Respiratory Physiology Flashcards
Which of the following does NOT belong to the lower airway? A. Trachea B. Alveoli C. Larynx D. None of the above
C. Larynx
In the trachea, C-shaped cartilages are found. Explain.
Trachea has a c-shaped cartilage in a way that when you swallow, esopagus compresses the posterior part of the trachea (non-cartilagenous part of the trachea) thus preventing aspiration of food particles or fluid into the lower airways.
What is the correct sequence of the tracheobronchial tree?
A. trachea-mainstem bronchi-segmental bronchi-lobar bronchi-bronchioles-alveoli
B. trachea-mainstem bronchi-lobar bronchi-segmental bronchi-bronchioles-alveoli
C. trachea-mainstem bronchi-lobar bronchioles-segmental bronchioles-bronchioles-alveoli
D. Trachea-bronchioles-mainstem bronchi-lobar bronchi-segmental bronchi-alveoli
B. trachea-mainstem bronchi-lobar bronchi-segmental bronchi-bronchioles-alveoli
Which of the following is NOT a characteristic of the right bronchi? A. Wider B. Shorter C. more vertical D. none of the above
D. None of the above. (Rationale: Right bronchi is wider, shorter and more vertical than the left bronchi which is narrower, wider and more horizontal)
In foreign body aspiration, the most common site of aspiration in an upright postion is into the _______? A. Left Bronchi B. Left Bronchioles C. Right Bronchi D. Right Bronchioles
C. Right Bronchi
Where does gas exchange occur? A. Mainstem bronchi B. segmental bronchi C. Terminal bronciole D. Respiratory bronchiole
D. Respiratory bronchiole
Which of the following is TRUE about Goblet cells? A. May play a role in epithelial regeneration after injury B. Produces mucus C. For gas exchange D. For production of lung surfactant
B. Produces Mucus (Rationale: A. is for Clara cells; C. is for Type I pneumocytes D. is for Type II Pneumocytes)
Which of the following is TRUE? A. Type I pneumocyte is more numerous than Type II B. Type II pneumocyte is more numerous than Type I C. Both D. Neither
D. Neither (Rationale: Type I and type II pneumocytes is the same in number)
Which of the following is NOT TRUE about sneeze reflex? A. Without depression of uvula B. Very quick C. It is a protective function D. With depression of uvula
A. without depression of uvula (Rationale: It is in cough reflex that we have absence of the depression of uvula. In sneeze reflex, depression of uvula is present)
The left lung contains: A. 3 lobes B. 2 lobes C. Horizontal Fissure D. Both A and C E. Both B and C
B. 2 lobes (Rationale: Lungs has 2 lobes and an Oblique fissure while the right lung has 3 lobes and has an oblique and horizontal fissure)
Which of the following is NOT true about pleural fluid? A. It is found in a potential space between the parietal pleura and fascia B. It has negative pressure C. It keeps the 2 pleura together D. It allows the 2 pleura to slide with one another
A. It is found in a potential space between the parietal pleura and fascia. (Rationale: It is found in a potential space between the parietal pleura and VISCERAL PLEURA)
Which of the following best describes Pleural effusion? A. Presence of air in the pleural space B. Presence of pus in the pleural space C. Presence of excess fluid in the pleural space D. All of the above
C. Presence of excess fluid in the pleural space (Rationale: A. is for Pneumothorax, B. is for Emphyema)
A puncture in the thoracic cavity may result to introduction of air into the pleural space. What is this condition? A. Pneumothorax B. Pleural Effusion C. Empyema D. Abcess
A. Pneumothorax (Rationale: B. Pleural Effusion refers to the accumulation of excess fluid in the pleural space. C. Emphyema refers to the accumulation of pus in the pleural spac. D. Abcess is the term used to describe presence of pus in a normal space.)
