Ch 22: Respiratory System

1) Ventilation perfusion coupling means that more blood flows past
functional alveoli than past nonfunctional alveoli.

TRUE

2) The olfactory mucosal lining of the nasal cavity contains the
receptors for the sense of smell.

TRUE

3) 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.

TRUE

4) The lungs are perfused by two circulations: the pulmonary and the
bronchial. The pulmonary circulation is for oxygenation of blood. The
bronchial circulation supplies blood to the lung structures (tissue).

TRUE

5) Changes in arterial pH can modify respiration rate and rhythm even
when carbon dioxide and oxygen levels are normal.

TRUE

6) Intrapleural pressure is normally about 4 mm Hg less than the
pressure in the alveoli.

TRUE

7) During normal quiet breathing, approximately 750 ml of air moves
into and out of the lungs with each breath.

FALSE

8) The alveolar ventilation rate is the best index of effective ventilation.

TRUE

9) In chronic bronchitis, mucus production is decreased and this
leads to the inflammation and fibrosis of the mucosal lining of the
bronchial tree.

FALSE

10) Labored breathing is termed dyspnea.

TRUE

11) The largest amount of carbon dioxide is transported in the
bloodstream in the form of carbonic anhydrase.

FALSE

12) Increased temperature results in decreased O2 unloading from hemoglobin.

FALSE

13) The paired lungs occupy the mediastinum of the thoracic cavity.

FALSE

14) The Heimlich maneuver is a procedure in which air in the lungs is
used to expel a piece of food that obstructs the opening to the trachea.

TRUE

15) Smoking diminishes ciliary action and eventually destroys the cilia.

TRUE

16) Tracheal obstruction is life threatening.

TRUE

17) The parietal pleura lines the thoracic wall.

TRUE

18) The average individual has 500 ml of residual volume in his lungs.

FALSE

19) Atelectasis (lung collapse) renders the lung useless for ventilation.

TRUE

20) The inflation (Hering-Breuer) reflex is a potentially dangerous
response that may cause overinflation of the lung.

FALSE

21) Strong emotions and pain, acting through the limbic system and
hypothalamus, send signals to the respiratory centers that modulate
respiratory rate and depth.

TRUE

22) 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 ions to be
generated (the Bohr effect).

FALSE

23) Dalton's law of partial pressures 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

24) Oxygenated hemoglobin releases oxygen more readily when the pH is
more basic.

FALSE

25) Nasal conchae mainly work on inhalation to warm and moisten air.
They serve minor functions for exhalation.

FALSE

26) Under certain conditions, the vocal folds act as a sphincter that
prevents air passage.

TRUE

1) The main site of gas exchange is the ________. A) alveolar duct B)
respiratory bronchiole C) alveoli D) alveolar sacs

C

2) The loudness of a person's voice depends on the ________. A)
length of the vocal folds B) force with which air rushes across the
vocal folds C) thickness of vestibular folds D) strength of the
intrinsic laryngeal muscles

B

3) The walls of the alveoli are composed of two types of cells, type
I and type II alveolar cells. The function of type II alveolar cells
is to ________. A) replace mucus in the alveoli B) protect the lungs
from bacterial invasion C) trap dust and other debris D) secrete surfactant

D

4) Complete the following statement using the choices below. Air
moves out of the lungs when the pressure inside the lungs is ________.
A) equal to the pressure in the atmosphere B) less than the pressure
in the atmosphere C) greater than the intra-alveolar pressure D)
greater than the pressure in the atmosphere

D

5) Which of the following is true regarding normal quiet expiration
of air? A) It depends on the complete lack of surface tension on the
alveolar wall. B) It is a passive process that depends on the recoil
of elastic fibers that were stretched during inspiration. C) It
requires contraction of abdominal wall muscles. D) It is driven by
increased blood CO2 levels.

