Inspiration occurs as a result of:
an upward movement of the diaphragm
movement of the ribs closer together due to the contraction of the inspiratory intercostal muscles
downward movement of the diaphragm
a and b
b and c
In order for the lungs to function normally, the intrapleural pressure must:
be lower than alveolar pressure
be between +5 and +10 mmHg above the atmospheric pressure
alternate between being less than and greater than the atmosphere pressure
change as respiratory demands of the body change
be the same as the atmosphenc pressure
Most of the CO2 that is transported in blood is:
dissolved in the plasma
bound to haemoglobin
in carbonic acid
in bicarbonate ions
in carbonic anhydrase
In which vesicular bed does hypoxia cause vasoconstriction?
coronary
pulmonary
cerebral
muscle
skin
Which sf the following is the site of the highest airway resistance?
mouth
largest bronchi
medium sized bronchi
smallest bronchi
alveoli
Compared with the systemic circulation, the pulmonary circulation has a:
higher flow
lower resistance
higher arterial pressure
higher capillary pressure
higher cardiac output
Hypoventilation will cause
hypercapnia
anoxia
hypoxia
hypocapnia
a and c
Which of the following events is caused by an increased pCO2 in tissues?
an increased pH
decreased association between hemoglobin and O2
decreased pH
vasodilatation
Vital Capacity includes:
Tidal Volume
Expiratory Reserve Volume
Residual Volume
Inspiratory Reserve Volume
a, b and d
Which muscles contract for quiet breathing?
abdominal
external intercostal muscles
diaphragm
pectoral muscle
Which of the following events are sympathetic effects?
vasoconstriction in the lungs
dilation of the bronchi
vasodilation in the lungs
constriction of the bronchi
Which of the following is the respiratory function of the lungs?
regulation of lung blood pressure
lung ventilation
diffusion of gases between the alveolar air and blood
fat metabolism
Which factors affect the gas diffusion through the respiratory membrane?
membrane thickness
membrane area
tidal volume
diffusion quotient
Gas exchange in the respiratory system of humans takes place in the:
trachea
bronchus
bronchioles
larynx
As regards the distribution of ventilation (V) and perfusion (Q), the VQ ratio:
gradient of change of ventilation is greater than that of per fusion
ventilation increases up the lung
perfusion increases up the lung
V/Q ratio at apex is greater than at base
none of the above
Surfactant:
is produced by type 1 alveolar cells
acts like detergent in water
reduces the amount of negative intrapleural pressure
reduces blood flow to the lungs
increases pulmonary compliance
Carbon dioxide transport is:
70% dissolved in plasma
70% carbamino hemoglobin
70% bicarbonate
10% bicarbonate
unaffected by pO2
Obligatory respiratory muscles are:
the diaphragm and mm. intercostales interni
the diaphragm and mm. intercostales externi
mm. abdominales
mm. serrati posteriores inferiores
all of the above
The bronchial muscles relax under the influence of:
epinephrine
atropine
epinephrine and atropine
bradikinine and histamine
acetylcholine
For the surfactant it is true that:
is produced by type II alveolar cells
consists of phospholipids, proteins and carbohydrates
decreases the alveolar surface tension at the end of expiration
protects the lungs from atelectasis and edema
For the alveolar capillary membrane it is true that:
consists of alveolar epithelium, pulmonary capillary endothelium and their base membranes with very thin interstitial space between them;
diffusion of 02 and CO2 occurs across it
has better permeability for 02 than CO2
Dilation of bronchi can be achieved by:
increased level of catecholamines
decreased level of catecholamines
increase of acetylcholine and serotonin levels
increase of bradikinine and histamine levels
a, c and d
Normal breathing at rest is called:
polypnoe
eupnoe
tachypnoe
dyspnoe
hyperpnoe
During expiration:
the thoracic cage recoils and the diaphragm moves upwards
the intrapleural pressure decreases
the intrapleural pressure increases
The sympathetic division of ANS affects the bronchial muscles activating:
