Multiple choice 16 -19

1) Which of the following processes is NOT a part of external respiration?
A) the movement of air into and out of the lungs by bulk flow
B) the exchange of oxygen and carbon dioxide between the lungs and blood by diffusion
C) the transportation of oxygen and carbon dioxide between the lungs and body tissues by the blood
D) the exchange of oxygen and carbon dioxide between the blood and tissues by diffusion
E) the use of oxygen and generation of carbon dioxide by the mitochondria during energy metabolism

E) the use of oxygen and generation of carbon dioxide by the mitochondria during energy metabolism

2) Which of the following specifically describes the movement of air into and out of the lungs?
A) Secondary ventilation
B) Pulmonary ventilation
C) Internal respiration
D) Respiration
E) Expiration

B) Pulmonary ventilation

3) Which of the following is NOT a function of the respiratory system?
A) vocalization
B) electrolyte balance of blood
C) acid-base balance of blood
D) enhancing venous return
E) heat loss

B) electrolyte balance of blood

4) Which of the following statements about respiratory system anatomy is FALSE?
A) Each lung has three lobes.
B) The nasal cavity and oral cavity are parts of the upper airways.
C) Both air and food travel in the pharynx.
D) The trachea remains open at all times.
E) The trachea branches into two bronchi, one of which travels to each lung.

A) Each lung has three lobes.

5. Food is prevented from entering the respiratory tract by the ________, which is/are located in the ________, the entry to the larynx.
A) glottis : pharynx
B) glottis : epiglottis
C) vocal cords : glottis
D) epiglottis : glottis
E) bronchioles : bronchi

D) epiglottis : glottis

6) What structure bifurcates into the bronchi that enter the right and left lungs?
A) trachea
B) larynx
C) glottis
D) pharynx
E) bronchioles

A) trachea

7) What are the smallest (and most distal) structures that remain a component of the conducting zone in the respiratory tract?
A) bronchi
B) secondary bronchi
C) tertiary bronchioles
D) terminal bronchioles
E) respiratory bronchioles

D) terminal bronchioles

8) What is the function of ciliated cells in the conducting zone?
A) provide the rigid support that keeps the conducting zone open
B) produce a viscous solution called mucus
C) engulf foreign material that has been trapped within the mucus
D) propel mucus containing trapped particles toward the glottis
E) move macrophages down the conducting zone toward the respiratory zone

D) propel mucus containing trapped particles toward the glottis

9) Which of the following becomes more abundant deeper into the conducting zone (from bronchi to bronchioles) .
A) Cartilage
B) Type I alveolar cells
C) Cilia
D) Goblet cells
E) Smooth muscle

E) Smooth muscle

10) Which of the following is most abundant in the trachea and bronchi, becoming much less dense (and eventually absent) in the bronchioles.
A) smooth muscle cells
B) cartilage
C) goblet cells
D) macrophages
E) type II alveolar cells

B) cartilage

11) The transition from the conducting to the respiratory zone in the lungs occurs at the ________.
A) alveoli
B) alveolar ducts
C) tertiary bronchi
D) terminal bronchioles
E) respiratory bronchioles

E) respiratory bronchioles

12) What structure is the region of the lungs where the majority of gas exchange occurs?
A) respiratory bronchiole
B) alveolar duct
C) alveolus
D) terminal bronchiole
E) bronchus

C) alveolus

13) What are the most common cells that line the surface of the alveoli and are therefore associated with the exchange of gases within the lungs?
A) Macrophages
B) Goblet cells
C) Type I alveolar cells
D) Type II alveolar cells
E) Type III alveolar cells

C) Type I alveolar cells

14) What is the thin barrier (0.2 μm) that allows for the efficient exchange of gases between the lungs and the blood called?
A) endothelial cell
B) type I alveolar cell
C) type II alveolar cell
D) alveolar macrophage
E) respiratory membrane

E) respiratory membrane

15) What type of cells secrete mucus in the respiratory tract?
A) type I alveolar cells
B) type II alveolar cells
C) goblet cells
D) macrophages
E) ciliated cells

C) goblet cells

16) Which of the following decreases when traveling from upper airways to the conducting zone to the respiratory zone?
A) cilia only
B) smooth muscle only
C) goblet cells only
D) both cilia and goblet cells
E) cilia, goblet cells, and smooth muscle

D) both cilia and goblet cells

17) What type of cell in the respiratory tract functions in phagocytosis of inhaled pathogens and foreign particles?
A) type I alveolar cells
B) type II alveolar cells
C) goblet cells
D) macrophages
E) ciliated cells

D) macrophages

18) Which of the following is NOT a muscle involved in breathing?
A) the pleural muscle
B) the internal intercostal muscle
C) the external intercostal muscle
D) the diaphragm
E) the abdominal muscle

A) the pleural muscle

19) The ________ is bounded by the interior surface of the chest wall and the exterior surface of the lung.
A) interpleural space
B) alveolar space
C) bronchiolar space
D) intraparietal cavity
E) thoracic cavity

A) interpleural space

20) What is the connective tissue surround each lung called?
A) pleural sac
B) visceral sac
C) parietal sac
D) peripulmonary sac
E) alveolar sac

A) pleural sac

21) What is the dome-shaped muscle that separates the thoracic and abdominal cavities and plays an important role in breathing?
A) internal intercostals
B) sternocleidomastoid
C) external intercostals
D) diaphragm
E) scalene

D) diaphragm

22) When air is no longer moving through the respiratory tract and the airway is open to the environment, the pressure within the lung is equal to ________.
A) systolic blood pressure
B) transpulmonary pressure
C) intrapleural pressure
D) atmospheric pressure
E) end-diastolic pressure

D) atmospheric pressure

23) The difference between what two pressures drives air into and out of the lungs?
A) pulmonary venous : atmospheric
B) central venous : intracoronary
C) intrapleural : intra-alveolar
D) atmospheric : intra-alveolar
E) atmospheric : intrapleural

D) atmospheric : intra-alveolar

24) Which of the following occurs when intra-alveolar pressure exceeds atmospheric pressure?
A) air moves into the lung
B) air moves out of the lung
C) the lung collapses
D) the lung must be expanding
E) intrapleural pressure is greater than intra-alveolar pressure

B) air moves out of the lung

25) Which of the following pressure(s) vary rhythmically with respiration?
A) atmospheric pressure only
B) intrapleural pressure only
C) intra-alveolar pressure only
D) both intrapleural pressure and intra-alveolar pressure
E) both atmospheric pressure and intrapleural pressure

D) both intrapleural pressure and intra-alveolar pressure

26) The difference between intrapleural pressure and intra-alveolar pressure is ________.
A) the driving force for air flow into and out of the lungs
B) atmospheric pressure
C) transpulmonary pressure
D) approximately 100 mm Hg
E) zero

C) transpulmonary pressure

27) Which of the following is a measure of the distending force across the lungs?
A) intrapleural pressure
B) intra-alveolar pressure
C) transpulmonary pressure
D) atmospheric pressure
E) difference between intra-alveolar pressure and atmospheric pressure

C) transpulmonary pressure

28) Equilibration of pressure between the intrapleural space and the alveoli will lead to which of the following?
A) air moving out of the lungs
B) air moving into the lungs
C) a pneumothorax (the lung will collapse)
D) chronic obstructive pulmonary disease
E) restrictive pulmonary disease

C) a pneumothorax (the lung will collapse)

29) What is the volume of air present in the lungs when the lungs are at rest (in between breaths)?
A) zero
B) functional residual capacity
C) residual volume
D) total lung capacity
E) tidal volume

B) functional residual capacity

30) Which of the following is true when the lung volume is equal to the functional residual capacity?
A) the elastic recoil of the lungs is balanced by the elastic recoil of the chest wall
B) intra-alveolar pressure is greater than atmospheric pressure
C) intra-alveolar pressure is less than atmospheric pressure
D) intra-alveolar pressure is less than intrapleural pressure
E) intrapleural pressure is zero

A) the elastic recoil of the lungs is balanced by the elastic recoil of the chest wall

31) As the lungs expand, intra-alveolar pressure ________ and air moves ________ the lungs.
A) increases : out of
B) increases : into
C) decreases : out of
D) decreases : into
E) does not change : neither into nor out of

D) decreases : into

32) As the volume of the lung increases, atmospheric pressure ________.
A) will not change
B) increases
C) decreases
D) will follow Starling's Law
E) will follow the Ideal Gas Law

A) will not change

33) What does contraction of the diaphragm cause?
A) decrease in the volume of the thoracic cavity and therefore a decrease in atmospheric pressure
B) decrease in the volume of the thoracic cavity and therefore a decrease in intra-alveolar pressure
C) increase in the volume of the thoracic cavity and therefore a decrease in intra-alveolar pressure
D) decrease in the volume of the thoracic cavity and therefore an increase in intra-alveolar pressure
E) increase in the volume of the thoracic cavity and therefore an increase in intra-alveolar pressure

C) increase in the volume of the thoracic cavity and therefore a decrease in intra-alveolar pressure

34) What are the primary inspiratory muscles?
A) external and internal intercostals
B) diaphragm and external intercostals
C) diaphragm and internal intercostals
D) diaphragm and the external and internal intercostals
E) diaphragm and abdominal muscles

B) diaphragm and external intercostals

35) The muscles of respiration are ________.
A) skeletal muscle innervated by the somatic nervous system
B) skeletal muscle innervated by the autonomic nervous system
C) smooth muscle innervated by the somatic nervous system
D) smooth muscle innervated by the autonomic nervous system
E) smooth muscle without innervation

A) skeletal muscle innervated by the somatic nervous system

36) As the volume of the chest wall increases, the concomitant expansion of the lungs is due to a(n) ________.
A) increase in atmospheric pressure
B) decrease in intra-alveolar pressure
C) increase in intrapleural pressure
D) decrease in transpulmonary pressure
E) increase in transpulmonary pressure

E) increase in transpulmonary pressure

37) At rest, expiration is a(n) ________ process that involves ________.
A) active : the contraction of the diaphragm
B) passive : relaxation of the diaphragm and external intercostals
C) active : contraction of the internal intercostals
D) passive : relaxation of the internal intercostals
E) active : relaxation of the diaphragm

B) passive : relaxation of the diaphragm and external intercostals

38) Which of the following pressures is lower during inspiration than during expiration?
A) intra-alveolar pressure only
B) transpulmonary pressure only
C) intrapleural pressure only
D) both intra-alveolar and transpulmonary pressures
E) both intra-alveolar and intrapleural pressures

