respquiz - Matching Questions Figure 22.1 Using Figure...

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Unformatted text preview: Matching Questions Figure 22.1 Using Figure 22.1, match the following: 1) Main (primary) bronchus. Answer: D Diff: 1 Page Ref: 832; Fig. 22.1 2) Pharynx. Answer: A Diff: 1 Page Ref: 832; Fig. 22.1 3) Larynx. Answer: B Diff: 1 Page Ref: 832; Fig. 22.1 4) Carina of trachea. Answer: E Diff: 1 Page Ref: 832; Fig. 22.1 5) Trachea. Answer: C Diff: 1 Page Ref: 832; Fig. 22.1 Figure 22.2 Using Figure 22.2, match the following: 6) Tidal volume. Answer: B Diff: 1 Page Ref: 852; Fig. 22.16 7) Inspiratory reserve volume. Answer: A Diff: 1 Page Ref: 852; Fig. 22.16 8) Residual volume. Answer: D Diff: 1 Page Ref: 852; Fig. 22.16 9) Expiratory reserve volume. Answer: C Diff: 1 Page Ref: 852; Fig. 22.16 10) Air that does not participate in the exchange of gases. Answer: D Diff: 2 Page Ref: 852; Fig. 22.16 A) Type I cells Diff: 1 Page Ref: 840 B) Respiratory bronchioles 12) Secrete a fluid containing surfactant. C) Type II cells Answer: C Diff: 1 Page Ref: 842 D) Alveolar duct 13) Where the respiratory zone of the lung E) Segmental bronchi begins. Answer: B Diff: 1 Page Ref: 842 Match the following: 11) No echange of gases occurs here. Answer: E 14) Composed of simple squamous epithelium. Answer: A Diff: 1 Page Ref: 842 15) Terminates in alveoli. Answer: D Diff: 1 Page Ref: 842 16) Composed of cuboidal cells. Answer: C Diff: 2 Page Ref: 842 17) The respiratory membrane is composed of fused basement membrane of the capillary walls and ________. Answer: A Diff: 2 Page Ref: 842 True/False Questions 1) The roof of the nasal cavity is formed by parts of the frontal bone. Answer: FALSE Diff: 1 Page Ref: 831-832 2) The olfactory mucosal lining of the nasal cavity contains the receptors for the sense of smell. Answer: TRUE Diff: 1 Page Ref: 831-832 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. Answer: TRUE Diff: 1 Page Ref: 833 4) Paranasal sinuses seem to have no useful function. Answer: FALSE Diff: 1 Page Ref: 833 5) The pleura is a thin, single-layered serosa that divides into parietal and visceral pleura. Answer: FALSE Diff: 1 Page Ref: 845-846 6) Intrapleural pressure is normally about 4 mm Hg less than the pressure in the alveoli. Answer: TRUE Diff: 1 Page Ref: 846 7) During normal quiet breathing, approximately 750 ml of air moves into and out of the lungs with each breath. Answer: FALSE Diff: 1 Page Ref: 849 8) The alveolar ventilation rate is the best index of effective ventilation. Answer: TRUE Diff: 1 Page Ref: 853 9) In chronic bronchitis, mucus production is decreased and this leads to the inflammation and fibrosis of the mucosal lining of the bronchial tree. Answer: FALSE Diff: 1 Page Ref: 871 10) Labored breathing is termed dyspnea. Answer: TRUE Diff: 1 Page Ref: 871 11) The largest amount of carbon dioxide is transported in the bloodstream, in the form of carbonic anhydrase. Answer: FALSE Diff: 1 Page Ref: 861 12) Each lung has an indention, the pelvis, through which blood vessels enter and leave the lung. Answer: FALSE Diff: 1 Page Ref: 842 13) Increased temperature results in decreased O2 unloading from hemoglobin. Answer: FALSE Diff: 1 Page Ref: 859 14) The epiglottis is a smooth muscle that covers the glottis during swallowing. Answer: FALSE Diff: 1 Page Ref: 837 15) The events of Valsalvaʹs maneuver include closing off the larynx by muscle action (i.e., the rising of the intraabdominal pressure causing holding of the air in the lower respiratory tract). Answer: TRUE Diff: 1 Page Ref: 838 16) Smoking diminishes ciliary action and eventually destroys the cilia. Answer: TRUE Diff: 1 Page Ref: 839 17) Tracheal obstruction is life threatening. Answer: TRUE Diff: 1 Page Ref: 838-839 18) The paired lungs are located in the mediastinum. Answer: FALSE Diff: 1 Page Ref: 842 19) The parietal pleura lines the thoracic wall. Answer: TRUE Diff: 1 Page Ref: 845-846 20) The average individual