α-adrenergic receptors
β-adrenergic receptors
M-cholinergic receptors
N-cholinergic receptors
H2 receptors
Tidal Volume (TV) is:
the volume of air, which passes through the lungs per minute
bigger than the Residual Volume (RV)
an element of the Functional Residual Capacity (FRC)
a, b and c
0.5-1 approximately
The intrapleural pressure is:
higher than the atmospheric pressure
lower than the atmospheric pressure
equal to the atmospheric pressure
depends on the water molecules surface tension and elastic fibers
b and d
The anatomical dead space
includes the volume of air within the an passages up to the terminal bronchioles
is the space where gas exchange doesn't occur
is approximately 140 ml
is approximately 500 ml
is about 6 L.min-1
The Residual Volume (RV) is:
the volume of air. which remains in the lungs after maximal expiration
the volume of air, which remains in the lungs after maximal inspiration
is about 2-3 L
is the tidal volume plus the inspiratory reserve volume
a component of the Vital Capacity (VC)
Which of the following factors shifts the dissociation curve of HbO2 to the right:
increased pCO2
decreased pCO2
decreased pO2
increased pO2
increased pH
It is not true that Vital Capacity (VC):
is a sum of ERV+TV+IRV
depends on sex and age
depends on chest measurement
is a sum of IC+ERV
is a sum of TV+ERV+RV
There are smooth muscles in the respiratory system:
on the external surface of the lungs
on the medial surface of the lungs
in the trachea, bronchi and bronchioles
around the alveoli
on the external and medial surfaces of the lungs
It is true that the air in the alveoli:
has a higher CO2 content than the atmosphere
has lower 02 content than in the atmosphere
consists of N2 approximately equal to that in the atmosphere
has the name components as the atmosphere
The elastic fibers in the lungs are situated:
around the terminal branches of the bronchi
on the external and the medial surface of the lungs
The peripheral chemoreceptors are situated:
on the ventral surface of medulla oblongata
on the dorsal surface of medulla oblongata
in arcus aortae and arteria carotis communis
in the inferior and superior venae cavae and the right atrium
in the hypothalamus
Which of the following compounds doesn't take part in the transport of CO2 under physiological conditions:
carbamino Hb
carboxi Hb
NaHCO3
physically dissolved in fluids
carbamino Hb and physically dissolved in the fluids
Which of the following factors increases the rate of breathing:
alkalosis
decreased pCO2 and increased pO2
increased pCO2 and decreased pO2
The ventilation/perfusion (V/Q) ratio of 0.8 refers to:
the upper parts of the lungs in upright position
the middle parts of the lungs in upright position
the lower parts of the lungs in upright position
in all parts of the lungs in supine position
Which of the following does not happen during inspiration?
the ribs move upward
the diaphragm lifts up
the antero-posterior dimensions of the chest are increased
the transverse dimensions of the thorax are increased
the scalene and sternocleidomastoid muscles can be recruited for inspiration
Total Lung Capacity (TLC) of men would normally be about:
4200 ml
1500 ml
6000 ml
8000 ml
10000 ml
Oxygen enters a cell via?
diffusion
filtration
osmosis
active transport
passive transport
Most of the carbon dioxide produced by tissues is transported to the lungs as:
small gas bubble in the plasma
gas bound to the hemoglobin in the red blood cells
bicarbonate ions in the plasma
gas bound to white blood cells and albumin
gas transported through the lymphatic system
The need to breathe is caused by:
a drop in blood pH
a rise in blood pH
a drop in blood oxygen levels
a drop in carbon dioxide levels
Where does gas exchange take place?
bronchi
pulmonary capillaries
roots of the lungs
What is the most common portal of entry for diseases, into the body?
respiratory system
endocrine system
gastrointestinal system
excretory system
any opening into the body
Hemoglobin gives up oxygen when the environment is more:
acidic
alkaline
icy
open
Acidosis is when you blood pH is below?
