,Chapter 02: Physiology of the Cardiovascular and Pulmonary Systems
Hillegass: Essentials of Cardiopulmonary Physical Therapy, 4th Edition
MULTIPLE CHOICE
1. The primary function of the pulmonary system is which of the following?
a. Regulating acid–base balance and maintaining normal blood pH
b. Filtering and metabolizing toxic substances
c. Achieving temperature homeostasis through evaporative heat loss
d. Exchange of oxygen and carbon dioxide between environment, blood, and tissue
ANS: D
According to the author, the most important function of the pulmonary system is to exchange
oxygen and carbon dioxide between the environment, blood, and tissue.
PTS: 1
2. The total volume of air that is inhaled or exhaled in 1 minute is termed:
a. tidal volume.
b. minute ventilation.
c. inspiratory reserve volume.
d. inspiratory capacity.
ANS: B
The minute ventilation represents the total volume of air that is inhaled or exhaled in 1
minute.
PTS: 1
3. The maximum amount of air that can be inhaled after a normal tidal exhalation is termed:
a. inspiratory reserve volume.
b. expiratory reserve volume.
c. inspiratory capacity.
d. vital capacity.
ANS: C
The inspiratory capacity (IC) is the sum of the tidal and inspiratory reserve volumes; it is the
maximum amount of air that can be inhaled after a normal tidal exhalation.
PTS: 1
4. Which of the following brain areas provides control for automatic breathing?
a. Medulla oblongata
b. Pons
c. Frontal lobe of the cerebrum
d. Hypothalamus
ANS: A
The medulla oblongata contains inspiratory neurons that produce inspiration and expiratory
neurons that are triggered with force expiration. These neurons control automatic breathing.
, PTS: 1
5. Which of the following statements BEST explains why increasing administered oxygen
should be done cautiously in a patient with severe chronic obstructive pulmonary disease
(COPD) AT REST?
a. The body may rely on hypoxic drive to breathe (oxygen receptors) and increasing
administered oxygen at rest leads to hyperoxemia suppressing the hypoxic drive.
b. The body needs additional time to allow the peripheral chemoreceptors to cause an
increase of ventilatory rate to improve oxygenation.
c. The body is relying on carbon dioxide to regulate the respiratory cycle, and
increasing administered oxygen at rest leads to inhibition of the carbon dioxide
receptors.
d. Increasing administered oxygen to the body oversaturates the system leading to
toxicity.
ANS: A
A patient with severe COPD who develops high CO2 blood levels subsequently leads to the
body relying more on oxygen receptors instead of carbon dioxide receptors. This is termed
hypoxic drive to breathe. If administered oxygen is too high and causes hyperoxemia
(increased oxygen in the blood), the oxygen receptors may be suppressed, which reduces the
drive to breathe.
PTS: 1
6. Which of the following lung tissue receptors are located along the smooth muscles lining the
airways are sensitive to increasing size and volume within the lung, termed the Hering–Breuer
reflex?
a. Irritant receptors
b. Stretch receptors
c. Chemoreceptors
d. Juxtapulmonary receptors
ANS: B
Stretch receptors are located along smooth muscles lining the airways and are sensitive to
increasing size and volume within the lung. The Hering–Breuer reflex is active with large
increases in the tidal volume, especially seen during exercise, and protects the lung from
excessive inflation.
PTS: 1
7. Which of the following lung receptors are stimulated in a patient with left-sided congestive
heart failure who develops pulmonary edema causing the patient to breathe in a SHALLOW,
tachypneic pattern.
a. Irritant receptors
b. Stretch receptors
c. Chemoreceptors
d. Juxtapulmonary receptors
ANS: D
, The juxtapulmonary receptors (J receptor) are located near the pulmonary capillaries and are
sensitive to increased pulmonary capillary pressures. On stimulation, these receptors initiate a
rapid, shallow breathing pattern. In a patient with congestive heart failure, pulmonary edema
would stimulate the interstitial J receptors.
