Respiratory, Urinary, and Fluid/Electrolyte/Homeostasis Key Concepts

What is the structure positioned behind the trachea

the esophagus

what is emphysema

a lung disease that damages the alveolar sacs making it difficult to breathe

• can lead to hypoventilation

• can lead to respiratory acidosis

respiratory acidosis

• breathing in too much H+

• low blood pH

• caused by

  • rebreathing

  • hypoventilation

  • lung obstruction

  • emphysema

  • drug overdose

• treatment:

  • renal system excretes H+ and retains H3O-

respiratory alkalosis

• breathing too much H3O-

• high blood pH

• caused by 

  • hyperventilation

  • asthma

  • high altitude traveling

• treatment:

  • renal system retains H3O- and excretes H+ to fix pH

The first 1/3 of the esophagus is made of which type of muscle?

a. cardiac

b. smooth

c. skeletal

d. none of the above

c. skeletal

the lower 1/3 of the esphagus is made of which of the following type(s) of muscle(s)?

a. smooth

b. skeletal

c. combo of smooth and skeletal

d. none of the above

a. smooth

the middle 1/3 of the esophagus is made of which of the following type(s) of muscle(s)?

a. smooth

b. skeletal

c. combo of smooth and skeletal

d. none

c. combo

type 1 cells of the alveoli contain which of the following?

a. myoepithelial cells

b. epithelial cells

c. connective tissue

d. neurons

b. epithelial cells

what type of epithelial cells compose the walls of the alveolus?

a. simple columnar

b. simple squamous

c. simple cuboidal

d. none of the above

b. simple sqaumous

In the order that they occur, which of the following is the correct order through which air moves.

a. Type 1 epithelial cell, basement membrane of type 1 epithelial cell, basement membrane of the endothelial cell, endothelial cell.

b. Type 2 epithelial cell, basement membrane of type 1 epithelial cell, basement membrane of the endothelial cell, endothelial cell.

c. Type 1 epithelial cell, basement membrane of type 2 epithelial cell, basement membrane of the endothelial cell, endothelial cell.

d. none of the above

a.

When hemoglobin is 99.99% saturated, the pO2 of the plasma is

a. 100mmhg

b. 40mmhg

c. 10mmhg

d. none of the above

a. 100mmhg

which of the following causes the oxy-hemoglobin to shift to the right

a. increased temp

b. decreased temp

c. increased pH

d. none of the above

a. increased temp

what does “shift to the right” refer to on an oxy-hemoglobin graph?

it refers to a decrease in oxygen’s affinity, allowing oxygen to be released by hemoglobin more readily

OXYGEN IS RELEASED MORE

What does “shift to the left” refer to on an oxy-hemoglobin graph?

it refers to an increase in oxygen’s affinity, making less oxygen release from the hemoglobin

OXYGEN IS RELEASED LESS

an increase in pH causes a shift to the ____ of the oxy-hemoglobin curve

left

an increase in pH means the pH is less acidic

with positive cooperativity

a. oxygen loads easier on the 2nd subunit

b. oxygen loads the hardest on the 4th subunit

c. its difficult to load oxygen

d. this property has no effect on oxygen loading

a. correct!

positive cooperativity means the subunits load on easier than the last, which the first being the most difficult, and the last being the easiest to load.

how many protons does oxygen have?

8

Where is more than 98% of oxygen located in the blood?
a. attached to hemoglobin
b. dissolved in the plasma
c. attached to carbon dioxide
d. none of the above

a. attached to hemoglobin

how many subunits does hemoglobin have

4

When hemoglobin is referred to as heterotetrameric, which of the following defines what is meant by that term?
a. Hemoglobin has 4 subunits and they are all different
b. Hemoglobin has four subunits and three of the four are identical
c. Hemoglobin has 4 subunits and 2 of the 4 are identical
d. none of the above

c.

hetero tetra meric

^ different ^4 ^part (sub-unit)

there are 2 types (hetero) of subunits (meric) out of the four (tetra)

how many oxygen molecules can bind to one subunit

1 for 1

venous blood has how many oxygen molecules attached to it?

venous blood is 75% saturated, meaning 3 oxygen molecules are attached to it

what is the average pO2 of venous blood?

a. 100 mmHg
b. 40 mmHg
c. 20 mmHg
d. 27 mmHg

b. 40 mmHg is the average

How far along the distance of a capillary is 25% of the oxygen delivered to the tissues?
a. the first one third
b. the first 2/3
c. the first 3/4
d. none of the above

a

• due to the immidiate pressure gradient with more pO2 in the arterial end & less in the venous end.