has 500 ml of residual volume in his lungs. Answer: FALSE Diff: 1 Page Ref: 851 21) Atelectasis (lung collapse) renders the lung useless for ventilation. Answer: TRUE Diff: 2 Page Ref: 847 22) The Hering-Breuer reflex is a potentially dangerous response that may cause overinflation of the lung. Answer: FALSE Diff: 2 Page Ref: 869 23) Strong emotions and pain acting through the limbic system activate sympathetic centers in the hypothalamus, thus modulating respiratory rate and depth by sending signals to the respiratory centers. Answer: TRUE Diff: 2 Page Ref: 865 24) 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 ion to be generated (the Bohr effect). Answer: FALSE Diff: 2 Page Ref: 860 25) Daltonʹs law 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. Answer: TRUE Diff: 2 Page Ref: 854 26) Oxygenated hemoglobin releases oxygen more readily when the pH is more basic. Answer: FALSE Diff: 3 Page Ref: 858 27) Nasal conchae mainly work on inhalation to warm and moisten air. They serve minor functions for exhalation. Answer: FALSE Diff: 1 Page Ref: 832 28) Under certain conditions, the vocal folds act as a sphincter that prevents air passage. Answer: TRUE Diff: 1 Page Ref: 837 29) Apneustic breathing is characterized by prolonged inspirations. Answer: TRUE Diff: 1 Page Ref: 864 Multiple-Choice Questions 1) Air and food are routed into the proper channels by the ________. A) trachea B) pharynx C) larynx D) carina Answer: C Diff: 1 Page Ref: 835 2) The loudness of a personʹs voice depends on ________. A) the thickness of vestibular folds B) the length of the vocal folds C) the strength of the intrinsic laryngeal muscles D) the force with which air rushes across the vocal folds Answer: D Diff: 1 Page Ref: 837 3) The walls of the alveoli are composed of two types of cells, type I and type II. The function of type II is ________. A) to secrete surfactant B) to trap dust and other debris C) to replace mucus in the alveoli D) to protect the lungs from bacterial invasion Answer: A Diff: 1 Page Ref: 842 4) After the segmental (tertiary) bronchus, the next smaller branch of the respiratory passageway is (are) the ________. A) terminal bronchioles B) atrium C) alveolar ducts D) respiratory bronchiole Answer: A Diff: 1 Page Ref: 840 5) The smallest macroscopic subdivision of the lung is the ________. A) lobule B) pleura C) primary bronchiole D) extrinsic ligament Answer: A Diff: 1 Page Ref: 842 6) The pleurae are vital to the integrity of the lungs because ________. A) they contain cilia that protect the lungs B) they control the volume of the lungs C) they maintain the proper temperature of the lungs during sleep D) they produce a lubricating serous secretion, allowing the lungs to glide over the thorax wall during breathing Answer: D Diff: 1 Page Ref: 845-846 7) Intrapulmonary pressure is the ________. A) pressure within the pleural cavity B) pressure within the alveoli of the lungs C) negative pressure in the intrapleural space D) difference between atmospheric pressure and respiratory pressure Answer: B Diff: 1 Page Ref: 846 8) The relationship between the pressure and volume of gases is given by ________. A) Boyleʹs law B) Henryʹs law C) Charlesʹ law D) Daltonʹs law Answer: A Diff: 1 Page Ref: 847 9) The statement, ʺin a mixture of gases, the total pressure is the sum of the individual partial pressures of gases in the mixtureʺ paraphrases ________. A) Henryʹs law B) Boyleʹs law C) Daltonʹs law D) Charlesʹ law Answer: C Diff: 1 Page Ref: 854 10) Surfactant helps to prevent the alveoli from collapsing by ________. A) humidifying the air before it enters B) warming the air before it enters C) interfering with the cohesiveness of water molecules, thereby reducing the surface tension of alveolar fluid D) protecting the surface of alveoli from dehydration and other environmental variations Answer: C Diff: 1 Page Ref: 850 11) For gas exchange to be efficient, the respiratory membrane must be ________. A) at least 3 micrometers