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PHYSIOLOGY > Respi - Batch 2019 > Flashcards

Respi - Batch 2019 Flashcards

1
Q
  1. A person who has resected carotid bodies due to surgery would probably be able to hold his breath:
    a. Longer
    b. Shorter c. No change
    d. He would not be able to hold his breath
A

A

Carotid artery contains baroreceptors for monitoring blood pressure including the partial pressure of arterial gases; once resected those baroreceptors are devoid of arterial blood supply thus the cells die, once their number lowers, the person can hold breaths longer because the arteries has diminished capability to monitor gas pressure in the arterial supply.

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2
Q
  1. Which of the following has the greatest direct influence in an individual’s breathing pattern?
    a. High concentration of carbon dioxide in the blood
    b. High concentration of hydrogen ions in the cerebrospinal fluid
    c. High concentration of hydrogen ions in the blood
    d. High concentration of carbon dioxide in the cerebrospinal fluid
A

A - leads to an increase in ventilation by stimulating phrenic and intercostal nerves that activate the respiratory muscles.

changes in pO2 has no significant direct effect on Central Respiratory Center.

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3
Q
  1. A patient came in the emergency room with a waxing and waning breathing pattern. Which of the following in the patient’s history can most likely be linked to this?
    a. Frequent intermittent chest pain
    b. Had 3 episodes of non-fatal myocardial infarction
    c. Head trauma with injury to the brainstem
    d. Ischemic stroke in the pons
A

B

  • Cheyne-Stokes Respiration
  • waxing and waning
  • trigerred by CO2 fluctuations
  • poor blood delivery
  • CNS damage

rhythmic waxing and waning of breathing, with intermittent periods of apnea = Cheyne-Stokes breathing commonly seen in patients with cardiac disease

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4
Q
  1. A patient with Cheyne-Stokes respiration has a:
    a. Delayed excitement of respiratory centers
    b. Delayed excitement of peripheral chemoreceptors
    c. Delayed detection of carbon dioxide levels in the cerebrospinal fluid
    d. Delayed detection of carbon dioxide levels in the peripheral chemoreceptors
A

A

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5
Q
  1. Which of the following breathing patterns carry the poorest prognosis?
    a. Kussmaul Respiration
    b. Ataxic Breathing c. Cheyne-Stokes Respiration
    d. Apneustic Breathing
A

B Ataxic Breathing - very irregular breathing, damage to the medulla, POOR prognosis

  • Kussmaul Breathing - rapid deep breathing; severe metabolic acidosis
  • Apneystic Breathing - prolonged inspiration, sudden expiration, damage to pons
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6
Q
  1. Anticipation of exercise helps in regulating which of the following aspects of respiration?
    a. Perfusion Rate
    b. Alveolar Ventilation c. Response to hypoxia
    d. Response to hypercarbia
A

B

2019, razo, ppt, pg 20 chart

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7
Q
  1. Which of the following is not influenced by a low oxygen environment?
    a. Yawning
    b. Central Chemoreceptor activity
    c. Peripheral Chemoreceptor activity
    d. Acclimatization
A

A

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8
Q
  1. Pneumonia has the least influence on the:
    a. Myelinated nerve fibers
    b. Juxtaalveolar receptors c. Juxtacapillary receptors
    d. Unmyelinated nerve fibers
A

B

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9
Q
  1. A pontine tumor can cause:
    a. Prolonged expiration b. Prolonged inspiration c. Erratic breathing pattern
    d. All of the other choices are correct.
A

D

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10
Q
  1. Which of the following can cause tachypnea?
    a. Damage of the glomus cells
    b. Decreased impulses from Cranial Nerve IX and X
    c. Increased pneumotaxic center activity
    d. Increased activity of the central chemoreceptors
A

C

*pneumotaxic center has a secondary effect of increasing the rate of breathing, because limitation of inspiration (primary effect) also shortens expiration and the entire of each respiration

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11
Q
  1. The ventral respiratory group is greatly activated in:
    a. Severe diabetic ketoacidosis
    b. Freediving
    c. Being suddenly surprised by a scary stranger
    d. REM stage of sleep
A

A

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12
Q
  1. How can the diving reflex temporarily help a patient with COPD with his dyspnea?
    a. Placing cold water on the face of the patient can regulate his ventilation more effectively
    b. Placing cold water on the face of the patient can help acclimatize the patient to low oxygen
    c. Placing cold water on the face of the patient can help him anticipate decrease in oxygen supply
    d. Placing cold water on the face of the patient can decrease his respiratory drive
A