• This allows tissues to quickly get oxygen, especially when in need

How much does molecular oxygen weigh?
a. 16 amu
b. 32 amu
c. 8 amu
d. none of the above

b. 32 amu

molecular oxygen is O2

O is 16 amu

16 × 2 = 32 amu

Which of the following is a structural component of hemoglobin?
a. globin chains
b. porphyrin ring
c. ferrous iron
d. all of the above

all of the above

Oxygen binds to which of the following?
a. globin chains
b. ferrous iron
c. amino acids
d. none of the above

b

The relationship between the partial pressure of oxygen and the percent O₂ saturation defines which of the following?
a. a straight line
b. an s-shaped curve
c. bell-shaped curves
d. Gaussian curve

b

Which of the following leads to a rightward shift of the oxy-hemoglobin curve?
a. increased body temperature
b. increased pH
c. increased product of glycolysis
d. none of the above

a

The main difference between chlorophyll and hemoglobin is which of the following?
a. chlorophyll has magnesium in the center of its porphyrin ring
b. chlorophyll has iron in the center of its porphyrin ring
c. hemoglobin has magnesium in the center of its porphyrin ring
d. none of the above statements is true

a

What effect does lead have on hemoglobin?
a. decreases the amount of hemoglobin made
b. increases the amount of hemoglobin made
c. decreases overall protein synthesis
d. none of the above

a

If left unopposed, the alveoli will …

Options:
a. collapse
b. overinflate
c. remain the same
d. fill with air

a. collapse

If left unopposed, the chest wall will

a. spring forward

b. collapse

c. collapse and then spring forward

d. none of the above

a. they will spring forward due to the elastic properties

The intrapulmonary pressure is zero when

a. the glottis is open and air is moving into the lung

b. the glottis is closed and air is not moving into the lung

c. The glottis is closed and air is moving into the intrapleural cavity

d. none of the above

b. 

The pressure in the pleural cavity is referred to as the

a. interpleural pressure

b. intrapleural pressure

c. intraaveolar

d. none of the above

b.

A normal inflated lung is associated with which of the following?

a. The intrapleural pressure is always negative

b. The intrapleural pressure is always positive pressure

c. The intrapleural pressure is negative during inhalation and positive during exhalation.

d. none of the above

a

Patients with heart disease should avoid straining at stool for which of the following reasons?

a. Straining at stool increases intrathoracic pressure and increases venous return

b. Straining at stool decreases intrathoracic pressure and decreases venous return c. Straining at stool increases intrathoracic pressure decreases venous return

d. None of the above

c

An otherwise normal person has lost enough blood to decrease his body's hemoglobin concentration from 15 g/100 mL blood to 12 g/100 mL blood. Which of the following would be expected to decrease?

a. Arterial pO₂
b. Blood oxygen-carrying capacity
c. Arterial hemoglobin saturation
d. Arterial carbon dioxide content

b

An increase in carbon monoxide will:

a. Increase firing from the peripheral chemoreceptors
b. Increase pCO₂
c. Decrease arterial pO₂
d. Decrease in arterial oxygen content

d

A 22-year-old man was involved in a fight and received a blow to the head. On arrival to emergency department he was unconscious and was receiving assisted ventilation via a manual bag. His blood gases were: pO₂ = 45 mmHg, pCO₂ = 80 mmHg, pH = 7.05, HCO₃⁻ = 27 mM. In which form was most CO₂ being transported in this patient?

