Unit 2: Chapters 18, 19, 22 Study Packet
Table of Contents
Chapter 18 Objectives ……………………………………….. 2
Chapter 18 Lecture Outline …………………………………. 3
Chapter 19 Objectives ……………………………………….. 6
Chapter 19 Lecture Outline …………………………………. 7
Chapter 22 Objectives ……………………………………….. 12
Chapter 22 Lecture Outline …………………………………. 14
Exam 2 Study Guide ………………………………………..... 20
Chapters 18, 19, 22 Sample Exam ………………..…......... 25
Notes:
1. The lecture outlines are just an outline and not a replacement for your notes. You should
insert extra lines in the lecture outlines and use them as note taking guides.
2. The Exam 2 Study Guide is not meant to be an exclusive guide but rather a collection of
questions that address items I think are important – notice that the wording is as odd as
my lectures, which reflects how I write test questions.
3. The sample exam is not the exam. Don’t memorize the questions and answers and think
that will substitute for studying. I wouldn’t even look at it until you’ve completed your
studying.
1
The Cardiovascular System: The Heart
Objectives
Heart Anatomy
1. Describe the size, location, and orientation of the heart.
2. Identify structures of the pericardium.
3. Define the endocardium, myocardium, and epicardium.
4. Compare the function of the atria and the ventricles, and describe the difference between
the function of the right and left ventricles.
5. Discuss the need for coronary circulation, and name the vessels that play a role in it.
6. Indicate the function and location of the atrioventricular valves and aortic and pulmonary
valves.
Properties of Cardiac Muscle Fibers
7. Describe the microscopic anatomy and control of cardiac muscle cells, and compare to
skeletal muscle cells.
8. Name the energetic requirements of cardiac muscle and how these requirements are met.
Heart Physiology
9. Describe the structures and activities of the intrinsic conduction system.
10. Draw a typical ECG. Label and define the three phases.
11. Discuss the cardiac cycle in terms of relative pressure in each set of chambers.
12. Explain the normal heart sounds and how the sounds relate to closure of specific valves and
systole or diastole of the ventricles.
13. Define cardiac output, stroke volume, and heart rate. Calculate cardiac output and cardiac
reserve.
14. List the factors that affect stroke volume of the heart.
15. Describe the effects of the divisions of the autonomic nervous system on the heart.
Developmental Aspects of the Heart
16. Describe the events of development of the heart from two separate tubes to a fin-ished
structure.
17. Explain age-related changes that occur in the heart. Discuss possible changes in heart
function due to these changes.
2
Lecture Outline
I. Heart Anatomy (pp. 678–689; Figs. 18.1–18.10)
A. Size, Location, and Orientation (p. 678; Fig. 18.1)
1. The heart is the size of a fist and weighs 250–300 grams.
2. The heart is found in mediastinum and two-thirds lies left of the midsternal line.
3. The base is directed toward the right shoulder and the apex points toward the left hip.
B. Coverings of the Heart (p. 678; Fig. 18.2)
1. The heart is enclosed in a doubled-walled sac called the pericardium.
2. Deep to pericardium is the serous pericardium.
3. The parietal pericardium lines the inside of the pericardium.
4. The visceral pericardium, or epicardium, covers the surface of the heart.
C. Layers of the Heart Wall (pp. 678–680; Fig. 18.3)
1. The myocardium is composed mainly of cardiac muscle and forms the bulk of the
heart.
2. The endocardium lines the chambers of the heart.
D. Chambers and Associated Great Vessels (pp. 680–684; Fig. 18.4)
1. The right and left atria are the receiving chambers of the heart.
2. The right ventricle pumps blood into the pulmonary trunk; the left ventricle pumps
blood into the aorta.
E. Pathway of Blood Through the Heart (pp. 684–685; Fig. 18.5)
1. The right side of the heart pumps blood into the pulmonary circuit; the left side of the
heart pumps blood into the systemic circuit.
F. Coronary Circulation (pp. 685–686; Fig. 18.7)
1. The heart receives no nourishment from the blood as it passes through the chamber.
2. The coronary circulation provides the blood supply for the heart cells.
3. In a myocardial infarction, there is prolonged coronary blockage that leads to cell
death.
G. Heart Valves (pp. 686–689; Figs. 18.8–18.10)
1. The tricuspid and bicuspid valves prevent backflow into the atria when the ventricles
contract.
2. When the heart is relaxed the AV valves are open, and when the heart contracts the
AV valves close.
3. The aortic and pulmonary valves are found in the major arteries leaving the heart.
They prevent backflow of blood into the ventricles.
4. When the heart is relaxed the aortic and pulmonary valves are closed, and when the
heart contracts they are open.
II. Properties of Cardiac Muscle Fibers (pp. 689–692; Figs. 18.11–18.12 )
A. Microscopic Anatomy (pp. 689–690; Fig. 18.11)
1. Cardiac muscle is striated and contraction occurs via the sliding filament mechanism.
2. The cells are short, fat, branched, and interconnected by intercalated discs.
B. Mechanism and Events of Contraction (pp. 690–692; Fig. 18.12)
1. Some cardiac muscle cells are self-excitable.
2. The heart contracts as unit or not at all.
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3. The heart’s absolute refractory period is longer than a skeletal muscle’s, preventing
tetanic contractions.
C. Energy Requirements (p. 692)
1. The heart relies exclusively on aerobic respiration for its energy demands.
2. Cardiac muscle is capable of switching nutrient pathways to use whatever nutrient
supply is available.
III. Heart Physiology (pp. 692–705; Figs. 18.13–18.23)
A. Electrical Events (pp. 692–697; Figs. 18.13–18.18)
1. Intrinsic conduction system is made up of specialized cardiac cells that initiate and
distribute impulses, ensuring that the heart depolarizes in an orderly fashion.
2. The autorhythmic cells have an unstable resting potential, called pacemaker
potentials, that continuously depolarizes.
3. Impulses pass through the autorhythmic cardiac cells in the following order: sinoatrial
node, atrioventricular node, atrioventricular bundle, right and left bundle branches,
and Purkinje fibers.
4. The autonomic nervous system modifies the heartbeat: the sympathetic center
increases rate and depth of the heartbeat, and the parasympathetic center slows the
heartbeat.
5. An electrocardiograph monitors and amplifies the electrical signals of the heart and
records it as an electrocardiogram (ECG).
B. Heart Sounds (pp. 697–698; Fig. 18.19)
1. Normal
a. The first heart sound, lub, corresponds to closure of the AV valves, and occurs
during ventricular systole.
b. The second heart sound, dup, corresponds to the closure of the aortic and
pulmonary valves, and occurs during ventricular diastole.
2. Abnormal
a. Heart murmurs are extraneous heart sounds due to turbulent backflow of blood
through a valve that does not close tightly.
C. Mechanical Events: The Cardiac Cycle (pp. 698–700; Fig. 18.20)
1. Systole is the contractile phase of the cardiac cycle and diastole is the relaxation
phase of the cardiac cycle.
2. Cardiac Cycle
a. Ventricular Filling: Mid-to-Late Diastole
b. Ventricular Systole
c. Isovolumetric Relaxation: Early Diastole
D. Cardiac Output (pp. 700–705; Figs. 18.21–18.23)
1. Cardiac output is defined as the amount of blood pumped out of a ventricle per beat,
and is calculated as the product of stroke volume and heart rate.
2. Regulation of Stroke Volume
a. Preload: the Frank-Starling law of the heart states that the critical factor controlling
stroke volume is the degree of stretch of cardiac muscle cells immediately before
they contract.
b. Contractility: contractile strength increases if there is an increase in cytoplasmic
calcium ion concentration.
c. Afterload: ventricular pressure that must be overcome before blood can be ejected
from the heart.
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3. Regulation of Heart Rate
a. Sympathetic stimulation of pacemaker cells increases heart rate and contractility,
while parasympathetic inhibition of cardiac pacemaker cells decreases heart rate.
b. Epinephrine, thyroxine, and calcium influence heart rate.
c. Age, gender, exercise, and body temperature all influence heart rate.
4. Homeostatic Imbalance of Cardiac Output
a. Congestive heart failure occurs when the pumping efficiency of the heart is so low
that blood circulation cannot meet tissue needs.
b. Pulmonary congestion occurs when one side of the heart fails, resulting in
pulmonary edema.
IV. Developmental Aspects of the Heart (pp. 705–709; Figs. 18.24–18.25)
A. Embryological Development (pp. 705–708; Figs. 18.24–18.25)
1. The heart begins as a pair of endothelial tubes that fuse to make a single heart tube
with four bulges representing the four chambers.
2. The foramen ovale is an opening in the interatrial septum that allows blood returning
to the pulmonary circuit to be directed into the atrium of the systemic circuit.
3. The ductus arteriosus is a vessel extending between the pulmonary trunk to the aortic
arch that allows blood in the pulmonary trunk to be shunted to the aorta.
B. Aging Aspects of the Heart (pp. 708–709)
1. Sclerosis and thickening of the valve flaps occurs over time, in response to constant
pressure of the blood against the valve flaps.
2. Decline in cardiac reserve occurs due to a decline in efficiency of sympathetic
stimulation.
3. Fibrosis of cardiac muscle may occur in the nodes of the intrinsic conduction system,
resulting in arrhythmias.
4. Atherosclerosis is the gradual deposit of fatty plaques in the walls of the systemic
vessels.
5
The Cardiovascular System: Blood Vessels
Objectives
PART 1: OVERVIEW OF BLOOD VESSEL STRUCTURE AND FUNCTION
1.
2.
3.
4.
5.
Define the direction of flow and oxygenation state of blood in arteries and veins.
Describe the structural arrangement and composition of the layers of blood vessels.
State the function of each type of blood vessel.
List the types of capillary endothelium and the functional applications of each.
Explain the pathway of blood flow through capillary beds, and the role of precapillary
sphincters.
PART 2: PHYSIOLOGY OF CIRCULATION
6. Define blood flow, blood pressure, and resistance, and describe the factors that affect each.
7. State the relationship between flow, pressure, and resistance.
8. Discuss systemic blood pressure in terms of pressure gradients and characteristics in each
type of vessel.