E) both intra-alveolar and intrapleural pressures

39) The compliance of the lungs can be determined by measuring the change in ________ for a given change in ________.
A) lung volume : intra-alveolar pressure
B) lung volume : transpulmonary pressure
C) intra-alveolar pressure : lung volume
D) airway resistance : lung volume
E) lung volume : airway resistance

B) lung volume : transpulmonary pressure

40) The compliance of the lung is determined by the elasticity of the lung and ________.
A) volume
B) transpulmonary pressure
C) airway resistance
D) surface tension
E) intra-alveolar pressure

D) surface tension

41) The surface tension of the alveolus is reduced by surfactants produced by what type of cells?
A) ciliated
B) goblet
C) type I alveolar
D) type II alveolar
E) type III alveolar

D) type II alveolar

42) Which of the following is NOT involved in altering the resistance of the airway to air movement?
A) transpulmonary pressure
B) contractile activity of bronchiolar smooth muscle cells
C) secretion of mucus into the airway
D) pulmonary surfactant concentration
E) tractive forces exerted on the airway by surrounding tissue

D) pulmonary surfactant concentration

43) How do tractive forces affect the airways during inspiration.
A) increase in compliance
B) decrease in compliance
C) increase in airway resistance
D) decrease in airway resistance
E) bronchodilation

D) decrease in airway resistance

44) Which of the following is responsible for changes in airway resistance that occur in a single breath?
A) surrounding atmospheric pressure
B) autonomic nervous system
C) passive forces exerted on the airways
D) contractility of smooth muscle cells
E) sensitivity of smooth muscle cells to allergens

C) passive forces exerted on the airways

45) Which of the following chemicals will NOT result in a decrease in airway resistance?
A) norepinephrine
B) epinephrine
C) carbon dioxide
D) bronchodilators
E) histamine

E) histamine

46) Which of the following is NOT part of the response of an airway to specific allergens that initiate an asthmatic response?
A) increased airway resistance
B) increased inflammatory response
C) increased histamine release
D) increased secretion of mucus
E) increased release of corticosteroids

E) increased release of corticosteroids

47) What benefit are corticosteroids in the treatment of asthma?
A) They induce bronchodilation.
B) They induce bronchoconstriction.
C) They reduce inflammation of the airways.
D) They increase blood flow to the airways.
E) They decrease mucus secretion into the airways.

C) They reduce inflammation of the airways.

48) A(n) ________ is used clinically to measure lung volumes and rates of air flow.
A) spirometer
B) electrocardiograph
C) ratiometer
D) electroencephalogram
E) X-ray

A) spirometer

49) What is the volume of air moved into and out of the lungs in a single breath during unforced breathing called?
A) Total lung capacity
B) Functional residual capacity
C) Tidal volume
D) Vital capacity
E) Minute ventilation

C) Tidal volume

50) The presence of a negative intrapleural pressure at maximum expiration is responsible for which of the following?
A) residual volume
B) functional residual volume
C) tidal volume
D) vital capacity
E) functional residual capacity

A) residual volume

51) The tidal volume and inspiratory reserve volume together make up which of the following?.
A) Residual volume
B) Functional residual capacity
C) Total lung capacity
D) Inspiratory capacity
E) Vital capacity

D) Inspiratory capacity

52) Functional residual capacity is comprised of which of the following?
A) vital capacity and expiratory reserve volume
B) tidal volume and inspiratory reserve volume
C) tidal volume and expiratory reserve volume
D) tidal volume, inspiratory reserve volume, and expiratory reserve volume
E) residual volume and expiratory reserve volume

E) residual volume and expiratory reserve volume

53) Which of the following measurements cannot be determined by a spirometer?
A) vital capacity
B) tidal volume
C) residual volume
D) inspiratory capacity
E) inspiratory reserve volume

C) residual volume

54) A normal tidal volume at rest is approximately ________ mL.
A) 100
B) 500
C) 1,000
D) 5,000
E) 10,000

B) 500

55) A normal vital capacity is approximately ________ mL.
A) 100
B) 500
C) 1,000
D) 4,500
E) 9,000

D) 4,500

56) A healthy person can normally exhale what percentage of his/her vital capacity in one second?
A) 10
B) 20
C) 50
D) 80
E) 100

D) 80

57) In an obstructive disease, the lungs can become overinflated because the difficulty in ________ tends to ________.
A) expiration : increase vital capacity
B) expiration : decrease total lung capacity and vital capacity
C) expiration : increase residual volume and total lung capacity
D) inspiration : decrease total lung capacity and vital capacity
E) inspiration : increase total lung capacity and vital capacity

C) expiration : increase residual volume and total lung capacity

58) A decrease in ________ is indicative of a restrictive pulmonary disease.
A) minute ventilation
B) tidal volume
C) forced expiratory volume
D) residual volume
E) vital capacity

E) vital capacity

59) A decrease in ________ is indicative of an obstructive pulmonary disease.
A) minute ventilation
B) tidal volume
C) forced expiratory volume
D) residual volume
E) forced vital capacity

C) forced expiratory volume

60) What is the term for the volume of air moved into the lungs every minute?
A) alveolar ventilation
B) tidal volume
C) total lung capacity
D) minute ventilation
E) pulmonary ventilation

D) minute ventilation

61) What is the term for the volume of air that reaches the respiratory zone each minute?
A) alveolar ventilation
B) tidal volume
C) total lung capacity
D) minute ventilation
E) pulmonary ventilation

A) alveolar ventilation

62) What is the volume of the respiratory pathway that is not able to exchange gases (conducting pathway) called?
A) dead volume
B) functional dead space
C) anatomical dead space
D) residual volume
E) functional residual volume

C) anatomical dead space

1) The respiratory quotient is calculated as the ________.
A) ratio of the volume of oxygen consumed per volume of carbon dioxide produced
B) ratio of the volume of carbon dioxide produced per volume of oxygen consumed
C) product of the volume of carbon dioxide consumed and the volume of oxygen produced
D) product of the volume of oxygen consumed and the volume of carbon dioxide produced
E) sum of the volume of oxygen consumed and the volume of carbon dioxide produced

B) ratio of the volume of carbon dioxide produced per volume of oxygen consumed

2) If oxygen is consumed by the body cells at a rate of 300 mL per minute, then how much oxygen diffuses from the alveoli into the blood in the pulmonary capillaries?
A) 300 mL per minute
B) more than 300 mL per minute
C) less than 300 mL per minute
D) depends on where the oxygen is being utilized
E) depends on whether or not carbon dioxide is being produced at the same rate

A) 300 mL per minute

3) Oxygenated blood is found in which of the following?
A) right atrium only
B) pulmonary artery only
C) pulmonary vein only
D) both the right atrium and pulmonary artery
E) both the right atrium and pulmonary vein

C

4) Movement of oxygen and carbon dioxide between alveoli and blood occurs by what process?
A) simple diffusion
B) facilitated diffusion
C) osmosis
D) primary active transport
E) secondary active transport

A) simple diffusion

5) Which of the following is NOT part of the pathway that must be crossed by oxygen on its way to binding with hemoglobin?
A) alveolar epithelial cell
B) basement membrane
C) alveolar mucosal barrier
D) endothelial cell
E) red blood cell membrane

C

6) Which of the following does NOT contribute to the rapid movement of gases into and out of the blood within the lungs?
A) rapid blood flow
B) thin membrane
C) large surface area
D) concentration gradient
E) permeability of the membrane

A

7) In a mixture of gases, the driving force for the movement of an individual gas within that mixture is ultimately the ________.
A) solubility of the gas
B) total pressure of the gases
C) fractional concentration of that gas
D) partial pressure of that gas
E) volume of the gas

D

8) What is the most abundant gas in the air that we breathe?
A) oxygen
B) carbon dioxide
C) water vapor
D) argon
E) nitrogen

E

9) What percentage of air is oxygen?
A) < 1%
B) 6%
C) 12%
D) 21%
E) 79%

D

10) What percentage of air is carbon dioxide?
A) < 1%
B) 6%
C) 12%
D) 21%
E) 79%

A

11) What is the partial pressure of oxygen in a gas mixture that is 40% oxygen, 40% argon, and 20% helium, when the total pressure of the gas is 1,000 mm Hg?
A) 100 mm Hg
B) 200 mm Hg
C) 333 mm Hg
D) 400 mm Hg
E) 600 mm Hg

D

12) What is the partial pressure of oxygen in air at sea level?
A) 60 mm Hg
B) 160 mm Hg
C) 210 mm Hg
D) 400 mm Hg
E) 600 mm Hg

B

13) As humidity increases, the partial pressure of oxygen in air ________.
A) increases as the total pressure of air remains the same
B) increases as the total pressure of air increases
C) decreases as the total pressure of air remains the same
D) decreases as the total pressure of air increases
E) does not change

C) decreases as the total pressure of air remains the same

14) As the air is saturated with water vapor (humidified) upon entry into the conducting pathway, there will be ________.
A) a selective increase in the partial pressure of nitrogen
B) a selective decrease in the partial pressure of nitrogen
C) no change in the partial pressure of the remaining gases
D) a decrease in the partial pressure of the remaining gases
E) an increase in the partial pressure of the remaining gases

D) a decrease in the partial pressure of the remaining gases

15) At equilibrium, the gas molecules that dissolve in solution and those that remain in the gaseous phase are, by definition, at the same ________.
A) temperature
B) concentration
C) partial pressure
D) volume
E) humidity

C) partial pressure

16) The relationship between the concentration of a gas in solution and the partial pressure of that gas can be described by ________.
A) Boyle's Law
B) Fick's Law
C) Dalton's Law
D) Henry's Law
E) Poiseuille's Law

D) Henry's Law

17) Which of the following can increase the concentration of a particular gas in a solution?
A) increase the partial pressure of that gas exposed to the solution
B) increase the volume of the container containing the gas and solution
C) increase the volume of the gas only
D) increase the volume of the solution only
E) decrease the concentration of other gases in the solution

A

18) At equilibrium, which of the following statements is true when helium and nitrogen are present in a gas at equal partial pressures over water?
A) The concentrations of helium and nitrogen in the gas are equal.
B) The partial pressures of helium and nitrogen in the water are equal.
C) The concentrations of helium and nitrogen in the water are equal.
D) The concentrations of helium and nitrogen in BOTH the water and gas are equal.
E) The partial pressure of nitrogen is greater than the partial pressure of helium.

B) The partial pressures of helium and nitrogen in the water are equal.