B

6) Which of the following maintains the patency (openness) of the
trachea? A) pseudostratified ciliated epithelium B) C-shaped cartilage
rings C) surfactant production D) surface tension of water

B

7) Intrapulmonary pressure is the ________. A) difference between
atmospheric pressure and respiratory pressure B) pressure within the
pleural cavity C) pressure within the alveoli of the lungs D) negative
pressure in the intrapleural space

C

8) The relationship between gas pressure and gas volume is described
by ________. A) Dalton's law B) Charles' law C) Boyle's law D) Henry's law

C

9) The statement, "in a mixture of gases, the total pressure is
the sum of the individual partial pressures of gases in the
mixture" paraphrases ________. A) Charles' law B) Henry's law C)
Boyle's law D) Dalton's law

D

10) Surfactant helps to prevent the alveoli from collapsing by
________. A) humidifying the air before it enters B) protecting the
surface of alveoli from dehydration and other environmental variations
C) warming the air before it enters D) interfering with the
cohesiveness of water molecules, thereby reducing the surface tension
of alveolar fluid

D

11) For gas exchange to be efficient, the respiratory membrane must
be ________. A) between 5 and 6 micrometers thick B) at least 3
micrometers thick C) 0.5 to 1 micrometer thick D) The thickness of the
respiratory membrane is not important in the efficiency of gas exchange.

C

12) With the Bohr effect, more oxygen is released because a(n)
________. A) decrease in pH (acidosis) weakens the hemoglobin-oxygen
bond B) increase in pH (alkalosis) strengthens the hemoglobin-oxygen
bond C) decrease in pH (acidosis) strengthens the hemoglobin-oxygen
bond D) increase in pH (alkalosis) weakens the hemoglobin-oxygen bond

A

13) The local matching of blood flow with ventilation is ________. A)
ventilation-perfusion coupling B) the Bohr effect C) the Haldane
effect D) chloride shifting

A

14) In the plasma, the quantity of oxygen in solution is ________. A)
only about 1.5% of the oxygen carried in blood B) not present except
where it is combined with carrier molecules C) about equal to the
oxygen combined with hemoglobin D) greater than the oxygen combined
with hemoglobin

A

15) Which of the following is the leading cause of cancer death for
both men and women in North America? A) lung B) colorectal C)
esophageal D) skin

A

16) Which of the choices below describes the forces that act to pull
the lungs away from the thorax wall and thus collapse the lungs? A)
compliance and transpulmonary pressures B) compliance and the surface
tension of the alveolar fluid C) the natural tendency for the lungs to
recoil and the surface tension of the alveolar fluid D) the natural
tendency for the lungs to recoil and transpulmonary pressures

C

17) Which of the following counteracts the movement of bicarbonate
ions from the RBC? A) the Bohr effect B) the Haldane effect C) release
of hydrogen ion D) chloride shifting

D

18) Which of the following is NOT a form of lung cancer? A) squamous
cell carcinoma B) Kaposi's sarcoma C) small cell carcinoma D) adenocarcinoma

B

19) Which of the following refers to the movement of air into and out
of the lungs? A) pulmonary ventilation B) external respiration C)
internal respiration D) gas exchange

A

20) The major nonelastic source of resistance to air flow in the
respiratory passageways is ________. A) air pressure B) friction C)
surfactant D) surface tension

B

21) Which of the following determines lung compliance? A) muscles of
inspiration B) alveolar surface tension C) airway opening D)
flexibility of the thoracic cage

B

22) Tidal volume is air ________. A) exchanged during normal
breathing B) remaining in the lungs after forced expiration C) inhaled
after normal inspiration D) forcibly expelled after normal expiration

A

23) Possible causes of hypoxia include ________. A) too little oxygen
in the atmosphere B) getting very cold C) obstruction of the esophagus
D) taking several rapid deep breaths

A

24) The lung volume that represents the total volume of exchangeable
air is the ________. A) tidal volume B) expiratory reserve volume C)
inspiratory capacity D) vital capacity

D

25) Which of the following is correct regarding acclimatization? A)
At high altitudes, hemoglobin's affinity for O2 is increased because
BPG concentrations increase. B) High-altitude conditions always result
in lower-than-normal hemoglobin saturation levels because less O2 is
available to be loaded. C) Decreases in arterial PO2 cause the
peripheral chemoreceptors to become less responsive to increases in
PCO2. D) When blood O2 levels decline, the kidneys produce more
erythropoietin, which stimulates breakdown of red blood cells in the spleen.