9. Define systolic and diastolic pressure, pulse pressure, and mean arterial pressure.
10. Explain the mechanisms used to regulate blood pressure.
11. Define hypertension and hypotension, and identify contributing factors.
12. Explain how blood flow is regulated by the body.
13. Identify the types and causes of circula-tory shock.
PART 3: CIRCULATORY PATHWAYS: BLOOD VESSELS OF THE BODY
14. List the major blood vessels of the body and the areas and organs they serve.
15. Describe the major differences between arteries and veins.
Developmental Aspects of Blood Vessels
16. Explain how the vascular system develops during fetal development.
17. Discuss special structural adaptations of the fetal circulation.
18. Identify the changes that occur in the vascular system as a consequence of age.
6
Lecture Outline
I. Part 1: Overview of Blood Vessel Structure and Function (pp. 714–723; Figs. 19.1–
19.4; Table 19.1)
A. Structure of Blood Vessel Walls (p. 714; Fig. 19.1; Table 19.1)
1. The walls of all blood vessels except the smallest consist of three layers: the tunica
intima, tunica media, and tunica externa.
2. The tunica intima reduces friction between the vessel walls and blood; the tunica
media controls vasoconstriction and vasodilation of the vessel; and the tunica externa
protects, reinforces, and anchors the vessel to surrounding structures.
B. Arterial System (pp. 716–722; Figs. 19.2–19.4)
1. Elastic, or conducting, arteries contain large amounts of elastin, which enables these
vessels to withstand and smooth out pressure fluctuations due to heart action.
2. Muscular, or distributing, arteries deliver blood to specific body organs, and have the
greatest proportion of tunica media of all vessels, making them more active in
vasoconstriction.
3. Arterioles are the smallest arteries and regulate blood flow into capillary beds through
vasoconstriction and vasodilation.
4. Capillaries are the smallest vessels and allow for exchange of substances between
the blood and interstitial fluid.
a. Continuous capillaries are most common and allow passage of fluids and small
solutes.
b. Fenestrated capillaries are more permeable to fluids and solutes than continuous
capillaries.
c. Sinusoidal capillaries are leaky capillaries that allow large molecules to pass
between the blood and surrounding tissues.
5. Capillary beds are microcirculatory networks consisting of a vascular shunt and true
capillaries, which function as the exchange vessels.
6. A cuff of smooth muscle, called a precapillary sphincter, surrounds each capillary at
the metarteriole and acts as a valve to regulate blood flow into the capillary.
C. Venous System (pp. 722–723)
1. Venules are formed where capillaries converge and allow fluid and white blood cells
to move easily between the blood and tissues.
2. Venules join to form veins, which are relatively thin-walled vessels with large lumens
containing about 65% of the total blood volume.
D. Vascular anastomoses form where vascular channels unite, allowing blood to be
supplied to and drained from an area even if one channel is blocked (p. 723).
II. Part 2: Physiology of Circulation (pp. 723–742; Figs. 19.5–19.17; Table 19.2)
A. Introduction to Blood Flow, Blood Pressure, and Resistance (pp. 723–724)
1. Blood flow is the volume of blood flowing through a vessel, organ, or the entire
circulation in a given period, and may be expressed as ml/min.
2. Blood pressure is the force per unit area exerted by the blood against a vessel wall,
and is expressed in millimeters of mercury (mm Hg).
3. Resistance is a measure of the friction between blood and the vessel wall, and arises
from three sources: blood viscosity, blood vessel length, and blood vessel diameter.
4. Relationship Between Flow, Pressure, and Resistance
7
a. If blood pressure increases, blood flow increases; if peripheral resistance
increases, blood flow decreases.
b. Peripheral resistance is the most important factor influencing local blood flow,
because vasoconstriction or vasodilation can dramatically alter local blood flow,
while systemic blood pressure remains unchanged.
B. Systemic Blood Pressure (pp. 724–726; Figs. 19.5–19.6)
1. The pumping action of the heart generates blood flow; pressure results when blood
flow is opposed by resistance.
2. Systemic blood pressure is highest in the aorta, and declines throughout the pathway
until it reaches 0 mm Hg in the right atrium.
3. Arterial blood pressure reflects how much the arteries close to the heart can be
stretched (compliance, or distensibility), and the volume forced into them at a given
time.
a. When the left ventricle contracts, blood is forced into the aorta, producing a peak in
pressure called systolic pressure (120 mm Hg).
b. Diastolic pressure occurs when blood is prevented from flowing back into the
ventricles by the closed semilunar valve, and the aorta recoils (70–80 mm Hg).
c. The difference between diastolic and systolic pressure is called the pulse
presssure.
d. The mean arterial pressure (MAP) represents the pressure that propels blood to
the tissues.
4. Capillary blood pressure is low, ranging from 40–20 mm Hg, which protects the
capillaries from rupture, but is still adequate to ensure exchange between blood and
tissues.
5. Venous blood pressure changes very little during the cardiac cycle, and is low,
reflecting cumulative effects of peripheral resistance.
C. Maintaining Blood Pressure (pp. 726–733; Figs. 19.7–19.11; Table 19.2)
1. Blood pressure varies directly with changes in blood volume and cardiac output,
which are determined primarily by venous return and neural and hormonal controls.
2. Short-term neural controls of peripheral resistance alter blood distribution to meet
specific tissue demands, and maintain adequate MAP by altering blood vessel
diameter.
a. The vasomotor center is a cluster of sympathetic neurons in the medulla that
controls changes in the diameter of blood vessels.
b. Baroreceptors detect stretch and send impulses to the vasomotor center, inhibiting
its activity and promoting vasodilation of arterioles and veins.
c. Chemoreceptors detect a rise in carbon dioxide levels of the blood, and stimulate
the cardioacceleratory and vasomotor centers, which increases cardiac output and
vasoconstriction.
d. The cortex and hypothalamus can modify arterial pressure by signaling the
medullary centers.
3. Chemical controls influence blood pressure by acting on vascular smooth muscle or
the vasomotor center.
a. Norepinephrine and epinephrine promote an increase in cardiac output and
generalized vasoconstriction.
b. Atrial natriuretic peptide acts as a vasodilator and an antagonist to aldosterone,
resulting in a drop in blood volume.
c. Antidiuretic hormone promotes vasoconstriction and water conservation by the
kidneys, resulting in an increase in blood volume.
8
d. Angiotensin II acts as a vasoconstrictor, as well as promoting the release of
aldosterone and antidiuretic hormone.
e. Endothelium-derived factors promote vasoconstriction, and are released in
response to low blood flow.
f. Nitric oxide is produced in response to high blood flow or other signaling molecules,
and promotes systemic and localized vasodilation.
g. Inflammatory chemicals, such as histamine, prostacyclin, and kinins, are potent
vasodilators.
h. Alcohol inhibits antidiuretic hormone release and the vasomotor center, resulting in
vasodilation.
4. Long-Term Mechanisms
a. The direct renal mechanism counteracts an increase in blood pressure by altering
blood volume, which increases the rate of kidney filtration.
b. The indirect renal mechanism is the renin-angiotensin mechanism, which
counteracts a decline in arterial blood pressure by causing systemic
vasoconstriction.
5. Monitoring circulatory efficiency is accomplished by measuring pulse and blood
pressure; these values together with respiratory rate and body temperature are called
vital signs.
a. A pulse is generated by the alternating stretch and recoil of elastic arteries during
each cardiac cycle.
b. Systemic blood pressure is measured indirectly using the ascultatory method,
which relies on the use of a blood pressure cuff to alternately stop and reopen
blood flow into the brachial artery of the arm.
6. Alterations in blood pressure may result in hypotension (low blood pressure) or
transient or persistent hypertension (high blood pressure).
D. Blood Flow Through Body Tissues: Tissue Perfusion (pp. 733–742; Figs. 19.12–19.17)
1. Tissue perfusion is involved in delivery of oxygen and nutrients to, and removal of
wastes from, tissue cells; gas exchange in the lungs; absorption of nutrients from the
digestive tract; and urine formation in the kidneys.
2. Velocity or speed of blood flow changes as it passes through the systemic circulation;
it is fastest in the aorta, and declines in velocity as vessel diameter decreases.
3. Autoregulation: Local Regulation of Blood Flow
a. Autoregulation is the automatic adjustment of blood flow to each tissue in
proportion to its needs, and is controlled intrinsically by modifying the diameter of
local arterioles.
b. Metabolic controls of autoregulation are most strongly stimulated by a shortage of
oxygen at the tissues.
c. Myogenic control involves the localized response of vascular smooth muscle to
passive stretch.
d. Long-term autoregulation develops over weeks or months, and involves an
increase in the size of existing blood vessels and an increase in the number of
vessels in a specific area, a process called angiogenesis.
4. Blood Flow in Special Areas
a. Blood flow to skeletal muscles varies with level of activity and fiber type.
b. Muscular autoregulation occurs almost entirely in response to decreased oxygen
concentrations.
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c. Cerebral blood flow is tightly regulated to meet neuronal needs, since neurons
cannot tolerate periods of ischemia, and increased blood carbon dioxide causes
marked vasodilation.
d. In the skin, local autoregulatory events control oxygen and nutrient delivery to the
cells, while neural mechanisms control the body temperature regulation function.
e. Autoregulatory controls of blood flow to the lungs are the opposite of what happens
in most tissues: low pulmonary oxygen causes vasoconstriction, while higher
oxygen causes vasodilation.
f. Movement of blood through the coronary circulation of the heart is influenced by
aortic pressure and the pumping of the ventricles.
5. Blood Flow Through Capillaries and Capillary Dynamics
a. Vasomotion, the slow, intermittent flow of blood through the capillaries, reflects the
action of the precapillary sphincters in response to local autoregulatory controls.
b. Capillary exchange of nutrients, gases, and metabolic wastes occurs between the
blood and interstitial space through diffusion.
c. Hydrostatic pressure (HP) is the force of a fluid against a membrane.
d. Colloid osmotic pressure (OP), the force opposing hydrostatic pressure, is created
by the presence of large, nondiffusible molecules that are prevented from moving
through the capillary membrane.
e. Fluids will leave the capillaries if net HP exceeds net OP, but fluids will enter the
capillaries if net OP exceeds net HP.