19) The mixing of atmospheric air within the dead space of the conducting zone of the lung upon inspiration results in a partial pressure of ________.
A) water vapor in the alveoli that is lower than atmospheric
B) nitrogen in the alveoli that is higher than atmospheric
C) oxygen in the alveoli that is lower than atmospheric
D) carbon dioxide in the alveoli that is lower than atmospheric
E) oxygen in the alveoli that is higher than atmospheric

C) oxygen in the alveoli that is lower than atmospheric

20) Which of the following causes a decrease in the PO2 of air as it enters the conducting zone of the lungs?
A) humidifying the air
B) warming of the air
C) the increasing PCO2
D) the consumption of oxygen
E) decreasing alveolar PO2

A) humidifying the air

21) Pulmonary edema describes a condition where the uptake of oxygen and unloading of carbon dioxide is reduced as a consequence of a(n) ________.
A) thickening of the diffusion barrier by fluid accumulation in the pulmonary blood
B) thickening of the diffusion barrier by fluid accumulation in the alveoli
C) decrease in the partial pressure of oxygen in the alveolus
D) decrease in the partial pressure of carbon dioxide in the alveolus
E) increase in the partial pressure of oxygen in the blood

B) thickening of the diffusion barrier by fluid accumulation in the alveoli

22) At sea level, what is the normal partial pressure of oxygen in alveolar air?
A) 21 mm Hg
B) 40 mm Hg
C) 46 mm Hg
D) 100 mm Hg
E) 160 mm Hg

D) 100 mm Hg

23) At sea level, what is the normal partial pressure of carbon dioxide in alveolar air?
A) 21 mm Hg
B) 40 mm Hg
C) 46 mm Hg
D) 100 mm Hg
E) 160 mm Hg

B) 40 mm Hg

24) At sea level, what is the normal partial pressure of oxygen in the pulmonary veins?
A) 21 mm Hg
B) 40 mm Hg
C) 46 mm Hg
D) 100 mm Hg
E) 160 mm Hg

D) 100 mm Hg

25) At sea level, what is the normal partial pressure of carbon dioxide in pulmonary arteries?
A) 21 mm Hg
B) 40 mm Hg
C) 46 mm Hg
D) 100 mm Hg
E) 160 mm Hg

C) 46 mm Hg

26) At sea level, what is the normal partial pressure of oxygen in the systemic veins?
A) 21 mm Hg
B) 40 mm Hg
C) 46 mm Hg
D) 100 mm Hg
E) 160 mm Hg

B) 40 mm Hg

27) At sea level, what is the normal partial pressure of carbon dioxide in systemic veins?
A) 21 mm Hg
B) 40 mm Hg
C) 46 mm Hg
D) 100 mm Hg
E) 160 mm Hg

C) 46 mm Hg

28) During intense exercise, the metabolic activity of muscle causes a ________ in the partial pressure of oxygen in the tissue, ________ the movement of oxygen into the tissue.
A) decrease : reducing
B) decrease : facilitating
C) increase : reducing
D) increase : facilitating
E) does not change : facilitating

B

29) A typical value for blood PO2 in the pulmonary vein is ________, whereas PCO2 is ________.
A) 150 mm Hg : 0.3 mm Hg
B) 46 mm Hg : 100 mm Hg
C) 40 mm Hg : 46 mm Hg
D) 40 mm Hg : 100 mm Hg
E) 100 mm Hg : 40 mm Hg

E) 100 mm Hg : 40 mm Hg

30) Under resting conditions, equilibration between alveolar PO2 and PCO2 with blood PO2 and PCO2 in the pulmonary capillaries occurs in approximately how many seconds?
A) 3
B) 2
C) 1
D) 0.5
E) 0.25

E

31) Under resting conditions, equilibration between alveolar PO2 and PCO2 with blood PO2 and PCO2 in the pulmonary capillaries is completed by the time the blood has traveled what portion of the distance of the pulmonary capillaries?
A) 1/10
B) 1/8
C) 1/4
D) 1/3
E) 1/2

D) 1/3

32) Mixed venous blood samples can be taken from which of the following blood vessels?
A) pulmonary vein
B) pulmonary artery
C) inferior vena cava
D) aorta
E) superior vena cava

B) pulmonary artery

33) The venous blood in the right ventricle is referred to as "mixed" because the blood that enters the heart ________.
A) has a low PO2
B) contains a mixture of oxygen and carbon dioxide
C) comes from tissue with differing metabolic activities
D) has a high PCO2
E) is drained from the body

C) comes from tissue with differing metabolic activities

34) What is an increase in alveolar ventilation to match the demands of increased metabolic activity in the cells called?
A) hyperventilation
B) hypoventilation
C) hyperpnea
D) hypopnea
E) dyspnea

C) hyperpnea

35) Hyperventilation would lead to a(n) ________ within the systemic arteries.
A) selective decrease in PO2
B) selective increase in PO2
C) selective decrease in PCO2
D) increase in PO2 and decrease in PCO2
E) decrease in PO2 and increase in PCO2

D) increase in PO2 and decrease in PCO2

36) What is a decrease in carbon dioxide within the blood called?
A) hypoxia
B) hypoxemia
C) hypocapnia
D) hypercapnia
E) hyperpnea

C) hypocapnia

37) The majority of oxygen present within the blood is ________.
A) bound to hemoglobin within the plasma
B) bound to hemoglobin in red blood cells
C) dissolved within the plasma
D) in the plasma as HCO3-
E) bound to plasma proteins

B) bound to hemoglobin in red blood cells

38) Each ________ on the hemoglobin subunit is capable of binding an oxygen molecule, thereby allowing ________ oxygen to bind with one hemoglobin molecule.
A) heme : four
B) heme : three
C) globin : four
D) globin : three
E) free iron : one

A

39) What is the primary driving force for the binding of oxygen to hemoglobin?
A) PCO2
B) PO2
C) pH
D) temperature
E) 2,3-bisphosphoglycerate (2,3-BPG)

B) PO2

40) If hemoglobin is saturated (1.3 mL of oxygen per gram) and there are 150 grams of hemoglobin per liter of blood, how much oxygen can be delivered to the tissue if cardiac output is 15 liters per minute?
A) 650 g O2/min
B) 1300 mL O2/min
C) 1300 g O2/min
D) 2925 mL O2/min
E) 2925 g O2/min

D) 2925 mL O2/min

41) What is the definition of anemia?
A) a decrease in PO2
B) a increase in PCO2
C) a decrease in hemoglobin
D) a decrease in the oxygen carrying capacity of the blood
E) a decrease in the affinity of hemoglobin for oxygen

D) a decrease in the oxygen carrying capacity of the blood

42) What is labored or difficult breathing called?
A) hyperpnea
B) dyspnea
C) hypopnea
D) eupnea
E) apnea

B) dyspnea

43) What is a deficiency of oxygen in the tissues called?
A) apnea
B) hypoxia
C) hypoxemia
D) hypocapnia
E) hypercapnia

B) hypoxia

44) What is rapid shallow breathing called?
A) tachypnea
B) apnea
C) dyspnea
D) hyperpnea
E) eupnea

A) tachypnea

45) What is a decrease in oxygen in the blood called?
A) hypoxia
B) hypoxemia
C) anemia
D) hypocapnia
E) dysnemia

B) hypoxemia

46) As oxygen binds to hemoglobin, the ________ of the hemoglobin molecule will change through a process of ________ such that the binding of oxygen is enhanced.
A) amino acid sequence : phosphorylation
B) cooperativity : negativity
C) cooperativity : positivity
D) affinity : negative cooperativity
E) affinity : positive cooperativity

E) affinity : positive cooperativity

47) Which of the following statements is FALSE of a leftward shift in the hemoglobin-oxygen dissociation curve?
A) Affinity for oxygen is increased.
B) Oxygen loading onto the hemoglobin is increased.
C) Hemoglobin is more saturated at a given PO2.
D) It can be caused by an increase in blood pH.
E) It can be caused by an increase in PCO2.

E) It can be caused by an increase in PCO2.

48) Which of the following statements is FALSE of a rightward shift in the hemoglobin-oxygen dissociation curve?
A) Affinity for oxygen is decreased.
B) A rightward shift usually occurs in active tissue.
C) Hemoglobin unloading of oxygen is increased.
D) Oxygen loading onto hemoglobin is decreased.
E) It can be caused by a decrease in 2, 3-BPG.

E) It can be caused by a decrease in 2, 3-BPG.

49) Which of the following will cause a shift in the hemoglobin-oxygen dissociation curve to the right?
A) increase in temperature only
B) increase in plasma pH only
C) increase in 2,3-BPG (2,3-bisphosphoglycerate) only
D) both an increase in temperature and an increase in 2, 3-BPG
E) both an increase in temperature and an increase in plasma pH

D) both an increase in temperature and an increase in 2, 3-BPG

50) As it leaves the lung in the pulmonary vein, blood is ________ saturated with oxygen.
A) 75%
B) 90%
C) 98%
D) completely (100%)
E) supersaturated (108%)

C) 98%

51) Which of the following increases oxygen unloading from hemoglobin?
A) increased carbon dioxide in the tissue
B) increased oxygen levels in the tissue
C) increased blood pH
D) decreased metabolism
E) decreased temperature

A) increased carbon dioxide in the tissue

52) Which of the following will increase the unloading of oxygen within the tissue?
A) increased hydrogen ion concentration only
B) increased PCO2 only
C) increased body temperature only
D) both increased hydrogen ion concentration and increased body temperature
E) increased hydrogen ion concentration, increased body temperature, and increased PCO2

E) increased hydrogen ion concentration, increased body temperature, and increased PCO2

53) Which of the following will increase the loading of oxygen onto the hemoglobin molecule within the lungs?
A) decreased hydrogen ion concentration
B) increased PCO2
C) decreased pH
D) increased 2,3-bishosphoglycerate (2,3-BPG)
E) increased body temperature

A) decreased hydrogen ion concentration

54) In the systemic arteries, the partial pressure of oxygen is approximately ________, and hemoglobin is approximately ________ saturated with oxygen.
A) 40 mm Hg : 75%
B) 60 mm Hg : 50%
C) 100 mm Hg : 75%
D) 40 mm Hg : 50%
E) 100 mm Hg : 98%

E) 100 mm Hg : 98%

55) In the pulmonary arteries, the partial pressure of oxygen is approximately ________, and hemoglobin is approximately ________ saturated with oxygen.
A) 25 mm Hg : 50%
B) 40 mm Hg : 75%
C) 60 mm Hg : 80%
D) 80 mm Hg : 90%
E) 100 mm Hg : 98%

B) 40 mm Hg : 75%

56) The carbamino effect describes a change in the conformation of hemoglobin that is induced by ________.
A) an increase in pH
B) a decrease in temperature
C) an increase in temperature
D) an increase in CO2
E) a decrease in pH

D) an increase in CO2

57) Which of the following statements about 2,3-BPG is FALSE?
A) 2,3-BPG is an intermediate of glycolysis.
B) 2,3-BPG produces a rightward shift in the hemoglobin-oxygen dissociation curve.
C) 2,3-BPG synthesis is inhibited by high levels of oxyhemoglobin.
D) 2,3-BPG increases the affinity of hemoglobin for oxygen.
E) 2,3-BPG is produced by red blood cells.

