Transcript No Slide Title

Pulmonary Jeopardy
Mech
Vent
Flow
Exc
Trans
Lab
BC
Pop
100
100
100
100
100
100
100
100
200
200
200
200
200
200
200
200
300
300
300
300
300
300
300
300
400
400
400
400
400
400
400
400
500
500
500
500
500
500
500
500
1000
1000
1000
1000
1000
1000
1000
1000
2000
2000
2000
2000
2000
2000
2000
2000
3000
3000
3000
3000
3000
3000
3000
3000
4000
4000
4000
4000
4000
4000
4000
4000
5000
5000
5000
5000
5000
5000
5000
5000
Which is TRUE concerning the pulmonary circulation
versus the systemic circulation?
A
B
C
D
E
Pulmonary arterial pressure is lower than systemic
arterial pressure due to a lower vascular resistance in
the pulmonary circulation.
Pulmonary cardiac output is lower than systemic
cardiac output due to the lower vascular resistance in
the pulmonary circulation.
Pulmonary circulation has a higher vascular
resistance thereby causing pulmonary arterial
pressure to be lower than systemic arterial pressure.
Systemic arterial pressure is higher than pulmonary
arterial pressure because systemic vascular
resistance is lower than pulmonary vascular
resistance.
Systemic arterial pressure is lower than pulmonary
arterial pressure.
Which can be measured with a laboratory
spirometer?
A FRC
B FVC
C TLC
D FEF(25 % -75 %)
E B and D above
Which is(are) TRUE?
A FEV1 / FVC is normally about 80%.
B
ERV is normally greater than FRC.
C
RV is normally greater than FRC.
D
ERV is normally greater than TLC.
E
C and D above
Which is normally the largest in a healthy young adult?
A ERV
B FEV(1.0)
C RV
D TV
E FEV(2.0)
Which has sub-components?
A ERV
B IRV
C TV
D FRC
E RV
Which is(are) TRUE concerning partial pressures?
A The first 150ml of Expired air CO2 is normally
the same as alveolar air CO2.
B At the end of expiration, anatomic dead space
CO2 is about 0 torr.
C At the end of inspiration, anatomic dead
space is filled with air whose O2 is much less
than 100 torr.
D At the end of inspiration, anatomic dead
space is filled with air whose CO2 is about
zero.
E B and D above.
In a normal subject at sea level breathing 50 % O2,
which compartment has the lowest CO2 partial
pressure?
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 atmosphere
of pressure, her:
A arterial blood O2 concentration is about 22.4
volumes %.
B arterial blood O2 concentration is about 10
volumes %.
C arterial hemoglobin is much less than100 %
saturated with O2.
D arterial blood O2 concentration is about 18
volumes %.
E dissolved arterial blood O2 concentration is
about 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?
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 by
change in transmural pressure.
B Lung compliance is normally about 0.2 cm water
per 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 airliquid interface in the pleural space.
E C and D above.
Which is TRUE?
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 diffusionlimited.
C Exchange of CO is normally diffusion-limited.
D Normally, the gradient for CO2 diffusion in the lung
is 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 more
and more resembles mixed venous blood.
B As alveolar dead space increases, alveolar gas
more and more resembles inspired air.
C As physiological shunt increases, arterial blood more
and more resembles inspired air.
D None of the above.
Which is(are) TRUE concerning the pulmonary
circulation?
A It is a high compliance and low resistance system.
B Its local resistance is regulated by vasoconstriction
in 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.
Which is(are) TRUE concerning ventilation and perfusion
of the normal erect lung?
A The highest absolute ventilation occurs in the base of
the lung.
B The apical end pulmonary capillary blood oxygen
concentration is considerably lower than 10 volumes
%.
C The basal end pulmonary capillary blood O2
concentration is considerably greater than 20
volumes %.
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.
Which is(are) TRUE concerning the normal pulmonary
circulation?
A Blood flow increases from the top to the 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.
E None of the above.
Which is(are) TRUE?
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.
B.
C.
D.
E.
Charles' Law
Boyle's Law
Dalton's Law
Henry's Law
O'Leary's Law
What is the partial pressure of oxygen
in the atmosphere at sea level
(barometric pressure = 760 mm Hg)
A.
B.
C.
D.
E.
600 mm Hg
160 mm Hg
0.3 mm Hg
47 mm Hg
0.0 mm Hg
The volume of air that could exit
the lung after a normal expiration
is the
A.
B.
C.
D.
E.
extra volume
expiratory reserve volume
expiratory capacity
expiratory extra volume
expiratory-expiratory
volume
During expiration, as the diaphragm
relaxes the pressure in the alveolus
becomes?
A.
B.
C.
D.
E.
more positive
less positive
more negative
equal to intrapleural pressure
subatmospheric
In an individual suffering from
pulmonary fibrosis, the work of
breathing is increased due to:
A.
B.
C.
D.
an increase in surface tension.
a decrease in lung compliance.
an increase in airway resistance.
an increase in chest wall
compliance.
E. an increase in diaphragm
stiffness.
Each of the following results in a
shift of the O2 dissociation curve to
the right EXCEPT:
A.
B.
C.
D.