Options:
a. Dissolved
b. Bicarbonate ions
c. Carbaminohemoglobin compounds
d. CO₂ bound to plasma proteins

b

If the blood lacked red blood cells but the lungs were functioning normally:

Options:
a. The arterial pO₂ would be normal
b. The oxygen content of arterial blood would be normal
c. Both A and B would apply
d. Neither A nor B would apply

b

A leftward shift of the oxyhemoglobin curve results in which of the following?

a. decreased affinity of hemoglobin for oxygen
b. increased affinity of hemoglobin for oxygen
c. increased oxygen delivery to the tissues
d. both a and c

b.

A patient has respiratory alkalosis. How will the kidneys handle this?

a. decrease bicarbonate reabsorption
b. increase bicarbonate reabsorption
c. increase CO₂ release
d. decrease CO₂ retention

a.

a pneumonectomy is…

a. removal of an entire lung
b. removal of a piece of the lung
c. removal of a lobe of the lung
d. none of the above

a.

A rightward shift of the oxyhemoglobin curve results in which of the following?
a. decreased affinity of hemoglobin for oxygen
b. increased affinity of hemoglobin for oxygen
c. increased oxygen delivery to the tissues
d. both a and c

d is correct!

affinity refers to the attraction of oxygen 

An hereditary deficiency of alpha-1 antitrypsin is associated with
a. asthma
b. emphysema
c. tuberculosis
d. bronchitis

b

Angiotensin II contains
a. 10 amino acids
b. 8 amino acids
c. 14 amino acids
d. none of the above

b. correct!

angiotensin I contains 10 amino acids, then two are cleaved via ACE

Angiotensin II
a. decreases hydrostatic pressure within the glomerular capillaries
b. decreases glomerular filtration
c. increases glomerular filtration
d. none of the above

c

Because of the anti-insulin effects of placental hormones, insulin requirements increase during the third trimester.

true or false

true

At the apex of the lung, ventilation exceeds perfusion. Therefore, this area of the lung is said to contain
a. high V/Q units
b. low V/Q units
c. very low V/Q units
d. none of the above

a

At a PO₂ of 70 mm Hg and normal temperature and pH, hemoglobin is ________% saturated with oxygen.
a. 10
b. 25
c. 50
d. 75
e. over 90

e

As blood enters the systemic capillaries
a. pO₂ is high in the blood and low in the tissues
b. pO₂ is low in the blood and high in the tissues
c. pO₂ is low in the blood and low in the tissues
d. pO₂ is high in the blood and high in the tissues

a

Because women with diabetes have a higher incidence of birth anomalies than women without diabetes, an alpha-fetoprotein level may be ordered at 15 to 17 weeks’ gestation.

true or false

true

Blocking afferent action potentials from the chemoreceptors in the carotid and aortic bodies would interfere with the brain’s ability to regulate breathing in response to all EXCEPT which of the following?
a. changes in PCO₂
b. changes in PO₂
c. changes in pH due to carbon dioxide levels
d. changes in blood pressure
e. All of the answers are correct

d

Before inspiration, alveolar pressure is 0 and intrapleural pressure is −5 cm H₂O. At the end of an inspiration in a healthy person, with the glottis open, these readings would be:
a. Alveolar pressure of +2, intrapleural pressure of −8 cm H₂O
b. Alveolar pressure of −2, intrapleural pressure of −8 cm H₂O
c. Alveolar pressure of 0, intrapleural pressure of +5 cm H₂O
d. Alveolar pressure of 0, intrapleural pressure of −5 cm H₂O
e. Alveolar pressure of 0, intrapleural pressure of −8 cm H₂O

e

CO₂ is
a. less soluble than oxygen
b. slightly more soluble than oxygen
c. twenty times more soluble than oxygen
d. none of the above

c

Emphysema is characterized by
a. airway collapse due to increased elasticity
b. increased surface area of alveoli and alveolar ducts available for gas exchange
c. lung hyperinflation caused by alveolar air trapping
d. none of the above

c

Diffusion rate is directly proportional to ________ and ________.

