Match these prefixes and suffixes to their meanings.
answer
The word root -pnea means breath or breathing.
The word root pneumo- means air, lung, or pulmonary.
The word root bronch- means throat or bronchial.
The word root -capnia means carbon dioxide in blood.
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Match these vocabulary terms to their meanings.
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A pneumothorax is the presence of air in the pleural cavity, which inhibits breathing.
Labored breathing is called dyspnea.
Small air passages less than 1 mm are called bronchioles.
Higher than normal CO2 in the blood is called hypercapnia.
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Which of the following descriptions accurately describes Boyle's law?
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The pressure of gas in your lungs is inversely proportional to the volume in your lungs.
Boyle's Law describes how air moves into and out of the lungs during inspiration and expiration. By changing the volume of the thoracic cavity, the pressure changes in the lungs. Increasing volume of the thoracic cavity leads to a decreased pressure, causing air to flow into the lungs (down its pressure gradient) and thus causing inspiration.
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Which muscles, when contracted, would increase the volume of air in the thoracic cavity?
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diaphragm and external intercostals
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Which pressure is the result of the natural tendency of the lungs to decrease their size (because of elasticity) and the opposing tendency of the thoracic wall to pull outward and enlarge the lungs?
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intrapleural pressure
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During an allergic reaction, which of the following would aid respiration?
-epinephrine
-histamine
-an increase in the parasympathetic nervous system
-acetylcholine (ACh)
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epinephrine
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If the transpulmonary pressure equals zero, what will happen to the lung?
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lungs will collapse
The transpulmonary pressure creates the suction that keeps the lungs inflated. When room air enters the pleural space, transpulmonary pressure is zero and the lungs deflate - this is known as a pneumothorax.
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Which of the following best describes how Boyle's law relates to the mechanics of breathing?
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If lung volume increases, intrapleural pressure decreases, drawing air into the lungs.
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Which of the following statements accurately describes transpulmonary pressure?
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Transpulmonary pressure is usually near 4 mmHg
Transpulmonary pressure is the difference between intrapulmonary and intrapleural pressures. Because intrapleural pressure is always about 4 mmHg lower than the intrapulmonary pressure, transpulmonary pressure tends to remain close to 4 mmHg.
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Which of the following could be responsible for an increase in intrapulmonary pressure?
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a decrease in lung volume
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Which of the following would likely result in a collapsed lung?
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an opening in the chest wall that allows the intrapleural pressure to equal atmospheric pressure
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This lung volume CANNOT be directly measured using a spirometer.
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residual volume
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Which lung volume tends to be the largest in healthy male and female adults?
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inspiratory reserve volume
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A patient with a restrictive lung disease such as tuberculosis is likely to see an increase in his or her __________.
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breathing rate
Restrictive lung diseases decrease vital capacity, total lung capacity, functional residual capacity, and residual volume. To provide adequate ventilation, the alveolar ventilation rate must increase.
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Which of the following behaviors would most likely result in an increased alveolar ventilation rate as compared to that of normal breathing?
answer
slow, deep breathing
Slow breathing provides adequate time for gases to pass into the alveoli, while breathing deeply increases the number of alveoli being utilized. The combination of these factors increases effective ventilation, or alveolar ventilation rate.
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_______ has a greater partial pressure in the pulmonary capillaries than in the alveoli, so it diffuses into the _______.
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CO2; alveoli
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Despite the fact that the partial pressure difference is so much smaller for CO2, why is there as much CO2 exchanged between the alveoli and blood as there is O2, ?
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CO2 is much more soluble in blood than O2
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How would the partial pressures of O2 and CO2 change in an exercising muscle?
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The partial pressure of O2 would decrease, and the partial pressure of CO2 would increase.
Cells use O2 and produce CO2 during cellular respiration to produce ATP. Exercising muscles need more ATP.
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Which way would O2 and CO2 diffuse during internal respiration?
answer
O2 would diffuse into the cells, and CO2 would diffuse into the systemic capillaries.
The PO2 would be higher in the systemic capillaries, and the PCO2 would be higher in the tissues.
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Internal and external respiration depends on several factors. Which of the following is NOT an important factor in gas exchange?
answer
-rate of blood flow through the tissue
-the molecular weight of the gas
-available surface area
-partial pressure of the gases
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Which statement is correct?
-The greater the available surface area the lower the amount of gas exchange during internal respiration.
-During external respiration, equilibrium is reached for O2 when the partial pressure for O2 in the pulmonary capillaries and the alveoli are the same.
-During external respiration, oxygen is unloaded from the blood.
-During internal respiration, carbon dioxide is unloaded from the blood.
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During external respiration, equilibrium is reached for O2 when the partial pressure for O2 in the pulmonary capillaries and the alveoli are the same.
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During inhalation,
answer
the diaphragm and rib muscles contract.
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From which structures do oxygen molecules move from the lungs to the blood?
answer
Alveoli
Alveoli are tiny sacs in the lungs surrounded by capillaries. The alveoli are where oxygen diffuses from the lungs to the blood.
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Which statement is correct?