thick B) 0.5 to 1 micrometer thick C) between 5 and 6 micrometers thick D) The thickness of the respiratory membrane is not important in the efficiency of gas exchange Answer: B Diff: 1 Page Ref: 858 12) With the Bohr effect, more oxygen is released because ________. A) a decrease in pH (acidosis) strengthens the hemoglobin-oxygen bond B) a decrease in pH (acidosis) weakens the hemoglobin-oxygen bond C) an increase in pH (alkalosis) strengthens the hemoglobin-oxygen bond D) an increase in pH (alkalosis) weakens the hemoglobin-oxygen bond Answer: B Diff: 1 Page Ref: 860 13) The most powerful respiratory stimulus for breathing in a healthy person is ________. A) loss of oxygen in tissues B) increase of carbon dioxide C) pH (acidosis) D) pH (alkalosis) Answer: B Diff: 1 Page Ref: 865-866 14) Nerve impulses from ________ will result in inspiration. A) the dorsal respiratory group B) the chemoreceptor center C) Brocaʹs center D) the preoptic nucleus of the hypothalamus Answer: A Diff: 1 Page Ref: 863 15) In the plasma, the quantity of oxygen in solution is ________. A) only about 1.5% of the oxygen carried in dissolved form B) aboutequal to the oxygen combined with hemoglobin C) greater than the oxygen combined with hemoglobin D) not present except where it is combined with carrier molecules Answer: A Diff: 1 Page Ref: 858 16) Which of the following statements is incorrect? A) During fetal life, lungs are filled with fluid. B) Respiratory rate is lowest in newborn infants. C) Descent of the diaphragm results in abdominal breathing. D) The chest wall becomes more rigid with age. Answer: B Diff: 1 Page Ref: 873-874 17) Another name for the inflation reflex is ________. A) Bohr B) Haldane C) Hering-Breuer D) pulmonary irritant Answer: C Diff: 1 Page Ref: 869 18) Which of the following does not influence the increase in ventilation that occurs as exercise is initiated? A) psychic stimuli B) decrease in lactic acid levels C) proprioceptors D) simultaneous cortical motor activation of the skeletal muscles and respiratory center Answer: B Diff: 1 Page Ref: 869-870 19) Which of the following is not a form of lung cancer? A) adenocarcinoma B) Kaposiʹs sarcoma C) small cell carcinoma D) squamous cell carcinoma Answer: B Diff: 1 Page Ref: 872-873 20) Which of the following is not an event necessary to supply the body with O2 and dispose of CO2? A) pulmonary ventilation B) blood pH adjustment C) internal respiration D) external respiration Answer: B Diff: 1 Page Ref: 858 21) Which of the following changes occurs as the conducting tubes of the lungs become smaller? A) Cartilage rings are gradually replaced by regular plates of cartilage. B) Resistance to air flow decreases due to the increased number of tubes. C) Smooth muscle amount increases. D) Lining of the tubes changes from ciliated columnar to simple squamous epithelium which lines the alveoli. Answer: C Diff: 1 Page Ref: 841 22) Which of the following does not diminish lung compliance? A) factors that block the bronchi B) factors that impair the flexibility of the thoracic cage C) factors that reduce the natural resilience of the lungs D) factors that decrease the surface tension of the fluid film of the alveoli Answer: D Diff: 1 Page Ref: 850 23) Tidal volume is air ________. A) remaining in the lungs after forced expiration B) exchanged during normal breathing C) inhaled after normal inspiration D) forcibly expelled after normal expiration Answer: B Diff: 1 Page Ref: 851 24) The ideal vital capacity of an individual is around ________. A) 1200 ml B) 3100 ml C) 4800 ml D) 6600 ml Answer: C Diff: 1 Page Ref: 851 25) Possible causes of hypoxia include ________. A) too little oxygen in the atmosphere B) obstruction of the esophagus C) taking several rapid deep breaths D) getting very cold Answer: A Diff: 1 Page Ref: 860-861 26) The lung volume that represents the total volume of exchangeable air is the ________. A) tidal volume B) vital capacity C) inspiratory capacity