B

26) Which of the following is NOT a stimulus for breathing? A) rising
blood pressure B) arterial PO2 below 60 mm Hg C) acidosis resulting
from CO2 retention D) rising carbon dioxide levels

A

27) The amount of air that can be inspired above the tidal volume is
called ________. A) inspiratory reserve volume B) vital capacity C)
reserve air D) expiratory capacity

A

28) Which statement about CO2 is FALSE? A) More CO2 dissolves in the
blood plasma than is carried in the RBCs. B) Its concentration in the
blood is decreased by hyperventilation. C) CO2 concentrations are
greater in venous blood than arterial blood. D) Its accumulation in
the blood is associated with a decrease in pH.

A

29) Oxygen and carbon dioxide are exchanged in the lungs and through
all cell membranes by ________. A) active transport B) filtration C)
diffusion D) osmosis

C

30) Select the correct statement about the pharynx. A) The pharyngeal
tonsil is located in the laryngopharynx. B) The palatine tonsils are
embedded in the lateral walls of the nasopharynx. C) The
laryngopharynx blends posteriorly into the nasopharynx. D) The
pharyngotympanic (auditory) tube drains into the nasopharynx.

D

31) The larynx contains ________. A) lateral cartilage ridges called
false vocal folds B) the thyroid cartilage C) an upper pair of
avascular mucosal folds called true vocal folds D) a cricoid cartilage
also called the Adam's apple

B

32) Which respiratory-associated muscles would contract or relax
during forced expiration, for example blowing up a balloon? A)
external intercostals would contract and diaphragm would relax B)
internal intercostals and abdominal muscles would contract C)
diaphragm contracts, internal intercostals would relax D) diaphragm
would contract, external intercostals would relax

B

33) How is the bulk of carbon dioxide transported in blood? A) as
carbonic acid in the plasma B) as bicarbonate ions in plasma after
first entering the red blood cells C) chemically combined with the
heme portion of hemoglobin D) chemically combined with the amino acids
of hemoglobin as carbaminohemoglobin in the red blood cells

B

34) Which of the choices below is NOT a role of the pleurae? A) allow
the lungs to easily glide easily over the thorax wall during breathing
movements B) assist in blood flow to and from the heart because the
heart sits between the lungs C) help limit the spread of local
infections D) help divide the thoracic cavity into three chambers

B

35) Which of the following INCORRECTLY describes mechanisms of CO2
transport? A) as bicarbonate ions in plasma B) 7-10% of CO2 is
dissolved directly into the plasma C) just over 20% of CO2 is carried
in the form of carbaminohemoglobin D) attached to the heme part of hemoglobin

D

36) Factors that influence the rate and depth of breathing include
________. A) stretch receptors in the alveoli B) temperature of
alveolar air C) voluntary cortical control D) thalamic control

C

37) The respiratory membrane is a combination of ________. A)
respiratory bronchioles and alveolar ducts B) alveolar and capillary
walls and their fused basement membranes C) respiratory bronchioles
and alveolar sacs D) atria and alveolar sacs

B

38) The symptoms of hyperventilation may be averted by breathing into
a paper bag because it ________. A) reduces brain perfusion by
constricting cerebral blood vessels B) helps retain oxygen in the
blood C) lowers blood pH levels D) helps retain carbon dioxide in the blood

D

39) Inspiratory capacity is ________. A) air inspired after a tidal
inhalation B) functional residual capacity C) the total amount of
exchangeable air D) the total amount of air that can be inspired after
a tidal expiration

D

40) Which center is located in the pons? A) inspiratory center B)
pacemaker neuron center C) pontine respirator group (PRG) D)
expiratory center

C

41) The nose serves all of the following functions EXCEPT ________.
A) cleansing the air B) warming and humidifying the air C) as a
passageway for air movement D) as the direct initiator of the cough reflex

D

42) According to the oxygen-hemoglobin dissociation curve, PO2 in the
lungs of 100 mm Hg results in Hb being 98% saturated. At high
altitude, there is less O2. At a PO2 in the lungs of 80 mm Hg, Hb
would be ________ saturated. A) 98% B) less than 50% C) 100% D) 95%

D

43) Which of the following is an appropriate response to carbon
monoxide (CO) poisoning? A) hyperventilation to exhale CO from the
body B) hyperbaric oxygen chamber to increase PO2 and clear CO from
the body C) slow breathing into a paper bag D) immediate application
of bicarbonate ions to facilitate removal of CO from Hb

B

44) 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 ventral respiratory group is
contained within the pons. D) The pontine respirator group (PRG)
continuously stimulates the medulla to provide inspiratory drive.

