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Respiratory Structure FunctionMedical-Surgical Nursing-7th edition

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What is the function of the chest wall?
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It protects the lungs from injury and works with the diaphragm to perform the work of breathing.
________ is the mechanical movement of air/gas in and out of the lungs.
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Ventilation
________ is the exchange of oxygen and carbon dioxide during cellular metabolism.
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Respiration
What is minute volume/minute ventilation?
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The ventilatory rate multiplied by the volume of air per breath (tidal volume). It represents the effectiveness of ventilation and is expressed in liters per minute.
How is the adequacy of alveolar ventilation measured?
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Through an arterial blood gas which can measure PaCO2.
There are several respiratory control centers in the brainstem. What are they?
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The pneumotaxic center (pons), chemosensitive center, apneuistic center (pons), dorsal respiratory group/DRG (medulla), and the ventral respiratory group/VRG (medulla).
What structure in the brain is responsible for setting the automatic rhythm of ventilation by sending efferent impulses to the diaphragm and intercostal muscles?
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The dorsal respiratory group/DRG located in the medulla
Receptors in the dorsal respiratory group/DRG change the ventilation rate in response to afferent impulses received peripheral chemoreceptors located in the ________ and _______.
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Carotid and aortic bodies (they sense PaCO2 levels).
The ventral respiratory group/VRG has both inspiratory and expiratory neurons that are stimulated by receptors in the ______. They become active only when additional ventilatory effort is needed.
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Lungs
What structures in the brain are responsible for modifying the inspiratory rate and depth established by the medulla?
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The pneumotaxic center (pons) and apneuistic center (pons).
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Three types of receptors send impulses from the lungs to the dorsal respiratory group/DRG. They are:
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Irritant receptors located in the epitelium of the conducting airways, stretch receptors located in the smooth muscles of airways, and J-receptors located near capillaries of alveolar septa.
________ receptors are located in the proximal larger airways of the lungs and are sensitive to noxious gases, aerosols, and particles. They initiate the cough reflex, bronchoconstriction and increased ventilatory rate.
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Irritant receptors.
________ receptors are sensitive to increases in the size or volume of lungs. They decrease the ventilatory rate and volume when stimulated. They are an important mediator of coughing.
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Stretch
What is the Hering-Breuer expiratory reflex and what lung receptor is it associated with?
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It is the reflex caused by stimulation of the stretch receptors in the lungs which results in decreased ventilation rate and volume. It is active in newborns to assist with ventilation. It only occurs in adults during periods of high tidal volumes (as with exercise).
_________ receptors are sensitive to increased pulmonary capillary pressure. They trigger rapid, shallow breathing, hypotension and bradycardia.
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Juxtapulmonary capillary receptors (J-receptors)
_________ receptors of the ANS causes the smooth muscle of the lungs to contract and they are the main controller of airway calibration under normal conditions.
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Parasympathetic
______ chemoreceptors are responsible for monitoring arterial blood by sensing changes in the pH of cerebrospinal fluid.
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Central (they are sensitive to hydrogen ions)
How do central chemoreceptors respond to decreases in CSF pH?
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They stimulate the respiratory center to increase the depth and rate of ventilation.
______ chemoreceptors are located in aortic bodies, the aortic arch, and in the carotid bodies at the bifurcation of the carotids.
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Peripheral
Central chemoreceptors are sensitive to _______, whereas peripheral chemoreceptors are sensitive to ________.
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Central chemoreceptors are sensitive to hydrogen ions in CSF and peripheral chemoreceptors are sensitive to oxygen levels in arterial blood.
How do peripheral chemoreceptors respond to decreases in arterial oxygenation?
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They stimulate the respiratory center to increase the rate of ventilation. They are responsible for all of the rate increase in response to arterial hypoxemia.
  
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