Surface area & concentration (partial pressure) gradient

Generally, PCO₂ in arterial blood is ________ than PCO₂ in venous blood.

lower

High carbon dioxide concentration in body fluids is called
a. carbonation
b. hyperdioxia
c. hyperoxia
d. hypercarbia
e. hypercapnia

e

How does pulmonary edema also negatively affect lung expansion?
a. elastic fibers are rendered inoperable
b. capillary hydrostatic pressure is too low
c. water moving into the alveolus reduces the concentration of surfactant
d. none of the above

c

In respiratory acidosis, what role does the lung play?
a. none
b. decrease CO₂ release
c. increase CO₂ retention
d. none of the above

d is correct! the lungs do not play a role in erspiratory acidosis, they just face teh conseqeunces of it. The kidneys are responsible.

In external respiration __________, while __________ occurs in internal respiration.

a. oxygen moves from the alveoli to the pulmonary capillaries; carbon dioxide moves from the pulmonary capillaries to the alveoli

b. oxygen moves from the alveoli to the pulmonary capillaries; oxygen moves from the pulmonary capillaries to the alveoli

c. carbon dioxide moves from the alveoli to the pulmonary capillaries; carbon dioxide moves from the pulmonary capillaries to the alveoli

d. oxygen moves from the alveoli to the pulmonary capillaries; oxygen moves from the tissues to the systemic capillaries

e. oxygen moves from the alveoli to the pulmonary capillaries; carbon dioxide moves from the tissues to the systemic capillaries

e

If the partial pressure of oxygen in both air and water is 100 mm Hg, then the concentration of the oxygen is the same in the air and water.

true or false

false

Which of the following lung volumes or capacities cannot be determined with a simple spirometer?
A. Vital capacity
B. Expiratory reserve volume
C. Inspiratory reserve volume
D. Tidal volume
E. Functional residual capacity

E

Which of the following represents the amount of air that cannot be exhaled from the lungs?
a. FRC
b. RV
c. IRV
d. ERV

b

Which of the following represents the amount of air remaining in the lungs following a normal exhalation?
a. FRC
b. RV
c. ERV
d. IRV

a

Which of the following represents the additional amount of air that can be inhaled following a normal inhalation?
a. TV
b. IRV
c. ERV
d. FRC

b

The normal tidal volume is equal to approximately:
a. 2.3 liters
b. 500 ml
c. 6 liters
d. 1.2 liters

b

The residual volume is approximately:
a. 2.3 liters
b. 500 ml
c. 6 liters
d. 1.2 liters

d

The FRC is approximately:
a. 2.3 liters
b. 500 ml
c. 6 liters
d. 1.2 liters

a

A client weighs 90 kg. His tidal volume averages:
a. 169 ml
b. 200 ml
c. 150 ml
d. none of the above

b

Which of the following volumes cannot be recorded using a spirometer?
a. RV
b. ERV
c. TLC
d. all of the above

d… according to my professor

WHICH OF THE FOLLOWING IS THE AVERAGE RESIDUAL VOLUME

a. 2.5 L
b. 1 L
c. 1.2 L
d. NONE OF THE ABOVE

c. 1.2 liters

THE TIDAL VOLUME AVERAGES

a. 5000 ML
b. 500 ML
c. 50ML
d. 50 L

b

DURING EXHALATION IN A PERSON WHO IS AT REST, EXHALATION IS

a. PASSIVE
b. ACTIVE
c. ATP DEPENDANT
d. NONE OF THE ABOVE

a. passive

WHICH ONE OF THE FOLLOWING REPRESENTS AIR THAT IS TRAPPED IN THE LUNG?

a. ERV
b. TV
c. RV
d. IRV

c. RV

ONCE EACH YEAR, MOST PEOPLE EXECUTE THE FOLLOWING ACTION

a. BREATHE IN UP TO TOTAL LUNG VOLUME AND THEN EXHALE DOWN TO RV
b. BREATHE IN DOWN TO TOTAL LUNG VOLUME AND THEN EXHALE DOWN TO RV
c. BREATHE IN UP TO TOTAL LUNG VOLUME AND THEN INHALE DOWN TO RV
d. NONE OF THE ABOVE

a.

