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Pulmonary Jeopardy
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Mech Vent Flow Blood LabExch Basics
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Misc.
The pulmonary circulation and systemic circulation are alike in that both receive the same flow per minute. The differ primarily in that:
A Pulmonary arterial pressure is lower than systemic
arterial pressure due to a lower vascular resistance in the pulmonary circulation.
B Pulmonary circulation has a higher vascular resistance thereby causing pulmonary arterial pressure to be lower than systemic arterial pressure.
D Systemic arterial pressure is higher than pulmonary arterial pressure because systemic vascular resistance is lower than pulmonary vascular resistance.
E Systemic arterial pressure is lower than pulmonary arterial pressure.
Which of the following can be directly measured with a laboratory spirometer?
A FRC B FVC C TLC D RV
In a normal subject, pulmonary function tests would be predicted to show that:
A FEV1 / FVC is about 80%. B ERV is greater than FRC. C RV is greater than FRC. D ERV is greater than IRV.
In a healthy young adult the largest of the lung volumes is: A ERV B FEV(1.0) C RV D TV E FEV(2.0)
A. IRVB. TVC. FRCD. RV
The lung volumes and capacities are measured using spirometry. Which of the following measured values is the sum of two volumes?
The partial pressures of O2 and CO2 change as air is inhaled into the dead space and lungs. Which of the following most accurately describes these gases in the anatomical dead space? A In the first 150ml of expired air, PCO2 is normally
the same as alveolar air PCO2. B At the end of expiration, anatomic dead space
PCO2 is about 0 mmHg. C At the end of inspiration, anatomic dead space is
filled with air whose PO2 is less than inspired PO2.
D At the end of inspiration, anatomic dead space is
filled with air whose PCO2 is about zero.
In a normal subject at sea level breathing 50 % O2,which compartment has the lowest CO2 partialpressure?
A basal lung end pulmonary capillary blood
B alveolar air
C anatomic dead space at the start of expiration
D arterial blood
E anatomic dead space at the start of inspiration
If a normal subject breathes pure O2 at 1 atmosphereof pressure, her:
A arterial blood O2 concentration is about 22.4volumes %.
B arterial blood O2 concentration is about 10volumes %.
C arterial hemoglobin is much less than100 %saturated with O2.
D arterial blood O2 concentration is about 18volumes %.
E dissolved arterial blood O2 concentration isabout 30 volumes %.
The normal chestwall has the greatest negative(outwardly directed) recoil at:
A FRC
B 1 L above FRC
C about 70-80 % of VC
D 1 L below FRC
E TLC
Which gradient is used to compute the compliance of the lung alone?
A P(B) - P(pl) B P(alv) - P(B) C P(pl) - P(B) D P(alv) - P(alv) E P(alv) - P(pl)
Which is(are) TRUE concerning compliance?
A Lung compliance = change in volume divided bychange in transmural pressure.
B Lung compliance is normally about 0.2 cm waterper L.
C Compliance is the reciprocal of conductance.
D Compliance is the reciprocal of resistance.
E A and D above.
Which is(are) TRUE concerning lung surface tension?
A Because of surfactant, lung surface tension normally accounts for only about 5 % of the elastic work of inspiration.
B Surface tension explains, in part, why inspiration
under resting conditions is an energy-requiring process.
C Without surfactant, large radius alveoli would tend
to collapse into small radius alveoli. D Normally, surface tension is the result of an air-
liquid interface in the pleural space. E C and D above.
When patients lie down the effect of gravity on lung function is greatly reduced including:
A FRC is less in the supine position than in the
standing position. B Chest wall elastic recoil = lung elastic recoil at
approximately 70-80 % VC. C Lung elastic recoil is 0 at FRC. D Chest wall inward elastic recoil is maximal at 70-80
% VC. E FRC is greater in a healthy young adult than in an
individual emphysema.
Which is(are) TRUE concerning gas diffusion in the lungs?
A Exchange of O2 is normally diffusion-limited.
B Exchange of nitrous oxide is normally diffusion-limited.
C Exchange of CO is normally diffusion-limited.
D Normally, the gradient for CO2 diffusion in the lungis much greater than that for O2.
E Gas does not normally exchange in the lungs.
Which is(are) TRUE concerning ventilation / perfusion (V /Q) ratios?
A As alveolar dead space increases, alveolar gas moreand more resembles mixed venous blood.
B As alveolar dead space increases, alveolar gasmore and more resembles inspired air.
C As physiological shunt increases, arterial blood moreand more resembles inspired air.