D) 2,3-BPG increases the affinity of hemoglobin for oxygen.

58) Where in blood does the conversion of CO2 to bicarbonate occur?
A) erythrocytes
B) platelets
C) capillary endothelial cells
D) leukocytes
E) plasma

A) erythrocytes

59) What is the primary mechanism of carbon dioxide transport in blood?
A) dissolved in the plasma
B) dissolved in the red blood cells
C) bound to hemoglobin
D) as bicarbonate dissolved in the plasma
E) as bicarbonate dissolved in the red blood cells

D) as bicarbonate dissolved in the plasma

60) The presence of bicarbonate ions in the blood has an important direct effect, aside from the transport of CO2, that involves ________.
A) stimulating the proliferation of alveolar epithelial cells
B) altering the activity of several receptors
C) altering the affinity of hemoglobin for oxygen
D) maintaining acid-base balance
E) altering the activity of carbonic anhydrase

D) maintaining acid-base balance

61) Within an erythrocyte, the conversion of CO2 to bicarbonate is prevented from reaching equilibrium by the ________.
A) absence of a nucleus
B) presence of oxygen
C) temperature of the body
D) presence of hydrogen ions
E) efflux of bicarbonate from the erythrocyte via the chloride shift

E) efflux of bicarbonate from the erythrocyte via the chloride shift

62) The hydrogen ions released by the dissociation of carbonic acid are buffered by their ________.
A) transport out of the erythrocyte as a sodium ion moves in
B) binding to DNA within the nucleus
C) transport into the erythrocyte as sodium ions move out
D) binding to hemoglobin
E) active transport out of the erythrocyte

D) binding to hemoglobin

63) The Haldane effect describes the increase in the affinity of hemoglobin for CO2 in the presence of a lowered ________.
A) PCO2
B) concentration of bicarbonate (HCO3-)
C) PO2
D) pH
E) temperature

C) PO2

64) During quiet breathing, a person's breathing cycle consists of ________.
A) contraction of inspiratory muscles
B) contraction and relaxation of inspiratory muscles
C) contraction and relaxation of inspiratory and expiratory muscles
D) contraction of expiratory muscles
E) contraction of inspiratory muscles and relaxation of expiratory muscles

B) contraction and relaxation of inspiratory muscles

65) Which of the following nerves have activity during quiet inspiration?
A) phrenic nerve only
B) internal intercostal nerve only
C) external intercostal nerve only
D) both the phrenic nerve and internal intercostal nerves
E) both the phrenic nerve and external intercostal nerves

E) both the phrenic nerve and external intercostal nerves

66) During active breathing, bursts of action potentials are observed to occur ________.
A) exclusively in the inspiratory motor neurons
B) simultaneously in the inspiratory and expiratory motor neurons
C) exclusively in the expiratory motor neurons
D) asynchronously in the inspiratory and expiratory motor neurons
E) synchronously in the inspiratory and expiratory motor neurons

D) asynchronously in the inspiratory and expiratory motor neurons

67) The ________ is the respiratory center that appears to facilitate the transition between inspiration and expiration.
A) medullary respiratory group
B) pontine respiratory group
C) dorsal respiratory group
D) ventral respiratory group
E) central pattern generator

B) pontine respiratory group

68) Inspiratory neurons are located in the ________.
A) dorsal respiratory group only
B) ventral respiratory group only
C) pontine respiratory group only
D) both dorsal and ventral respiratory groups
E) dorsal, ventral, and pontine respiratory groups

E) dorsal, ventral, and pontine respiratory groups

69) In the model of quiet breathing, the breathing rhythm originated by the central pattern generator activates the ________.
A) inspiratory neurons in the dorsal respiratory center
B) expiratory neurons in the dorsal respiratory center
C) inspiratory neurons in the ventral respiratory center
D) both expiratory neurons in the ventral respiratory center
E) both inspiratory neurons in the dorsal and ventral respiratory center

E) both inspiratory neurons in the dorsal and ventral respiratory center

70) In the model for quiet breathing, expiration is induced by ________.
A) abrupt termination of inspiration
B) activation of expiratory neurons in the dorsal respiratory center
C) activation of inspiratory neurons in the ventral respiratory center
D) activation of expiratory neurons in the ventral respiratory center
E) activation of inspiratory neurons in the dorsal respiratory center

A) abrupt termination of inspiration

71) Which of the following is NOT one of the sensory receptors that alter the output from the central pattern generator?
A) peripheral chemoreceptor
B) central chemoreceptor
C) pulmonary stretch receptor
D) pulmonary baroreceptors
E) irritant receptors

D) pulmonary baroreceptors

72) Coughing is initiated by ________ located in the ________.
A) chemoreceptors : trachea
B) irritant receptors : nose and pharynx
C) irritant receptors : trachea
D) chemoreceptors : nose and pharynx
E) stretch receptor : trachea

C) irritant receptors : trachea

73) Peripheral chemoreceptors are specialized cells in contact with arterial blood that respond directly to changes in blood ________.
A) pH
B) PO2
C) PCO2
D) PCO2 and PO2
E) PO2, pH, and PCO2

E) PO2, pH, and PCO2

74) Central chemoreceptors are neurons in the medulla that respond directly to changes in ________.
A) cerebrospinal fluid pH
B) blood pH
C) cerebrospinal fluid PO2 and pH
D) blood pH and PO2
E) cerebrospinal fluid PO2

A) cerebrospinal fluid pH

75) Chemoreceptors respond primarily to changes in PCO2 indirectly by its effect on ________.
A) 2,3-diphosphoglycerate (2,3-DPG) concentration
B) PO2
C) lactic acid concentration
D) hydrogen ion concentration
E) hemoglobin concentration

D) hydrogen ion concentration

76) Hyperventilation will cause changes in PCO2 that are detected by the chemoreceptors which causes a(n) ________.
A) decrease in breathing rate only
B) increase in depth of breathing only
C) increase in breathing rate only
D) increase in breathing rate and depth of breathing
E) decrease in breathing rate and depth of breathing

E) decrease in breathing rate and depth of breathing

77) Where are the peripheral chemoreceptors in humans?
A) aortic bodies only
B) carotid bodies only
C) medulla oblongata only
D) both aortic and carotid bodies
E) both carotid bodies and medulla oblongata

B) carotid bodies only

78) Which of the following BEST describes a chemoreceptor response to PO2?
A) Peripheral chemoreceptors respond to small changes in PO2.
B) Central chemoreceptors respond to only large decreases in PO2.
C) Peripheral chemoreceptors respond only indirectly to PO2.
D) Central chemoreceptors do not respond to changes in PO2.
E) Peripheral chemoreceptors respond to oxyhemoglobin.

D) Central chemoreceptors do not respond to changes in PO2.

79) A decrease in PCO2 within the lung will result in a ________ in the pulmonary vasculature and a ________ in the bronchioles.
A) vasoconstriction : lack of change
B) weak vasoconstriction : bronchodilation
C) vasodilation : weak bronchodilation
D) weak vasodilation : bronchoconstriction
E) lack of change : weak bronchoconstriction

D) weak vasodilation : bronchoconstriction

80) A local bronchodilation within the alveolus will result in a(n) ________ in the ventilation-perfusion ratio in that region, whereas a vasoconstriction will result in a(n) ________ in the ventilation-perfusion ratio.
A) increase : increase
B) increase : decrease
C) decrease : increase
D) decrease : decrease
E) lack of change : increase

A) increase : increase

81) The primary effect of increased PO2 in the lungs is to cause ________ which ________ the ventilation-perfusion ratio.
A) bronchoconstriction : decreases
B) bronchodilation : increases
C) vasoconstriction : decreases
D) vasodilation : decreases
E) vasoconstriction : increases

D) vasodilation : decreases

82) The primary effect of increased PCO2 in the lungs is to cause ________ which ________ the ventilation-perfusion ratio.
A) bronchoconstriction : decreases
B) bronchodilation : increases
C) vasoconstriction : decreases
D) vasodilation : decreases
E) vasoconstriction : increases

B) bronchodilation : increases

83) When the blood becomes ________, it can lead to a depression in the activity of the central nervous system.
A) hypoxic
B) hypocapnic
C) pH 7.4
D) acidic
E) alkaline

D) acidic

84) The buffering capacity of hemoglobin is directly related to its ability to bind with ________.
A) oxygen
B) carbon dioxide
C) carbon monoxide
D) hydrogen ions
E) nitrogen

D) hydrogen ions

85) Bicarbonate is an important buffer in blood, whose concentration is regulated by the ________.
A) kidneys
B) lungs
C) heart
D) liver
E) pancreas

A) kidneys

86) A change in the ratio of bicarbonate to carbon dioxide concentration in the blood will ________.
A) change blood potassium concentration
B) change blood chloride concentration
C) cause a bronchodilation
D) cause a vasodilation of systemic arterioles
E) change blood pH

E) change blood pH

87) Respiratory acidosis will result from a(n) ________.
A) increase in blood CO2 concentration
B) decrease in blood CO2 concentration
C) increase in blood bicarbonate
D) decrease in blood bicarbonate
E) increase in carbon monoxide

A) increase in blood CO2 concentration

CH 19
11) Kidneys compensate for changes in plasma volume and osmolarity by adjusting the rate of water ________.
A) reabsorption only
B) secretion only
C) resorption only
D) reabsorption and secretion
E) secretion and resorption

A) reabsorption only

CH 19
12) Which of the following mechanisms is NOT important in the maintenance of the osmotic gradient within the proximal tubule that drives water movement?
A) cotransport of chloride
B) cotransport of amino acids
C) cotransport of glucose
D) active reabsorption of sodium
E) diffusion of urea

E) diffusion of urea

CH 19
13) Which of the following accurately describes the thick ascending limb of the loop of Henle?
A) permeable to water in the presence of specific hormones
B) permeable to water and does NOT contain Na+/K+/Cl- cotransporters
C) impermeable to water and does NOT contain Na+/K+/Cl- cotransporters
D) impermeable to water and contains Na+/K+/Cl- cotransporters
E) permeable to water and contains Na+/K+/Cl- cotransporters

D) impermeable to water and contains Na+/K+/Cl- cotransporters

CH 19
14) In the ascending limb of the loop of Henle, the filtrate will always be ________.
A) in equilibrium with the the medullary interstitial fluid
B) of a lower osmolarity than the medullary interstitial fluid
C) a higher osmolarity than the medullary interstitial fluid
D) the same osmolarity as the filtrate in the descending limb of the loop of Henle
E) a higher osmolarity than the filtrate in the descending limb of the loop of Henle

B) of a lower osmolarity than the medullary interstitial fluid

CH 19
15) The osmotic gradient in the medullary region of the kidneys is established and maintained by which of the following?
A) Na+/K+/Cl- cotransporters in the ascending limb of the loop of Henle
B) Na+/K+/Cl- cotransporters in the descending limb of the loop of Henle
C) efflux of water from the ascending limb of the loop of Henle
D) efflux of water from the descending limb of the loop of Henle
E) efflux of Na+ from the descending limb of the loop of Henle

A) Na+/K+/Cl- cotransporters in the ascending limb of the loop of Henle

CH 19
16) Which of the following comparisons of osmolarity within the kidneys is INCORRECT?
A) The fluid in the proximal tubule is iso-osmotic with cortical interstitial fluid.
B) Osmolarity of the ascending limb of the loop of Henle is greater than that of the descending limb.
C) Osmolarity of the descending limb of the loop of Henle is iso-osmotic with the medullary interstitial fluid.
D) The osmolarity of plasma in the vasa recta varies with its location in the renal medulla.
E) Osmolarity of fluid in the proximal tubule is greater than the osmolarity of fluid in the end of the loop of Henle as it enters the distal tubule

B) Osmolarity of the ascending limb of the loop of Henle is greater than that of the descending limb.