The partial pressure of oxygen of arterial blood averages

a. 100 mmHg
b. 75 mmHg
c. 40 mmHg
d. 0 mmHg

a

The partial pressure of oxygen in venous blood averages

a. 100 mmHg
b. 75 mmHg
c. 40 mmHg
d. 0 mmHg

c

A leftward shift of the oxyhemoglobin curve results in which of the following?

a. decreased affinity of hemoglobin for oxygen
b. increased affinity of hemoglobin for oxygen
c. increased oxygen delivery to the tissues
d. both a and c

b

Which of the following binds to hemoglobin with greater affinity than oxygen?

a. CO
b. CO2
c. N2
d. none of the above

a

Fetal hemoglobin

a. lies to the left of the adult oxyhemoglobin curve
b. lies to the right of the adult oxyhemoglobin curve
c. binds oxygen with a lesser affinity than does adult hemoglobin
d. both a and c

a

Which of the following should decrease the affinity of hemoglobin for oxygen?

a. Low pCO2

b. alkalosis
c. Acidosis
d. Decreased body temperature

c - acidosis

Which does NOT affect the rate of pulmonary and systemic gas exchange?

a. partial pressure of the gases
b. surface area available for gas exchange
c. diffusion distance
d. number of gases to be exchanged
e. molecular weight and solubility of the gases

d

During internal and external respiration, gases move by

a. osmosis
b. active transport
c. endocytosis
d. diffusion

d

How many amino acids does Ang II have?

a. 10
b. 8
c. 14
d. none of the above

b. 8

Which of the following enzymes is needed to convert Ang I into Ang II?

a. Angiotensin Transferase
b. Angiotensin hydrolase
c. Angiotensin-Converting Enzyme
d. None of the above

c.

Which of the following enzymes is located in the lung?

a. insulinase
b. tyrosinase
c. ACE
d. None of the above

c

Which of the following is required to convert angiotensinogen to Ang I?

a. ACE
b. renin
c. angiotensinogen
d. none of the above

b

Angiotensin II is a powerful

a. vasodilator
b. vasoconstrictor
c. hypernatremic agent
d. none of the above

b

Which of the following lung volumes or capacities cannot be determined with a simple spirometer?

A. Vital capacity
B. Expiratory reserve volume
C. Inspiratory reserve volume
D. Functional Residual Capacity

d

Calculate the minute ventilation and the alveolar ventilation for a patient with a respiratory rate of 10 breaths/minute, a tidal volume of 600 mL, and a dead space of 150 mL.

Minute Ventilation (L/min) | Alveolar Ventilation (L/min)
A. 4.5 | 3.0
B. 6.0 | 4.5
C. 8 | 6.5
D. 10 | 8.5
E. 12 | 10.5

a

A 50-year-old man participates in a marathon. Which muscle(s) are being used for inspiration during the marathon?

A. Gastrocnemius
B. Internal intercostals
C. Abdominals
D. External intercostals

d. external intercostals pull the ribs up & out, increasing lung volume (you breath faster and deeper during exercise)

Pulmonary surfactant is formed by:

A. Alveolar macrophages
B. Goblet cells
C. Type I alveolar cells
D. Type II alveolar cells

d. type II alveolar cells

Which of the following would be expected to increase the measured airway resistance?

A. Stimulation of parasympathetic nerves to the lungs
B. Low lung volumes
C. Release of histamine by mast cells
D. Forced expirations
E. All of the above

e. all of the above

Which of the following tend to decrease airway resistance?

A. Asthma
B. Stimulation by sympathetic fibers
C. Treatment with acetylcholine
D. Exhalation to residual volume

B - vasoconstriction & airway constriction

When the abdominals contract:

A. Intrapleural pressure becomes more negative
B. Alveolar pressure decreases
C. The recoil tendency of the lung increases
D. Functional residual capacity decreases

d

The most accurate statement about airway pressures during normal quiet breathing (as measured in the upper airway) is:

A. At the end of expiration there is a slight amount of positive airway pressure, between 3 and 5 mmHg above atmospheric
B. At the end of expiration airway pressure is the same as atmospheric
C. At the end of inspiration there is a slight negative airway pressure, between -3 and -5 mmHg
D. Airway pressure is atmospheric throughout the breathing cycle

b