-Carbon dioxide diffuses from the alveoli into surrounding capillaries.
-As oxygen diffuses from the lungs into capillaries, blood becomes deoxygenated.
-In the blood, oxygen is bound to hemoglobin, a protein found in red blood cells.
-Oxygen diffuses from large blood vessels into the body's cells.
-Oxygen is released from the mitochondria as a product of cellular respiration.
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In the blood, oxygen is bound to hemoglobin, a protein found in red blood cells.
When oxygen diffuses from the alveoli to the surrounding capillaries, it enters a red blood cell and binds to hemoglobin.
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After blood becomes oxygenated,
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it returns to the heart, and is then pumped to body cells.
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Hemoglobin
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is a protein that can bind four molecules of oxygen.
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What area in the brain sets the respiratory rhythm?
answer
ventral respiratory group (VRG)
The VRG is the rhythm-generating center in the medulla.
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Inspiratory neurons send information to the diaphragm via what nerve?
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phrenic nerve
The phrenic nerve innervates the diaphragm. Stimulation causes the diaphragm to contract (increasing volume and decreasing pressure), thus causing inspiration.
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What directly stimulates the central chemoreceptors, thus increasing respiration?
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H+ (hydrogen ions)
Hydrogen ions (H+) stimulate the central chemoreceptors. CO2 is converted to H+ in the extracellular fluid of the brain.
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As a result of hyperventilation, what will happen to the partial pressures of CO2 (pCO2) and pH?
answer
decreased pCO2 and increased pH
pCO2 would decrease and pH would increase. As CO2 is blown off, H+ would decrease, thus increasing pH.
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Which receptors inhibit inspiration during hyperinflation of the lungs?
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pulmonary stretch receptors
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What stimulates increased respiration at the beginning of exercise?
answer
sensory input from receptors in joints, neural input from the motor cortex, and other factors
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A homeostatic control mechanism controls respiration. What acts as the effector(s) in this system?
answer
respiratory muscles
Yes, the respiratory muscles change the volume of the thoracic cavity (and thus the pressure), resulting in inspiration and expiration.
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Focus your attention on the graph shown, from the left side of the Focus Figure. The percent of O2 saturation of hemoglobin is plotted (on the y-axis) against PPO2 (mm Hg) (on the x-axis). Use this graph to complete Parts A-C below. On this graph, the y-axis (the vertical edge) tells you how much O2 is bound to hemoglobin (Hb). At 100%, each Hb molecule has four bound oxygen molecules. The x-axis (the horizontal edge) tells you the relative amount (partial pressure) of O2 dissolved in the fluid surrounding the Hb.
If more O2 is present, more O2 is bound. However, because of Hb's properties (O2 binding strength changes with saturation), this is an S-shaped curve, not a straight line.
Which of the following represents a correct statement about data presented in the graph?
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In blood with a PO2PO2 of 30 mm Hg, the average saturation of all hemoglobin proteins is 60%.
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Using the same graph as in Part A, what is the average number of oxygens bound to hemoglobin at a saturation of 50%?
answer
two
question
Focus your attention on the graph shown, from the top right box, "In the lungs," of the Focus Figure.
Drag and drop the numerical terms to the appropriate blank target locations in the sentences.
answer
1. The PO2PO2 in the lungs at sea level is PO2PO2 of ~100 mm Hg
The P O 2 in the lungs at sea level is P O 2 of ~100 mm Hg.
2. The saturation of hemoglobin in the lungs at sea level is ~98% O2O2 saturation
The saturation of hemoglobin in the lungs at sea level is ~98% O 2 saturation at P O 2 ~100 mm Hg.
at PO2PO2 ~100 mm Hg.
3. The saturation of hemoglobin in the lungs at high altitude of PO2PO2 ~80 mm Hg is ~95% O2O2 saturation
The saturation of hemoglobin in the lungs at high altitude of P O 2 ~80 mm Hg is ~95% O 2 saturation.
4. The saturation of hemoglobin at the lungs at an altitude representing PO2PO2 ~60 mm Hg is closest to ~90% O2O2 saturation
The saturation of hemoglobin at the lungs at an altitude representing P O 2 ~60 mm Hg is closest to ~90% O 2 saturation.
5. The PO2PO2 in the lungs at a high altitude is PO2PO2 of ~80 mm Hg
The P O 2 in the lungs at a high altitude is P O 2 of ~80 mm Hg.
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Focus your attention on the graph shown, from the lower right box, "In the tissues," of the Focus Figure.
Sort the correct pressures into the appropriate bins that represent tissue descriptions. Each bin should contain a value for PO2 and a value for Hb.
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Resting Tissue:
Hb ~75% O2 saturation
PO2 ~40 mm Hg
Metabotically active tissue:
PO2 ~20 mm Hg
Hb ~40% O2 saturation
Neither:
PO2 ~30 mm Hg
Hb ~50% O2 saturation
question
A firefighter breathes in air normally as he enters a building following an explosion and fire. He has a meter that predicts the PO2PO2 will approximate 15 mm Hg in his tissue fluids as he actively moves about the room.