7.05
7.15
7.25
7.35
6.50
As blood passes through systemic capillaries:
pH rises
HCO3- ions pass from tissues to red blood cells
Cl- ion concentration in red cells falls
its oxygen dissociation curve shifts to the right
its oxygen dissociation curve shifts to the left
The carotid bodies:
are stretch receptors in the walls of the intenal carotid arteries
have a blood flow per unit volume similar to that in the brain
are influenced by the blood temperature
generate less afferent impulses when blood H+ concentration rises
and the aortic bodies are mainly responsible tor the increased ventilation in hypoxia
Pulmonary surfactant increases:
the surface tension of the fluid lining alveolar walls
lung compliance
in effectiveness as the lungs are inflated
in amount when pulmonary blood flow is interrupted
the airflow resistance in bronchi
As people age, there is usually a decrease in their:
ratio of lung residual volume to vital capacity
percentage of vital capacity expelled in one second
lung volume level at which small airways start to close during expiration
elastic fibers in lungs
During inspiration:
intrapleural pressure is lowest at mid-inspiration
intrapulmonary pressure is lowest around mid-inspiration
intraoesophageal pressure is lowest at mid-inspiration
the rate of air flow is greatest at end-inspiration
the lung volume/intrapleural pressure relationship is the same as in expiration
Carbon dioxide:
is carried as carboxyhaemoglobin on the haemoglobin molecule
uptake by the blood increases its oxygen-binding power
uptake by the blood leads to similar increases in H+ and HCO3- ion concentrations
stimulates ventilation when breathed at a concentration of 20 per cent
content is greater than oxygen content in arterial blood
In normal lungs:
the rate of alveolar ventilation at rest exceeds the rate of alveolar capillary perfusion
the ventilation/perfusion (V/Q) ratio in less 0.6 dieting maximal exercise
the V/Q ratio is higher at the apex than at the base of the lungs when a person is standing
oxygen transfer can be explained by active transport
dead space decreases during inspiration
Bronchial smooth muscle contractss in response to:
bronchial mucosal irritation
local beta adrenoceptor stimulation
a fall in bronchial pO2
inhalation of air warmed to 37°C
circulating noradrenaline
In early inspiration there is a fall in:
intrapulmonary pressure
aortic pressure
intra-abdominal pressure
dead space pO2
diastolic arterial pressure
At a high altitude where atmospheric pressure is halved, there is an increase in:
pulmonary ventilation
alveolar H2O vapour pressure
arterial pO2
intrapleural pressure
cerebral blood flow
venous return to the heart is increased
less energy is expended than during expiration
lung expansion is assisted by surface tension forces in the alveoli
lung expansion begins when intrapleural pressure falls below atmospheric
the relative concentration of surfactant increases in alveoli
The residual volume is:
the gas remaining in the lungs at the end of a full expiration
greater on average in women than in men
3-4 litres on average in young adults
measured directly using a spirometer
smaller in old than in young people
A rise in arterial pCO2 leads to:
an increase in ventilation due: to stimulation of peripheral and central chemoreceptors
a decrease in ventilation due to stimulation of central and peripheral chemoreceptors
a decrease in arterial pressure
a decrease in cerebral blood flow
a decrease in the plasma bicarbonate level
Ventilation increased during:
periods when cerebrospinal fluid pH is reduced
compensated chronic renal failure
periods when plasma bicarbonate level is raised
deep sleep
exercise because of the ensuing fall in arterial pO2
Pulmonary:
arterial mean pressure is about one-sixth systemic mean arterial pressure
blood flow/minute is greater then the systemic blood flow/minute
vascular resistance is about 50 per cent that of systemic vascular resistance
vascular capacity is similar to systemic vascular capacity
arterial pressure increases by about 50 per cent when cardiac output rises by 50 per cent
Carbon dioxide is carried in the blood in:
combination with the myoglobin molecule
combination with plasma globulins
physical solution in red blood cells
greater quantity in red blood cells than in plasma
greater quantity as HCO3- than as other forms
A shift of the oxygen dissociation curve of blood to the right:
occurs m the pulmonary capillaries
occurs if blood temperature decreases
favors oxygen delivery to the tissues
favors oxygen uptake from the lungs by alveolar capillary blood
occurs if the pH of the blood increases
The compliance of the lungs and chest wall is:
expressed as volume change per unit change in pressure
minimal during quiet breathing
increased by the surface tension of the fluid lining the alveoli
decreased by surfactant