6. Circulatory shock is any condition in which blood volume is inadequate and cannot
circulate normally, resulting in blood flow that cannot meet the needs of a tissue.
a. Hypovolemic shock results from a large-scale loss of blood, and may be
characterized by an elevated heart rate and intense vasoconstriction.
b. Vascular shock is characterized by a normal blood volume, but extreme
vasodilation, often related to a loss of vasomotor tone, resulting in poor circulation
and a rapid drop in blood pressure.
c. Transient vascular shock is due to prolonged exposure to heat, such as while
sunbathing, resulting in vasodilation of cutaneous blood vessels.
d. Cardiogenic shock occurs when the heart is too inefficient to sustain normal blood
flow, and is usually related to myocardial damage, such as repeated myocardial
infarcts.
III. Part 3: Circulatory Pathways: Blood Vessels of the Body (pp. 742–743; Figs. 19.18–
19.29; Tables 19.3–19.13)
A. Two distinct pathways travel to and from the heart: pulmonary circulation runs from the
heart to the lungs and back to the heart; systemic circulation runs to all parts of the body
before returning to the heart. (pp. 742–743; Figs. 19.18–19.20; Tables 19.3–19.4)
B. There are some important differences between arteries and veins.
1. There is one terminal systemic artery, the aorta, but two terminal systemic veins: the
superior and inferior vena cava.
2. Arteries run deep and are well protected, but veins are both deep, which run parallel
to the arteries, and superficial, which run just beneath the skin.
3. Arterial pathways tend to be clear, but there are often many interconnections in
venous pathways, making them difficult to follow.
4. There are at least two areas where venous drainage does not parallel the arterial
supply: the dural sinuses draining the brain, and the hepatic portal system draining
from the digestive organs to the liver before entering the main systemic circulation.
10
C. Four paired arteries supply the head and neck. (pp. 748–749; Fig. 19.21; Table 19.5)
D. The upper limbs are supplied entirely by arteries arising from the subclavian arteries. (pp.
750–751; Fig. 19.22; Table 19.6)
E. The arterial supply to the abdomen arises from the aorta. (pp. 752–755; Fig. 19.23;
Table 19.7)
F. The internal iliac arteries serve mostly the pelvic region; the external iliacs supply blood
to the lower limb and abdominal wall. (pp. 756–757; Fig. 19.24; Table 19.8)
G. The venae cavae are the major tributaries of the venous circulation. (pp. 758–759; Fig.
19.25; Table 19.9)
H. Blood drained from the head and neck is collected by three pairs of veins. (pp. 760–761;
Fig. 19.26; Table 19.10)
I. The deep veins of the upper limbs follow the paths of the companion arteries. (pp. 762–
763; Fig. 19.27; Table 19.11)
J. Blood draining from the abdominopelvic viscera and abdominal walls is returned to the
heart by the inferior vena cava. (pp. 764–765; Fig. 19.28; Table 19.12)
K. Most deep veins of the lower limb have the same names as the arteries they accompany.
(p. 766; Fig. 19.29; Table 19.13)
IV. Developmental Aspects of the Blood Vessels (p. 743)
A. The vascular endothelium is formed by mesodermal cells that collect throughout the
embryo in blood islands, which give rise to extensions that form rudimentary vascular
tubes.
B. By the fourth week of development, the rudimentary heart and vessels are circulating
blood.
C. Fetal vascular modifications include shunts to bypass fetal lungs (the foramen ovale and
ductus arteriosus), the ductus venosus that bypasses the liver, and the umbilical arteries
and veins, which carry blood to and from the placenta.
D. At birth, the fetal shunts and bypasses close and become occluded.
E. Congenital vascular problems are rare, but the incidence of vascular disease increases
with age, leading to varicose veins, tingling in fingers and toes, and muscle cramping.
F. Atherosclerosis begins in youth, but rarely causes problems until old age.
G. Blood pressure changes with age: the arterial pressure of infants is about 90/55, but
rises steadily during childhood to an average 120/80, and finally increases to 150/90 in
old age.
11
The Respiratory System
Objectives
Functional Anatomy of the Respiratory System
1. List the structures and functions of the nose, nasal cavity, and paranasal sinuses.
2. Describe the structures of the pharynx, larynx, and trachea.
3. Explain the structure of the lungs and the vascular and neural networks that supply them.
4. Discuss the relationship of the pleurae to the lungs and thoracic wall, and their functional
importance.
Mechanics of Breathing
5. Define intrapulmonary and intrapleural pressure.
6. Describe pulmonary ventilation and the relationships between pressure and volume changes
as they apply to the lungs.
7. Identify the events of quiet and forced inspiration, and passive and forced expiration.
8. Discuss the effects of airway resistance, alveolar surface tension, and lung compliance on
pulmonary ventilation.
9. List and define the respiratory volumes and capacities.
10. Distinguish between obstructive and restrictive respiratory disorders, and describe the role of
pulmonary function tests in distinguishing between them.
11. Name the nonrespiratory air movements.
Basic Properties of Gases
12. Define Dalton’s law of partial pressures, and relate it to atmospheric gases.
13. Explain Henry’s law, and describe its importance to gas exchange in the lungs.
Composition of Alveolar Gas
14. Compare the composition of alveolar gases to atmospheric gases.
Gas Exchanges Between the Blood, Lungs, and Tissues
15. Define external respiration and pulmonary gas exchange, and describe the factors that
affect exchange.
Transport of Respiratory Gases by Blood
16. Describe how oxygen and carbon dioxide are carried in the blood, and explain the role of
hemoglobin.
Control of Respiration
17. List the neural structures that control respiration, and the factors that affect rate and depth of
respiration.
Respiratory Adjustments
18. Explain the adjustments to respiration that occur in response to exercise and increased
altitude.
Homeostatic Imbalances of the Respiratory System
19. Identify the characteristics of chronic obstructive pulmonary disorders, asthma, tuberculosis,
and lung cancer.
12
Developmental Aspects of the Respiratory System
20. Describe the events of development and growth of the respiratory system.
21. List the changes that occur in the respiratory system with age.
13
Lecture Outline
I. Functional Anatomy of the Respiratory System (pp. 831–846; Figs. 22.1–22.11; Table
22.1)
A. The Nose and Paranasal Sinuses (pp. 831–835; Figs. 22.1–22.3)
1. The nose provides an airway for respiration; moistens, warms, filters, and cleans
incoming air; provides a resonance chamber for speech; and houses olfactory
receptors.
2. The nose is divided into the external nose, which is formed by hyaline cartilage and
bones of the skull, and the nasal cavity, which is entirely within the skull.
3. The nasal cavity consists of two types of epithelium: olfactory mucosa and respiratory
mucosa.
4. The nasal cavity is surrounded by paranasal sinuses within the frontal, maxillary,
sphenoid, and ethmoid bones that serve to lighten the skull, warm and moisten air,
and produce mucus.
B. The Pharynx (p. 835; Fig. 22.3)
1. The pharynx connects the nasal cavity and mouth superiorly to the larynx and
esophagus inferiorly.
a. The nasopharynx serves as only an air passageway, and contains the pharyngeal
tonsil, which traps and destroys airborne pathogens.
b. The oropharynx is an air and food passageway that extends inferiorly from the level
of the soft palate to the epiglottis.
c. The laryngopharynx is an air and food passageway that lies directly posterior to the
epiglottis, extends to the larynx, and is continuous inferiorly with the esophagus.
C. The Larynx (pp. 835–838; Figs. 22.3–22.5)
1. The larynx attaches superiorly to the hyoid bone, opening into the laryngopharynx,
and attaches inferiorly to the trachea.
2. The larynx provides an open airway, routes food and air into the proper
passageways, and produces sound through the vocal cords.
3. The larynx consists of hyaline cartilages: thyroid, cricoid, paired arytenoid,
corniculate, and cuneiform; and the epiglottis, which is elastic cartilage.
4. Vocal ligaments form the core of mucosal folds, the true vocal cords, which vibrate as
air passes over them to produce sound.
5. The vocal folds and the medial space between them are called the glottis.
6. Voice production involves the intermittent release of expired air and the opening and
closing of the glottis.
7. Valsalva’s maneuver is a behavior in which the glottis closes to prevent exhalation
and the abdominal muscles contract, causing intra-abdominal pressure to rise.
D. The trachea, or windpipe, descends from the larynx through the neck into the
mediastinum, where it terminates at the primary bronchi (pp. 838–840; Fig. 22.6).
E. The Bronchi and Subdivisions: The Bronchial Tree (pp. 840–842; Figs. 22.7–22.8)
1. The conducting zone consists of right and left primary bronchi that enter each lung
and diverge into secondary bronchi that serve each lobe of the lungs.
2. Secondary bronchi branch into several orders of tertiary bronchi, which ultimately
branch into bronchioles.
3. As the conducting airways become smaller, the supportive cartilage changes in
character until it is no longer present in the bronchioles.
14
4. The respiratory zone begins as the terminal bronchioles feed into respiratory
bronchioles that terminate in alveolar ducts within clusters of alveolar sacs, which
consist of alveoli.
a. The respiratory membrane consists of a single layer of squamous epithelium, type-I
cells, surrounded by a basal lamina.
b. Interspersed among the type-I cells are cuboidal type-II cells that secrete
surfactant.
c. Alveoli are surrounded by elastic fibers, contain open alveolar pores, and have
alveolar macrophages.
F. The Lungs and Pleurae (pp. 842–846; Figs. 22.9–22.11)
1. The lungs occupy all of the thoracic cavity except for the mediastinum; each lung is
suspended within its own pleural cavity and connected to the mediastinum by
vascular and bronchial attachments called the lung root.
2. Each lobe contains a number of bronchopulmonary segments, each served by its
own artery, vein, and tertiary bronchus.
3. Lung tissue consists largely of air spaces, with the balance of lung tissue, its stroma,
comprised mostly of elastic connective tissue.
4. There are two circulations that serve the lungs: the pulmonary network carries
systemic blood to the lungs for oxygenation, and the bronchial arteries provide
systemic blood to the lung tissue.
5. The lungs are innervated by parasympathetic and sympathetic motor fibers that
constrict or dilate the airways, as well as visceral sensory fibers.
6. The pleurae form a thin, double-layered serosa.
a. The parietal pleura covers the thoracic wall, superior face of the diaphragm, and
continues around the heart between the lungs.
b. The visceral pleura covers the external lung surface, following its contours and
fissures.