PTS: 1
8. Which of the following events occur as a result of the diaphragm and external intercostals
contracting to facilitate inspiration?
a. An increase in the volume of the thoracic cavity and lung reducing the
intrapulmonary pressure
b. An increase in the pressure within the lung occurring due to Boyle’s law
c. A decrease in the volume of the thoracic cavity and lung increasing the
intrapulmonary pressure
d. A change in the thoracic cavity and lung volume leading to an intrapulmonary
pressure that exceeds the atmospheric pressure
ANS: A
When the diaphragm and external intercostals contract to facilitate inspiration, it causes an
increase in the volume of the thoracic cavity and lung, which reduces the intrapulmonary
pressure. The intrapulmonary pressure is decreased below the atmospheric levels facilitating
the flow of air into the lungs to normalize pressure differences.
PTS: 1
9. Which of the following BEST describes the intrapleural pressure compared to the
intrapulmonary pressure?
a. Intrapleural pressure is less than intrapulmonary pressure.
b. Intrapleural pressure is the same as intrapulmonary pressure.
c. Intrapleural pressure is greater than intrapulmonary pressure.
d. Intrapleural pressure is not related to the intrapulmonary pressure.
ANS: A
The intrapleural pressure is normally lower than the intrapulmonary pressure developed
during both inspiration and expiration. This difference in pressures helps to maintain the lung
near the chest wall.
PTS: 1
10. Compliance is BEST explained by which of the following statements.
a. The tendency of a structure to return to its initial size after being distended
b. The pressure that acts to collapse the alveolus and increase the pressure of air
within the structure
c. The tendency of a force that exists to collapse or recoil the structure while inflated
d. The pressure that allows changes in lung volume to parallel changes in thoracic
excursion during breathing
ANS: C
Compliance of lung tissue is likened to a balloon during inspiration, where there exists a
tendency to collapse or recoil while inflated. A = elasticity; B = surface tension; D =
transmural pressure.
Hillegass: Essentials of Cardiopulmonary Physical Therapy, 4th Edition
MULTIPLE CHOICE
1. The primary function of the pulmonary system is which of the following?
a. Regulating acid–base balance and maintaining normal blood pH
b. Filtering and metabolizing toxic substances
c. Achieving temperature homeostasis through evaporative heat loss
d. Exchange of oxygen and carbon dioxide between environment, blood, and tissue
ANS: D
According to the author, the most important function of the pulmonary system is to exchange
oxygen and carbon dioxide between the environment, blood, and tissue.
PTS: 1
2. The total volume of air that is inhaled or exhaled in 1 minute is termed:
a. tidal volume.
b. minute ventilation.
c. inspiratory reserve volume.
d. inspiratory capacity.
ANS: B
The minute ventilation represents the total volume of air that is inhaled or exhaled in 1
minute.
PTS: 1
3. The maximum amount of air that can be inhaled after a normal tidal exhalation is termed:
a. inspiratory reserve volume.
b. expiratory reserve volume.
c. inspiratory capacity.
d. vital capacity.
ANS: C
The inspiratory capacity (IC) is the sum of the tidal and inspiratory reserve volumes; it is the
maximum amount of air that can be inhaled after a normal tidal exhalation.
PTS: 1
4. Which of the following brain areas provides control for automatic breathing?
a. Medulla oblongata
b. Pons
c. Frontal lobe of the cerebrum
d. Hypothalamus
ANS: A
The medulla oblongata contains inspiratory neurons that produce inspiration and expiratory
neurons that are triggered with force expiration. These neurons control automatic breathing.