D None of the above.
Which is(are) TRUE concerning the pulmonarycirculation?
A It is a high compliance and low resistance system.
B Its local resistance is regulated by vasoconstrictionin response to alveolar hypoxia.
C As lung volume increases from RV towards TLC,resistance of extra-alveolar blood vessels decreases.
D Blood flow is higher in basal lung sections.
E All of the above.
Ventilation and perfusion are equal only at one region near the middle of the lungs. The predicted result of this effect of gravity is that: A The highest absolute ventilation occurs in the base of
the lung. B The pulmonary capillary blood PO2 is low at the top. C The pulmonary capillary blood PO2 concentration is
high at the base. D Since the apex has the highest ventilation / perfusion
ratio, it accounts for a much larger percentage of total gas exchange than the basal areas with the lower ventilation / perfusion ratios.
The normal pulmonary circulation has some unique features that impact gas exchange. One of these important features is that:
A Blood flow increases from top to bottom of the lung. B Pulmonary vascular resistance is decreased with
sympathetic nervous system activation. C Histamine does not alter pulmonary blood vessels. D Increases in left atrial pressure will increase
pulmonary vascular resistance.
The volumes and capacities of the lungs are used to diagnose lung disease. For healthy individuals you predict that:
A FVC is greater than TLC B ERV is normally greater than FRC. C FRC=RV+ERV D During the tidal volume, a normal young male
adult expires about 4 L. E Anatomic dead space is approximately equal to
tidal volume
In a constant temperature system, the pressure of a gas is inversely proportional to the volume
A. Charles' LawB. Boyle's LawC. Dalton's LawD. Henry's LawE. O'Leary's Law
What is the partial pressure of oxygen in the atmosphere at sea level (barometric pressure = 760 mm Hg)
A. 600 mm HgB. 160 mm HgC. 0.3 mm HgD. 47 mm HgE. 0.0 mm Hg
The volume of air that can be forcible exhaled after a normal expiration is the
A. extra volumeB. expiratory reserve volumeC. expiratory capacityD. expiratory super volumeE. inspiratory-expiratory volume
During expiration, as the diaphragm relaxes the pressure in the alveolus becomes?
A. more positiveB. less positiveC. more negativeD. equal to intrapleural pressureE. subatmospheric
In an individual suffering from pulmonary fibrosis, the work of breathing is increased due to:
A. an increase in surface tension.B. a decrease in lung compliance.C. an increase in airway resistance.D. an increase in chest wall
compliance.E. an increase in diaphragm
stiffness.
Which of the following results in a shift of the O2 dissociation curve to the left?
A. a decrease in pH.B. an increase in arterial PCO2.
C. a rise in temperature.D. exercise.E. an increased pH.
In a lung unit with an abnormally low ventilation/perfusion ratio, it can be said that the:
A. amount of perfusion exceeds the amount of ventilation.B. amount of ventilation exceeds the amount of perfusion.C. blood emerging from the unit has a reduced PCO2.
D. anatomic dead space has decreased.E. physiological dead space has decreased.
A patient is having difficulty breathing. A spirometric evaluation reveals a FVC that is 50% of predicted, a FEV1.0 that is 55% of predicted, and a normal FEV1.0/FVC ratio. These observations suggest that the patient has:
A. an obstructive impairment.B. a restrictive impairment.C. both an obstructive and a restrictive impairment.D. a diffusive impairment.E. both an obstructive and a diffusive impairment.
FRC is increased in individuals with emphysema, because:
A. the decreased compliance of the chest wall keeps the lungs at a higher volume.
B. the increased compliance of the lungs allows the chest wall to move closer to its resting position.
C. the decrease in airway resistance limits the volume of air that can be exhaled during quiet breathing.
D. the patient breathes at a higher lung volume to overcome the diffusion limitation produced by the disease.
E. hypoxic stimulation of the peripheral chemoreceptors results in a reflex-mediated increase in FRC.
At end-inspiration, with an open glottis, the alveolar pressure is:
A. less than atmospheric pressure.B. less than pleural pressure.C. equal to pleural pressure.D. equal to atmospheric pressure.E. greater than atmospheric pressure.