II. Mechanics of Breathing (pp. 846–854; Figs. 22.12–22.16; Tables 22.2–22.3)
A. Pressure Relationships in the Thoracic Cavity (pp. 846–847; Fig. 22.12)
1. Intrapulmonary pressure is the pressure in the alveoli, which rises and falls during
respiration, but always eventually equalizes with atmospheric pressure.
2. Intrapleural pressure is the pressure in the pleural cavity. It also rises and falls during
respiration, but is always about 4 mm Hg less than intrapulmonary pressure.
B. Pulmonary Ventilation: Inspiration and Expiration (pp. 847–849; Figs. 22.13–22.14)
1. Pulmonary ventilation is a mechanical process causing gas flow into and out of the
lungs according to volume changes in the thoracic cavity.
a. Boyle’s law states that at a constant temperature, the pressure of a gas varies
inversely with its volume.
2. During quiet inspiration, the diaphragm and intercostals contract, resulting in an
increase in thoracic volume, which causes intrapulmonary pressure to drop below
atmospheric pressure, and air flows into the lungs.
3. During forced inspiration, accessory muscles of the neck and thorax contract,
increasing thoracic volume beyond the increase in volume during quiet inspiration.
4. Quiet expiration is a passive process that relies mostly on elastic recoil of the lungs
as the thoracic muscles relax.
5. Forced expiration is an active process relying on contraction of abdominal muscles to
increase intra-abdominal pressure and depress the ribcage.
C. Physical Factors Influencing Pulmonary Ventilation (pp. 849–851; Fig. 22.15)
15
1. Airway resistance is the friction encountered by air in the airways; gas flow is reduced
as airway resistance increases.
2. Alveolar surface tension due to water in the alveoli acts to draw the walls of the
alveoli together, presenting a force that must be overcome in order to expand the
lungs.
3. Lung compliance is determined by distensibility of lung tissue and the surrounding
thoracic cage, and alveolar surface tension.
D. Respiratory Volumes and Pulmonary Function Tests (pp. 851–854; Fig. 22.16; Tables
22.2–22.3)
1. Respiratory volumes and specific combinations of volumes, called respiratory
capacities, are used to gain information about a person’s respiratory status.
a. Tidal volume is the amount of air that moves in and out of the lungs with each
breath during quiet breathing.
b. The inspiratory reserve volume is the amount of air that can be forcibly inspired
beyond the tidal volume.
c. The expiratory reserve volume is the amount of air that can be evacuated from the
lungs after tidal expiration.
d. Residual volume is the amount of air that remains in the lungs after maximal forced
expiration.
e. Inspiratory capacity is the sum of tidal volume and inspiratory reserve volume, and
represents the total amount of air that can be inspired after a tidal expiration.
f. Functional residual capacity is the combined residual volume and expiratory
reserve volume, and represents the amount of air that remains in the lungs after a
tidal expiration.
g. Vital capacity is the sum of tidal volume, inspiratory reserve and expiratory reserve
volumes, and is the total amount of exchangeable air.
h. Total lung capacity is the sum of all lung volumes.
2. The anatomical dead space is the volume of the conducting zone conduits, which is a
volume that never contributes to gas exchange in the lungs.
3. Pulmonary function tests evaluate losses in respiratory function using a spirometer to
distinguish between obstructive and restrictive pulmonary disorders.
4. Nonrespiratory air movements cause movement of air into or out of the lungs, but are
not related to breathing (coughing, sneezing, crying, laughing, hiccups, and yawning).
III. Gas Exchanges Between the Blood, Lungs, and Tissues (pp. 854–858; Figs. 22.17–
22.20)
A. Gases have basic properties, as defined by Dalton’s law of partial pressures and Henry’s
law. (pp. 854–855)
1. Dalton’s law of partial pressures states that the total pressure exerted by a mixture of
gases is the sum of the pressures exerted by each gas in the mixture.
2. Henry’s law states that when a mixture of gases is in contact with a liquid, each gas
will dissolve in the liquid in proportion to its partial pressure.
B. The composition of alveolar gas differs significantly from atmospheric gas, due to gas
exchange occurring in the lungs, humidification of air by conducting passages, and
mixing of alveolar gas that occurs with each breath. (p. 855)
C. External Respiration: Pulmonary Gas Exchange (pp. 855–858; Figs. 22.17–22.19)
1. External respiration involves O2 uptake and CO2 unloading from hemoglobin in red
blood cells.
16
a. A steep partial pressure gradient exists between blood in the pulmonary arteries
and alveoli, and O2 diffuses rapidly from the alveoli into the blood, but carbon
dioxide moves in the opposite direction along a partial pressure gradient that is
much less steep.
b. The difference in the degree of the partial pressure gradients of oxygen and carbon
dioxide reflects the fact that carbon dioxide is much more soluble than oxygen in
the blood.
c. Ventilation-perfusion coupling ensures a close match between the amount of gas
reaching the alveoli and the blood flow in the pulmonary capillaries.
d. The respiratory membrane is normally very thin, and presents a huge surface area
for efficient gas exchange.
D. Internal Respiration: Capillary Gas Exchange in the Body Tissues (p. 858; Fig. 22.17)
1. The diffusion gradients for oxygen and carbon dioxide are reversed from those for
external respiration and pulmonary gas exchange.
2. The partial pressure of oxygen in the tissues is always lower than the blood, so
oxygen diffuses readily into the tissues, while a similar but less dramatic gradient
exists in the reverse direction for carbon dioxide.
IV. Transport of Respiratory Gases by Blood (pp. 853–863; Figs. 22.20–22.23)
A. Oxygen Transport (pp. 858–861; Figs. 22.20–22.22)
1. Since molecular oxygen is poorly soluble in the blood, only 1.5% is dissolved in
plasma, while the remaining 98.5% must be carried on hemoglobin.
a. Up to four oxygen molecules can be reversibly bound to a molecule of
hemoglobin—one oxygen on each iron.
b. The affinity of hemoglobin for oxygen changes with each successive oxygen that is
bound or released, making oxygen loading and unloading very efficient.
2. At higher plasma partial pressures of oxygen, hemoglobin unloads little oxygen, but if
plasma partial pressure falls dramatically, i.e. during vigorous exercise, much more
oxygen can be unloaded to the tissues.
3. Temperature, blood pH, PCO2, and the amount of BPG in the blood all influence
hemoglobin saturation at a given partial pressure.
4. Nitric oxide (NO), secreted by lung and vascular endothelial cells, is carried on
hemoglobin to the tissues where it causes vasodilation and enhances oxygen transfer
to the tissues.
B. Carbon Dioxide Transport (pp. 861–863; Figs. 22.22–22.23)
1. Carbon dioxide is transported in the blood in three ways: 7–10% is dissolved in
plasma, 20% is carried on hemoglobin bound to globins, and 70% exists as
bicarbonate, an important buffer of blood pH.
2. The Haldane effect encourages CO2 exchange in the lungs and tissues: when plasma
partial pressure of oxygen and oxygen saturation of hemoglobin decrease, more CO 2
can be carried in the blood.
3. The carbonic acid–bicarbonate buffer system of the blood is formed when CO 2
combines with water and dissociates, producing carbonic acid and bicarbonate ions
that can release or absorb hydrogen ions.
V. Control of Respiration (pp. 863–869; Figs. 22.24–22.27)
A. Neural Mechanisms and Generation of Breathing Rhythm (pp. 863–865; Figs. 22.24–
22.25)
17
1. The medulla oblongata contains the dorsal respiratory group, or inspiratory center,
with neurons that act as the pacesetting respiratory group, and the ventral respiratory
group, which functions mostly during forced breathing.
2. The pontine respiratory group within the pons modifies the breathing rhythm and
prevents overinflation of the lungs through an inhibitory action on the medullary
respiration centers.
3. It is likely that reciprocal inhibition on the part of the different respiratory centers is
responsible for the rhythm of breathing.
B. Factors Influencing Breathing Rate and Depth (pp. 865–869; Figs. 22.25–22.27)
1. The most important factors influencing breathing rate and depth are changing levels
of CO2, O2, and H+ in arterial blood.
a. The receptors monitoring fluctuations in these parameters are the central
chemoreceptors in the medulla oblongata, and the peripheral chemoreceptors in
the aortic arch and carotid arteries.
b. Increases in arterial PCO2 cause CO2 levels to rise in the cerebrospinal fluid,
resulting in stimulation of the central chemoreceptors, and ultimately leading to an
increase in rate and depth of breathing.
c. Substantial drops in arterial PO2 are required to cause changes in respiration rate
and depth, due to the large reserves of O 2 carried on the hemoglobin.
d. As H+ accumulates in the plasma, rate and depth of breathing increase in an
attempt to eliminate carbonic acid from the blood through the loss of C O2 in the
lungs.
2. Higher brain centers alter rate and depth of respiration.
a. The limbic system, strong emotions, and pain activate the hypothalamus, which
modifies respiratory rate and depth.
b. The cerebral cortex can exert voluntary control over respiration by bypassing
medullary centers and directly stimulating the respiratory muscles.
3. Pulmonary irritant reflexes respond to inhaled irritants in the nasal passages or
trachea by causing reflexive bronchoconstriction in the respiratory airways.
4. The inflation, or Hering-Breuer, reflex is activated by stretch receptors in the visceral
pleurae and conducting airways, protecting the lungs from overexpansion by inhibiting
inspiration.
VI. Respiratory Adjustments (pp. 869–870)
A. Adjustments During Exercise (pp. 869–870)
1. During vigorous exercise, deeper and more vigorous respirations, called hyperpnea,
ensure that tissue demands for oxygen are met.
2. Three neural factors contribute to the change in respiration: psychic stimuli, cortical
stimulation of skeletal muscles and respiratory centers, and excitatory impulses to the
respiratory areas from active muscles, tendons, and joints.
B. Adjustments at High Altitude (p. 870)
1. Acute mountain sickness (AMS) may result from a rapid transition from sea level to
altitudes above 8000 feet.
2. A long-term change from sea level to high altitudes results in acclimatization of the
body, including an increase in ventilation rate, lower than normal hemoglobin
saturation, and increased production of erythropoietin.
VII.
Homeostatic Imbalances of the Respiratory System (pp. 870–873; Fig. 22.28)
18
A. Chronic obstructive pulmonary diseases (COPD) are seen in patients that have a history
of smoking, and result in progressive dyspnea, coughing and frequent pulmonary
infections, and respiratory failure. (pp. 871–872)
1. Obstructive emphysema is characterized by permanently enlarged alveoli and
deterioration of alveolar walls.