Select the best statement.
answer
The firefighter's hemoglobin saturation will be about one oxygen per hemoglobin, and he will require an external air tank.
An O2O2 saturation of hemoglobin of ~25% is insufficient for the firefighter moving about the room, and he should use external oxygen.
question
Nurses Need Physiology: Collapsed Lungs
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You are doing a clinical on the medical-surgical floor of a local hospital when Mr. B arrives from the emergency room. Mr. B is a 32-year-old who was thrown off his bicycle in an accident; he has three fractured ribs and a punctured lung. In the ER, they inserted a chest tube to drain air and fluid out of his pleural cavity, allowing his lungs to re-expand. He had one dose of Demerol 3 hours ago for pain and a second dose just before transfer, according to the telephone report from the ER nurse.
How does removing air from the chest allow the lungs to expand? To begin, let's review the pleural cavity and what it is.
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Mr. B has been transferred to your floor to wait and see whether the chest tube allows his lungs to completely re-expand. But when he arrives, he is in severe respiratory distress. He says "I felt better before I came into the ER! Is this tube doing anything?"You tell the Clinical Nurse Specialist (CNS). As the two of you move him into the bed, you notice that his chest tube bottle is lying on its side on the gurney, with air going into it. When you point this out to the CNS, she immediately grabs the bottle and sets it upright on the floor. You see air start bubbling through the fluid right away. "That was the problem!" she says. "They lost the water seal, and air was going into his chest from the bottle. You would not believe how many times that happens on transport." When you examine Mr. B, you have trouble detecting his lung sounds on the left. Even stranger, his apical heart sound is in the wrong place - it is over toward the right side of his chest. His respiration rate and heart rate are both increased, and he is struggling to breathe. "Let's give him a little oxygen. He'll be a lot better in a half-hour," says the CNS. "Check back on him."Why would accumulation of air in his pleural space cause his heart sounds to be in the wrong place?
answer
Because the left side of Mr. B's chest is filling up with air, the organs in his chest are being pushed over to the right.
As Mr. B's left pleural cavity fills up with air, the organs in his chest will be pushed over to the right. If it gets bad enough, you will actually be able to see his trachea slanting toward the right as it runs down his neck. This condition is called a deviated mediastinum; the mediastinum is the big bundle of trachea, blood vessels, and heart that normally hangs in the center of the chest.
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While Mr. B is recovering, you check on your other patients. Mrs. H, a 57-year-old first-day post-cholecystectomy patient, is also showing signs of rapid breathing, increased heart rate, and decreased pulse oximeter readings. You ask if she has been using her incentive spirometer to make sure she breathes deeply, and she says, "It hurts my belly incision. There wasn't anything wrong with my lungs anyway.""There will be if you don't use it! You really need to do that at least once an hour. It's to keep your alveoli from collapsing.""Why would they collapse? The doctors didn't do anything to them, unless that anesthesia gas was toxic."
Choose the three best explanations for why Mrs. H's alveoli might collapse if she does not do her deep breathing with the incentive spirometer.
answer
• When she is lying down, it is harder for her to expand her chest cavity anyway. She needs to put extra effort into it.
• Shallow breathing that does not fill her lungs will only move air into the alveoli in the upper part of her lungs, letting those in the lower part stay closed.
• The alveoli are lined with water, and attraction between the water molecules pulls them together. This surface tension will pull the alveoli closed if she does not open them with deep breathing.
question
Mrs. H still isn't convinced. "I'm not dumb," she says. "I've done the math! Numbers don't lie - half as deep and twice as often means the same amount of air."Let's do some calculations for her.
Drag the correct numbers into position to show Mrs. H what will happen to her if she breathes half as deeply but twice as often.
answer
Sidenote: to calculate how much fresh air enters your alveoli in one breath (mL) you need to divide alveolar ventilation by respiration rate
•Assumes dead space volume equals 150 mL
question
When your clinical ends, Mr. B is resting peacefully. His respiratory rate and heart rate are back to normal, his chest tube is not bubbling anymore, and his breath sounds are even on both sides. Mrs. H is using her spirometer, and the respiratory tech says her vital capacity is a lot better than it was the first time he checked on her. The CNS tells your prof you made a good save in noticing Mr. B's tipped chest tube bottle. A great clinical all around! So you treat yourself to an after-class drink with a fellow student who spent her day in the NICU (neonatal intensive care unit)."You won't believe what happened to me today! The transport from ER collapsed somebody's lung!""It must be lung day. We have a preemie in the NICU with collapsed lungs as well.""Wow, what happened? Did it have a chest injury? Do they put chest tubes in babies?""No, she just never inflated them when she was born. The doctors keep talking about surfactant, but the mom didn't understand what that meant. She was so scared; I felt sorry for her. But I don't think I could explain it either!"You are on a roll today, so help your friend come up with a clear explanation of what surfactant does.
Choose the best explanation.
answer
The alveoli are lined with water molecules, which are attracted to one another and tend to move closer together, making the alveoli collapse. Surfactant molecules get in between the water molecules, keeping them apart.
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