Deck 9: Control of Ventilation

Question 1

Which portion of the brain gathers information from the peripheral stretch receptors and relays it to the VRG?

A) PRG
B) DRG
C) apneustic center
D) hypothalamus

Answer 1

B

Question 2

What effect will suppression of the VRG by overdose of alcohol or morphine have on ventilation?

A) respiratory rate increases
B) respiratory rate decreases
C) respiratory rate and depth of breathing increases
D) breathing completely stops

Answer 2

D

Question 3

Which of the following are located in the medulla oblongata?
I. VRG
II. PRG
III. DRG
IV. apneustic center

A) II and IV only
B) I and II only
C) I, II, and III only
D) I and III only

Answer 3

I and III only

Question 4

Which of the following are causes of phrenic nerve injuries?
I. blunt trauma to the neck
II. apneustic breathing
III. brainstem stroke
IV. spinal cord tumor

A) I, III, and IV only
B) I and II only
C) II and III only
D) III and IV only

Question 5

What effect will a complete injury above C3-C5 have on a patient's spontaneous ventilation?

A) complete diaphragmatic paralysis would result, and the patient would require mechanical ventilation
B) patient would require supplemental oxygen but would still be able to breathe spontaneously
C) ventilation would be unaffected since the respiratory centers are safely located in the brain
D) partial diaphragmatic paralysis would result and the patient would initially require mechanical ventilation

Question 6

Which of the following can readily cross the blood-brain barrier?
I. CO₂ molecules
II. Bicarbonate ions
III. H+ ions

A) I only
B) II and III only
C) I and III only
D) II only

Question 7

Which portion of the brain controls the rhythmicity of respiration?

A) cerebral cortex
B) medulla oblongata
C) cerebellum
D) pons

Question 8

What are the divisions of the pontine respiratory centers?

A) VRG and apneustic center
B) DRG and apneustic center
C) PRG and apneustic center
D) PRG and proprioceptor center

Question 9

What is the primary stimulus of the peripheral chemoreceptors?

A) low PO2 of CSF
B) H+ concentration of CSF
C) changes in PaCO2
D) low PaO2

Question 10

Which portion of the brain receives inhibitory signals from the Hering Breuer reflex?

A) apneustic center
B) DRG
C) PRG
D) VRG

Question 11

Which portion of the brain coordinates the rate, depth, and rhythm?

A) PRG
B) DRG
C) VRGs
D) apneustic center

Question 12

Where are the central chemoreceptors located?

A) lateral and ventral portion of the pons
B) aortic arch and carotid bodies
C) lateral and ventral portion of the medulla oblongata.
D) lateral walls of cerebral cortex

Question 13

Which portion of the brain smooths the transition between inspiration and expiration?

A) DRG
B) PRG
C) apneustic center
D) VRG

Question 14

What separates the blood from the CSF in the medulla?

A) a semipermeable membrane called the blood-brain barrier
B) a membrane that is permeable to H+ and bicarbonate ions
C) nothing-they are in direct contact
D) a thick gelatinous membrane that is impermeable to CO₂ molecules

Question 15

Which portion of the brain triggers inspiration?

A) DRG
B) VRGs
C) apneustic center
D) PRG

Question 16

At what approximate rate do the VRG's expiratory neurons fire per minute in a healthy adult at rest?

A) 18-22 times
B) 4-8 times
C) 24-28 times
D) 12-15 times

Question 17

What is the term for prolonged breathing in the inspiratory phase which can result from a pontine lesion?

A) apnea
B) dyspnea
C) arrhythmic breathing
D) apneustic breathing

Question 18

Which portion of the brain relays information from the chemoreceptors to the VRG?

A) apneustic center
B) hypothalamus
C) DRG
D) PRG

Question 19

What is the most powerful stimulus of the medullary respiratory centers?

A) increased PaCO2
B) decreased PaCO2 in CSF
C) increased H+ in CSF
D) decreased PaO2

Question 20

Where are the peripheral chemoreceptors located?

A) lateral walls of pons
B) lateral walls of medulla oblongata
C) femoral arteries and aortic arch
D) aortic arch and carotid arteries

Question 21

When J-receptors are stimulated, what response is triggered?

A) slow, deep breathing pattern
B) rapid, shallow breathing pattern
C) slow inspiration with breath hold
D) rapid, deep breathing pattern

Question 22

In which of the following conditions would PaO₂ be normal but CaO₂ would be reduced?
I. Chronic anemia
II. CO poisoning
III. Methemoglobinemia

A) I and III only
B) I only
C) I, II and III
D) I and II only

Question 23

At what point are the peripheral chemoreceptors suppressed?

A) PaCO2 below 60 mm Hg
B) PaO2 below 30 mm Hg
C) PaCO2 below 30 mm Hg
D) PaO2 below 60 mm Hg

Question 24

Which nerve transmits afferent signals from the carotid body to the medulla?

A) X cranial
B) IX cranial
C) phrenic
D) XI cranial

Question 25

Which nerve transmits afferent signals from the aortic bodies to the medulla?

A) XI cranial nerve
B) phrenic
C) IX cranial nerve
D) X cranial nerve

Question 26

When a patient has a low PaO2 with a chronically high PaCO2, how is ventilation exclusively controlled?

A) by the apneustic center
B) by the central chemoreceptors
C) by the peripheral chemoreceptors
D) by the VRG and DRG

Question 27

Where are the receptors associated with the Hering-Breuer reflex located?