B

Diving reflex:

  • stimulus: COLD water
  • receptor: Facial Cold Receptors
  • response: Apnea, bradycardia
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13
Q
  1. The rhythm of respiration is likely determined by the:
    a. Ventral Respiratory Group
    b. Pre-Botzinger Complex
    c. Apneustic Center
    d. Dorsal Respiratory Group
A

B. pre-botzinger complex - rhythym of breathing; pacemaker of breathing

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14
Q
  1. Emma was so depressed from all of her problems in life that she decided to commit suicide by drinking muriatic acid. She was rushed by her relatives to the hospital for immediate care. Given that her airway remained intact, what would her breathing pattern likely be?
    a. Apneustic
    b. Ataxic
    c. Biot’s Breathing
    d. Kussmaul Respiration
A

D

*Kussmaul Breathing - rapid deep breathing; severe metabolic ACIDOSIS

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15
Q
  1. Damage to which structure can cause Biot’s breathing?
    a. Nucleus Parabrachialis
    b. Peripheral Chemoreceptors
    c. Glomus Cells
    d. Nucleus Retroambiguus
A

A

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16
Q
  1. Cutting the 10th cranial nerve will result in the body being less sensitive to
    a. Hypercarbia
    b. Respiratory Alkalosis
    c. Metabolic Acidosis
    d. Hypoxia
A

D

  • D - 9th and 10th Cranial Nerves innervate the Peripheral Chemoreceptors called Glomus Cells in the Internal Carotid Bodies as well as Aortic Bodies respectively. These chemoreceptors are stimulated in response to pO2 in the arterial blood.
  • A - Hypercarbia - an increase in CO2 in the blood - sensed by the Central Chemoreceptors in the Medulla which are actually sensitive to H+ ion formed after passing through the BBB and acted upon by the enzyme Carbonic Anhydrase.
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17
Q
  1. When the pH of the body is alkaline, you would expect that the alveolar ventilation would be increased in which level of carbon dioxide?
    a. Carbon dioxide has no effect
    b. At normal levels
    c. Less than normal levels
    d. Greater than normal
A

D

kasi acidic environment o kay high pCO2 ang nakakaincrease ng alveolar ventilation.

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18
Q
  1. Which of the following protects you from choking while eating?
    a. Aspiration reflex
    b. Diving reflex
    c. Cough Reflex
    d. Sneezing reflex
A

A

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19
Q
  1. When a patient with COPD is tachypneic, which of the following influences his breathing pattern, EXCEPT?
    a. Hering-Breuer Deflation Reflex
    b. Hypoxia
    c. Hypercarbia
    d. Hering-Breuer Inflation Reflex
A

A

in COPD, there is poor gas exchange occuring inside the alveoli, leading to both hypoxia and hypercarbia, and there is the characteristic air-trapping, attributing to the increased residual volume in the lungs. This increased residual volume becomes a factor to stimulate the stretch receptors faster and initiate the Hering-Breuer Inflation Reflex earlier to limit inhalation, thus increasing the rate of respiration.

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20
Q
  1. Which of the following patients will be affected the least with an increase in pCO2 in the environment?
    a. An asthmatic with poor disease control
    b. A patient with chronic kidney disease
    c. A resident of a town in the mountains
    d. Someone who suffers a panic attack
A

C

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21
Q
  1. Pulmonary shunt occurs when:
    a. Airflow is directed towards the apex
    b. The alveolar V/Q ratio is equal to zero
    c. An adequately ventilated alveolus does not receive perfusion
    d. None of the above
A

B

Pulmonary shunt:
V/Q=0
no ventilation, (+) perfusion
lung bases
bronchiolar obstruction
Physiologic Dead Space
V/Q=infinity
(+) ventilation, (-) perfusion
lung apices
destruction of alveolar walls
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22
Q
  1. Deoxygenated blood from the high pressure pulmonary circulation will drain to the:
    a. Pulmonary artery
    b. Left atrium
    c. Aorta
    d. Inferior vena cava
A

B

High pressure system - bronchial arteries supplies oxygenated blood to lung supporting structures.
Low pressure system - delivers deoxygenated blood to the lungs for gas exchange; pulmonary veins empty into the left atrium.