2. Chronic bronchitis results in excessive mucus production, as well as inflammation and
fibrosis of the lower respiratory mucosa.
B. Asthma is characterized by coughing, dyspnea, wheezing, and chest tightness, brought
on by active inflammation of the airways. (p. 872)
C. Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium
tuberculosis and spread by coughing and inhalation. (p. 872)
D. Lung Cancer (pp. 872–873)
1. In both sexes, lung cancer is the most common type of malignancy, and is strongly
correlated with smoking.
2. Squamous cell carcinoma arises in the epithelium of the bronchi, and tends to form
masses that hollow out and bleed.
3. Adenocarcinoma originates in peripheral lung areas as nodules that develop from
bronchial glands and alveolar cells.
4. Small cell carcinoma contains lymphocyte-like cells that form clusters within the
mediastinum and rapidly metastasize.
VIII. Developmental Aspects of the Respiratory System (pp. 873–875; Fig. 22.29)
A. By the fourth week of development, the olfactory placodes are present and give rise to
olfactory pits that form the nasal cavities.
B. The nasal cavity extends posteriorly to join the foregut, which gives rise to an
outpocketing that becomes the pharyngeal mucosa.
C. By the eighth week of development, mesoderm forms the walls of the respiratory
passageways and stroma of the lungs.
D. As a fetus, the lungs are filled with fluid, and vascular shunts are present that divert
blood away from the lungs; at birth, the fluid drains away, and rising plasma P CO2
stimulates respiratory centers.
E. Respiratory rate is highest in newborns, and gradually declines to adulthood; in old age,
respiratory rate increases again.
F. As we age, the thoracic wall becomes more rigid, the lungs lose elasticity, and the
amount of oxygen we can use during aerobic respiration decreases.
G. The number of mucus glands and blood flow in the nasal mucosa decline with age, as
does ciliary action of the mucosa, and macrophage activity.
19
Bio 211 Exam 2 Study Guide
Chapter 18
1. Which part of the heart is the base and which part is the apex?
2. Be able to trace the flow of blood from somewhere out in the systemic circuit through the
heart and back to the starting place.
3. Where does deoxygenated blood enter the heart? Where does oxygenated blood enter?
4. What is the valve between the left atrium and the left ventricle? Right atrium and right
ventricle? Right ventricle and pumonary artery? Left ventricle and aorta? Which valves
keep blood from flowing back into the venous circulation when the atria contract?
5. Where does the myocardium receive its supply of oxygen and nutrients from?
6. What is the function of the chordae tendineae?
7. What is the route of conductance of electrical activity through the heart?
8. What is the difference between intrinsic and extrinsic regulation of heart rate?
9. What is the pacemaker of the heart? If it blows out what can take over? How do the
pacemaker cells set the heart rate without nervous system input to cause them to
depolarize?
10. What are tachycardia, bradycardia, normal sinus rhythm, heart block, and atherosclerosis?
11. How does sympathetic innervation affect the heart? How does parasympathetic innervation
affect the heart? Which exerts dominant control under normal circumstances?
12. What kind of information does an EKG provide?
13. What is the cardiac cycle? Define systole and diastole.
14. What portion of the electrocardiogram represents the quiescent phase of the cardiac cycle
and what kinds of things are occurring with the heart muscle (atrial systole/diastole,
ventricular systole/diastole, atrial repolarization, ventricular depolarization, which is it?)
15. When do the papillary muscles contract and put pressure on the chordae tendinae?
16. Which valves are open and which are closed during ventricular systole and diastole?
17. Which valves are open and which are closed during atrial systole and diastole?
18. What is the period of isovolumetric contraction?
19. What pressure does left ventricular pressure have to exceed to pump blood into the
systemic circuit? Why? The left ventricle does pump into the systemic circuit doesn’t it?
You wouldn’t be confused by a question that asked something like “What pressure does left
ventricular pressure have to exceed to pump blood into the pulmonary circuit?” since you
know the left ventricle doesn’t pump into the pulmonary circuit (and the right doesn’t pump
into the systemic circuit), right? I mean, you would read the question carefully wouldn’t you?
20. What pressure does the right ventricle have to overcome to pump blood into the pulmonary
circuit? Why?
21. Why is the right ventricular wall thinner than the left?
22. What causes heart sounds I and II? Heart murmurs? What is the difference between
regurgitation and stenosis?
23. What is cardiac output?
24. What is the definition of end systolic volume, end diastolic volume, and stroke volume?
25. How do ESV, EDV, heart rate, and stroke volume affect cardiac output?
26. According to the Frank-Starling law of the heart what things will increase pre-load? What
happens inside the cardiac myocytes when preload is increased? Can preload be increased
too much? What happens in that case? How will this affect stroke volume?
27. How will an increase in free intracellular calcium affect the myocardium? (Choose one of the
following – it’s a multiple choice study guide question.)
A. Relaxation
20
B. Contraction
C. Repolarization
D. Return to the resting membrane potential
28. What is the Bainbridge reflex?
29. How does congestive heart failure affect the pooling of blood in the body? Failure on which
side of the heart will affect the systemic and pulmonic circuits respectively?
30. What is the ductus arteriosus? What is the fossa ovalis? What is the foramen ovale? What
is the ligamentum arteriosum? What is the ductus venosus?
Chapter 19
31. What is the difference between veins and arteries (which has more elastic tissue, smooth
muscle, larger lumen, connective tissue, valves, etc.)?
32. What makes up the tunica intima? Tunica media? Tunica adventitia?
33. How is the structure of a capillary wall is like that of a vein or artery? How is it different?
34. What are the different types of capillaries? How is the difference in their structure reflected
in their function?
35. What does the term “capacitance vessel” mean? To what type of blood vessel does this
term refer?
36. What is an anastomosis? What is a collateral channel?
37. What are vasa vasorum? What is a sinus?
38. What are varicose veins?
39. Define blood flow.
40. What is blood pressure?
41. What is a pressure gradient?
42. What is resistance?
43. What things affect peripheral resistance in the cardiovascular system?
44. What factors aid venous return?
45. What do baroreceptors sense?
46. What things cause arterial blood pressure to increase or decrease (blood volume, peripheral
resistance, cardiac output, viscosity, vasodilation, vasoconstriction, any others?)?
47. What is the pulse pressure?
48. What is mean arterial pressure and how is it calculated?
49. What are short-term regulators of blood pressure? What are long-term regulators of blood
pressure? (I told you that you would see that renin-angiotensin thing again)
50. What is hypertension? What is the difference between primary and secondary? What will
hypertension do for you? What are the risk factors?
51. How is blood flow through individual organs or tissues regulated?
52. What does Starlings Law of the Capillary tell us about filtration and reabsorption at the
arteriolar end of the capillary, the venous end of the capillary, and the net force over the
entire capillary?
53. What is circulatory shock? What causes it?
54. What things are compensatory responses to circulatory shock?
55. What is atherosclerosis?
Chapter 22
1. What are the major functions of the respiratory system?
2. What are the functions of the nose?
21
3.
4.
5.
6.
7.
What is the difference between olfactory mucosa and respiratory mucosa?
What are the functions of the conchae?
How is dust (and other small particles) prevented from entering the lungs?
What are the functions of the sinuses?
Compare and contrast the divisions of the pharynx. (What are they, how are they alike,
how are they different)
8. Where is the uvula and what does it do?
9. What are the fauces?
10. Where are the pharyngeal, palatine, and lingual tonsils located? ("In the pharynx" is not
the best answer to prepare for the test)
11. The epithelium changes between the nasopharynx and oropharynx. What is the major
difference and why does the epithelium undergo this change?
12. What is the larynx? What are its two main functions? What is its third function?
13. How many cartilages make up the framework of the larynx? What kind of cartilage are
they composed of? Which one is different in composition? What kind of cartilage is it
composed of? Why? (What is its function?)
14. Where is the Adam's apple found? (in the center of which cartilage?)
15. What is the function of the cricoid cartilage?
16. What is the function of the arytenoid cartilage?
17. What is the difference between the vocal folds and the vestibular folds (location and
function)
18. What is the opening between the mucosal folds that comprise the vocal and vestibular
folds called?
19. How do the vocal cords and glottis contribute to vocal tone and pitch?
20. What is Valsalva's maneuver?
21. What is the position of the trachea relative to the esophagus?
22. What might be found in the mucosa, submucosa, and adventitia? (note the resumption
of pseudostratified ciliated columnar epithelium below the level of the epiglottis)
23. Why are the cartilage rings C shaped?
24. What is the carina? What is its function?
25. Describe the bronchial tree: What is the difference between primary and secondary
bronchi? What is the difference between bronchi and bronchioles? What are terminal
bronchioles, respiratory bronchioles, and alveolar ducts? What structural changes occur
as the bronchial tree branches to ever smaller tubes?
26. What are alveoli? What are their walls composed of? What is the respiratory
membrane?
27. What is surfactant?
28. What is the difference between Type I and Type II cells?
29. What are "dust cells"?
30. Which lung is larger? Which lung has more lobes? How many does it have?
31. Identify the cardiac notch, root, hilus, apex, and base.
32. How do the lungs receive nutrients?
33. What is a bronchopulmonary segment? What is a lobule?
34. What is the pulmonary pleura composed of?
35. Describe the innervation of the lungs?
36. What is pulmonary ventilation?
37. What does pressure have to do with air movement?
38. What is the difference (definition and number) between intrapulmonary pressure and
intrapleural pressure?
39. What factors contribute to the difference?
22
40. What is a pneumothorax? What is atelectasis?
41. What is Boyle's Law?
42. How does inspiration occur? What muscles are involved?
43. What process do the accessory muscles assist in?
44. How does expiration work? (2 factors) Is it active or passive? What about forced
expiration?
45. What factors influence ventilation?
46. What factors influence resistance?
47. What is compliance? What things will decrease compliance?
48. What is elasticity? What will cigarettes do for it?
49. How does surface tension affect ventilation? Does surfactant increase or decrease
surface tension? How?
50. Know your volumes and capacities
51. What is dead space? What is the difference between anatomical and alveolar dead
space?