Residual volume is the lung volume at which the:
A. tendency for the lung to recoil inward is exactly balanced by the tendency for the chest wall to recoil outward.
B. respiratory musculature can cause no further movement of the chest wall inward.
C. lungs contain their "absolute" volume.
D. only remaining air in the lung is that contained in the anatomic dead space.
E. chest wall is at its "resting position".
The expiratory reserve volume (ERV) is defined as the:
A. volume of gas that can be exhaled after a maximal inspiration.
B. volume of gas that can be maximally exhaled from functional residual capacity.
C. volume of gas in the lungs after a maximal inspiration.
D. volume of gas in a single inspiration or expiration.
E. volume of hot air released during a single lecture.
The blood emerging from a lung unit with an abnormally low ventilation/perfusion ratio would have a:
A. PO2 greater than 100 mmHg and a PCO2 lower than 40 mmHg.
B. PO2 equaling 100 mmHg and a PCO2 equaling 40 mmHg.
C. PO2 less than 100 mmHg and a PCO2 greater than 40 mmHg.
D PO2 less than 100 mmHg and a PCO2 less than 40 mmHg.
E. PO2 greater than 100 mmHg and a PCO2 greater than 40 mmHg.
In an upright individual, blood flow to the base of the lungs exceeds that to the apex because:
A. basal blood vessels are intrinsically larger than apical vessels and thus have a reduced resistance to flow.B. enhanced sympathetic nerve activity to the basal vessels causes them to preferentially vasodilate.C. valves in the pulmonary artery preferentially direct blood to the basal portions of the lungs.D. basal blood vessels are intrinsically more compliant than apical vessels.E. the hydrostatic pressure gradient distends basal vessels more and thus lowers their resistance to flow.
Type II epithelial cells of the lungs produce a chemical called surfactant. The presence of surfactant:
A.prevents airway resistance from increasing to exceedingly high values.
B.decreases the muscular effort required to ventilate the lungs.
C. is responsible for the infant respiratory distress syndrome.
D.is responsible for the fluid in prenatal lungs.
E. causes small alveoli to empty into large alveoli.
At high alveolar volumes:A. compliance is reduced and further
increase in volume is more difficult.B. compliance is reduced and further
increase in volume is facilitated.
C. compliance is increased and further increase in volume is more difficult.
D. the slope of the compliance curve is the same as it is at low lung volumes.
E. surface tension becomes decreased due to surfactant.
– 20. The stimulus for hypoxic pulmonary vasoconstriction is:
– A. venous hypoxemia.
– B. arterial hypoxemia.
– C. cerebral hypoxia.
– D. alveolar hypoxia.
– E. tissue hypoxia.
– 21. Airway resistance may be decreased by:
– A. deflating the lung.
– B. parasympathetic stimulation.
– C. sympathetic stimulation.
• .being in a room full of smokers.
• .Inhaling a marble
– 22. Normally the peripheral chemoreceptorsdo not increase ventilation when arterial PO2
falls from 100 to 75 torr. If they did, which of the following would occur?
• A. Both arterial PO2 and O2 content would significantly rise.
• B. Arterial PO2 would remain the same, but O2
content would increase significantly.
• C. Arterial PO2 would increase, but O2 content would not change significantly.
• D. Neither arterial PO2 or O2 content would increase.
• E. Arterial PO2 and O2 saturation would increase.
– 23. At zero gravity, blood flow:
• A. to the base of the lung should exceed that to the apex.
• B. throughout the lung should be homogeneously distributed.
• C. in the lung will not differ from that which occurs at normal gravity.
• .to the ventral surface of the lung will exceed that to the dorsal surface.
• .to the lung would completely stop
– 24. An individual whose lungs have a large number of lung units with abnormally high ventilation/perfusion (/) ratios would exhibit a/an:
• A. normal arterial PO2 of 100 mmHg but an abnormally high arterial PCO2.
• B. reduced arterial PO2.
• C. alveolar PO2 and PCO2 approximating those of mixed venous blood.
• .increase in physiological dead space.
• .Increase in heavy breathing
– 25. During inspiration from functional residual capacity, alveoli at the base of the lung expand to a greater degree than alveoli at the apex, because:
• A. alveoli at the base are located on a steeper portion of the compliance curve than those at the apex.
• B. the forces of surface tension prevent adequate expansion of alveoli in the apex.
• C. dynamic compression of the airways prevents alveoli in the apex from adequately expanding.
• E. the accessory muscles of inspiration do not become activated until very high ventilatoryvolumes are reached.
– 24. A patient arrives in the emergency room with a right-sided pneumothorax caused by a knife wound to the chest. You suture the wound, but a close observation of the patient suggests that the right lung is still collapsed. These observations indicate that:
– A. alveolar pressure of the right lung has become negative.
– B. transpulmonary pressure of the right lung was positive.
– C. pleural pressure between the right lung and chest wall was atmospheric.