D) expiratory reserve volume Answer: B Diff: 1 Page Ref: 851 27) Since the lungs are filled with fluid during fetal life, which of the following statements is true regarding respiratory exchange? A) Respiratory exchanges are made through the ductus arteriosus. B) Respiratory exchanges are not necessary. C) Respiratory exchanges are made through the placenta. D) Since the lungs develop later in gestation, fetuses do not need a mechanism for respiratory exchange. Answer: C Diff: 1 Page Ref: 873-874 28) Which of the following is not a stimulus for breathing? A) rising carbon dioxide levels B) rising blood pressure C) arterial Po2 below 60 mm Hg D) arterial pH resulting from CO2 retention Answer: B Diff: 1 Page Ref: 865-867 29) Respiratory control centers are located in the ________. A) midbrain and medulla B) medulla and pons C) pons and midbrain D) upper spinal cord and medulla Answer: B Diff: 1 Page Ref: 863 30) The amount of air that can be inspired above the tidal volume is called ________. A) reserve air B) expiratory reserve C) inspiratory capacity D) vital capacity Answer: C Diff: 1 Page Ref: 851 31) Which statement about CO2 is incorrect? A) Its concentration in the blood is decreased by hyperventilation. B) Its accumulation in the blood is associated with a decrease in pH. C) More CO2 dissolves in the blood plasma than is carried in the RBCs. D) CO2 concentrations are greater in venous blood than arterial blood. Answer: C Diff: 1 Page Ref: 859 32) Oxygen and carbon dioxide are exchanged in the lungs and through all cell membranes by ________. A) osmosis B) diffusion C) filtration D) active transport Answer: B Diff: 1 Page Ref: 858 33) Select the correct statement about the pharynx. A) The adenoids are located in the laryngopharynx. B) The auditory tube drains into the nasopharynx. C) The laryngopharynx blends posteriorly into the nasopharynx. D) The palatine tonsils are embedded in the lateral walls of the nasopharynx. Answer: B Diff: 1 Page Ref: 835 34) The larynx contains ________. A) the thyroid cartilage B) a cricoid cartilage also called the Adamʹs apple C) an upper pair of avascular mucosal folds called true vocal folds D) lateral cartilage ridges called false vocal folds Answer: A Diff: 1 Page Ref: 835-837 35) Which respiratory-associated muscles would contract if you were to blow up a balloon? A) diaphragm would contract, external intercostals would relax B) internal intercostals and abdominal muscles would contract C) external intercostals would contract and diaphragm would relax D) diaphragm contracts, internal intercostals would relax Answer: B Diff: 1 Page Ref: 848-849 36) The oropharynx does not include ________. A) fauces B) palatine tonsils C) lingual tonsils D) pharyngeal tonsils Answer: D Diff: 1 Page Ref: 835 37) Which of the following is not found on the right lobe of the lung? A) middle lobe B) cardiac notch C) horizontal fissure D) oblique fissure Answer: B Diff: 1 Page Ref: 842 38) Impairments of oxygen transport include ________. A) anemic hypoxia, usually caused by congestive heart failure B) carbon monoxide poisoning, a form of hypoxemic hypoxia C) stagnant hypoxia, due to a functional problem with the lungs D) hypoxemic hypoxia, resulting from a decrease in levels of functional red blood cells Answer: B Diff: 1 Page Ref: 861 39) Which of the following correctly describes mechanisms of CO2 transport? A) 20% of CO2 is dissolved directly into the plasma. B) 7-8% of CO2 is carried in the form of carbaminohemoglobin. C) The chloride shift mechanism enhances CO2 transport. D) Carbonic anhydrase is responsible for bonding CO2 to hemoglobin. Answer: C Diff: 1 Page Ref: 861 40) Factors that influence the rate and depth of breathing include ________. A) thalamic control B) voluntary cortical control C) stretch receptors in the alveoli D) composition of alveolar gas Answer: B Diff: 1 Page Ref: 868 41) Which of the following provide the greatest surface area for gas exchange? A) alveolar sacs B) alveoli