52. What will pulmonary function tests tell you?
53. What is the difference between obstructive pulmonary disease and restrictive disorders?
54. What is MRV? What is AVR?
55. By what process are oxygen and carbon dioxide exchanged in the lungs and through cell
membranes?
56. What is Dalton's law of partial pressures? In practical terms, what does this mean in
regard to gas exchange?
57. What is Henry's Law and how does it effect gas exchange?
58. What is hyperbaric oxygen?
59. List (and understand) 4 factors that influence gas exchange.
60. How is oxygen transported in the blood?
61. Understand the oxygen-hemoglobin dissociation curve.
62. What is the % saturation of hemeglobin in the lungs? In venous blood? How many
mmHg is that?
63. What is venous reserve?
64. How does temperature affect the association of oxygen with hemoglobin? Does this
push the oxygen-hemoglobin dissociation curve to the right or left? (or both or either)
65. How are CO2, blood pH, the Bohr effect, and oxygen-hemoglobin dissociation related?
66. So what does this say about muscles working in anaerobic conditions?
23
67. What does BPG have to do with the oxygen-hemoglobin dissociation curve?
68. What is hypoxia and what does it result from?
69. How is CO2 transported in the blood (3 ways)?
70. I would know that carbonic acid/bicarbonate ion buffer system equation:
CO2 + H2O _ H2CO3 _H+ + HCO371. What is chloride shift?
72. What is the Haldane effect?
73. Where are the inspiratory and expiratory centers found? What is their function?
74. Where are the pneumotaxic and apneustic centers found? What is their function?
75. List 6 factors that affect respiratory rate.
76. What is the Hering-Breuer reflex?
77. Is CO2 more likely to to stimulate increased respiration centrally or peripherally? How about
O2? Which mechanism is more important in healthy people?
78. Define hypercapnia, hypocapnia, hyperventilation, apnea, eupnea, hyperpnea.
79. What is the danger of hyperventilation?
80. Under what circumstance does nitrogen as a respiratory gas become a problem?
81. Why would you not treat someone with chronic pulmonary disease who was in respiratory
distress with high levels of oxygen?
82. What is COPD? Compare and contrast emphysema and bronchitis. What is the major causal
factor in these diseases?
83. Is there any relation between cigarettes and lung cancer?
84. How does the fetus exchange gases? What stimulates the first breath?
24
Biology 211 Sample Exam 2 Heart/ Circulation/ Respiratory
1. The left ventricular wall of the heart is thicker than the right wall in order to:
A. Pump more blood
B. Pump blood through a smaller valve.
C. Pump blood with a greater pressure
D. Expand the thoracic cage during diastole.
E. Push blood into the lungs.
2. The P wave of a normal electrocardiogram indicates:
A. Atrial depolarization
B. Ventricular depolarization
C. Atrial repolarization
D. Ventricular repolarization
E. Tachycardia
3. Blood in the pulmonary veins enters:
A. Right atrium
B. Left atrium
C. Right ventricle
D. Left ventricle
E. Lung
4. The presence of fatty plaques in large and medium arteries best defines:
A. Congestive heart failure
B. Hypertension
C. Obesity
D. Atherosclerosis
E. Arteriosclerosis
5. Blood enters which of these vessels during ventricular systole?
A. Aorta
B. Pulmonary artery
C. Pulmonary vein
D. Aorta and pulmonary artery
E. Aorta and pulmonary vein
6. Small muscle masses attached to the chordae tendineae are the:
A. Trabeculae carneae
B. Papillary muscles
C. Pectinate muscles
D. Interventricular septum
25
7. Which of the following is not part of the conduction system of the heart?
A. AV node
B. Bundle of His
C. AV valve
D. SA node
8. Blood is carried to capillaries in the myocardium by way of:
A. The coronary sinus
B. Fossa ovale
C. Coronary arteries
D. Coronary veins
9. The tricuspid valve is closed:
A. While the ventricle is in diastole
B. By the movement of blood from atrium to ventricle
C. While atrium is contracting
D. When the ventricle is in systole
E. During all of the above
Match the following
A. Myocardium
B. Epicardium
C. Endocardium
D. Parietal pericardium
10. The outermost layer of the pericardial sac D
11. The inside lining of the heart C
12. Heart muscle A
13. Serous membrane layer outside or covering the surface of the heart B
14. Which statement best describes arteries?
A. All carry oxygenated blood to the heart.
B. All contain valves to prevent the back-flow of blood.
C. All carry blood away from the heart
D. Only large arteries are lined with endothelium
E. Only muscular arteries contain smooth muscle.
15. Which of the following are involved directly in pulmonary circulation?
A. Superior vena cava, right atrium, and left ventricle
B. Inferior vena cava, right atrium, and left ventricle
C. Right ventricle, pulmonary artery, and left atrium
D. Left ventricle, aorta, and inferior vena cava
E. Right atrium, aorta, left ventricle
26
16. Which tunic of an artery contains endothelium?
A. Intima
B. Media
C. Externa
D. Adventitia
17. Permitting the exchange of nutrients and gases between the blood and tissue cells is the primary
function of:
A. Capillaries
B. Arteries
C. Veins
D. Arterioles
18. The arteries that directly feed the capillary beds are called:
A. Muscular arteries
B. Arterioles
C. Elastic arteries
D. Aorta
19. Factors which aid venous return include all except:
A. Activity of skeletal muscles
B. Pressure changes in the abdominal and thoracic cavities during respiration
C. Venous valves
D. Greater uriinary output
Peripheral resistance (Answer A for TRUE and B for FALSE)
20. Increases as blood viscosity increases A
21. Decreases with increasing length of blood vessel B
22. Increases as blood vessel diameter increases B
MATCH
A. Large arteries
B. Arterioles
C. Capillaries
D. Venules
E. Large veins
23. Site where resistance to blood flow is greatest B
24. Site where blood is flowing fastest A
25. Site where blood is flowing slowest C
26. Site where histamine increases permeability D
27. Site where blood pressure is greatest A
28. Site where exchanges of nutrients and gases are made C
27
29. Slowing down the heart rate is a function of the:
A. Parasympathetic nervous system
B. Sympathetic nervous system
C. SA node
D. Epinephrine
E. AV node
30. The structure of a capillary wall differs from the wall of a vein or artery because:
A. It has two tunics instead of one.
B. There is less smooth muscle.
C. It is a single layer - only a tunica intima.
D. There are no endothelial cells.
31. Which sequence of events best represents the intrinsic conduction of an impulse through the
heart?
1.
2.
3.
4.
Sinoatrial node
Atrioventricular node
Purkinje fibers
Bundle of HIS
A. 1, 4, 3, 2
B. 1, 2, 3, 4,
C. 1, 3, 2, 4
D. 1, 2, 4, 3
32. Arterial blood pressure increases if:
A. Blood volume is lost
B. Peripheral resistance falls
C. Peripheral resistance increases
D. Viscosity of the blood decreases
E. Maximal vasodilation is achieved
33. The normal pacemaker of the heart is the:
A. A-V Node
B. Bundle of HIS
C. Purkinje fibers
D. S-A Node
34. Arterial blood pressure depends on:
A. Cardiac output
B. Blood volume
C. Peripheral resistance
D. All of these
28
35. Cardiac output equals:
A. Stroke volume times heart rate
B. Heart rate divided by stroke volume
C. Stroke volume plus heart rate
D. Heart rate times blood pressure
36. The valve between the right atrium and the right ventricle is the:
A. Tricuspid valve
B. Bicuspid valve (Mitral)
C. Aortic semilunar valve
D. Pulmonic semilunar valve
E. No valve is needed
37. A heart rate less than 60 beats a minute is:
A. Tachycardia
B. Bradycardia
C. Normal sinus rhythym
D. Heart block
E. Atherosclerosis
38. Smooth muscle and elastin of vessels would be found in the:
A. Tunica media
B. Tunica adventitia
C. Tunica intima
D. Vaso vasorum
39. The mean arterial blood pressure is:
A. The average of the systolic and diastolic pressure
B. Closer to the systolic pressure
C. Closer to the diastolic pressure
D. The pulse pressure
40. If the atrioventricular valves are open during ventricular systole the blood would:
A. Exit via the arteries
B. Enter the atria
C. Enter the lungs
D. Remain in the ventricles
41. Pressure in the left ventricle must exceed the pressure in the
systemic circuit.
A. Pulmonary artery
B. Brachiocephalic artery
C. Left atrium
D. Right ventricle
E. Aorta
to eject blood into the
42. The quiescent phase, or relaxation of all chambers in the cardiac cycle, is during:
A. QRS complex
B. Ventricular systole
C. The interval between the end of the T wave and P wave
29
D. Interval preceding the QRS complex
E. Atrial systole
43. The flow of blood from the cerebral circulation:
1. Right atrium
2. Left atrium
3. Pulmonary vein
4. Pulmonary artery
5. Left ventricle
6. Right ventricle
7. Carotid artery
8. Jugular vein (returns blood from the head and is near carotid artery)
9. Inferior vena cava
10. Superior vena cava
11. Aortic arch
12. Abdominal aorta
13. Thoracic aorta
14. Lungs
A. 10,1,6,3,14,4,2,5,11,12,13,8
B. 2,5,3,14,4,1,6,11,13,12,7,10
C. 8,10,1,6,4,14,3,2,5,11,7
D. 8,9,2,5,4,14,3,1,4,13,7
44. Semilunar valves are located:
A. Atria and ventricles
B. Where veins enter the atria
C. Where arteries leave the ventricles
D. At the intraventricular septum
45. In Starlings Law of the Capillary, the driving force for filtration is largely due to:
A. A higher hydrostatic pressure on the arteriole end of the capillary
B. A higher hydrostatic pressure on the venule side of the capillary
C. A large osmotic pressure due to proteins pulling fluid into the interstitium
D. A large osmotic pressure due to proteins driving fluid out of the capillaries
30
46. If the right side of the heart is affected in congestive heart failure the result would be:
A. Pooling of blood in the systemic circuit and edema
B. Pooling of blood and edema in the lungs
C. The myocardium cannot contract
D. Pooling of blood in both atria
E. None of these
47. The first and second heart sounds are due to:
A. Muscle contraction
B. Opening of valves
C. Closing of valves
D. Blood rushing into aorta
48. Contraction always follows:
A. Repolarization
B. Depolarization
C. Refractory period
D. Cardiac cycle
E. The T wave
49. Closing of the AV and semilunar valves:
A. Can be seen on the ECG
B. Make up the first and second heart sounds
C. Cannot be heard
D. Occur at the same time
50. Repolarization of the atria:
A. Occurs with the P wave
B. Follows the QRS complex
C. Occurs during the QRS complex
D. Occurs at the T wave
E. Does not occur
51. The pointed end of the heart is the:
A. Base
B. Intraventricular septum
C. Coronary sinus
D. Apex
52. Deoxygenated blood leaves the heart in the:
A. Aorta
B. Pulmonary artery
C. Pulmonary vein
D. Vena cava
53. The volume of blood in the ventricles at the end of the ventricular relaxation is the:
A. End systolic volume
B. End diastolic volume
C. Stroke volume
D. Cardiac output
31
54. The amount of blood leaving the heart with each beat is the:
A. Cardiac output
B. End systolic volume
C. End diastolic volume
D. Stroke volume
55. This reflex results in increasing rate and force of the heartbeat and blood pressure to relieve
blood congestion in the heart.