What is the ratio Type I pneumocytes and type II pneumocytes in the alveoli in terms of number? A. 1:2 B. 2:1 C. 1:1 D. 2:2
C. 1:1 (Rationale: Type I and Type II pneumocytes is the same in number but differ in extent of the surface area occupied in the alveoli because Type I pneumocyte is larger than Type II. 96-98% for Type I penumocyte, 2-4% for type II pneumocytes)
The surfactant _______ surface tension. A. Increases B. Decreases C. does not affect
B. Decreases. (Rationale: Surface tension is the force exerted by the water molecules at the air-liquid interface that decreases the surface area. Surfactant are ampiphatic molecules that contains DPPC that breaks the hydrogen bond in between water molecules thus resulting in decreased surface tension)
__________ explains how surface tension and alveolar radius affects the collapsing pressure of the alveoli. A. Poiseuille formula B. Law of Laplace C. Bernoulli’s Principle D. None of the above
B. Law of Laplace (P=2T/r where P=collapsing pressure in alveolus; T=surface tension and r=alveolar radius)
Which of the following is TRUE regarding collapsing pressure? A. The greater the alveolar radius the greater collapsing pressure B. The lesser the alveolar radius the greater collapsing pressure C. The greater the surface tension the lesser ccollapsing pressureD. The lesser the surface tension the greater collapsing pressure
B. The lesser the alveolar radius the greater collapsing pressure (Rationale: Law of Laplace states that P=2T/r. Surface tension has a direct relationship with collapsing pressure, while alveolar radius has an inverse relationship with the collapsing pressure)
What is the active component of pulmonary surfactant? A. H20 B. DPPC C. Phosphatidyl glycerol D. Calcium ions
B. DPPC
What is the major component of pulmonary surfactant? A. H20 B. DPPC C. Phosphatidyl glycerol D. Calcium ions
A. H2O
Increase pulmonary surfactant causes increase in lung compliance. A. True B. False
A. True (Rationale: Increase in surfactant reduces surface tension therefore increasing lung compliance)
It is the capacity of an alveoli to exert traction on other surrounding alveoli to prevent collapse. A. Interdependence B. Collapsing Pressure C. Surface Tension D. None of the above
A. Interdependence
It connects the terminal airway to adjacent alveoli. A. Pores of Kohn B. Canals of lambert C. Pneumocyte I D. Pneumocyte II
B. Canals of Lambert
_________ limits lung distensibility. A. Collagen B. Elastin C. Cartilage D. Smooth Muscles
A. Collagen (Rationale: B. Elastin contributes to elastic recoil of the lungs, C. Cartilage supports conducting airways and D. Smooth muscles dilate or constrict airways.
It is the blood supply of the lungs that carries oxygenated blood to the lungs. A. Bronchial circulation B. Pulmonary Circulation C. Both D. None of the above
A. Bronchial Circulation (Rationale: B. Pulmonary circulation carries deoxygenated blood to the lungs)
In a state of hypoxia, the pulmonary arterioles respond by: A. Constriction B. Dilatation
A. Constriction. “All arterioles responds to hypoxia by vasodilating except for PULMONARY ARTERIOLES, where it vasoconstricts to shunt blood to an area with greater oxygenation”
An increase in the Pulmonary Capillary pressure signifies: A. Decrease in Left atrial pressure B. Decrease in Right atrial pressure C. Increase in Left atrial pressure D. Increase in Right atrial pressure
C. Increase in left atrial pressure. (Rationale: Pulmonary Capillary wedge pressure(PCWP) estimates atrial pressure therefore an increase in Left atrial pressure increases PCWP and vice versa. If there is an increase in Left Atrial pressure, pulmonary capillary pressure also increases in order to facilitate a forward flow of the blood from pulmonary capillaries to the left atrium. Remember that blood flows from an area with higher pressure to an area with a lower pressure to ensure adequate blood flow)
Which of the following lung zones has a greater local alveolar pressure than alveolar air pressure throughout the cycle? A. Zone 1 B. Zone 2 C. Zone 3 D. Zone 4
C. Zone 3 (Rationale: A. Zone 1 has ACP Alveolar air pressure but less than that during diastole; and D. There is no zone 4)
Which of the following zone has NO blood flow? A. Zone 1 B. Zone 2 C. Zone 3 D. Zone 4
A. Zone 1
Which has the greatest ventilation? A. Base of the lungs B. Apex of the Lungs C. Middle portion of the Lungs
A. Base (Base has the highest ventilation and perfusion BUT the Apex has the greatest Ventilation-Perfusion ratio)
What is the MAJOR MUSCLE OF RESPIRATION? A. SCM B. Alae Nasi C. Genioglossus D. Diaphragm
D. Diaphragm (RATIONALE: The diaphragm is the major muscle of respiration and it divides the thoracic covaity from the abdominal cavity. During contraction it forces the abdominal contents to move downward and forward. This increases the vertical dimension of the chest cavity and creates a pressure difference bet. the thorax and abdomen. Reference Berne& Levy Physiology 6th Ed. Chap. 20 p.425)
Which of the following vertebral segments when injured will result to a complete dependency of the patient on a ventilator in order to breathe? A. T4-T6 B. L1-L3 C. C3-C5 D. S1-S3
C. C3-C5 (RATIONALE: The diaphragm is innervated by the right and left phrenic nerves, which have their origins at the 3rd to 5th cervical vertebral segments of the spinal cord. Reference Berne & Levy Physiology 6th ed. Chap. 20 p. 425)
TRUE OR FALSE. Paralysis of the external intercostal muscle will have a significant effect on respiration.