CH 19
17) A long loop of Henle would result in which of the following?
A) a higher osmolarity in the deeper regions of the renal medulla and the ability to produce a more concentrated urine
B) a lower osmolarity in the deeper regions of the renal medulla and the ability to produce a more concentrated urine
C) a higher osmolarity in the deeper regions of the renal medulla and the ability to produce a more dilute urine
D) a lower osmolarity in the deeper regions of the renal medulla and the ability to produce a more dilute urine
E) a higher osmolarity in the renal cortex and the ability to produce a more dilute urine

A) a higher osmolarity in the deeper regions of the renal medulla and the ability to produce a more concentrated urine

CH 19
18) The hormone-induced increases in water permeability of the distal tubule and collecting ducts is mediated by a(n) ________.
A) increase in aquaporin-2 activity
B) increase in aquaporin-3 activity
C) increase in paracellular permeability
D) decrease in "tightness" of tight junctions
E) decrease in paracellular permeability

A) increase in aquaporin-2 activity

CH 19
19) What keeps the capillaries of the vasa recta from dissipating the medullary osmotic gradient?
A) the smooth muscle cells contain Na+/K+/Cl- cotransporters
B) the smooth muscle cells are impermeable to water and ions
C) the vascular endothelial cells are impermeable to water and ions
D) capillary blood enters and exits the medulla at a similar osmolarity
E) the vascular endothelial cells contain Na+/K+/Cl- cotransporters

D) capillary blood enters and exits the medulla at a similar osmolarity

CH 19
20) If nothing else is removed from the filtrate once it reaches the late distal tubules, the urine excreted would have which of the following properties?
A) devoid of ions and large volume
B) high osmolarity and low volume
C) low osmolarity and low volume
D) low osmolarity and large volume
E) high osmolarity and large volume

D) low osmolarity and large volume

CH 19
21) What solute maintains the medullary interstitial fluid osmotic gradient?
A) urea
B) sodium ions
C) potassium ions
D) water
E) glucose

A) urea

CH 19
42) Which of the following is an effect of aldosterone on principal cells?
A) decreased number of open Na+ and K+ channels in the basolateral membrane
B) decreased number of Na+/K+ pumps in the basolateral membrane
C) increased number of open Na+ and K+ channels in the basolateral membrane
D) increased number of open Na+ and K+ channels in the apical membrane
E) increased number of Na+/K+ pumps in the apical membrane

D) increased number of open Na+ and K+ channels in the apical membrane

CH 19
43) Which of the following is associated with actions of aldosterone on principal cells?
A) increased sodium secretion
B) increased potassium secretion
C) decreased blood pressure
D) decreased plasma osmolarity
E) increased calcium reabsorption

B) increased potassium secretion

CH 19
44) Renin is released by ________ cells of the ________.
A) principal : afferent arteriole
B) granular : afferent arteriole
C) principal : distal tubule
D) granular : distal tubule
E) intercalated : afferent arteriole

B) granular : afferent arteriole

CH 19
45) What enzyme converts angiotensinogen into angiotensin I.
A) Carbonic anhydrase
B) Atrial natriuretic peptide
C) Angiotensin converting enzyme (ACE)
D) Renin
E) Mucin

D) Renin

CH 19
46) What enzyme converts angiotensin I into angiotensin II.
A) Carbonic anhydrase
B) Atrial natriuretic peptide
C) Angiotensin converting enzyme (ACE)
D) Renin
E) Mucin

C) Angiotensin converting enzyme (ACE)

CH 19
47) Which of the following is NOT one of the functions of angiotensin II?
A) vasoconstriction
B) stimulate aldosterone secretion
C) stimulate antidiuretic hormone (ADH) secretion
D) increased thirst
E) stimulate renin secretion

E) stimulate renin secretion

CH 19
48) Angiotensin II acts directly in the hypothalamus to stimulate what?
A) an increase in thirst
B) the release of oxytocin
C) an increase in body temperature
D) the release of aldosterone
E) a systemic increase in blood pressure

A) an increase in thirst

CH 19
49) Which of the following conditions is NOT responsible for stimulating the release of renin?
A) decreased pressure within the afferent arteriole
B) increase in sympathetic nerve activity
C) decrease in sodium and chloride in the distal tubule
D) increased glomerular filtration rate
E) decreased mean arterial pressure

D) increased glomerular filtration rate

CH 19
50) Angiotensinogen is synthesized by what organ?
A) kidney
B) bone marrow
C) liver
D) adrenal gland
E) pituitary gland

C) liver

CH 19
51) What role do the macula densa cells have in controlling renin release?
A) They release renin in response to an increase in mean arterial pressure.
B) They release renin in response to a decrease in mean arterial pressure.
C) They detect changes in the pressure of afferent arterioles, and communicate these changes to juxtaglomerular cells, which secrete renin.
D) They detect changes in the pressure of efferent arterioles, and communicate these changes to juxtaglomerular cells, which secrete renin.
E) They detect changes in the amount of sodium and chloride in the distal tubules, and communicate these changes to juxtaglomerular cells, which secrete renin.

E) They detect changes in the amount of sodium and chloride in the distal tubules, and communicate these changes to juxtaglomerular cells, which secrete renin.

CH 19
78) Which of the following is NOT one of the effects of changes in pH on the body?
A) alterations in protein function
B) alterations in central nervous system activity
C) alterations in potassium homeostasis
D) alteration in water balance
E) alterations in cardiac rhythm

D) alteration in water balance

CH 19
79) The activity of the respiratory system can increase pH by ________.
A) a hyperventilation-induced increase in PCO2
B) a hypoventilation-induced increase in PCO2
C) a hyperventilation-induced decrease in PCO2
D) a hypoventilation-induced decrease in PCO2
E) increasing amount of carbonic acid in the blood

C) a hyperventilation-induced decrease in PCO2

CH 19
80) What is the normal range of blood pH?
A) 6.80-7.20
B) 6.90-7.10
C) 6.75-6.95
D) 7.20-7.60
E) 7.35-7.45

E) 7.35-7.45

CH 19
81) During hyperventilation, why do some people detect a tingling sensation in their hands and feet?
A) due to hyperexcitability of afferent neurons
B) due to a decrease in blood flow to the distal extremities
C) due to a decrease in carbon dioxide in blood
D) due to an increase in carbon dioxide in blood
E) due to widespread release of catecholamines

A) due to hyperexcitability of afferent neurons

CH 19
82) Which of the following is NOT a metabolic disturbance that can result in a metabolic acidosis?
A) high protein diet
B) high fat diet
C) heavy exercise
D) excessive vomiting
E) severe diarrhea

D) excessive vomiting

CH 19
83) What is the most rapid defense against changes in blood pH?
A) respiratory compensation
B) buffering of hydrogen ions
C) renal compensation
D) cardiac compensation
E) hepatic compensation

B) buffering of hydrogen ions

CH 19
84) How does severe diarrhea cause a metabolic acidosis?
A) production of bicarbonate
B) production of hydrogen ions
C) loss of hydrogen ions
D) loss of phosphate
E) loss of bicarbonate

E) loss of bicarbonate

CH 19
85) How does severe vomiting cause a metabolic alkalosis?
A) production of bicarbonate
B) production of hydrogen ions
C) loss of hydrogen ions
D) loss of phosphate
E) loss of bicarbonate

C) loss of hydrogen ions

CH 19
86) Which of the following ions acts as a buffer to minimize changes in intracellular pH?
A) phosphate
B) bicarbonate
C) chloride
D) potassium
E) sodium

A) phosphate

CH 19
87) The role of a buffer is to ________.
A) reduce the reabsorption of hydrogen ions in the kidneys
B) limit the change in pH with changing hydrogen ion concentrations
C) reduce the secretion of hydrogen ions in the kidneys
D) reduce the secretion of bicarbonate ions in the kidneys
E) enhance the ability of an increase in hydrogen ions to increase pH

B) limit the change in pH with changing hydrogen ion concentrations

CH 19
88) What is the secondary defense against changes in pH that requires minutes to be activated?
A) respiratory compensation
B) buffering of hydrogen ions
C) renal compensation
D) cardiac compensation
E) hepatic compensation

A) respiratory compensation

CH 19
89) Respiratory compensation for changes in pH are originated by ________.
A) proprioceptors
B) baroreceptors
C) central chemoreceptors
D) peripheral chemoreceptors
E) directly affecting the activity of the diaphragm

D) peripheral chemoreceptors

CH 19
90) When an increase in hydrogen ions remains after one hour, this will lead to a(n) ________.
A) decrease in bicarbonate reabsorption in the kidneys
B) increased hydrogen reabsorption in the kidneys
C) increase in bicarbonate secretion in the kidneys
D) increase in hydrogen ion secretion from the kidneys
E) failure of the kidneys to filter any more hydrogen ions

D) increase in hydrogen ion secretion from the kidneys

CH 19
91) Which of the following is an effect of the transporters in the proximal tubules?
A) secretion of urea
B) secretion of potassium
C) reabsorption of hydrogen
D) secretion of sodium
E) reabsorption of bicarbonate