A. Carotid sinus reflex
B. Aortic reflex
C. Bainbridge reflex
D. Tachycardia
56. The fetal connection between the pulmonary trunk and the aorta is the:
A. Ductus arteriosus
B. Foramen ovale
C. Pulmonary vein
D. Aortic arch
57. An ECG provides information on:
A. Electrical activity of the heart
B. Heart murmurs
C. Cardiac output
D. All of these
58. The chordae tendineae:
A. Open the semilunar valves
B. Prevent the AV valves trom entering the atria
C. Contract the papillary muscles
D. Close the AV valves
E. Close the semilunar valves
59. An alternate pathway or branch in a vessel is a(an):
A. Anastomosis
B. Arteriosus
C. Vaso vasorum
D. Sinus
32
60. Blood vessels to the blood vessels are the:
A. Anastomosis
B. Vaso vasorum
C. Capillaries
D. Coronary circulation
E. Mesentary circulation
61. Tidal volume is air:
A. Forcibly exhaled after normal expiration.
B. Exchanged during normal breathing.
C. Inhaled after normal inspiration.
D. Remaining in lungs after forced expiration.
E. Total volume that lungs can hold.
62. 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 the air.
D. Humidifying or adding moisture to the inhaled air.
E. Cleansing the air.
63. The lung volume which represents the total volume of exchangeable air is the:
A. Tidal volume.
B. Vital capacity.
C. Inspiratory capacity.
D. Expiratory reserve volume.
E. Residual air.
64. The concentration of oxygen and/or total atmospheric pressure is lower at high altitudes therefore
the body will compensate to deliver more oxygen to tissues by:
A. Making more erythrocytes
B. Making more leukocytes
C. Increasing metabolic rate
D. Decreasing ph
E. All of these will occur over time
65. Amount of air that can be inspired above the tidal volume:
A. Residual volume
B. Expiratory reserve
C. Inspiratory reserve.
D. Vital capacity
E. Tidal volume
33
66. The most important factor that prevents dust and small particles from entering the lungs after air
has passed the nasal cavity is:
A. Abundant blood supply to the respiratory system
B. Ciliated mucous producing cells that line the respiratory system.
C. Particles are trapped by hair that lines the airways.
D. Bronchioconstriction
E. Action of the epiglottis
67. Oxygen and carbon dioxide are exhanged in the lungs and through all cell membranes by:
A. Active transport
B. Diffusion
C. Filtration
D. Osmosis
68. Identify the structure with the smallest diameter:
A. Primary bronchus
B. Bronchiole
C. Trachea
D. Secondary bronchus
E. Larynx
69. If the partial pressure of oxygen in the atmosphere were to be increased and all other gasses
remained the same:
A. More oxygen would move from the blood to the alveolar
B. Air space.
C. More oxygen would move into the blood
D. More carbon dioxide would move into the blood
E. More carbon dioxide would move into the alveoli from the blood.
70. If the PO2 of air in the alveoli is 100mmhg, then the PO 2 of blood in the pulmonary vein would be
about:
A. 40mm Hg (the same as the tissue)
B. 100mm Hg
C. Much greater than 100mm Hg
D. The pulmonary venous system has no oxygen
E. Not enough information
71. A normal expiration involves:
A. Contraction of respiratory muscles and air rushes in
B. Relaxation of respiratory muscles and air rushes in
C. Relaxation of respiratory muscles and air rushes out
D. Contraction of respiratory muscles and air rushes out
34
72. The functional unit of the respiratory system is the:
A. Bronchus
B. Larynx
C. Bronchiole
D. Alveolus
73. The diffusion of oxygen from the blood to body tissues is dependent upon which of the following?
A. High partial pressure of oxygen in body tissues
B. Decrease in body temperature
C. Low partial pressure of oxygen in body tissues
D. Low partial pressure of carbon dioxide in body tissues
74. Air moves into the lungs during inspiration because:
A. The pressure inside the thorax increases
B. The pressure inside the thorax decreases
C. Oxygen and carbon dioxide are exchanged
D. The diaphragm relaxes
75. The substance produced by the alveoloar cells that helps reduce surface tension and decreases
their tendency to collapse is:
A. Carbonic anhydrase
B. Mucus
C. Surfactant
D. Pleural fluid
76. Which of the following staements about the C-shaped rings of cartilage of the trachea is
incorrect?
A. They prevent collapse of the trachea during swallowing.
B. They maintain an open airway.
C. They contain hyaline cartilage.
D. They form a complete circle in the trachea.
77. The cartilage which routes substances away from the respiratory system during swallowing is the:
A. Glottis
B. Palate
C. Uvula
D. Thyroid cartilage
E. Epiglottis
35
78. The membrane that forms the covering on the outer surface of the lungs:
A. Parietal pleura
B. Visceral pleura
C. Parietal peritoneum
D. Visceral peritoneum
E. Messentary
79. According to the ideal gas law, if the temperature is constant and volume increases the pressure:
A. Increases
B. Decreases
C. Is constant
D. Ceases
80. This reflex prevents over inflation of the lungs:
A. Bainbridge
B. Herring Breuer
C. Cough
D. Dalton's
81. The diaphragm contacts during:
A. Expiration
B. Inspiration
C. Digestion
D. Perspiration
36
Biology 211 Sample Exam 2 (Answers) Heart / Circulation/ Respiratory
1. The left ventricular wall of the heart is thicker than the right wall in order to:
A. Pump more blood
B. Pump blood through a smaller valve.
C. Pump blood with a greater pressure
D. Expand the thoracic cage during diastole.
E. Push blood into the lungs.
2. The P wave of a normal electrocardiogram indicates:
A. Atrial depolarization
B. Ventricular depolarization
C. Atrial repolarization
D. Ventricular repolarization
E. Tachycardia
3. Blood in the pulmonary veins enters:
A. Right atrium
B. Left atrium
C. Right ventricle
D. Left ventricle
E. Lung
4. The presence of fatty plaques in large and medium arteries best defines:
A. Congestive heart failure
B. Hypertension
C. Obesity
D. Atherosclerosis
E. Arteriosclerosis
5. Blood enters which of these vessels during ventricular systole?
A. Aorta
B. Pulmonary artery
C. Pulmonary vein
D. Aorta and pulmonary artery
E. Aorta and pulmonary vein
6. Small muscle masses attached to the chordae tendineae are the:
A. Trabeculae carneae
B. Papillary muscles
C. Pectinate muscles
D. Interventricular septum
37
7. Which of the following is not part of the conduction system of the heart?
A. AV node
B. Bundle of His
C. AV valve
D. SA node
8. Blood is carried to capillaries in the myocardium by way of:
A. The coronary sinus
B. Fossa ovale
C. Coronary arteries
D. Coronary veins
9. The tricuspid valve is closed:
A. While the ventricle is in diastole
B. By the movement of blood from atrium to ventricle
C. While atrium is contracting
D. When the ventricle is in systole
E. During all of the above
Match the following
E. Myocardium
F. Epicardium
G. Endocardium
H. Parietal pericardium
10. The outermost layer of the pericardial sac D
11. The inside lining of the heart C
12. Heart muscle A
13. Serous membrane layer outside or covering the surface of the heart B
14. Which statement best describes arteries?
A. All carry oxygenated blood to the heart.
B. All contain valves to prevent the back-flow of blood.
C. All carry blood away from the heart
D. Only large arteries are lined with endothelium
E. Only muscular arteries contain smooth muscle.
15. Which of the following are involved directly in pulmonary circulation?
A. Superior vena cava, right atrium, and left ventricle
B. Inferior vena cava, right atrium, and left ventricle
C. Right ventricle, pulmonary artery, and left atrium
D. Left ventricle, aorta, and inferior vena cava
E. Right atrium, aorta, left ventricle
38
16. Which tunic of an artery contains endothelium?
A. Intima
B. Media
C. Externa
D. Adventitia
17. Permitting the exchange of nutrients and gases between the blood and tissue cells is the primary
function of:
A. Capillaries
B. Arteries
C. Veins
D. Arterioles
18. The arteries that directly feed the capillary beds are called:
A. Muscular arteries
B. Arterioles
C. Elastic arteries
D. Aorta
19. Factors which aid venous return include all except:
A. Activity of skeletal muscles
B. Pressure changes in the abdominal and thoracic cavities during respiration
C. Venous valves
D. Greater uriinary output
Peripheral resistance (Answer A for TRUE and B for FALSE)
20. Increases as blood viscosity increases A
21. Decreases with increasing length of blood vessel B
22. Increases as blood vessel diameter increases B
MATCH
A. Large arteries
B. Arterioles
C. Capillaries
D. Venules
E. Large veins
23. Site where resistance to blood flow is greatest B
24. Site where blood is flowing fastest A
25. Site where blood is flowing slowest C
26. Site where histamine increases permeability D
27. Site where blood pressure is greatest A
28. Site where exchanges of nutrients and gases are made C
39
29. Slowing down the heart rate is a function of the:
A. Parasympathetic nervous system
B. Sympathetic nervous system
C. SA node
D. Epinephrine
E. AV node
30. The structure of a capillary wall differs from the wall of a vein or artery because:
A. It has two tunics instead of one.
B. There is less smooth muscle.
C. It is a single layer - only a tunica intima.
D. There are no endothelial cells.
31. Which sequence of events best represents the intrinsic conduction of an impulse through the
heart?