– D. absorption atelectasis has occurred.
– 25. Except for the very earliest portions of a forced expiratory maneuver, the expiratory flow rate is independent of the effort generated because the:
• A. pleural pressure rises at the same rate as the alveolar pressure.
• B. pleural pressure rises at a rate greater than the alveolar pressure.
• C. pleural pressure rises at a slower rate than the alveolar pressure.
• D. alveolar-atmospheric pressure gradient remains constant.
• E. pleural-atmospheric pressure gradient remains constant.
– 26. The following figure shows both a normal O2 dissociation curve (solid line) and a
– curve that has been shifted to the right (dashed line). The rightward shifted curve:
• A. allows more O2 to be unloaded from the blood for a given fall in PO2.
• B. allows less O2 to be unloaded from the blood for a given fall in PO2.
• C. allows a greater degree of oxygen loading of the blood within the lungs.
• D. reduces the amount of oxygen that can be maximally carried by the blood.
• E. may have resulted from carbon monoxide poisoning.
– 27. An individual with anemia (blood hemoglobin concentration of 6 g/dl) would have all of the following, EXCEPT:
– A. reduced total arterial oxygen content.
– B. normal arterial dissolved oxygen content.
– C. normal arterial PO2.
– D. increased arterial CO2 content.
– E. normal oxyhemoglobin saturation.
– 28. At a given PCO2, CO2 is greater when there is less O2 in the blood, because:
• A. less HCO3- is produced, which allows more
CO2 to be carried in solution.
• B. the CO2 solubility coefficient is increased.
• C. plasma proteins can form more carbaminocompounds when PO2 is reduced.
• D. deoxygenated Hb is a better buffer of H+ ions and can form more carbamino compounds than oxygenated Hb.
– 29. The table below shows alveolar and arterial PO2 and the alveolar-arterial PO2
gradient (A-a O2 grad.) for subject X (who is normal) and subject Y (who has an unknown respiratory problem):
The stimulus for hypoxic pulmonary vasoconstriction is:
A. venous hypoxemia.B. arterial hypoxemia.C. cerebral hypoxia.D. alveolar hypoxia.E. tissue hypoxia.
Airway resistance may be decreased by:
A. deflating the lung.B. parasympathetic stimulation.C. sympathetic stimulation.D. being in a room full of smokers.E. Inhaling a marble
At zero gravity, blood flow:
A.to the base of the lung should exceed that to the apex.
B.throughout the lung should be homogeneously distributed.
C. in the lung will not differ from that which occurs at normal gravity.
D to the ventral surface of the lung will exceed that to the dorsal surface.
E. to the lung would completely stop
An individual whose lungs have a large number of lung units with abnormally high ventilation/perfusion ratios would exhibit a/an:
A. normal arterial PO2 of 100 mmHg but an abnormally high arterial PCO2.
B. reduced arterial PO2.
C. alveolar PO2 and PCO2 approximating those of mixed venous blood.
D. increase in physiological dead space.E. Increase in heavy breathing
During inspiration from functional residual capacity, alveoli at the base of the lung expand to a greater degree than alveoli at the apex, because:
A. alveoli at the base are located on a steeper portion of the compliance curve than those at the apex.
B. the forces of surface tension prevent adequate expansion of alveoli in the apex.
C. dynamic compression of the airways prevents alveoli in the apex from adequately expanding.
D. the accessory muscles of inspiration do not become activated until very high ventilatory volumes are reached.
A patient arrives in the emergency room with a right-sided pneumothorax caused by a knife wound to the chest. You suture the wound, but a close observation of the patient suggests that the right lung is still collapsed. These observations indicate that:
A. alveolar pressure of the right lung has become negative.
B. transmural pressure of the right lung was positive.
C. pleural pressure between the right lung and chest wall was atmospheric.
D. that the patient stabbed himself.
On a normal O2 dissociation curve and a curve that has been shifted to the right . The rightward shifted curve:
A. allows more O2 to be unloaded from the blood for a given fall in PO2.
B. allows less O2 to be unloaded from the blood for a given fall in PO2.
C. allows a greater degree of oxygen loading of the blood within the lungs.
D. reduces the amount of oxygen that can be maximally carried by the blood.
E. may have resulted from a boring lecture.
An individual with anemia (blood hemoglobin concentration of 6 g/dl) would have all of the following, EXCEPT:
A. reduced total arterial oxygen content.B. normal arterial dissolved oxygen content.C. normal arterial PO2.
D. decreased oxyhemoglobin saturation.E. normal oxyhemoglobin saturation.
At a given PCO2, CO2 content is greater when there is less O2 in the blood (Haldane effect), because:
A. less HCO3- is produced, which
allows more CO2 to be carried in solution.