E) reabsorption of bicarbonate

CH 19
92) In the basolateral membrane of proximal tubular cells, bicarbonate is moved out of the cells by ________.
A) K+/HCO3- countertransporters only
B) HCO3-/Cl- countertransporters only
C) Na+/HCO3- cotransporters only
D) both K+ HCO3- and HCO3- /CI- countertransporters
E) both HCO3- /CI- countertransporters and Na+ / HCO3- cotransporters

E) both HCO3- /CI- countertransporters and Na+ / HCO3- cotransporters

CH 19
93) In the proximal tubule, hydrogen ions are transported into the filtrate by ________.
A) Na+/H+ countertransporters only
B) H+ primary active transporters only
C) H+/Cl- cotransporters only
D) both Na+/H+ countertransporters and H+ primary active transporters
E) both Na+/H+ countertransporters and H+/Cl- cotransporters

D) both Na+/H+ countertransporters and H+ primary active transporters

CH 19
94) Bicarbonate crosses the apical membrane of the proximal tubule by ________.
A) HCO3-/Cl- countertransporters
B) Na+/HCO3- cotransporters
C) conversion to carbon dioxide
D) HCO3- active transporters
E) Na+/HCO3- countertransporters

C) conversion to carbon dioxide

CH 19
95) Which of the following transporters is NOT found embedded in the membrane of the intercalated cells of the late distal tubule and collecting ducts?
A) HCO3-/Cl- countertransporters in the basolateral membrane
B) Na+/HCO3- cotransporters in the basolateral membrane
C) chloride channels in the basolateral membrane
D) H+ pumps in the apical membrane
E) K+/H+ countertransporters in the apical membrane

B) Na+/HCO3- cotransporters in the basolateral membrane

CH 19
96) What is the normal source of the new bicarbonate in the late distal tubule and collecting ducts?
A) carbon monoxide produced in the distal tubule
B) catabolism of lysine
C) catabolism of glutamine
D) carbon dioxide from the system circulation
E) carbon dioxide produced by the tubule cells

E) carbon dioxide produced by the tubule cells

CH 19
97) Under severe acidic conditions, the proximal tubules can convert ________ into bicarbonate.
A) glutamate
B) carbon monoxide
C) lysine
D) glutamine
E) glycine

D) glutamine

CH 19
98) Hydrogen ions in the filtrate within the collecting ducts are buffered by the presence of ________.
A) phosphate
B) bicarbonate
C) carbon dioxide
D) glutamine
E) proteins

A) phosphate

CH 19
99) In order to compensate for a hyperventilation, the ________.
A) kidneys decrease the reabsorption of bicarbonate
B) kidneys increase the conversion of glutamine to bicarbonate
C) kidneys increase the secretion of hydrogen ions
D) lungs increase ventilation rate
E) kidneys increase the reabsorption of hydrogen ions

A) kidneys decrease the reabsorption of bicarbonate

CH 19
100) Which of the following is NOT a compensation that would occur in response to a metabolic acidosis?
A) increased excretion of hydrogen ions
B) increased ventilation
C) decreased tidal volume
D) increased bicarbonate production
E) increased conversion of glutamine to bicarbonate

C) decreased tidal volume

CH 19
101) A patient is exhibiting several signs of acid-base imbalance. Blood tests reveal that blood pH is 7.3, and bicarbonate and carbon dioxide levels in blood are both low. What is the state of this patient?
A) metabolic acidosis with respiratory compensation
B) respiratory acidosis with renal compensation
C) metabolic alkalosis with respiratory compensation
D) respiratory alkalosis with renal compensation
E) blood pH is normal

A) metabolic acidosis with respiratory compensation

CH 19
102) A patient is exhibiting several signs of acid-base imbalance. Blood tests reveal that blood pH is 7.5, and bicarbonate and carbon dioxide levels in blood are both low. What is the state of this patient?
A) metabolic acidosis with respiratory compensation
B) respiratory acidosis with renal compensation
C) metabolic alkalosis with respiratory compensation
D) respiratory alkalosis with renal compensation
E) blood pH is normal

D) respiratory alkalosis with renal compensation

CH 18
1) Which of the following is NOT a function of the kidneys?
A) regulation of plasma ionic concentration
B) regulation of plasma osmolarity
C) regulation of plasma temperature
D) regulation of plasma volume
E) regulation of plasma hydrogen concentration

C) regulation of plasma temperature

CH 18
2) The primary function of the kidneys involves regulating the ________ and the ________ of plasma and interstitial fluid.
A) volume : temperature
B) volume : composition
C) temperature : composition
D) pressure : volume
E) composition : osmolarity

B) volume : composition

CH 18
3) Once produced, urine travels through the ________ until it reaches the bladder, from which it is released into the external environment through the ________.
A) ureter : urethra
B) urethra : ureter
C) collecting duct : ureter
D) collecting duct : urethra
E) renal hilus : ureter

A) ureter : urethra

CH 18
4) Which of the following is NOT part of the urinary system?
A) kidneys
B) liver
C) ureters
D) urethra
E) bladder

B) liver

CH 18
5) Despite being less than 1% of body weight, the kidneys receive what percent of resting cardiac output?
A) 1%
B) 5%
C) 15%
D) 20%
E) 35%

D) 20%

CH 18
6) What are the conical sections of the renal medulla called?
A) renal cortex
B) renal pelvis
C) renal pyramids
D) minor calyces
E) major calyces

C) renal pyramids

CH 18
7) Where do the collecting ducts of the renal tubules drain?
A) ureters
B) minor calyces
C) major calyces
D) renal pelvis
E) glomerulus

B) minor calyces

CH 18
8) What is the functional unit of the kidney?
A) loop of Henle
B) proximal tubule
C) collecting ducts
D) nephron
E) glomerulus

D) nephron

CH 18
9) What two structures make up the renal corpuscle?
A) afferent and efferent arterioles
B) major and minor calyces
C) nephron and collecting duct
D) Bowman's capsule and glomerulus
E) proximal straight and proximal convoluted tubules

D) Bowman's capsule and glomerulus

CH 18
10) Blood leaves the ________ and enters the glomerulus.
A) afferent arteriole
B) efferent arteriole
C) peritubular capillary
D) vasa recta
E) Bowman's capsule

A) afferent arteriole

CH 18
11) Where does blood leaving the glomerulus go to next?
A) afferent arteriole
B) efferent arteriole
C) peritubular capillary
D) vasa recta
E) Bowman's capsule

B) efferent arteriole

CH 18
12) After fluid passes through the entire proximal tubule, the fluid will enter the ________.
A) loop of Henle
B) distal tubule
C) connecting tubule
D) collecting duct
E) Bowman's capsule

A) loop of Henle

CH 18
13) What type of nephrons are located within the outer region of the kidney and comprise nearly 80% of the nephrons?
A) peritubular
B) medullary
C) juxtaglomerular
D) juxtamedullary
E) cortical

E) cortical

CH 18
14) The juxtaglomerular apparatus describes the unique region of the nephron where ________.
A) the efferent arteriole is in contact with the distal tubule
B) the afferent arteriole is in contact with the distal tubule
C) the afferent and efferent arterioles are in contact with the distal tubule
D) the afferent arteriole is in contact with the proximal tubule
E) the afferent and efferent arterioles are in contact with the proximal tubule

C) the afferent and efferent arterioles are in contact with the distal tubule

CH 18
15) What capillaries come off of the efferent arterioles associated with cortical nephrons?
A) glomerulus
B) peritubular
C) vasa recta
D) arcuate
E) lobular

B) peritubular

CH 18
16) What capillaries come off of the efferent arterioles associated with juxtamedullary nephrons?
A) glomerulus
B) peritubular
C) vasa recta
D) arcuate
E) lobular

C) vasa recta

CH 18
17) Which of the following is the correct order of blood supply to the kidneys?
A) renal artery interlobar arteries arcuate arteries segmental arteries interlobular arteries efferent arteriole glomerulus afferent arteriole
B) renal artery segmental arteries interlobar arteries arcuate arteries interlobular arteries afferent arteriole glomerulus efferent arteriole
C) renal artery arcuate arteries interlobular arteries segmental arteries afferent arteriole glomerulus efferent arteriole interlobar arteries
D) renal artery segmental arteries interlobular arteries arcuate arteries interlobar arteries efferent arteriole glomerulus afferent arteriole
E) renal artery interlobar arteries interlobular arteries arcuate arteries segmental arteries afferent arteriole glomerulus efferent arteriole

B) renal artery segmental arteries interlobar arteries arcuate arteries interlobular arteries afferent arteriole glomerulus efferent arteriole

CH 18
18) During what renal process are molecules selectively removed from the tubule lumen, moved into the interstitial space, and removed from the kidneys by the peritubular capillaries and the vasa recta?
A) filtration
B) secretion
C) excretion
D) reabsorption
E) absorption

D) reabsorption

CH 18
19) The peritubular capillaries and vasa recta drain into hat veins?
A) interlobular
B) interlobar
C) arcuate
D) efferent
E) segmental

A) interlobular

CH 18
20) As fluid moves out of the glomerular capillaries, it passes through gaps in the podocytes called slit pores, whose size is regulated by what?
A) fenestrations
B) slit diaphragm
C) slit muscle
D) corpuscle
E) glomerular capillary

B) slit diaphragm

CH 18
21) What is the process whereby molecules are selectively transported from the peritubular fluid to the lumen of the renal tubules?
A) glomerular filtration
B) reabsorption
C) absorption
D) secretion
E) excretion

D) secretion

CH 18
22) What is the process whereby protein-free plasma moves by bulk flow from the glomerulus into Bowman's capsules?
A) glomerular filtration
B) reabsorption
C) absorption
D) secretion
E) excretion

A) glomerular filtration

CH 18
23) Which of the following forms the filtration barrier?
A) capillary endothelial cells only
B) podocytes only
C) basement membrane only
D) both capillary endothelial cells and basement membrane
E) capillary endothelial cells, basement membrane, and podocytes

E) capillary endothelial cells, basement membrane, and podocytes

CH 18
24) What is the sum of Starling's forces within the renal corpuscle called?
A) glomerular filtration pressure
B) glomerular filtration rate
C) glomerular filtration volume
D) glomerular oncotic pressure
E) glomerular capillary hydrostatic pressure

A) glomerular filtration pressure

CH 18
25) What Starling force, which drives fluid out of the glomerulus, is relatively high (~60 mm Hg) due to the resistance of the efferent arterioles.
A) Bowman's capsule oncotic
B) Glomerular capillary hydrostatic
C) Bowman's capsule hydrostatic
D) Glomerular oncotic
E) Glomerular filtration

B) Glomerular capillary hydrostatic

CH 18
26) Which of the following pressures across the glomerular capillaries approaches zero?
A) glomerular filtration pressure
B) glomerular oncotic pressure
C) glomerular capillary hydrostatic pressure
D) Bowman's capsule oncotic pressure
E) Bowman's capsule hydrostatic pressure