1.
2.
3.
4.
Sinoatrial node
Atrioventricular node
Purkinje fibers
Bundle of HIS
E. 1, 4, 3, 2
F. 1, 2, 3, 4,
G. 1, 3, 2, 4
H. 1, 2, 4, 3
32. Arterial blood pressure increases if:
A. Blood volume is lost
B. Peripheral resistance falls
C. Peripheral resistance increases
D. Viscosity of the blood decreases
E. Maximal vasodilation is achieved
33. The normal pacemaker of the heart is the:
A. A-V Node
B. Bundle of HIS
C. Purkinje fibers
D. S-A Node
34. Arterial blood pressure depends on:
A. Cardiac output
B. Blood volume
C. Peripheral resistance
D. All of these
40
35. Cardiac output equals:
A. Stroke volume times heart rate
B. Heart rate divided by stroke volume
C. Stroke volume plus heart rate
D. Heart rate times blood pressure
36. The valve between the right atrium and the right ventricle is the:
A. Tricuspid valve
B. Bicuspid valve (Mitral)
C. Aortic semilunar valve
D. Pulmonic semilunar valve
E. No valve is needed
37. A heart rate less than 60 beats a minute is:
A. Tachycardia
B. Bradycardia
C. Normal sinus rhythym
D. Heart block
E. Atherosclerosis
38. Smooth muscle and elastin of vessels would be found in the:
A. Tunica media
B. Tunica adventitia
C. Tunica intima
D. Vaso vasorum
39. The mean arterial blood pressure is:
A. The average of the systolic and diastolic pressure
B. Closer to the systolic pressure
C. Closer to the diastolic pressure
D. The pulse pressure
40. If the atrioventricular valves are open during ventricular systole the blood would:
A. Exit via the arteries
B. Enter the atria
C. Enter the lungs
D. Remain in the ventricles
41. Pressure in the left ventricle must exceed the pressure in the
systemic circuit.
A. Pulmonary artery
B. Brachiocephalic artery
C. Left atrium
D. Right ventricle
E. Aorta
to eject blood into the
42. The quiescent phase, or relaxation of all chambers in the cardiac cycle, is during:
A. QRS complex
B. Ventricular systole
C. The interval between the end of the T wave and P wave
41
D. Interval preceding the QRS complex
E. Atrial systole
43. The flow of blood from the cerebral circulation:
1. Right atrium
2. Left atrium
3. Pulmonary vein
4. Pulmonary artery
5. Left ventricle
6. Right ventricle
7. Carotid artery
8. Jugular vein (returns blood from the head and is near carotid artery)
9. Inferior vena cava
10. Superior vena cava
11. Aortic arch
12. Abdominal aorta
13. Thoracic aorta
14. Lungs
A. 10,1,6,3,14,4,2,5,11,12,13,8
B. 2,5,3,14,4,1,6,11,13,12,7,10
C. 8,10,1,6,4,14,3,2,5,11,7
D. 8,9,2,5,4,14,3,1,4,13,7
44. Semilunar valves are located:
A. Atria and ventricles
B. Where veins enter the atria
C. Where arteries leave the ventricles
D. At the intraventricular septum
45. In Starlings Law of the Capillary, the driving force for filtration is largely due to:
A. A higher hydrostatic pressure on the arteriole end of the capillary
B. A higher hydrostatic pressure on the venule side of the capillary
C. A large osmotic pressure due to proteins pulling fluid into the interstitium
D. A large osmotic pressure due to proteins driving fluid out of the capillaries
42
46. If the right side of the heart is affected in congestive heart failure the result would be:
A. Pooling of blood in the systemic circuit and edema
B. Pooling of blood and edema in the lungs
C. The myocardium cannot contract
D. Pooling of blood in both atria
E. None of these
47. The first and second heart sounds are due to:
A. Muscle contraction
B. Opening of valves
C. Closing of valves
D. Blood rushing into aorta
48. Contraction always follows:
A. Repolarization
B. Depolarization
C. Refractory period
D. Cardiac cycle
E. The T wave
49. Closing of the AV and semilunar valves:
A. Can be seen on the ECG
B. Make up the first and second heart sounds
C. Cannot be heard
D. Occur at the same time
50. Repolarization of the atria:
A. Occurs with the P wave
B. Follows the QRS complex
C. Occurs during the QRS complex
D. Occurs at the T wave
E. Does not occur
51. The pointed end of the heart is the:
A. Base
B. Intraventricular septum
C. Coronary sinus
D. Apex
52. Deoxygenated blood leaves the heart in the:
A. Aorta
B. Pulmonary artery
C. Pulmonary vein
D. Vena cava
53. The volume of blood in the ventricles at the end of the ventricular relaxation is the:
A. End systolic volume
B. End diastolic volume
C. Stroke volume
D. Cardiac output
43
54. The amount of blood leaving the heart with each beat is the:
A. Cardiac output
B. End systolic volume
C. End diastolic volume
D. Stroke volume
55. This reflex results in increasing rate and force of the heartbeat and blood pressure to relieve
blood congestion in the heart.
A. Carotid sinus reflex
B. Aortic reflex
C. Bainbridge reflex
D. Tachycardia
56. The fetal connection between the pulmonary trunk and the aorta is the:
A. Ductus arteriosus
B. Foramen ovale
C. Pulmonary vein
D. Aortic arch
57. An ECG provides information on:
A. Electrical activity of the heart
B. Heart murmurs
C. Cardiac output
D. All of these
58. The chordae tendineae:
A. Open the semilunar valves
B. Prevent the AV valves trom entering the atria
C. Contract the papillary muscles
D. Close the AV valves
E. Close the semilunar valves
59. An alternate pathway or branch in a vessel is a(an):
A. Anastomosis
B. Arteriosus
C. Vaso vasorum
D. Sinus
44
60. Blood vessels to the blood vessels are the:
A. Anastomosis
B. Vaso vasorum
C. Capillaries
D. Coronary circulation
E. Mesentary circulation
61. Tidal volume is air:
A. Forcibly exhaled after normal expiration.
B. Exchanged during normal breathing.
C. Inhaled after normal inspiration.
D. Remaining in lungs after forced expiration.
E. Total volume that lungs can hold.
62. 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 the air.
D. Humidifying or adding moisture to the inhaled air.
E. Cleansing the air.
63. The lung volume which represents the total volume of exchangeable air is the:
A. Tidal volume.
B. Vital capacity.
C. Inspiratory capacity.
D. Expiratory reserve volume.
E. Residual air.
64. The concentration of oxygen and/or total atmospheric pressure is lower at high altitudes therefore
the body will compensate to deliver more oxygen to tissues by:
A. Making more erythrocytes
B. Making more leukocytes
C. Increasing metabolic rate
D. Decreasing ph
E. All of these will occur over time
65. Amount of air that can be inspired above the tidal volume:
A. Residual volume
B. Expiratory reserve
C. Inspiratory reserve.
D. Vital capacity
E. Tidal volume
45
66. The most important factor that prevents dust and small particles from entering the lungs after air
has passed the nasal cavity is:
A. Abundant blood supply to the respiratory system
B. Ciliated mucous producing cells that line the respiratory system.
C. Particles are trapped by hair that lines the airways.
D. Bronchioconstriction
E. Action of the epiglottis
67. Oxygen and carbon dioxide are exhanged in the lungs and through all cell membranes by:
A. Active transport
B. Diffusion
C. Filtration
D. Osmosis
68. Identify the structure with the smallest diameter:
A. Primary bronchus
B. Bronchiole
C. Trachea
D. Secondary bronchus
E. Larynx
69. If the partial pressure of oxygen in the atmosphere were to be increased and all other gasses
remained the same:
A. More oxygen would move from the blood to the alveolar
B. Air space.
C. More oxygen would move into the blood
D. More carbon dioxide would move into the blood
E. More carbon dioxide would move into the alveoli from the blood.
70. If the PO2 of air in the alveoli is 100mmhg, then the PO2 of blood in the pulmonary vein would be
about:
A. 40mm Hg (the same as the tissue)
B. 100mm Hg
C. Much greater than 100mm Hg
D. The pulmonary venous system has no oxygen
E. Not enough information
71. A normal expiration involves:
A. Contraction of respiratory muscles and air rushes in
B. Relaxation of respiratory muscles and air rushes in
C. Relaxation of respiratory muscles and air rushes out
D. Contraction of respiratory muscles and air rushes out
46
72. The functional unit of the respiratory system is the:
A. Bronchus
B. Larynx
C. Bronchiole
D. Alveolus
73. The diffusion of oxygen from the blood to body tissues is dependent upon which of the following?
A. High partial pressure of oxygen in body tissues
B. Decrease in body temperature
C. Low partial pressure of oxygen in body tissues
D. Low partial pressure of carbon dioxide in body tissues
74. Air moves into the lungs during inspiration because:
A. The pressure inside the thorax increases
B. The pressure inside the thorax decreases
C. Oxygen and carbon dioxide are exchanged
D. The diaphragm relaxes
75. The substance produced by the alveoloar cells that helps reduce surface tension and decreases
their tendency to collapse is:
A. Carbonic anhydrase
B. Mucus
C. Surfactant
D. Pleural fluid
76. Which of the following staements about the C-shaped rings of cartilage of the trachea is
incorrect?
A. They prevent collapse of the trachea during swallowing.
B. They maintain an open airway.
C. They contain hyaline cartilage.
D. They form a complete circle in the trachea.
77. The cartilage which routes substances away from the respiratory system during swallowing is the:
A. Glottis
B. Palate
C. Uvula
D. Thyroid cartilage
E. Epiglottis
47
78. The membrane that forms the covering on the outer surface of the lungs:
A. Parietal pleura
B. Visceral pleura
C. Parietal peritoneum
D. Visceral peritoneum
E. Messentary
79. According to the ideal gas law, if the temperature is constant and volume increases the pressure:
A. Increases
B. Decreases
C. Is constant
D. Ceases
80. This reflex prevents over inflation of the lungs:
A. Bainbridge
B. Herring Breuer
C. Cough
D. Dalton's
81. The diaphragm contacts during:
A. Expiration
B. Inspiration
C. Digestion
D. Perspiration
48