FALSE. (RATIONALE: Respiration is primarily dependent on the diaphragm which is innervated by the phrenic nerve that originates from C3-C5. Innervation of the external intercostal muscle originated from the intercostal nerves that arise from the same level of the spinal cord. Reference Berne & Levy Physiology 6th ed. Chap. 20 p. 425)
On contraction of the diaphragm, it protrudes into the abdominal cavity and moves the abdomen outward to create a _____ pressure inside the chest. A. Positive B. Negative C. Neutral
B. Negative (RATIONALE: The process of respiration/gas exchange begins with the act of inspiration which is initiated by the contraction of the diaphragm. The negative pressure facilitates the inward flow of air to the lungs because gases flow from higher (atmospheric pressure) to lower pressure. Reference Berne & Levy Physiology 6th ed. Chap. 20 p. 425)
Which of the following muscles of inspiration causes an increase in both the lateral and AP diameter of the thorax? A. External Intercostal Muscle B. Internal Intercostal Muscle C. Sternocelidomastoid D. Transversus Abdominis
A. External Intercostal Muscle (RATIONALE: The external intercostal Muscle pulls the ribs upward and forward which facilitates an increase in the lateral and AP diameter of the lungs. Reference Berne & Levy Physiology 6th ed. Chap. 20 p. 425)
TRUE OR FALSE. Accessory msucles of inspiration do not contract during normal breathing.
TRUE. (RATIONALE. Accessory muslces action during normal breathing is involuntary which does not require contraction. However, they do contract vigorously during exersie, and when airway obstruction is significant, they actively pull up on the rib cage. Reference Berne & Levy Physiology 6th ed. Chap. 20 p. 425)
The respiratory muslces’ force of contraction ________ when they are stretched and_______ when shortened. A. Increases; Decreases B. Increases; Increases C. Decreases; Decreases D. Decreases: Increases
A. Increases; Decreases (RATIONALE: Respiratory muscles provide the driving force for ventilation and its force of contraction also increases at larger lung volumes. Reference Berne & Levy Physiology 6th ed. Chap. 20 p. 425)
The diaphragm can generate airway pressures of up to _____ to _____ cm H2O during maximal inspiratory effort. A. 200 to 300 B. 150 to 300 C. 200 to 250 D. 150 to 200
D. 150 to 200 (Reference Berne & Levy Physiology 6th ed. Chap. 20 p. 425)
Lung volume _____ at inspiration and ____ at expiration. A. Increases; Decreases B. Increases; Increases C. Decreases; Decreases D. Decreases: Increases
A. Increases; Decreases (RATIONALE: During inspiration O2 is taken into the lungs thus increasing lung volume, while at exhalation CO2 and other gases flow passively out of the lungs. Reference Berne & Levy Physiology 6th ed. Chap. 20 p. 425)
Which of the following is correct? A. Normal Inspiration: Passive Process B. Force Inspiration: Internal Intercostal C. Normal Inspiration: Active Process D. Force Expiration: External Intercostal
C. Normal Inspiration: Active Process (Force Inspiration - External Intercostal; Force Expiration - Internal Intercostal; Normal Expiration - Passive Process)
Which of the following statement is/are TRUE? A. The tidal volume is the volume of air remaining in the lungs after the most forceful expiration B. The tidal volume is the volume of air inspired or expired with each normal breath C. The tidal volume is the volume of air (about 3500 milliliters) a person can breathe in, beginning at the normal expiratory level and distending the lungs to the maximum amount D. The tidal volume is the volume of air inspired and expired with each normal breath
Answer: B (A – residual volume; C - inspiratory capacity ( changed “capacity” to “volume”); D – inspired OR expired – not “and”
The rate at which new air reaches alveoli is called? A. alveolar ventilation B. The minute respiratory volume C. Alveolar sac ventilation D. Alveoli pressure
A. Alveolar ventilation
The lung has two circulations, which of the following statement is/are TRUE? A. a high-pressure, low-flow circulation B. a low-pressure, high-flow circulation C. Neither of A and B D. Both A and B
D. Both A and B
TRUE or FALSE. the pleural space—the space between the parietal and visceral pleurae—is called a potential space
Answer: true, it normally is so narrow that it is not obviously a physical space.