D) Bowman's capsule oncotic pressure

CH 18
27) Which of the forces across the glomerular capillaries tends to increase from the afferent to the efferent arteriole ends?
A) glomerular filtration pressure
B) Bowman's capsule hydrostatic pressure
C) Bowman's capsule oncotic pressure
D) glomerular capillary hydrostatic pressure
E) glomerular oncotic pressure

E) glomerular oncotic pressure

CH 18
28) Which of the equations below describes the calculation of glomerular filtration pressure (BC = Bowman's capsule and GC = glomerular capillary)?
A) (PGC + πBC) - (PBC + πGC)
B) (PBC + πBC) - (PGC + πGC)
C) (PGC + πGC) - (PBC + πBC)
D) (PGC + PBC) - (πGC + πBC)
E) (PBC + πGC) - (PGC + πBC)

A) (PGC + πBC) - (PBC + πGC)

CH 18
29) Which of the following conditions would increase glomerular filtration pressure?
A) decreased resistance of the efferent arterioles
B) increased protein in Bowman's space
C) increased resistance of the afferent arteriole
D) increased protein content in the blood
E) increased Bowman's capsule pressure

B) increased protein in Bowman's space

CH 18
30) Which of the following equations is correct for calculating the filtered load?
A) glomerular filtration pressure × plasma concentration of solvent
B) glomerular filtration pressure / renal plasma flow
C) glomerular filtration rate / renal plasma flow
D) glomerular filtration pressure × plasma concentration of solute
E) glomerular filtration rate × plasma concentration of solute

E) glomerular filtration rate × plasma concentration of solute

CH 18
31) Changes in mean arterial pressure have the potential to alter glomerular filtration rate by directly altering which of the following?
A) glomerular oncotic pressure
B) glomerular capillary hydrostatic pressure
C) Bowman's capsule oncotic pressure
D) Bowman's capsule hydrostatic pressure
E) efferent arteriole resistance

B) glomerular capillary hydrostatic pressure

CH 18
32) What is the normal glomerular filtration rate?
A) 125 mL/min
B) 625 mL/min
C) 3 L/day
D) 30 L/day
E) 1 gallon/day

A) 125 mL/min

CH 18
33) If the glomerular filtration rate is 150 mL/min, renal blood flow is 750 mL/min, and the plasma concentration of solute X is 10 ng/mL, then what is the filtration fraction?
A) 10%
B) 20%
C) 50 ng/min
D) 1500 ng/min
E) 75 ng/min

B) 20%

CH 18
34) If the glomerular filtration rate is 150 mL/min, renal blood flow is 750 mL/min, and the plasma concentration of solute X is 10 ng/mL, then what is the filtered load of X?
A) 10%
B) 20%
C) 50 ng/min
D) 1500 ng/min
E) 7500 ng/min

D) 1500 ng/min

CH 18
35) Which of the following can increase the filtered load of a particular solute?
A) increasing the glomerular filtration rate
B) increasing the rate of reabsorption
C) decreasing the plasma concentration of the solute
D) increasing the rate of secretion
E) decreasing the rate of excretion

D) increasing the rate of secretion

CH 18
36) Over what range of mean arterial pressure does glomerular filtration rate remain stable due to intrinsic regulation?
A) 50-150 mm Hg
B) 80-180 mm Hg
C) 70-110 mm Hg
D) 80-100 mm Hg
E) 80-120 mm Hg

B) 80-180 mm Hg

CH 18
37) During myogenic regulation of glomerular filtration rate, an increase in mean arterial pressure will ________.
A) cause the efferent arterioles to constrict and thereby maintain a relatively constant glomerular filtration pressure
B) cause the afferent arterioles to constrict and thereby maintain a relatively constant glomerular filtration pressure
C) cause the efferent arterioles to dilate and thereby maintain a relatively constant glomerular filtration pressure
D) cause the afferent arterioles to dilate and thereby maintain a relatively constant glomerular filtration pressure
E) cause the afferent arterioles to dilate and thereby allow glomerular filtration pressure to increase

B) cause the afferent arterioles to constrict and thereby maintain a relatively constant glomerular filtration pressure

CH 18
38) In tubuloglomerular feedback, an increase in glomerular filtration rate would increase the ________, thereby stimulating the release of a paracrine factor from the macula densa that would ________.
A) afferent arteriolar pressure : constrict the afferent arteriole
B) afferent arteriolar pressure : increase filtrate flow
C) flow of tubular fluid : dilate the afferent arteriole
D) flow of tubular fluid : constrict the efferent arteriole
E) flow of tubular fluid : constrict the afferent arteriole

E) flow of tubular fluid : constrict the afferent arteriole

CH 18
39) Contraction of mesangial cells results in a ________, which decreases glomerular filtration.
A) decrease in surface area of capillaries available for filtration
B) increase in surface area of capillaries available for filtration
C) constriction of the afferent arterioles
D) dilation of the afferent arterioles
E) dilation of the efferent arterioles

A) decrease in surface area of capillaries available for filtration

CH 18
40) Which of the following is NOT a mechanism whereby glomerular filtration rate is regulated?
A) tubuloglomerular feedback
B) myogenic regulation
C) mesangial cell contraction
D) granular cell contraction
E) sympathetic nervous system

D) granular cell contraction

CH 18
41) A hemorrhage-induced decrease in mean arterial pressure will decrease glomerular filtration rate by intrinsic and extrinsic mechanisms; the extrinsic mechanisms act through ________.
A) tubuloglomerular feedback
B) the parasympathetic nervous system
C) the sympathetic nervous system
D) myogenic responses
E) mesangial cells

C) the sympathetic nervous system

CH 18
42) How does the sympathetic nervous system decrease glomerular filtration rate?
A) stimulates constriction of the afferent arteriole only
B) stimulates constriction of the efferent arteriole only
C) stimulates constriction of both the afferent and efferent arterioles
D) stimulates relaxation of the mesangial cells
E) stimulates contraction of mesangial cells

C) stimulates constriction of both the afferent and efferent arterioles

CH 18
43) What is the primary barrier to reabsorption in the renal tubules?
A) capillary endothelial cell
B) tubule epithelial cell
C) capillary basement membrane
D) tubule basement membrane
E) peritubular space

B) tubule epithelial cell

CH 18
44) What condition(s) must exist for a solute to be passively reabsorbed from the renal tubules?
A) The solute must be able to permeate the membrane of the tubule epithelial cells, and the solute must be in greater concentration in the plasma than tubule fluid.
B) The solute must be able to permeate the membrane of the capillary endothelial cells, and the solute must be in greater concentration in the plasma than tubule fluid.
C) The solute must be able to permeate the membrane of the capillary endothelial cells, and the solute must be in greater concentration in the tubule fluid than plasma.
D) The solute must be able to permeate the membrane of the tubule epithelial cells, and the solute must be in greater concentration in the tubule fluid than plasma.
E) The solute must be able to permeate the membrane of the tubule epithelial cells and capillary endothelial cells. Its concentration is irrelevant.

D) The solute must be able to permeate the membrane of the tubule epithelial cells, and the solute must be in greater concentration in the tubule fluid than plasma.

CH 18
45) Within the kidneys, what membrane has microvillli?
A) apical membrane of renal tubule epithelial cells
B) basolateral membrane of renal tubule epithelial cells
C) basolateral membrane of peritubular capillary endothelial cells
D) apical membrane of vasa recta endothelial cells
E) glomerulus

A) apical membrane of renal tubule epithelial cells

CH 18
46) The apical membranes of the tubular epithelial cells contain ________ that increase the surface area for reabsorption.
A) mitochondria
B) loose junctions
C) a basement membrane
D) microvilli
E) tight junctions

D) microvilli

CH 18
47) The diffusion of water across a tubule is driven by differences in ________ across the membrane.
A) osmolarity
B) partial pressure
C) active transport
D) volume
E) potassium concentration

A) osmolarity

CH 18
48) When the solute concentration is high enough in the lumen of the renal tubules such that all of the carrier proteins or pumps for that solute are occupied, the system is operating at ________.
A) diffusional saturation
B) tubular threshold
C) renal threshold
D) transport maximum
E) tubular maximum

D) transport maximum

CH 18
49) The concentration of glucose in tubular epithelial cells is maintained in an elevated state by what type of transporter on the apical membrane?
A) ion channel
B) carrier protein
C) glucose-linked secondary active transporter
D) potassium-linked secondary active transporter
E) sodium-linked secondary active transporter

E) sodium-linked secondary active transporter

CH 18
50) Which of the following is FALSE concerning glucose transport across the proximal tubule?
A) Glucose is normally 100% reabsorbed.
B) Glucose is actively transported across the apical membrane by cotransport with sodium.
C) Glucose is passively transported across the basolateral membrane by facilitated diffusion.
D) Glucose transport requires energy.
E) Glucose moves by paracellular transport.

E) Glucose moves by paracellular transport.

CH 18
51) Which of the following is FALSE concerning renal handling of glucose?
A) The maximum rate of glucose reabsorption is 375 mg/min.
B) The maximum rate of glucose filtration is 375 mg/min.
C) Once glucose concentration in the plasma exceeds the renal threshold, glucose will be excreted in the urine.
D) Glucose is completely reabsorbed when its plasma concentration is 100 mg/dL.
E) Glucose is actively reabsorbed in the proximal tubule.

B) The maximum rate of glucose filtration is 375 mg/min.

