Deck 9: Control of Ventilation

Question 1

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

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

Answer 1

A

Question 2

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

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

Answer 2

A

Question 3

In which portion of the brain controls the rhythmicity of respiration?

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

Answer 3

A

Question 4

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

Question 5

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

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

Question 6

What is the primary stimulus of the peripheral chemoreceptors?

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

Question 7

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

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

Question 8

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

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

Question 9

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) a thick gelatinous membrane that is impermeable to CO₂ molecules
D) nothing-they are in direct contact

Question 10

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

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

Question 11

Which nerve emerges from the spinal cord between C3 and C5?

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

Question 12

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

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

Question 13

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

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

Question 14

What are the divisions of the pontine respiratory centers?

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

Question 15

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

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

Question 16

Where are the central chemoreceptors located?

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

Question 17

Where are the peripheral chemoreceptors located?

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

Question 18

Which portion of the brain triggers inspiration?

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

Question 19

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

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

Question 20

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

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

Question 21

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

Question 22

In which age group is the Hering-Breuer reflex most significant?

A) newborns
B) toddlers
C) adults under age 50
D) adults over age 50

Question 23

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

Question 24

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

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

Question 25

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

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

Question 26

At what point are the peripheral chemoreceptors initially activated?

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

Question 27

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

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

Question 28

What is another name for the Hering-Breuer reflex?

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

Question 29

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 30

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

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

Question 31

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

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

Question 32

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

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

Question 33

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

Question 34

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

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

Question 35

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

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

Question 36

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

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

Question 37

At what point are the peripheral chemoreceptors suppressed?

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

Question 38

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

Question 39

What is the secondary stimulus of the peripheral chemoreceptors?

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

Question 40

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

Question 41

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

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

Question 42

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

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

Question 43

What is the term for an involuntary diaphragmatic spasm followed by sudden glottic closure?

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

Question 44

Which respiratory reflex or center is triggered by strong emotions?

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

Question 45

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

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

Question 46

What effect does an elevated body temperature have on ventilation?

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

Question 47

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

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

Question 48

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

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

Question 49

What effect does tactile stimulation of the larynx have on breathing?

A) It causes temporary apnea
B) It causes hyperpnea
C) It causes tachypnea
D) It causes dyspnea

Question 50

What effect does sudden pain have on breathing?

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