When the concentration of O2 in the air of the alveoli ________ below normal, especially when it falls below 70 percent of normal (i.e., below 73 mm Hg Po2), the adjacent blood vessels _________, with vascular resistance increasing more than fivefold at extremely low O2 levels? A. decreases; constrict B. decreases; dilate C. increases; dilate D. increases; constrict
A. decreases; constrict
which of the following is not part of upper airways? A. Nose B. Trachea C. Sinuses D. larynx
B. Trachea (part of lower airway)
Which of the following is TRUE regarding cough and sneeze reflex? A. It removes irritating substances in airway B. It is a protective mechanism C. Both A and B D. None of the above
C. Both A and B
What type of pneumocyte that is responsible for gas exchange? A. Type I B. Type II C. Type III D. Type IV
A. Type I
Pulmonary circulation carries ____________ blood to the lungs ; bronchial circulation carries ____________ blood to the lungs? A. Oxygenated, Deoxygenated B. Deoxygenated, Deoxygenated C. Oxygenated, Oxygenated D. Deoxygenated, Oxygenated
D. Deoxygenated, Oxygenated
Which of the following statements is/are TRUE? A. Restrictive disease is characterized by limitation of airflow usually resulting from an increase in resistance caused by partial or complete obstruction at any level B.Restrictive disease, characterized by reduced expansion of lung parenchyma accompanied by decreased total lung capacity C. In diffuse obstructive diseases, FVC is reduced and the expiratory flow rate is normal or reduced proportionately. Hence, the ratio of FEV1 to FVC is near normal D. Both B and C are correct
“Answer: B
A – Obstructive
C - Restrictive
Source: Robbinson Basic Pathology 8th edition”
The major diffuse obstructive disorders are: A. Chronic bronchitis B. Bronchiectasis C. Asthma D. All of the above
“Answer: D
Source: Robbinson Basic Pathology 8th edition”
“Which of the following statements is/are TRUE: A. The total lung capacity is the maximum volume to which the lungs can be expanded with the greatest possible effort. It is equal to the tidal volume plus the residual volume B. Total capacity is equal to about 5,800 mL C. The inspirational capacity equals the inspiratory reserve volume plus the tidal volume plus the expiratory reserve volume D. Both A and B are correct
“
“Answer: B
A – It is equal to the vital volume plus the residual volume
C – Vital capacity
Source: Guyton and Hall: Textbook of Medical Physiology, 12 edition “
“What is the marker of lung function? A. Functional Residual Capacity B. Equilibrium Volume C. Vital Capacity D.Either A or B
“
“Answer: D
Source: Notes from the discussion”
“Which of the following statements is/are TRUE: A. Surfactant is an active surface agent in water, which means it greatly increases the surface tension of water B. One of the components of surfactant is dipalmitoyl phosphaditylcholine also known as lysine C. Surfactant is secreted by the type II alveolar epithelial cells D. Both A and C are correct E. Both B and C are correct
“
“Answer: C
A – reduces/decreases
B - Lecithin
Source: Guyton and Hall: Textbook of Medical Physiology, 13 edition”
“What is the normal dead space in young adult man?A. 250 mL B. 350 mLC. 500 mL D. 150 mL
“
“Answer: D
Source: Guyton 13th ed. Page 504
“
“The total amount of new air moved into the respiratory passages each minute is known as: A. Tidal volume B. Inspiratory reserved volume C. Minute Respiratory Volume D. Residual Volume
“
“Answer: C
Source: Guyton 13th ed. Page 503
“
During hypoxia, which of the following statements is/are TRUE: A. All pulmonary arterioles vasodilate B. All arterioles vasodilate C. All pulmonary arterioles vasoconstrict D. All arterioles vasoconstrict
Answer: A
Which of the following is/are NOT true regarding pleural pressure and its changes during respiration A. It is slightly negative pressure B. The pressure of the fluid in the thin space between the lung pleura and the chest wall pleura C. During normal expiration ,expansion of the chest cage pulls outward on the lungs with greater force and create a more negative pressure. D. All are true
“Answer: C
C – during inspiration
“
Which is not TRUE of the following statements A. Lung compliance is the complete reverse of recoil B. Lung compliance is defined as the extent to which the lungs expand to each unit increase in transpulmonary pressure C. Both are true D. Both are not correct