B. the CO2 solubility coefficient is increased.
C. plasma proteins can form more carbamino compounds when PO2 is reduced.
D. deoxygenated Hb is a better buffer of H+ ions.
Alveolar pressure may exceed arterial pressure in all of the following conditions EXCEPT
A. Hemorrhage
B. Patients on positive pressure ventilation
C. Normal individual playing a wind instrument
D. Healthy woman during normal inspiration
Alveolar pressure of oxygen at sea level is approximately
A. 21 mmHg
B. 45 mmHg
C. 40 mmHg
D. 100 mmHg
Pulmonary vascular resistance
A. Falls when left atrial pressure increases
B. Is maximum near the functional residual
capacity
C. Is very low during the fetal life
D. Is decreased on sympathetic stimulation
Please select the correct relationship
Top of the lung Bottom of the lung
A. Ventilation Higher Lower
B. Blood Flow Higher Lower
C. V/Q Higher Lower
D. PO2 Lower Higher
E. PCO2 Higher Lower
Select the FALSE statement regarding the diffusion capacity for oxygen
A. It is directly proportional to the number of pulmonary capillaries opened at a given time
B. It is inversely proportional to the thickness of the alveolar-capillary membrane
C. It is increased during the exercise
D. It is unaffected by removal of part of the lung
Transfer of CO into the blood is “diffusion limited” because
A. Partial pressure of CO rises very high in the blood as it flows along the pulmonary capillary
B. CO chemically combines with Hb at a very high rate, keeping
the pressure gradient at a high level
C. CO transports is not dependent on thickness of alveolar-capillary membrane
D. CO transport is limited by the amount of blood flowing through pulmonary capillaries
Which of the following has the greatest effect on the ability of blood to transport oxygen
A. Capacity of the blood to dissolve oxygen
B. pH of plasma
C. CO2 content of red blood cells
D. Amount of hemoglobin in the blood
E. Temperature of the blood
What is the difference in the arterial oxygen content of an individual who is breathing room air versus breathing 100%oxygen
A. Zero
B. About 1.8ml
C. About 5.4ml
D. 10.2ml
The affinity of hemoglobin for oxygen is decreased by all of the following EXCEPT
A. Increased hydrogen ion concentration
B. Increased temperature
C. Exercise
D. Increased 2,3 DPG
E. Decreased temperature
How is CO2 transported ?
A A small portion of CO2 (5%) is transported in the dissolved state to the lungs.
B The dissolved CO2 reacts with water to form carbonic acid.
C Formation of carbamino compounds with plasma proteins and hemoglobin.
D All of the above
E None of the above
BOYLES law states
A. In a constant temperature system, pressure is inversely proportional to volume.
B. In a constant volume system, pressure is directly proportional to the temperature.
C. In a constant temperature system, pressure is directly proportional to volume.
D. In a constant volume system, pressure is inversely proportional to the temperature.
On the the summit of Mt. Everest, where the barometric pressure is about 247mmHg, the partial pressure of inspired oxygen is about?
A. 1 mm HgB. 8 mm HgC. 42 mm HgD. 100 mm Hg
The volume of air that could enter the lung after a normal inspiration is the
A. Tidal volume
B. Expiratory reserve volume
C. Residual volume
D. Inspiratory reserve volume
E. Dead space volume
During inspiration, as the diaphragm contracts, the pressure in the pleural space becomes?
A. Equal to zero
B. More positive
C. More negative
D. Equal to the pressure in the alveoli
E. Equal to the pressure in the atmosphere
When a pneumothorax is induced, the chest wall__________ and the lungs____A. Collapses in, Expands out
B. Expands out, Collapses in
C. Both Remain where they were
D. Both collapse in
A lack of normal surfactant results in?
A. An increased lung compliance
B. Stabilization of alveolar volume
C. An increased retractive force of the lungs
D. A reduced alveolar-arterial oxygen tension difference
E. A decrease in the filtration forces in the pulmonary capillary
During the effort independent region of a forced expiration, flow is limited by?