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23
Q
  1. In Mitral Stenosis (MS):
    a. Mean arterial systemic pressure increases
    b. Left atrium dilates to accommodate the increase in pressure
    c. Pulmonary artery pressure increases rapidly during the early stages of MS
    d. Pulmonary capillary wedge pressure decreases
A

B Left Atrium dilates to increase in pressure.

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24
Q
  1. Zone II type of blood flow is described as:
    a. Blood flow only occurring during ventricular diastole
    b. Intermittent blood flow coinciding with ventricular systole
    c. Persistent blood flow throughout the cardiac cycle
    d. No blood flow during all phases of cardiac cycle
A

B

Zone I: no blood flow
Zone II: intermittent flow (during systole)
Zone III: constant flow (both systole and diastole)

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25
Q
  1. The following forces can cause the fluid to leak out of the pulmonary capillaries, EXCEPT:
    a. Negative interstitial fluid pressure
    b. Intracapillary hydrostatic pressure
    c. Intersititial fluid osmotic pressure
    d. Intracapillary oncotic pressure
A

C

Outward Force:
Capillary pressure,
Insterstitial fluid colloid oncotic pressure,
negative insterstitial fluid pressure

inward force:
plasma colloid osmotic pressure

—-

  • A - negative interstitial fluid pressure suck fluid out of the vascular system and into the tissue space
  • B - interstitial hydrostatic pressure - pressure drives water back to the vessel
  • C - intracapillary hydrostatic pressure - pushes fluid outside of the vessel
  • D - intracapillary oncotic pressure - oncotic pressure drops that causes filtration -> fluid leaks out
26
Q
  1. In pulmonary edema:
    a. The partial pressure gradient of gases dramatically increases
    b. The kinetic energy of gas molecules decreases
    c. The cross sectional area of the pulmonary membrane is increased
    d. The diffusion distance that gases must travel increases
A

D

Pulmonary edema
-diffusion distance that gases must travel increases because of the the fluid that collects inside alveoli
left sisded heart/valvular problems that will increase pulmonary venous and capillary pressure

27
Q
  1. True of transudate fluid:
    a. Can arise from increased capillary hydrostatic pressure
    b. Inflammation is the primary mechanism
    c. It will appear usually as dark brown to reddish in color
    d. Transudate is rich in proteins and necrotic debris
A

A

Transudate

  • from increase in hydrostatic pressure or decrease in oncotic pressure
  • mostly water

Exudate

  • from inflammation
  • contains plasma proteins, necrotic debris
  • dark brown to reddish in color
28
Q
  1. True of the blood inside the left atrium:
    a. Majority is oxygenated blood from the pulmonary veins
    b. Some deoxygenated blood is also present
    c. The pO2 of the blood inside the left atrium is higher than the pO2 of the blood just leaving the pulmonary capillaries
    d. All of the above
    e. A and B only
A

E

Left atrial blood = 98% oxygenated from pulmonary cappillaries->pulmonary veins +
2% deoxygenated from bronchial circulation

29
Q
  1. Arranged from smallest to largest in terms of volume, the correct sequence is:
    a. Tidal volume → anatomic dead space → residual volume
    b. Residual volume → tidal volume → anatomic dead space
    c. Anatomic dead space → tidal volume → residual volume
    d. Residual volume → anatomic dead space → tidal volume
A 
C
anatomic dead space = air that never reaches the gas exchange areas but simply fills respiratory passages = 150mL
TV = 500mL
ERV = 1100 mL
RV = 1200mL
IRV= 3000mL
30
Q
  1. The amount of air that can be inhaled over and above the normal tidal volume is called:
    a. Inspiratory reserve volume
    b. Residual volume
    c. Inspiratory capacity
    d. Inspiratory residual capacity
A

D

31
Q
  1. True of spirometry findings in emphysema:
    a. Peak expiratory flow rate is increased
    b. FEV1 is decreased
    c. Total lung volume is markedly decreased
    d. Residual volume is usually decreased
A

B

Emphysema - marked decrease in surface area due to destruction of alveolar walls

32
Q
  1. Vital capacity is the sum of:
    a. Tidal volume and inspiratory reserve volume
    b. Expiratory reserve volume and inspiratory capacity
    c. Inspiratory capacity and residual volume
    d. Residual volume and tidal volume
A

B

VC = IRV + TV + ERV
VC = IC + ERV
TLC = VC + FRC
TLC = IC + FRC
FRC = ERV + RV
33
Q
  1. Function/s of the upper respiratory passages:
    a. Filter air for particulate matter
    b. Warming and humidification of the air
    c. Reduce physiologic dead space
    d. All of the above
    e. A and B only
A