C) respiratory bronchioles D) alveolar ducts Answer: B Diff: 2 Page Ref: 842 42) The respiratory membrane is a combination of ________. A) respiratory bronchioles and alveolar ducts B) alveolar and capillary walls and their fused basement membranes C) atria and alveolar sacs D) respiratory bronchioles and alveolar sacs Answer: B Diff: 2 Page Ref: 841-842 43) A gas emboli may occur because ________. A) a person holds his breath too long B) a diver holds his breath upon ascent C) a pilot holds her breath upon descent D) a person breathes pure oxygen in a pressurized chamber Answer: B Diff: 2 Page Ref: 868 44) Inspiratory capacity is ________. A) the total amount of air that can be inspired after a tidal expiration B) the total amount of exchangeable air C) functional residual capacity D) air inspired after a tidal inhalation Answer: A Diff: 2 Page Ref: 851 45) Which center is located in the pons? A) pontine respirator group (PRG) B) expiratory C) inspiratory D) pacemaker neuron center Answer: A Diff: 2 Page Ref: 864 46) The nose serves all the following functions except ________. A) as a passageway for air movement B) as the initiator of the cough reflex C) warming and humidifying the air D) cleansing the air Answer: B Diff: 2 Page Ref: 831 47) A premature baby usually has difficulty breathing. However, the respiratory system is developed enough for survival by ________. A) 17 weeks B) 24 weeks C) 28 weeks D) 36 weeks Answer: C Diff: 2 Page Ref: 873-874 48) Which of the following statements is true regarding the respiratory rate of a newborn? A) The respiratory rate of a newborn is slow. B) The respiratory rate of a newborn varies between male and female infants. C) The respiratory rate of a newborn is approximately 30 respirations per minute. D) The respiratory rate of a newborn is, at its highest rate, approximately 40-80 respirations per minute. Answer: D Diff: 2 Page Ref: 873-874 49) 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 ventral respiratory group (expiratory center) neurons depolarize in a rhythmic way to establish the pattern of breathing. C) The pontine respirator group (PRG) continuously stimulates the medulla to provide inspiratory drive. D) The dorsal respiratory group (inspiratory center) is contained within the pons. Answer: A Diff: 2 Page Ref: 863-864 50) Which of the following statements is correct? A) H+ acts directly on central chemoreceptors to decrease the rate and depth of breathing. B) Low arterial pH is the most powerful stimulator of respiration. C) Arterial pH does not affect central chemoreceptors directly. D) H+ has little effect on the blood pH. Answer: A Diff: 2 Page Ref: 865 51) The factors responsible for holding the lungs to the thorax wall are ________. A) the smooth muscles of the lung B) the diaphragm and the intercostal muscles alone C) the visceral pleurae and the changing volume of the lungs D) surface tension from pleural fluid, negative pressure, and atmospheric pressure on the thorax Answer: D Diff: 3 Page Ref: 846 52) The erythrocyte count increases after a while when an individual goes from a low to a high altitude because ________. A) the temperature is lower at higher altitudes B) the basal metabolic rate is higher at high altitudes C) the concentration of oxygen and/or total atmospheric pressure is higher at higher altitudes D) the concentration of oxygen and/or total atmospheric pressure is lower at high altitudes Answer: D Diff: 2 Page Ref: 870 53) Most inspired particles such as dust fail to reach the lungs because of the ________. A) ciliated mucous lining in the nose B) abundant blood supply to nasal mucosa C) porous structure of turbinate bones D) action of the epiglottis Answer: A Diff: 2 Page Ref: 831-832 54) Which of the following is not possible? A) Gas flow equals pressure gradient over resistance. B) Pressure gradient equals gas flow over resistance. C) Resistance equals pressure gradient over gas flow. D) 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. Answer: B Diff: 3 Page Ref: 849 55) Select the correct statement about the physical factors influencing pulmonary ventilation. A) A decrease in compliance causes an increase in ventilation. B) A lung that is less elastic will require less muscle action to perform adequate ventilation. C) As alveolar surface tension increases, additional muscle action will be required. D) Surfactant helps increase alveolar surface tension. Answer: C Diff: 3 Page Ref: 850 56) Select the correct statement about oxygen transport in blood ________. A) During normal activity, a molecule of hemoglobin returning to the lungs contains one molecule of O2 B) During conditions of acidosis, hemoglobin is able to carry oxygen more efficiently C) Increased BPG levels in the red blood cells enhance oxygen-carrying capacity D) A 50% oxygen saturation level of blood returning to the lungs might indicate an activity level higher than normal Answer: D Diff: 3 Page Ref: 858-859 57) Which of these is not a characteristic of emphysema? A) bronchial edema B) destruction of alveolar walls C) loss of lung elasticity D) air trapping Answer: A Diff: 1 Page Ref: 871 Fill-in-the-Blank/Short Answer Questions 1) Type II alveolar cells secrete ________. Answer: surfactant Diff: 1 Page Ref: 842 2) ________ law is called the law of partial pressure. Answer: Daltonʹs Diff: 1 Page Ref: 854 3) ________ law would apply to the amount of CO2 you could dissolve in a Pepsi. Answer: Henryʹs Diff: 1 Page Ref: 854 4) Oxygen unloading in a RBC due to declining pH is called the ________. Answer: Bohr effect Diff: 1 Page Ref: 860 5) The ________ center of the pons exerts mainly inhibitory effects on breathing rates. Answer: pontine respirator group (PRG) Diff: 1 Page Ref: 864 6) ________ is the most common lethal genetic disease in the United States. Answer: Cystic fibrosis Diff: 1 Page Ref: 874 7) The cartilaginous flap that closes the trachea during swallowing is called the ________. Answer: epiglottis Diff: 1 Page Ref: 837 8) The archway in the back of the throat is called the ________. Answer: fauces Diff: 1 Page Ref: 835 9) The trachea is lined with ________ epithelium. Answer: ciliated pseudostratified columnar Diff: 2 Page Ref: 838-839 10) Terminal bronchioles are lined with ________ epithelium. Answer: cuboidal Diff: 1 Page Ref: 841 11) How is alveolar gas exchange affected by emphysema and pneumonia? Answer: With pneumonia, if the lungs become edematous, the thickness of the exchange membrane may increase dramatically, restricting gas exchange, and body tissues begin to suffer from hypoxia. With emphysema, the lungs become progressively less elastic and more fibrous, which hinders both inspiration and expiration. Gas exchange remains adequate initially, but muscular activity must be enlisted to expire. Additionally, a symptom of emphysema is fusion of alveoli, resulting in less surface area for gas exchange. Diff: 2 Page Ref: 858, 871, 875 12) Briefly differentiate between atmospheric pressure, intrapulmonary pressure, and intrapleural pressure. Which of these is always negative in a healthy individual? What happens if intrapleural pressure becomes equal to atmospheric pressure? Answer: Atmospheric pressure is the pressure exerted by gases of the atmosphere. Intrapulmonary pressure is the pressure within the alveoli of the lungs. Intrapleural pressure is the pressure within the intrapleural space. Intrapleural pressure is always negative relative to the other two. Equalization of the intrapleural pressure with atmospheric pressure or intrapulmonary pressure immediately causes lung collapse. Diff: 3 Page Ref: 846-847 13) The contraction of the diaphragm and the external intercostal muscles begins inspiration. Explain exactly what happens, in terms of volume and pressure changes in the lungs, when these muscles contract. Answer: With contraction of the diaphragm, the height of the thoracic cavity increases. Contraction of the intercostal muscles expands the diameter