E.
a decrease in pH.
an increase in arterial PCO2.
a rise in temperature.
exercise.
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.
B.
C.
D.
E.
an obstructive impairment.
a restrictive impairment.
both an obstructive and a restrictive impairment.
a diffusive impairment.
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.
B.
C.
D.
E.
less than atmospheric pressure.
less than pleural pressure.
equal to pleural pressure.
equal to atmospheric pressure.
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.
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.
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.
Except for the 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.
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, 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
C. CO transports is not dependent on thickness of alveolarcapillary 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
Which statement is correct?
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
not 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 250mmHg, the partial pressure
of oxygen is?
A.
B.
C.
D.
1 mm Hg
8 mm Hg
53 mm Hg
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.
B.
C.
D.
E.
1000ml/min
2000ml/min
3000ml/min
4000ml/min
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 lung
volume consists of
A.
B.
C.
D.
E.
IRV + TV + RV
IRV + FRC + TV
VC - RV
TLC - RV
IRV + TV
At the very start of inspiration at sea level,
the CO2 partial pressure in the Anatomic
Dead Space is normally
A. about zero torr
B. about 15 torr
C. about 40 torr
D. about 100 torr
E. 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/thorax
combination is correct ?
A. If a bilateral pneumothorax occurred at VC, the
thorax would expand to 100% TLC and the lungs would
collapse down to RV
B. At FRC, the collapsing force of the lungs equals the
expanding force of the thorax: therefore intrapleural
pressure is zero
C. At the very end of resting expiration, intrapleural
pressure is zero
D. At the very end of resting inspiration, intrapleural
pressure 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 [D(l)]
A. rises as the thickness of the alveolarcapillary membrane falls
B. rises during exercise
C. rises as the surface area of the alveolarcapillary 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 with
a pO2 of 150 torr cause a significant alleviation
of the hypoxia ?
A.
B.
C.
D.
E.
V/Q mismatch
Anemia
Anatomical shunt
Diffusion impairment
None of the above
With normal aging
A. lung compliance decreases
B. chestwall compliance increases
C. lung compliance increases
D. chestwall compliance decreases
E. C and D are correct
In a normal subject breathing ambient air on
the 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 much
lower 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.
B.
C.
D.
nitrous oxide
carbon monoxide
oxygen
(A) and (C)
Which difference is used to calculate the
compliance 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 lung
circulation is true ?
A. Alveolar pressure may exceed arterial pressure
at the apex of the lung
B. Arterial pressure may exceed alveolar pressure
at the base of the lung
C. At the base of the lung, the functional driving
gradient is P(arterial) - P(venous)
D. Alveolar pressure may exceed venous pressure
at the apex of the lung
E. All are correct
Which statement about surface tension is correct ?
A. Normally surface tension accounts for some of
the work of inspiration
B. LaPlace's Law predicts that a higher
distending pressure would be required to
maintain inflation in alveoli of smaller radii
C. Normally surface tension in the lung has been
reduced because of the presence of surfactant
D. None are correct
E. All are correct
Which of the following can be measured directly
with 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 a
healthy 22 year old ?
A. IRV
B. ERV
C. FRC
D. 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
Which statement about the Equal Pressure Point
and its related phenomena is correct?
A. At the EPP, alveolar pressure equals
intrapleural 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 in
exchange for chloride ions
B.Since inspired air has Virtually no C02, arterial blood's
total C02 concentration is less than half that of mixed
venous blood
C.Normally the volume of C02 picked up from peripheral
tissues greatly exceeds the volume of 02 released to the
tissues
D.Arterial 02 partial pressure is normally a few mm Hg
lower 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 carbonic
anhydrase for attachment to hemoglobin (Hb).
B. Mostly as a physically dissolved gas within the
plasma.
C. Mostly by reversible chemical attachment to
hemoglobin 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
exspiration.
D. The accessory muscles are essential for exspiration.
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 barometric
pressure is 547 Torr. The partial pressure of O2 (PO2) in the
ambient 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 flight
surgeon with an aerospace company, you are asked to
determine the PO2 of the air inside a manned spacecraft
when a 40% O2-60% N2 gas mixture is used at 1.5
Atmospheres (ATM):
A. 159 Torr.
B. 456 Torr.
C. 1140 Torr..
D. 304 Torr.
E. 684 Torr.
The most important factor in the determination of water
vapor 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 pulmonary
capillary blood is:
A. Inversely proportion to the partial pressure gradient
between these spaces.
B. Inversely related to the fourth power of the alveolar
radius.
C. Directly related to the solubility of the gases in blood
fluids.
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. Is 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 pulmonary
circulation 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 left
atrium.
C. Metabolizing circulating vasoactive substances such as
angiotension and bradykinin.
D. Synthetizing and releasing vasoactive substances into the
circulation.
E. All the above.
The difference between the PO2 in ambient air and the
aortic 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 of
alveoli at the apex of the upright lung.
C. Is largely accounted for by the PO2 that is present in
lung alveoli comprising the FRC.
D. Unleated to the addition of water vapor to inspired
air.
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 %
B. 14.6 %
C. 19.6%
D.98%
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 or
pulmonary 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