E

34
Q
  1. The following cause bronchoconstriction, EXCEPT:
    a. Cigarette smoke
    b. Bradykinin
    c. Histamine
    d. Epinephrine
A

D

Parasympathetic
-constricts bronchioles
activated by smoke, gases, infection, histamine, bradykinin

Sympathetic

  • dilates bronchioles
  • epinephrine & NE
35
Q
  1. Physiologic dead space is defined as anatomic dead space together with the:
    a. Lower airway passages
    b. Perfused alveoli without ventilation
    c. Upper airway passages
    d. Alveoli with V/Q ratio of infinity
A

D

Physiologic Dead Space = Anatomic Dead Space + non functional alveoli (non or poorly perfused)

36
Q

All of the following are muscles of inspiration, EXCEPT:

a. Scalene muscles
b. Diaphragm
c. External intercostals
d. Rectus abdominis

A

D

Muscles of INSPIRATION
diaphragm (for quiet normal breathing)
external intercostal muscles (accessory muscle)
sternocleidomastoid
serratus anterior (accessory)
scalenes

EXPIRATION

  • generally passive
  • can be assisted by Rectus abdominis & Internal intercostals
37
Q
  1. True of the pleural pressure:
    a. It is negative during inspiration and positive during normal expiration
    b. Turns more negative upon expiration
    c. Mostly at zero in between breaths
    d. It is maintained by continuous production and drainage of pleural fluid
A

D

slightly negative (-5cm H2O) always

38
Q
  1. The following chest cavity movements/events will translate to lung expansion:
    a. Increase in vertical diameter
    b. Increase in Antero-posterior diameter
    c. Upward movement of the ribs and sternum
    d. All of the above
    e. A and B only
A

D

bukod dun eto pa:
increased A-P diameter
external intercostals contracted
internal intercostals relaxed
diaphragmatic contraction

pag exhalation:
abdominals contracted

39
Q
  1. The alveolar pressure will turn positive:
    a. In late expiration
    b. In between inspiration and expiration
    c. In early expiration
    d. In early inspiration
A

C

negative during inspiration, zero in between, positive during early expiration

40
Q
  1. Transpulmonary pressure is:
    a. The difference between atmospheric and alveolar pressure
    b. The sum of alveolar and pleural pressure
    c. The difference between alveolar and pleural pressure
    d. The sum of atmospheric and pleural pressure
A

C

measures “recoil pressure”

41
Q
  1. Boyle’s law states that at constant temperature:
    a. Volume increases as pressure increases
    b. Volume decreases as pressure increases
    c. Pressure remains unchanged as volume increases
    d. None of the above
A

B

42
Q
  1. A less-compliant lung:
    a. Will have less tidal volume for every change in transpulmonary pressure
    b. Will require a greater work of breathing
    c. Can result from pulmonary fibrosis
    d. All of the above
    e. A and B only
A

D

43
Q
  1. True of water surface tension in relation to breathing:
    a. The presence of water-air interface reduces the work of breathing
    b. Di palmitoyl lecithin reduces the attraction between water molecules
    c. A water/saline filled lung is harder to inflate
    d. Surfactant molecules would cause alveolar collapse
A

B

44
Q
  1. Gas inside a normal alveoli is a mixture of the following significant gases
    a. CO2 and Oxygen
    b. Oxygen and nitrogen
    c. Oxygen, water vapor, CO2 and nitrogen
    d. Water vapor, CO2, helium
A

C

45
Q
  1. Interstitial fluid pO2 will decrease if:
    a. Cells extract and use more oxygen
    b. Blood pO2 levels increase
    c. Cells decrease their metabolic rate
    d. Blood flow to the tissue increases
A

A

46
Q
  1. Interstitial fluid pCO2 will increase if:
    a. Cellular metabolism decreases
    b. Metabolic rate increases
    c. Interstitial fluid CO2 removal increases
    d. Blood flow increases
A

B

47
Q
  1. The oxy-hemoglobin-dissociation curve will shift to the right if:
    a. Temperature is increased
    b. DPG (/BPG) is increased
    c. pH is increased
    d. All of the above
    e. A and B only
A

E

48
Q
  1. Majority of CO2 is transported in this form:
    a. Dissolved CO2
    b. Carbonic acid
    c. HCO3
    d. Carbamino-Hgb
A