A. Contraction of expiratory muscles
B. Inertia of chest wall
C. Transmural pressure becomes zero
D. Increased airway compliance
E. Transmural pressure becomes positive
A patient is being artificially ventilated during surgery at a rate of 20 breaths/min and a tidal volume of 250ml/breath. Assuming a normal anatomical dead space of 150ml, the alveolar ventilation in this patient is
A. 1000ml/minB. 2000ml/minC. 3000ml/minD. 4000ml/minE. 5000ml/min
In which of the following conditions is alveolar PO2
increased and alveolar PCO2 decreased
A.Breathing air with low PO2
B.Increased alveolar ventilation and unchanged metabolism
C.Decreased alveolar ventilation and unchanged metabolism
D.Increased metabolism and unchanged alveolar ventilation E.Proportional increase in metabolism and alveolar ventilation
In the upright position, ventilation per unit lung volume is greater at the base of the lung than at the apex because the base of the lung
A.Has more negative intrapleural pressure than the apex at the start of inspiration
B. Is less expanded than the the apex
C. Has lower compliance than the apex
D.Has more intrapulmonary-intrapleural pressure difference than the apex at the start of inspiration
BOYLES law states
A. In a constant temperature system, pressure is inversely proportional to volume.
B. In a constant volume system, pressure is directly proportional to the temperature.
C. In a constant temperature system, pressure is directly proportional to volume.
D. In a constant volume system, pressure is inversely proportional to the temperature.
At the end of a maximal inspiration, the lungvolume consists of
A. IRV + TV + RV B. IRV + FRC + TV
C. VC - RVD. TLC - RVE. IRV + TV
At the very start of inspiration at sea level,the CO2 partial pressure in the AnatomicDead Space is normallyA. about zero torrB. about 15 torr
C. about 40 torrD. about 100 torrE. about 150 torr
We use Alveolar Ventilation Rate instead of Minute Ventilation to discuss the lung's ability to release CO2 because normally at rest,
A. during inspiration, only 350 ml of fresh air
enters the mouth B. during expiration, only 350 ml of air leaves
the alveoli C. during expiration, only 350 ml of air leaves
the mouth D. the TV is normally less than the Anatomic
Dead Space E. only the first 350 ml of air leaving alveoli
passes through the mouth
Which statement about the normal lungs/thoraxcombination is correct ?
A. If a bilateral pneumothorax occurred at VC, thethorax would expand to 100% TLC and the lungs wouldcollapse down to RV
B. At FRC, the collapsing force of the lungs equals theexpanding force of the thorax: therefore intrapleuralpressure is zero
C. At the very end of resting expiration, intrapleuralpressure is zero
D. At the very end of resting inspiration, intrapleuralpressure is zero
E. None of the above
Which statement about alveolar ventilation is correct ?
A. If a normal subject inspires, more of the incoming air goes initially to the apical areas compared with the basal areas of the lung
B. Alveolar ventilation equals tidal volume+ dead space volume
C. Alveolar ventilation equals tidal volume+ inspiratory reserve volume
D. In inspiration from FRC, the basal lung areas are more compliant than apical areas
E. Both (A) and (D) are correct
Diffusing Capacity of the Lung (DL) A. rises as the thickness of the alveolar-
capillary membrane falls B. rises during exercise C. rises as the surface area of the alveolar-
capillary membrane rises D. All of the above E. Only (A) and (C) are correct
Which statement about V/Q ratios is correct ?
A. Arterial blood more closely resembles end-pulmonary capillary blood in the apical lung area than in the basal lung area
B. High V/Q areas of the lung can't compensate for hypoxia resulting from low V/Q areas because the high V/Q areas are on the plateau portion of the HbO2 dissociation curve
C. Both of the above
D. Arterial blood more closely resembles end-pulmonary capillary blood in the basal lung area than in the apical lung area
E. B and D are correct
In which case would administration of air witha pO2 of 150 torr cause a significant alleviationof the hypoxia ?
A. V/Q mismatch
B. Anemia
C. Anatomical shunt
D. Diffusion impairment
E. None of the above
With normal agingA. lung compliance decreases
B. chestwall compliance increasesC. lung compliance increasesD. chestwall compliance decreasesE. C and D are correct
In a normal subject breathing ambient air onthe top of Mt. Everest
A. the air composition is much less than 15%oxygen
B. the air composition is much more than 15%CO2
C. Both of the above
D. the pulmonary vascular resistance is muchlower than at sea level
E. None of the above
Which gaseous flux is normally dependent on the area and thickness of the alveolar-capillary membrane rather than on pulmonary blood flow ?
A. nitrous oxide B. carbon monoxide C. oxygen D. carbon dioxide
Which difference is used to calculate thecompliance of the entire respiratory system ?