, PTS: 1
5. Which of the following statements BEST explains why increasing administered oxygen
should be done cautiously in a patient with severe chronic obstructive pulmonary disease
(COPD) AT REST?
a. The body may rely on hypoxic drive to breathe (oxygen receptors) and increasing
administered oxygen at rest leads to hyperoxemia suppressing the hypoxic drive.
b. The body needs additional time to allow the peripheral chemoreceptors to cause an
increase of ventilatory rate to improve oxygenation.
c. The body is relying on carbon dioxide to regulate the respiratory cycle, and
increasing administered oxygen at rest leads to inhibition of the carbon dioxide
receptors.
d. Increasing administered oxygen to the body oversaturates the system leading to
toxicity.
ANS: A
A patient with severe COPD who develops high CO2 blood levels subsequently leads to the
body relying more on oxygen receptors instead of carbon dioxide receptors. This is termed
hypoxic drive to breathe. If administered oxygen is too high and causes hyperoxemia
(increased oxygen in the blood), the oxygen receptors may be suppressed, which reduces the
drive to breathe.
PTS: 1
6. Which of the following lung tissue receptors are located along the smooth muscles lining the
airways are sensitive to increasing size and volume within the lung, termed the Hering–Breuer
reflex?
a. Irritant receptors
b. Stretch receptors
c. Chemoreceptors
d. Juxtapulmonary receptors
ANS: B
Stretch receptors are located along smooth muscles lining the airways and are sensitive to
increasing size and volume within the lung. The Hering–Breuer reflex is active with large
increases in the tidal volume, especially seen during exercise, and protects the lung from
excessive inflation.
PTS: 1
7. Which of the following lung receptors are stimulated in a patient with left-sided congestive
heart failure who develops pulmonary edema causing the patient to breathe in a SHALLOW,
tachypneic pattern.
a. Irritant receptors
b. Stretch receptors
c. Chemoreceptors
d. Juxtapulmonary receptors
ANS: D
, The juxtapulmonary receptors (J receptor) are located near the pulmonary capillaries and are
sensitive to increased pulmonary capillary pressures. On stimulation, these receptors initiate a
rapid, shallow breathing pattern. In a patient with congestive heart failure, pulmonary edema
would stimulate the interstitial J receptors.
PTS: 1
8. Which of the following events occur as a result of the diaphragm and external intercostals
contracting to facilitate inspiration?
a. An increase in the volume of the thoracic cavity and lung reducing the
intrapulmonary pressure
b. An increase in the pressure within the lung occurring due to Boyle’s law
c. A decrease in the volume of the thoracic cavity and lung increasing the
intrapulmonary pressure
d. A change in the thoracic cavity and lung volume leading to an intrapulmonary
pressure that exceeds the atmospheric pressure
ANS: A
When the diaphragm and external intercostals contract to facilitate inspiration, it causes an
increase in the volume of the thoracic cavity and lung, which reduces the intrapulmonary
pressure. The intrapulmonary pressure is decreased below the atmospheric levels facilitating
the flow of air into the lungs to normalize pressure differences.
PTS: 1
9. Which of the following BEST describes the intrapleural pressure compared to the
intrapulmonary pressure?
a. Intrapleural pressure is less than intrapulmonary pressure.
b. Intrapleural pressure is the same as intrapulmonary pressure.
c. Intrapleural pressure is greater than intrapulmonary pressure.
d. Intrapleural pressure is not related to the intrapulmonary pressure.
ANS: A
The intrapleural pressure is normally lower than the intrapulmonary pressure developed
during both inspiration and expiration. This difference in pressures helps to maintain the lung
near the chest wall.
PTS: 1
10. Compliance is BEST explained by which of the following statements.
a. The tendency of a structure to return to its initial size after being distended
b. The pressure that acts to collapse the alveolus and increase the pressure of air
within the structure
c. The tendency of a force that exists to collapse or recoil the structure while inflated
d. The pressure that allows changes in lung volume to parallel changes in thoracic
excursion during breathing
ANS: C
Compliance of lung tissue is likened to a balloon during inspiration, where there exists a
tendency to collapse or recoil while inflated. A = elasticity; B = surface tension; D =
transmural pressure.