C

49
Q
  1. Hypoxic hypoxia occurs in which setting:
    a. Hemorrhage
    b. Exposure to high altitude
    c. Carbon monoxide poisoning
    d. Cyanide poisoning
A

B

50
Q
  1. During exercise, how does the pulmonary circulation accommodate the increase in blood flow?
    a. Capillary distention
    b. Increasing the number of open capillaries
    c. Increasing pulmonary artery pressure
    d. All of the above
A

D

51
Q
  1. The transit time of blood inside pulmonary capillaries during exercise is reduced by half. This will result in:
    a. Normal blood oxygenation
    b. Lower blood oxygenation
    c. Decrease in hemoglobin levels
    d. Impaired blood oxygenation
A

A

kasi kahit hindi mag-exercise, 1/3 transit time pa lang, oxygenated na ang blood. so kahit maging 1/2 transit time dahil sa exercise, normal oxygenation pa rin.

52
Q
  1. INCREASING which of the following will DECREASE the rate of gas diffusion:
    a. Partial pressure difference
    b. Solubility of the gas
    c. The molecular weight of the gas
    d. Cross sectional area of the respiratory membrane
A

D

diffusion is directly proportional to change in pressure, cross sectional area of the fluid, and solubilikty of the gas

diffusion is indirectly proportional to distance the gas must travel and teh gas molecular weight.

53
Q
  1. Which of these gases has the highest diffusion coefficient?
    a. Oxygen
    b. Helium
    c. Nitrogen
    d. Carbon Dioxide
A

E

diffusion coefficient - measures how easily a gas will diffuse

  • carbon dioxide =20.3
  • oxygen =1.0
  • helium = 0.95
  • Carbon Monoxide = 0.81
  • Nitrogen =0.95
54
Q
  1. The actual expired air has a higher pO2 compared to alveolar air. The reason for this is:
    a. Expired air has no water vapor content
    b. Oxygen is consumed by alveolar cells for metabolism
    c. Oxygen is released into the alveoli from capillary
    d. Expired air contains dead space air which has higher pO2
A

D

expired air = alveolar air + dead space air

55
Q
  1. True of alveolar air turn over:
    a. 100% of alveolar air is replaced with every breath
    b. There is rapid turn over of air inside the alveoli
    c. Multiple breaths are necessary to replace most of the alveolar air
    d. All of the above
    e. A and B only
A

C

Slow turnover of alveolar air.

  • stabilize blood gas levels
  • tissue pH and gas levels remain stable
  • multiple breaths are required to replace most alveolar air
56
Q
  1. Which of the following will affect the partial pressure of oxygen inside the alveoli?
    a. Rate of oxygen absorption in the blood
    b. Rate of delivery of new oxygen into the Alveoli
    c. Depth and frequency of breaths per minute
    d. All of the above
A

D

57
Q
  1. What is the relation between alveolar ventilation and alveolar pCO2?
    a. Alveolar pCO2 levels are independent of alveolar ventilation
    b. A decrease in alveolar ventilation will also decrease alveolar pCO2
    c. An increase in alveolar ventilation will decrease alveolar pCO2
    d. An increase in alveolar ventilation will increase alveolar pCO2
A

C

58
Q
  1. The Ventilation/Perfusion (V/Q) ratio more commonly observed in the lung bases is:
    a. Close to zero
    b. Close to infinity
    c. Both
A

A

59
Q
  1. In V/Q = Infinity, the pO2 inside the alveoli is at 149mmHg, this is because:
    a. CO2 diffuses readily
    b. There is good blood perfusion
    c. Alveolar pO2 approximates blood pO2
    d. Alveolar oxygen remains unextracted
A

D

Physiologic Dead Space
V/Q=infinity
pO2=149; pCO2=0
alveolar oxygen remains unextracted
blood CO2 unable to diffuse towards the alveoli
lung apices
Shunt
V/Q=0
pO2=40; pCO2=45
blood passing through the capillaties remain unoxygenated
lung bases
60
Q
  1. True of Oxygen diffusion from the alveoli to the blood inside the pulmonary capillaries:
    a. An increase in pO2 gradient from alveoli to the blood increases the rate of diffusion.
    b. Majority of the O2 is carried by the blood in dissolved state.
    c. Blood pO2 is higher than alveolar pO2 as blood enters the pulmonary capillaries.
    d. The blood becomes fully saturated with oxygen only as blood leaves the capillaries.
A

A

because pO2 in alveoli is GREATER THAN the pO2 in the pulmonary capillary blood

PHYSIOLOGY (21 decks)

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