of the thorax. With an increase in volume of the thorax, the intrapulmonary volume increases, causing a drop in pressure relative to atmospheric pressure. Air rushes into the lungs along this pressure gradient until intrapulmonary and atmospheric pressures are equal. Diff: 2 Page Ref: 847-849 14) What is the chloride shift and why does it occur? Answer: chloride shift is an ionic exchange process whereby chloride ions move from the plasma into the The erythrocytes to counterbalance the net positive charge left within the erythrocytes by the rapid outrush of negative bicarbonate ions. Diff: 2 Page Ref: 861 15) If a baby is born at 28 weeksʹ gestation, what major problem will the doctors look for? Answer: type II alveolar cells may not have fully developed; therefore, there is the possibility of lung The collapse. Diff: 2 Page Ref: 873-874 16) How is it possible to change the pitch of our voice from high to low? Answer: Usually, the tenser the vocal folds, the faster they vibrate and the higher the pitch. To produce deep tones, theglottis widens, and to produce high-pitched tones, the glottis becomes a slit. Intrinsic laryngeal muscles control the true vocal folds and the size of the glottis. Diff: 3 Page Ref: 837 17) The partial pressure gradient for oxygen (in the body) is much steeper than that for carbon dioxide. Explain how equal amounts of these two gases can be exchanged (in a given time interval) in the lungs and at the tissues. Answer: Equal amounts of O2 and CO2 can be exchanged in the lungs and at the tissues because CO2 solubility in plasma and alveolar fluid is 20 times greater than that of O2. Diff: 3 Page Ref: 856-857 18) Define anatomical dead space. What is the relationship between anatomical and alveolar dead space? Which value is likely to increase during lung pathology? Answer: Anatomical dead space is the space in the conducting respiratory passageways. Alveolar dead space is the space in nonfunctional alveoli. Anatomical dead space and alveolar dead space together make up the total dead space. Alveolar dead space will increase during lung pathology. Diff: 3 Page Ref: 852 Clinical Questions 1) Timothy has been having difficulty breathing since he had pneumonia last month. Recently he had severe pain in his chest and back, and his breathing was extremely irregular. The doctor at the emergency room told him that one of the lobes of his lung had collapsed. How could this happen? Answer: Timothy suffered atelectasis, or lung collapse, most likely caused by air entering the pleural cavity due to a rupture of the visceral pleura. The rupture could have happened as a result of coughing during his bout with pneumonia. Diff: 3 Page Ref: 847 2) While having a physical examination, a young male informed his doctor that at age 8 he had lobar pneumonia and pleurisy in his left lung. The physician decided to measure his VC. Describe the apparatus and method used for taking this measurement. Define the following terms used in the description of lung volumes: TV, IRV, ERV, RV, and VC. Answer: vital capacity (VC) was measured using a spirometer. As he breathed into a mouthpiece, a hollow His bell, inverted over water, was displaced, giving a graphic recording on a rotating drum. Tidal volume (TV) is the amount of air that moves into and out of the lungs with normal breathing. Inspiratory reserve volume (IRV) is the amount of air that can be forcibly inhaled beyond the tidal volume. The expiratory reserve volume (ERV) is the amount of air that can be evacuated from the lungs over and above a tidal expiration. Residual volume (RV) is the amount of air that remains in the lungs even after the most strenuous expiration. Vital capacity (VC) is the total amount of exchangeable air. Diff: 3 Page Ref: 851-853 3) Jane had been suffering through a severe cold and was complaining of a frontal headache and a dull, aching pain at the side of her face. What regions are likely to become sites of secondary infection following nasal