A) visceral pleura and walls of bronchi and bronchiole
B) intercostal spaces and walls of the bronchi and bronchioles
C) parietal pleura and walls of the bronchi and bronchioles
D) visceral pleura and walls of the trachea, bronchi, and bronchioles

Question 28

Below what temperature in the bronchi and bronchioles is the Hering-Breuer reflex inactive?

A) < 8 º C
B) < 8 º F
C) 98.6 º F
D) 37º C

Question 29

What is another name for the Hering-Breuer reflex?

A) irritant reflex
B) inflation reflex
C) Head's paradoxical reflex
D) deflation reflex

Question 30

What is the secondary stimulus of the peripheral chemoreceptors?

A) decreased H+ level
B) increased PaCO2
C) increased H+ level
D) decreased PaCO2

Question 31

What is the term for the C-fibers located near the alveolar capillaries?

A) A-receptors
B) L receptors
C) J-receptors
D) D-receptors

Question 32

Which of the following can stimulate the peripheral chemoreceptors?
I. Hypoperfusion
II. Increased temperature
III. Nicotine

A) I only
B) I, II, and III
C) II only
D) I and III only

Question 33

Stimulation of what receptors may produce a reflex cough, sneeze, or bronchoconstriction?

A) irritant
B) deflation
C) Hering-Breuer
D) peripheral proprioceptor

Question 34

What impact will the administration of a high FIO2 likely have on a patient with chronic hypercapnia and hypoxemia?

A) peripheral chemoreceptors may be suppressed due to the low H+ and ventilation would be depressed
B) peripheral chemoreceptors may be suppressed by the excess oxygen being administered and ventilation would be depressed
C) central chemoreceptors may be suppressed by the high O2 being administered and ventilation would be depressed
D) both central and peripheral chemoreceptors would respond by triggering oxygen induced hyperventilation

Question 35

What would most likely trigger the peripheral chemoreceptors when uncontrolled diabetes is present?

A) excessive H+ accumulation
B) low PaCO2
C) low H+ levels in the blood
D) high PaCO2

Question 36

Which of the following may occur when the lungs are exposed to noxious gases and the irritant reflex is activated?
I. Ventilatory rate increases
II. Reflex cough
III. Sneeze
IV. Bronchospasm

A) I and III only.
B) I, II, III, and IV
C) I, II, and III only
D) I and III only

Question 37

If a low-land resident ascends to a high mountain altitude, which of the following would be stimulated first?

A) peripheral chemoreceptors due to drop in PaCO2
B) peripheral chemoreceptors due to drop in PaO2
C) central chemoreceptors due to increase in H+ in CSF
D) central chemoreceptors due to drop in PaO2

Question 38

At what point are the peripheral chemoreceptors initially activated?

A) PaCO2 of 60 mmHg
B) PaCO2 of 30 mmHg
C) PaO2 of 30 mmHg
D) PaO2 of 60 mmHg

Question 39

Which of the following can stimulate the J-receptors?
I. Alveolar inflammation
II. Pulmonary capillary edema
III. Pulmonary emboli
IV. Hypercapnia

A) I and III only
B) I, II, and III only
C) I, II, II, and IV only
D) II and III only

Question 40

In addition to ventilatory changes, which of the following can occur in response to peripheral chemoreceptor stimulation?
I. Peripheral vasoconstriction
II. Systemic arterial hypertension
III. Bradycardia
IV. Increased pulmonary vascular resistance

A) I, II, III, and IV
B) I and IV only
C) I and II only
D) I, II, and IV only

Question 41

What effect does sudden pain have on breathing?

A) causes an increase in tidal volume
B) causes a short period of apnea
C) causes the respiratory rate to increase
D) causes a decrease in respiratory rate

Question 42

The stimulus for a second wind is associated with which phenomena?
I. Lactic acid
II. Endorphins
III. Cold temperature
IV. Confidence and pride

A) I and II only
B) I, II, III, and IV
C) I, II, and IV only
D) II and III only

Question 43

Which receptors initiate reflexes in heart rate and breathing in response to changes in systemic blood pressure?

A) carotid sinus and aortic baroreceptors
B) peripheral proprioceptors
C) aortic bodies and carotid bodies
D) J-receptors

Question 44

Which respiratory reflex or center is triggered by strong emotions?

A) Irritant reflex
B) peripheral proprioceptors
C) hypothalamic controls
D) Hering-Breuer reflex

Question 45

What is the term for a forceful involuntary expulsion of air through the nose and mouth?

A) hiccup
B) cough
C) burp
D) sneeze

Question 46

What effect does foreign matter in the trachea have on ventilation in a healthy adult?

A) An increase in the rate and depth of breathing is activated.
B) The sneeze reflex is activated.
C) Apnea is triggered.
D) The cough reflex is activated.

Question 47

Which peripheral proprioceptors play a role in initiating and maintaining an increased respiratory rate during exercise?

A) proprioceptors in skin
B) proprioceptors in joints and tendons
C) proprioceptors in muscles
D) proprioceptors in muscles and skin

Question 48

Where are the peripheral proprioceptors located?
I. Muscles
II. Tendons
III. Joints
IV. Pain receptors in skin and muscles

A) II, III, and IV only
B) I and II only
C) I, II, and IV only
D) I, II, III, and IV

Question 49

Which reflex or center allows conscious, voluntary control over breathing?

A) hypothalamus
B) pons
C) cerebellum
D) cerebral cortex

Question 50

What effect does an elevated body temperature have on ventilation?

A) It causes a decreased respiratory rate.
B) It does not affect ventilation.
C) It causes an increased respiratory rate.
D) It causes apnea.