changed by parallel displacement of the line relating lung volume to distending pressure
Respiratory dead space:
saturates inspired air with water vapour before it reaches the alveoli
removes all particles from inspired air before it reaches the alveoli
decreases when blood catecholamines levels rise
decreases during a deep inspiration
is equal to the tidal volume
Vital capacity is:
the volume of air expired from full inspiration to full expiration
increased as one grows older
greater in women than in men of the same age and height
related more to total body mass than to lean body mass
the sum of the inspiratory and expiratory reserve volumes
Oxygen debt is:
the amount of O2 consumed after cessation of exercise
incurred because the pulmonary capillary walls limit 02 uptake during exercise
possible since skeletal muscle can function temporarily without oxygen
associated with a decrease in blood lactate
associated with metabolic alcalosis
The CO2 dissociation curve for whole blood shows that:
its shape is sigmoid
blood saturates with CO2 when pCO2 exceeds normal alveolar levels
blood contains some CO2 even when the pCO2 is zero
oxygenation of the blood drives CO2 out of the blood
adding CO2 to the blood drives 02 out of the blood
Bronchial asthma is likely to be relieved by:
stimulation of cholinergic receptors
stimulation of beta adrenoceptors
histamine aerosols
non steroidal anti-inflammatory drugs
mineralcorticoids
Air in the pleural cavity (pneumothorax):
allows intrapleural pressure to rise to atmospheric pressure
causes the underlying lung to collapse by compressing it
increases the functional residual capacity
leads to a slight inward movement of the chest wall
increases the vital capacity
Loss of pulmonary elastic tissue in ‘emphysema’ reduces:
physiological dead space
the surfactant
residual volume
vital capacity
the intrapleural pressure
Complete obstruction of a major bronchus usually results in:
collapse of the alveoli supplied by the bronchus
a rise in local intrapleural pressure
an increase in physiological dead space
an increase in blood flow to the lung tissue supplied by the bronchus
cyanosis
A shift of the oxygen dissociation curve of blood to the left:
decreases the O2 content of blood at a given pO2
impairs O2 delivery to the tissues at the normal tissue pO2
occurs in blood perfusing hot extremities
occurs in blood with lower pH than with higher pH
is characteristic of adult blood when compared with fetal blood
A diver breathing air at a depth of 30 metres under water:
is exposed to a pressure equal to that at the surface
has a raised pressure of nitrogen in the alveoli
has a four-fold increase in the oxygen content of blood
has a fourfold increase in alveolar water vapour pressure
expends less energy than manna! on the work of breathing
Cyanosis:
may be caused by high levels of carboxyhaemoglobin in the blood
may be caused by high levels of methaemoglobin in the blood
is seen in fingers of hands immersed in iced water
occurs more easily in anaemic than in polycythaemic patients
is severe in cyanide poisoning
A patient with carbon dioxide retention is likely to have:
metabolic acidosis
alkaline urine
cool extremeties
decreased cerebral blood flow
raised plasma bicarbonate
Coughing:
is reflexly initiated by irritation of the alveoli
is associated with relaxation of airways smooth muscle
depends on contraction of the diaphragm for expulsion of air
differs from sneezing in that the glottis is initially closed
is equivalent of sneezing
The severity of an obstructive airways disease is indicated by the degree of change in the:
total ventilation/perfusion ratio
peak expiratory flow rate
respiratory quotient
dead space
A 50% fall in the ventilation/perfusion (V/Q) ratio in one lung would:
lower systemic arterial oxygen content
has no effect on the O2 in systemic circulation
increase the physiological dead space
lower systemic arterial carbon dioxide content
be compensated (with respect to oxygen uptake) by a high ratio in the other lung
The total amount of O2 carried by the circulation to the tissues/min. (oxygen delivery or total available oxygen):
normally equals the rate of O2 consumption by the body/min
is normally more than 95 per cent combined with haemoglobin
must fall by about half if haemoglobin concentration is halved
is more closely related to PO2 than to percentage saturation of the blood with O2
must double if body oxygen consumption doubles
For air to enter the lungs during inspiration
the pressure inside the lungs must be higher than the atmospheric pressure
the pressure inside the lungs must become lower than the atmospheric pressure
the pressure inside the lungs must be equal to the atmospheric pressure
the diaphragm must be relaxed
the external intercostal muscles must be relaxed
Given: CO2 + H2O <--> H2CO3 <--> HCO3- + H+, what happens if bicarbonate ions are increased?