infection? Answer: Following nasal infection, the paranasal sinuses can become infected. Diff: 2 Page Ref: 833 4) A smoker sees his doctor because he has a persistent cough and is short of breath after very little exertion. What diagnosis will the doctor make and what can the person expect if he does not quit smoking? Answer: person is suffering from chronic bronchitis, which causes the dyspnea and coughing. If he does The not stop smoking, he can expect frequent pulmonary infections, more coughing, and progressively worse dyspnea (all symptoms of chronic obstructive pulmonary disease). Ultimately, he can expect to develop hypoxemia, CO2 retention, and respiratory acidosis. He may develop emphysema or lung cancer. Diff: 3 Page Ref: 871 5) After a long scuba diving session on a Caribbean reef, Carl boards a plane to Dallas. He begins to feel pain in his elbow on the flight back to Dallas. What is happening to him? Answer: is experiencing the bends due to several problems: (1) Applying Boyleʹs law, a lot of gas was Carl forced into Carlʹs bloodstream during the dive and there was not sufficient time to decompress the excess before he boarded the plane. (2) The plane is not pressurized to sea level, which further reduced atmospheric pressure holding the gases in suspension (Henryʹs law). Carl will have to be transported to a hyperbaric chamber to be repressurized. This will reduce the volume of the gas bubbles in his arm so that normal circulation can resume. Diff: 3 Page Ref: 868 6) A patient was admitted to the hospital with chronic obstructive pulmonary disease. His PaO2 was 55 and PaCO2 was 65. A new resident orders 54% oxygen via the venturi mask. One hour later, after the oxygen was placed, the nurse finds the patient with no respiration or pulse. She calls for a Code Blue and begins cardiopulmonary resuscitation (CPR). Explain why the patient stopped breathing. Answer: people who retain carbon dioxide because of pulmonary disease, arterial PaCO2 is chronically In elevated and chemoreceptors become unresponsive to this chemical stimulus. In such cases, declining PaO2 levels act on the oxygen-sensitive peripheral chemoreceptors and provide the principle respiratory stimulus, or the so-called hypoxic drive. Pure oxygen will stop a personʹs breathing, because his respiratory stimulus (low PaO2 levels) would be removed. Diff: 3 Page Ref: 871 7) While dining out in a restaurant a man suddenly chokes on a piece of meat. The waitress is also a student nurse and comes to the manʹs aid. She asks him if he can talk. The man responds by shaking his head no and grabbing at his neck. What is the significance of the manʹs inability to talk? Answer: Speech involves the intermittent release of expired air and opening and closing of the glottis. Because the man is unable to speak, this indicates that he is choking on a piece of food that suddenly closed off the glottis in the larynx. Diff: 3 Page Ref: 840 8) How will the lungs compensate for an acute rise in the partial pressure of CO2 in arterial blood? Answer: Respiratory rate will increase. Diff: 2 Page Ref: 871 9) A patient with tuberculosis is often noncompliant with treatment. Explain why this may happen. Answer: Noncompliance may occur because of the length of treatment. Treatment entails a 12-month course of antibiotics. Once the patient begins to feel better and the clinical symptoms dissipate, the patient may stop taking the medication. Diff: 3 Page Ref: 872 10) John has undergone surgery and has developed pneumonia. He also has a history of emphysema. Which assessment parameters would the nurse expect to find? Answer: The patient may have dyspnea. 1. 2. The patient may have hypoxemia because of increased secretions in the lungs. 3. The patient may use his accessory muscles to assist breathing. 4. The patient may have a productive cough. 5. The patientʹs breath sounds may have crackles. Diff: 3 Page Ref: 870-872 ...
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