A. P(pl) - P(B)
B. P(Alv) - P(B)
C. P(pl) - P(alv)
D. P(Alv) - P(pl)
E. P(alv) - P(pl) - P(pl) - P(B)
Which statement about the 4 zone model of the lungcirculation is true ?
A. Alveolar pressure may exceed arterial pressureat the apex of the lung
B. Arterial pressure may exceed alveolar pressureat the base of the lung
C. At the base of the lung, the functional drivinggradient is P(arterial) - P(venous)
D. Alveolar pressure may exceed venous pressureat the apex of the lung
E. All are correct
Which statement about surface tension is correct ?
A. Normally surface tension accounts for some ofthe work of inspiration
B. LaPlace's Law predicts that a higherdistending pressure would be required tomaintain inflation in alveoli of smaller radii
C. Normally surface tension in the lung has beenreduced because of the presence of surfactant
D. None are correct
E. All are correct
Which of the following can be measured directlywith a spirometer ?
A. Tidal volume
B. FVC
C. IRV
D. ERV
E. SED
F. ALL of the above EXCEPT (E)
Which lung space is normally the smallest in ahealthy 22 year old ?A. IRVB. ERVC. FRCD. TV
E. Anatomic Dead Space
Which factor increases the affinity of Hb for O2 the most ?
A. a blood temperature of 37 degrees Centigrade
B. an increase in the blood level of 2,3-DPG C. an increase in arterial blood hydrogen ion
concentration D. an increase in arterial blood pCO2 E. a leftward shift of the HbO2 dissociation
curve
As you sit here reading this question: A. your Alveolar Ventilation Rate is
about 4200 ml/sec B. your respiratory rate is about 12 per
second C. your Minute Ventilation is about 100
ml/sec D. your cardiac output is about 5
liters/second E. None of the above
Which component of the work of breathing is normally the greatest?
A. Inspiratory work to stretch elastin fibers B. Inspiratory work to overcome frictional
resistance to airflow C. Expiratory work to overcome frictional
resistance to airflow D. Inspiratory work to overcome tissue resistance E. Inspiratory work to overcome viscous
resistance
Which statement about the Equal Pressure Pointand its related phenomena is correct?
A. At the EPP, alveolar pressure equalsintrapleural pressure
B. Flow becomes independent of effort
C. Dynamic compression occurs
D. All of the above
Which statement about 02-C02 transport is correct?
A.In the pulmonary circulation, red cells release water inexchange for chloride ions
B.Since inspired air has Virtually no C02, arterial blood'stotal C02 concentration is less than half that of mixedvenous blood
C.Normally the volume of C02 picked up from peripheraltissues greatly exceeds the volume of 02 released to thetissues
D.Arterial 02 partial pressure is normally a few mm Hglower than the alveolar value for a healthy young adult
The cartilaginous airways: A. Aid in the warming, humidification, and cleaning of incoming air. B. Are constricted by smooth muscle innervated by sympathetic branches of the automonic nervous system. C. Are lined with endothelial cells. D. Receive their oxygen and nutrient supply from the pulmonary circulation.
Oxygen transport in blood is:
A. Largely dependent upon the enzyme carbonicanhydrase for attachment to hemoglobin (Hb).
B. Mostly as a physically dissolved gas within theplasma.
C. Mostly by reversible chemical attachment tohemoglobin located inside the red blood cell.
D.By reversible chemical bonding to plasma proteins.
The diaphragm, a principal muscle of respiration: A. Separates the abdominal from the thoracic cavity. B. Moves in an upward direction during contraction similar to a piston moving up a cylinder. C. Reduces the size of the thoracic cavity during contraction. D. Receives its innervation for the intercostal nerves.
For a healthy person during normal breathing, A. Inspiration is generally consider to be passive because of the natural tendency of the chest cage to expand. B. Expiration is generally thought to be passive resulting largely from recoil of the lung, which is stretched during inspiration. C. Activity in the phrenic nerve is totally restricted to expiration. D. The accessory muscles are essential for expiration.
The loss of pulmonary surfactant is likely to cause: A. Decreased atelectasis. B. A decrease in respiratory muscle work to inflate the lung. C. An increase in alveolar stability. D. An intrapleural pressure that is more subatmospheric than normal.
The surfactant comprising the thin fluid film lining alveoli: A. Is a highly complex carbohydrate. B. Increases opening pressures for collapsed alveoli. C. Tends to reduce alveolar surface tension as alveolar radius is decreased. D. Is likely produced by alveolar macrophages. E. Yields a higher surface tension at Residual Volume than Total Lung Capacity.