A

45) Which of the choices below is NOT a factor that promotes oxygen
binding to and dissociation from hemoglobin? A) number of red blood
cells B) temperature C) partial pressure of oxygen D) partial pressure
of carbon dioxide

A

46) Which of the following is responsible for holding the lungs to
the thorax wall are ________. A) the visceral pleurae and the changing
volume of the lungs B) the smooth muscles of the lung C) the diaphragm
and the intercostal muscles alone D) surface tension from pleural
fluid and negative pressure in the pleural cavity

D

47) The erythrocyte (red blood cell) count increases after a while
when an individual goes from a low to a high altitude because the
________. A) basal metabolic rate is higher at high altitudes B)
concentration of oxygen and/or total atmospheric pressure is lower at
high altitudes C) concentration of oxygen and/or total atmospheric
pressure is higher at higher altitudes D) temperature is lower at
higher altitudes

B

48) Most inspired particles such as dust fail to reach the lungs
because of the ________. A) action of the epiglottis B) ciliated
mucous lining in the nose C) porous structure of turbinate bones D)
abundant blood supply to nasal mucosa

B

49) Which of the following is INCORRECT? A) 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) Resistance equals pressure gradient over gas flow. C)
Pressure gradient equals gas flow over resistance. D) Gas flow equals
pressure gradient over resistance.

C

50) Select the correct statement about the physical factors
influencing pulmonary ventilation. A) Surfactant helps increase
alveolar surface tension. B) A lung that is less elastic will require
less muscle action to perform adequate ventilation. C) A decrease in
compliance causes an increase in ventilation. D) As alveolar surface
tension increases, additional muscle action will be required.

D

51) Select the correct statement about oxygen transport in blood. A)
During conditions of acidosis, hemoglobin is able to carry oxygen more
efficiently. B) Increased BPG levels in the red blood cells enhance
oxygen-carrying capacity. C) A 50% oxygen saturation level of blood
returning to the lungs might indicate an activity level higher than
normal. D) During normal activity, a molecule of hemoglobin returning
to the lungs carries one molecule of O2.

C

52) Which of the disorders below is characterized by destruction of
the walls of the alveoli producing abnormally large air spaces that
remain filled with air during exhalation? A) coryza B) tuberculosis C)
pneumonia D) emphysema

D

53) Which of the following does NOT influence hemoglobin saturation?
A) BPG B) nitric oxide C) temperature D) partial pressure of carbon dioxide

B

54) For inspiration of air, which of the following happens first? A)
diaphragm descends and rib cage rises B) intrapulmonary pressure drops
C) air (gases) flows into lungs D) thoracic cavity volume decreases

A

55) Spirometry results reveal a vital capacity of two liters which is
well below the predicted value of five liters. This suggests which
disorder? A) emphysema B) asthma C) restrictive disease D) obstructive
pulmonary disease

C

56) The law that applies to the amount of CO2 you could dissolve in a
soda is called ________ law. A) Boyle's B) Dalton's C) Henry's D) Murphy's

C

57) The Bohr effect refers to the unloading of ________ in a RBC due
to declining blood pH. A) chloride ions B) carbon dioxide C) BPG D) oxygen

D

58) Which structure is lined with simple squamous epithelium? A)
oropharynx B) alveolus C) trachea D) nasopharynx

B

59) Using spirometry, a patient discovers their forced expiratory
volume (FEV) after the first second is 40%. What does this suggest? A)
exposure to asbestos B) restrictive disease C) obstructive pulmonary
disease D) healthy lungs

B

60) Which of the following anchor(s) the vocal folds? A) cuneiform
cartilages B) arytenoid cartilages C) cricoid cartilage D) corniculate cartilages

B

61) Which of the following is a conducting zone structure? A)
respiratory bronchiole B) terminal bronchiole C) alveolar sac D)
alveolar duct

B