more carbon monoxide produced
more bicarbonate ions produced
an increase in protons
there would be a shift to the left
there would be a shift to the right first, then to the left
The values (mm Hg) for pCO2 and pO2 in the interstitial spaces of peripheral tissues are approximately:
60; 40
40; 60
46; 40
66; 46
46; 100
If forcefully exhaling as much air as possible after a normal breath this is:
expiratory reserve volume
maximum expiratory flow rate
eupnea
inspiratory reserve volume
Which of the following reactions takes place in the systemic capillaries (where CO2 is greater and O2 is less)?
Hb + O2 -> HbO2
Hb + CO2 -> HbCO2
HbCO2 -> Hb + CO2
H2CO3 -> HCO3- + H+
Na+ + HCO3- -> NaHCO3
Water molecules on the surface of the alveoli generate surface tension; this force;
inhibits alveolar collapse
assists pulmonary compliance
assists elastic recoil
resists elastic recoil
impairs gas exchange
What does the ventral respiratory group within the medulla oblongata do?
triggers inspiration
decreased ventilation rate
nothing
for forced breathing
inhibits apneustic center, sets limits to over inflation of lungs
The region in the brain that sets the limit for over-inflation of lungs is located in the:
pons
apneustic center
arterial blood chemistry
medulla oblongata
stretch receptors
In Caissons disease pain in the joints and muscles is due to:
formation of N2 bubbles
formation of CO2 bubbles
due to fatigue
due to increase in barometric pressure
formation of O2 bubbles
Normal value of FEV in an adult is:
95%
80%
65%
50%
40%
The most important gas maintaining alveolar ventilation is:
oxygen
hydrogen
carbon dioxide
N2
CO
Hyperbaric oxygen is useful in all except:
congenital heart disease
gas gangrene
CO poisoning
N2 toxicity
advanced pulmonary carcinoma
As one ascends to higher than 3000 meters above sea level changes in alveolar pO2 and pCO2 are as follows:
decrease in pO2, increase in pCO2
decrease in pO2, decrease in pCO2
increase in both pO2 and pCO2
increase in pO2, decrease in pCO2
no change in pO2 and pCO2
Surfactant is secreted by:
type 1 pneumatocytes
type 2 pneumatocytes
goblet cells
pulmonary vessels
bronchial smooth muscle cells
Which of the following effects is not observed during prolonged stay is space:
decrease in blood volume
decrease in muscle strength
increase in red cell mass
loss of bone mass
osteroporosis
Airway resistance:
increases in asthma
decreases in emphysema
increases in paraplegic patients
does not affect work of breathing
decreases in asthma
Decreases on pCO2, decrease in H+ and increased pO2 causes:
hyperventilation
hypoventilation
hypercapnoea
The intrapleural pressure at the end of deep inspiration is:
-4 mm Hg
+4 mm Hg
-6 mm Hg
+6 mm Hg
-10 mm Hg
Exercise which doubles the metabolic rate is likely to at least double the:
oxygen consumption
cardiac output
stroke volume
arterial pCO2
ventilation/perfusion ratio
Sudden complete obstruction of the respiratory tract causes:
a fall in blood pressure
stimulation of central chemoreceptors
cianosis
increased breathing
constriction of the pupils
The effects of moving from sea level to an altitude of 5000 metres include an increase in:
alveolar ventilation
blood bicarbonate level
appetite for food
exercise tolerance
muscle strength