Airway resistance in the tracheobronchial tree:
A. Decreases when an irritant is inhaled.
B. Is higher during inspiration than expiration.
C. Increases as breathing frequency decreases.
D. Is located chiefly in the bronchi.
At a mountain ski resort in Colorado, the barometricpressure is 547 Torr. The partial pressure of O2 (PO2) in theambient air at this resort would be closest to:
A. 89 Torr.
B. 115 Torr.
C. 159 Torr..
D. 105 Torr.
E. 149 Torr.
On an employment application for the position of flightsurgeon with an aerospace company, you are asked todetermine the PO2 of the air inside a manned spacecraftwhen a 40% O2-60% N2 gas mixture is used at 1.5Atmospheres (ATM):
A. 159 Torr.
B. 456 Torr.
C. 1140 Torr..
D. 304 Torr.
E. 684 Torr.
The most important factor in the determination of watervapor pressure (PH2O) in alveolar air is:
A. The mixture or composition of the inspired gases.
B. The alveolar PCO2.
C. The alveolar PO2.
D. Body temperature.
E. Ambient air temperature.
If a subject at rest voluntarily increased breathing rate (f) while maintaining the same tidal volume: A. Minute ventilation would be unchanged. B. Dead space ventilation would be increased. C. Alveolar ventilation would be unchanged. D. Alveolar ventilation would decrease.
The diffusion of gases between the alveoli and pulmonarycapillary blood is:
A. Inversely proportion to the partial pressure gradientbetween these spaces.
B. Inversely related to the fourth power of the alveolarradius.
C. Directly related to the solubility of the gases in bloodfluids.
D.Directly related to the length of the diffusion pathway.
Pulmonary diffusing capacity is: A. A measure of the resistance to diffusion of gases
between alveoli and pulmonary capillary blood B. Often measured clinically using inhaled carbon dioxide
(CO2) rather than O2. C. Decreased as pulmonary capillary blood volume is
increased. D. Decreases with pulmonary edema.
The bronchopulmonary circulation: A. Refers to venous vessels of the bronchial circulation that anastomose with the pulmonary vein. B. Is responsible for a higher-than-expected O2 partial pressure in the left atrium. C. Refers to branches of the pulmonary artery that perfuse a small percentage of the bronchi and bronchioles. D. Refers to the entire venous drainage from the bronchial circulation.
In addition to gas exchange with lung alveoli, the pulmonarycirculation has several non-respiratory (non-gas exchange)functions. These include:
A. Serving as a blood filter to trap circulating emboli.
B. Serving as a blood reservior or extension of the leftatrium.
C. Metabolizing circulating vasoactive substances such asangiotension and bradykinin.
D. Synthetizing and releasing vasoactive substances into thecirculation.
E. All the above.
The difference between the PO2 in ambient air and theaortic blood for a normal person at sea level is:
A.Only about 10 Torr higher in air than in the aorta.
B. Is mostly accounted for the very high V/Q ratio ofalveoli at the apex of the upright lung.
C. Is largely accounted for by the PO2 that is present inlung alveoli comprising the FRC.
D. Unleated to the addition of water vapor to inspiredair.
The anatomical shunt is: A. Largely a result of V/Q mismatching. B. Mostly accounted for by venous drainage from the bronchopulmonary circulation and Thebesian veins. C. Caused by problems with gas diffusion between alveoli and pulmonary capillary blood. D.Anatomical shunts do not occur in healthy people.
The percentage of total arterial blood O2 that is carried by reversible chemical combination with hemoglobin (Hb) is closest to: A. 1 vol % B. 14.6 vol % C. 19.6 vol % D.98 vol%
For the oxyhemoglobin dissociation curve: A. The portion between a PO2 of 70 to 100 Torr is called
the "dissociation" part of the curve. B. A shift to right indicates an increased affinity of Hb for
oxygen. C. The PO2 is a very reliable indicator of blood O2
content. D. Is shifted to the right by an increase in the
concentration of 2,3-DPG in the red cell.
The exchange of Cl- for HCO3 by the RBC in the tissue orpulmonary capillary is termed:
A. The Hurst shift.
B. The Haldane effect.
C. Hamburger shift.
D. Bohr effect.
Daily Double
Daily Double
Daily Double
Final Jeopardy
With a typical resting oxygen consumption of 250ml/min, what must Cardiac output be for survival, if the blood had no hemoglobin??
V02 = CO X a-v02
250ml/min = CO X 0.3 ml02/dl blood
250ml/min 3ml/L
= 83L/min
