid (pH).
Increases the respiratory depth and rate.
Central Chemoreceptors
Located in the aorta and carotid bodies.
Is stimulated by hypoxemia (Pao2).
Is responsible for all of the increase in ventilation that occurs in response to arterial hypoxemia.
Peripheral Chemoreceptors
They sense the PCO2, PO2 and pH of blood
Peripheral chemoreceptors
Major muscles of inspiration
Diaphragm and external intercostal muscles
Vasoconstriction occurs (diminishes GFR).
(Neural regulation
Sympathetic nervous system
Vasoconstriction of afferent arterioles with activation of α1-adrenoreceptors
Decreases glomerular perfusion and GFR.
Baroreceptor reflex:
Increases systemic arterial pressure, and increases sodium reabsorption.
Renin-angiotensin-aldosterone system (RAAS)
Stimulates the secretion of aldosterone by the adrenal cortex.
Angiotensin II
is secreted from myocardial cells in the atria.
Atrial natriuretic peptide (ANP)
is secreted from myocardial cells in the ventricles.
Brain natriuretic peptide (BNP)
Chronic Kidney Disease
Kidney damage: GFR less than __ mL/min/1.73 m2 for __ months or more, irrespective of cause
60 mL/min/1.73 m2
3 months
4 steps in Gas Transport
Ventilation of the lungs
Diffusion of oxygen from the alveoli into the capillary blood
Perfusion of systemic capillaries with oxygenated blood
Diffusion of oxygen from systemic capillaries into the cells
Cheyne-Stokes respirations are characterized by:
audible wheezing or stridor.
a slightly increased ventilatory rate, large tidal volumes, and no expiratory pause.
rapid respirations alternating with periods of apnea.
very slow inhalations and rapid expirations.
rapid respirations alternating with periods of apnea.
Respiratory acidosis can result from:
increased minute ventilation.
decreased PaCO2
tissue hypoxia.
reduced tidal volumes
reduced tidal volumes
Which of the following conditions causes a decreased drive to breathe that results in hypoxemia and hypercapnia?
Emphysema
Asthma
Central nervous system disorders
Central nervous system disorders
Central nervous system disorders
A decrease in tidal volume results in a decrease in:
PaCO2
the respiratory rate.
minute ventilation.
acidity
minute ventilation.
Which of the following alterations in lab values would indicate that a patient is hyperventilating?
High PaO2
High pH
High PaCO2
High osmolarity
High pH
The loss of alpha1-antitrypsin in emphysema results in:
chronic mucus secretion and airway fibrosis.
the destruction of alveolar septa and the loss of elastic recoil
pulmonary edema and increased alveolar compliance.
bronchoconstriction and airway edema.
the destruction of alveolar septa and the loss of elastic recoil
A high ventilation/perfusion (V/Q) ratio can be caused by:
increased dead space
alveolar collapse
obstruction to pulmonary blood flow.
bronchoconstriction
obstruction to pulmonary blood flow.
Nephrotic syndrome occurs when damage to the glomeruli results in a loss of _____ in the urine.
a. protein
b. glucose
c. sodium
d. red blood cells
protein
In renal failure, the kidneys will continue to adapt until renal function decreases to what percentage of normal?
a. 25%
b. 75%
c. 10%
d. 50%
a. 25%
n chronic renal failure, which of the following hormones often needs to be pharmacologically supplemented?
Antidiuretic hormone (ADH)
Cortisol
Erythropoietin
Aldosterone
Erythropoietin