”
Answer: C
Source: Guyton 13th edition page 499 and lecture note”
If the radius of the alveoli increases, what would be the effect: A. Pressure will increase B. Surface tension increases C. NO effect on Pressure and Tension D. Pressure will decrease
“Answer: D
Source: Guyton 13th ed. Page 504
“
The volume of air that remains in the lungs at the end of each normal expiration. A. Tidal volume B. residual volume C. functional residual capacity D. functional residual volume
C. Functional Residual Capacity (Guyton page 470)
The maximum extra volume of air that can be expired by forceful expiration after the end of a normal tidal expiration; this normally amounts to about 1100 milliliters. A.Expiratory reserve volume B. Residual Volume C. Tidal Volume D. Expiratory Reserve function
B. Residual Volume (Guyton page 469)
What is the VA of a normal 67kg person with a respiratory rate of 13 bpm? A. 4200 B. 4360 C. 4550 D. 4530
C. 4550 (Formula VA=RRx(TV-Physiologic dead space) (VA=13bpm(500ml-150) (VA=13bpm(350)) (VA=4550)
All but one are structures that comprises the “dead space air”: A. Pharynx B. Nose C. Alveolar sac D. Trachea
C. Alveolar Sac (pharynx, nose, and trachea are the anatomic dead space)
This drug is an antidote of acetylcholine, it relaxes the passages enough to relieve obstruction when parasympathetic nervous stimulation occurs in asthma? A.H2 blockers B. Atropine C. ARB D. Norepinephrine
B. Atropine (Guyton page 473)
Several substances formed in the lungs are often quite active in causing bronchiolar constriction. Two of the most important of these are: A. Histidine and fast reactive substance of anaphylaxis B. histamine and fast reactive substance of anaphylaxis C. Histamine and slow reactive substance of anaphylaxis D. histidine and slow reactive substance of anaphylaxis
C. Histamine and slow reactive substance of anaphylaxis (Guyton page 473)
It applies to the nasal passageways instead of the lower respiratory passages. A. Cough reflex B. Hiccups C. Sneeze reflex D. Coryza
C. Sneeze Reflex (Guyton page 473)
Total amount of new air moved into the respiratory passages each minute? A. Minute Respiratory Capacity B. Minute Respiratory movement C. Minute Respiratory Volume D. Minute Respiratory spirometry
C. Minute Respiratory Volume (Guyton page 471)
What is the total minute respiratory volume of an adult person with RR of 12bpm? A. 7L/min B 8L/min C. 5L/min D. 6L/min
D. 6L/min (TMR is TVxRR/min) (TMR=TV500ml or .5L x 12bpm) (6L/min)
What’s the difference in Lung Volumes and Capacities bet. Males and females? A. 15-20% B. 20-25% C. 25-30% D. 30-35%
B. 20-25% (Guyton page 469)
Left in lungs after maximal expiration? A. Residual volume B. Tidal Volume C. Inspiratory Reserve Volume D. Expiratory Reserve Volume
A. Residual Volume (Guyton page 469)
The amount of air that remains in the lungs at the end of normal expiration? A. total lung capacity B. Functional residual capcity C. Expiratory reserve volume D. inspiratory reserve volume
C. Expiratory Reserve Volume (Guyton page 469)
All but one are resonators. A. mouth B. Nose C. Associated Nasal Sinuses D. Diaphragm
D. Diaphragm (Guyton page 475)
Decrease in oxygen affinity of hemoglobin when ph of the blood falls is called: A. Bohr effect B. Ficks law C. Henry’s law D. Daltons law of partial pressure
A. Bohr effect
An increase in the concentration of 2,3-DPG cause: A. Shift to the right B. Shift to the left C. Increase binding of oxygen D. Decrease unloading of oxygen to the tissues
A. Shift to the right
” Increased oxygen causes unloading of carbon dioxide from hemoglobin is called: A. Bohr effect B. Haldane effect C. Ficks law D. Henry’s law
“
B. Haldane effect
An increase of pH would cause: A.shift to the right, unloading B. shift to the left, unloading C. shift to the right,binding D. shift to the left, binding
D. Shift to the left, Binding
Carbon dioxide is produced in the? A. citric acid cycle B. electron transport C. urea cycle D. pentose phosphate pathway
A. citric acid cycle
Primary transport system of carbon dioxide in the blood. A. freely dissolved in the plasma B. carbaminohemoglobin C.HCO3- D. carboxyhemoglobin
C. HCO3-
How may ml of new air is brought to the alveoli? A. 500ml B.350ml C. 1L D.2300ml
B. 350ml
Site of highest ventilation and perfusion ratio? A.base B. apex C. base and apex D.alveoli
B.. apex