CH 18
52) Which of the following substances is NOT secreted at any point into the renal tubules?
A) choline
B) creatinine
C) potassium
D) hydrogen
E) sodium

E) sodium

CH 18
53) By the time filtrate reaches the loop of Henle, what percentage of the sodium and water has been reabsorbed?
A) 1%
B) 50%
C) 70%
D) 90%
E) 100%

C) 70%

CH 18
54) By the time the filtrate reaches the loop of Henle, the reabsorption of water and ions has ________.
A) left the filtrate iso-osmotic
B) left the filtrate hyperosmotic
C) left the filtrate hypoosmotic
D) removed all of the potassium from the filtrate
E) removed all of the sodium from the filtrate

A) left the filtrate iso-osmotic

CH 18
55) Which of the following is NOT an accurate description of differences between epithelial cells of the proximal and distal tubules?
A) less prominent microvilli in the epithelial cells of the distal tubule
B) greater paracellular transport in the epithelial cells of the distal tubule
C) fewer mitochondria in the epithelial cells of the distal tubule
D) receptors for hormones on the epithelial cells of the distal tubule
E) less permeable tight junctions between the epithelial cells of the distal tubule

B) greater paracellular transport in the epithelial cells of the distal tubule

CH 18
56) In diabetes mellitus, why does polyuria occur?
A) a lack of ADH decreases water reabsorption
B) a lack of insulin decreases water reabsorption
C) hyperglycemia causes increased permeability of the renal tubules to water
D) hyperglycemia causes some glucose to remain in the renal tubules which pulls water with it by osmosis
E) hypoglycemia causes the excretion of a dilute urine

D) hyperglycemia causes some glucose to remain in the renal tubules which pulls water with it by osmosis

CH 18
57) What is the brush border?
A) the epithelial cells of the renal corpuscle
B) microvilli on the apical membrane of Bowman's capsule
C) tight junctions between epithelial cells of the loops of Henle
D) microvilli on the apical membrane of the proximal tubule
E) tight junctions between epithelial cells of the distal tubule

D) microvilli on the apical membrane of the proximal tubule

CH 18
58) Most reabsorption occurs in the ________ and is ________.
A) proximal tubule : regulated
B) proximal tubule : not regulated
C) distal tubule and collecting duct : regulated
D) distal tubule and collecting duct : not regulated
E) loop of Henle : regulated

B) proximal tubule : not regulated

CH 18
59) Tubular epithelial cells of the collecting duct and distal tubule contain receptors for what hormone that stimulates sodium reabsorption?
A) antidiuretic hormone
B) renin
C) aldosterone
D) atrial natriuretic peptide
E) erythropoietin

C) aldosterone

CH 18
60) Tubular epithelial cells of the collecting duct and distal tubule contain receptors for what hormone that stimulates water reabsorption.
A) antidiuretic hormone
B) renin
C) aldosterone
D) atrial natriuretic peptide
E) erythropoietin

A) antidiuretic hormone

CH 18
61) What creates the osmotic gradient in the renal medulla?
A) active transport of solute out of the proximal tubule
B) special transport systems of the loops of Henle of juxtamedullary nephrons
C) special transport systems of the loops of Henle of cortical nephrons
D) active transport of solute out of the distal tubules and collecting ducts
E) passive transport of solute out of the distal tubules and collecting ducts

B) special transport systems of the loops of Henle of juxtamedullary nephrons

CH 18
62) Substances can enter the renal tubules by what renal processes?
A) filtration only
B) reabsorption only
C) secretion only
D) both filtration and secretion
E) both reabsorption and secretion

D) both filtration and secretion

CH 18
63) The amount of a substance excreted from the kidneys is calculated by which of the following equations?
A) filtration + secretion + reabsorption
B) filtration - secretion - reabsorption
C) filtration + secretion - reabsorption
D) filtration + (secretion × reabsorption)
E) filtration - (secretion × reabsorption)

C) filtration + secretion - reabsorption

CH 18
64) Solutes that enter the lumen of the renal tubules are excreted unless they are ________.
A) secreted
B) reabsorbed
C) filtered
D) degraded
E) bound to receptors

B) reabsorbed

CH 18
65) If the amount of solute excreted per minute is greater than the filtered load, then the NET effect on the solute is ________.
A) a combination of reabsorption and secretion in the renal tubules
B) an absence of secretion in the renal tubules
C) an absence of reabsorption in the renal tubules
D) secretion into the renal tubules
E) reabsorption from the renal tubules

D) secretion into the renal tubules

CH 18
66) Which of the following equations for determining clearance is correct?
A) Clearance = filtered load/glomerular filtration rate
B) Clearance = filtered load × glomerular filtration rate
C) Clearance = excretion rate/plasma concentration
D) Clearance = excretion rate × plasma concentration
E) Clearance = excretion rate/glomerular filtration rate

C) Clearance = excretion rate/plasma concentration

CH 18
67) Which of the following equations for determining clearance is correct?
A) Clearance = (plasma concentration x urine flow rate) / urine concentration
B) Clearance = (urine concentration x urine flow rate) / plasma concentration
C) Clearance = plasma concentration / (urine flow rate x urine concentration)
D) Clearance = urine concentration / (urine flow rate x plasma concentration)
E) Clearance = GRF × urine concentration

B) Clearance = (urine concentration x urine flow rate) / plasma concentration

CH 18
68) Calculate renal clearance of X given the following information: GFR = 100 mL/min, urine flow rate = 5 mL/min, plasma concentration of X = 10 mg/mL, urine concentration of X = 50 mg/mL.
A) 50 mg/min
B) 25 mg/min
C) 4 mg/min
D) 50 mL/min
E) 25 mL/min

E) 25 mL/min

CH 18
69) Given that GFR is 125 mL/min and the clearance of substance Y is 200 mL/min, which of the following MUST be true of the renal handling of substance Y.
A) Y is freely filterable.
B) Y is reabsorbed.
C) Y is secreted.
D) Y is neither reabsorbed nor secreted.
E) Y is not freely filtered.

B) Y is reabsorbed.

CH 18
70) The clearance of what substance provides the best estimate of glomerular filtration rate?
A) sodium
B) glucose
C) inulin
D) creatine
E) PAH

C) inulin

CH 18
71) The clearance of what substance provides the best estimate of renal blood flow rate?
A) sodium
B) glucose
C) inulin
D) creatine
E) PAH

E) PAH

CH 18
72) The clearance of which of the following substances is normally zero?
A) sodium
B) glucose
C) inulin
D) creatine
E) PAH

B) glucose

CH 18
73) If a substance is neither reabsorbed nor secreted, then its excretion rate is equal to the ________.
A) glomerular filtration rate
B) filtered load
C) glomerular filtration rate
D) plasma concentration of the substance
E) renal threshold

B) filtered load

CH 18
74) What structure is formed by the thickening of the smooth muscle cell wall surrounding the bladder that regulates the flow of urine from the bladder.
A) bladder sphincter
B) urethral muscle
C) detrusor muscle
D) internal urethral sphincter
E) external urethral sphincter

D) internal urethral sphincter

CH 18
75) How is urine moved through the ureter?
A) pressure created within the renal pelvis
B) contraction of the internal urethral sphincter
C) wavelike contractions of the ureter
D) contraction of the detrusor muscle
E) contraction of the external urethral sphincter

C) wavelike contractions of the ureter

CH 18
76) Which muscle(s) that regulates micturition is under involuntary control?
A) detrusor
B) internal urethral sphincter
C) external urethral sphincter
D) detrusor and the internal urethral sphincter
E) detrusor and the external urethral sphincter

D) detrusor and the internal urethral sphincter

CH 18
77) Which of the following occurs during micturition?
A) The detrusor muscles relax, muscles of the internal urethral sphincter relax, and muscles of the external urethral sphincter relax.
B) The detrusor muscles contract, muscles of the internal urethral sphincter contract, and muscles of the external urethral sphincter contract.
C) The detrusor muscles relax, muscles of the internal urethral sphincter contract, and muscles of the external urethral sphincter contract.
D) The detrusor muscles relax, muscles of the internal urethral sphincter contract, and muscles of the external urethral sphincter relax.
E) The detrusor muscles contract, muscles of the internal urethral sphincter relax, and muscles of the external urethral sphincter relax.

E) The detrusor muscles contract, muscles of the internal urethral sphincter relax, and muscles of the external urethral sphincter relax.

CH 18
78) Stretching of the bladder reflexively causes all of the following EXCEPT ________.
A) excitation of parasympathetic neurons, causing the detrusor muscles to contract
B) excitation of sympathetic neurons, causing the internal urethral sphincter to relax
C) inhibition of somatic neurons to the external urethral sphincter, causing the sphincter to open
D) micturition
E) opening of the urethral sphincters

B) excitation of sympathetic neurons, causing the internal urethral sphincter to relax

CH 18
79) What effect does the sympathetic nervous system have on micturition?
A) Sympathetic activity excites muscles of the internal urethral sphincter inhibiting micturition.
B) Sympathetic activity inhibits muscles of the internal urethral sphincter inhibiting micturition.
C) Sympathetic activity excites muscles of the external urethral sphincter allowing micturition.
D) Sympathetic activity inhibits muscles of the external urethral sphincter inhibiting micturition.
E) Sympathetic activity excites muscles of the internal urethral sphincter allowing micturition.

A) Sympathetic activity excites muscles of the internal urethral sphincter inhibiting micturition.

CH 18
80) Which of the following is smooth muscle?
A) internal urethral sphincter only
B) external urethral sphincter only
C) detrusor muscle only
D) both the internal urethral sphincter and detrusor muscle
E) both internal and external urethral sphincters

D) both the internal urethral sphincter and detrusor muscle

CH 18
81) To voluntarily control urination, the ________ nervous system innervates the ________.
A) somatic : internal urethral sphincter
B) somatic : external urethral sphincter
C) somatic : detrusor muscle
D) autonomic : internal urethral sphincter
E) autonomic : external urethral sphincter

B) somatic : external urethral sphincter

CH 18
82) During micturition, neural activity to sphincters or detrusor muscles from which of the following is increased?
A) parasympathetic nervous system only
B) sympathetic nervous system only
C) somatic nervous system only
D) both parasympathetic and somatic nervous systems
E) both sympathetic and somatic nervous systems

A) parasympathetic nervous system only

CH 18
83) In older children and adults, the cerebral cortex is able to block micturition by inhibiting nerve activity to the ________.
A) detrusor muscle only
B) internal urethral sphincter only
C) external urethral sphincter only
D) detrusor muscle and external urethral sphincter
E) internal and external urethral sphincters

D) detrusor muscle and external urethral sphincter

CH 18
84) Substance X is freely filtered at the glomerulus. 3 mmole X is filtered, 2 mmole X is reabsorbed, and 2 mmole X is secreted per minute. How much X is excreted per minute?
A) 1 mmole
B) 2 mmole
C) 3 mmole
D) 4 mmole
E) 5 mmole

C) 3 mmole

CH 18
85) During tubuloglomerular feedback of glomerular filtration rate, paracrines secreted from what structure cause constriction of the afferent arteriole?
A) glomerulus
B) macula densa
C) mesangial cells
D) proximal tubule
E) juxtaglomerular cells

B) macula densa

CH 18
86) In comparison to the distal tubule, the proximal tubule has a ________.
A) leakier epithelium and a larger apical surface area
B) leakier epithelium and is more responsive to hormones
C) tighter epithelium and a larger apical surface area
D) tighter epithelium and is more responsive to hormones
E) small apical surface area and is more responsive to hormones

A) leakier epithelium and a larger apical surface area

Multiple choice 16 -19 - Subjecto.com

Multiple choice 16 -19

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1) Which of the following processes is NOT a part of external respiration?
A) the movement of air into and out of the lungs by bulk flow
B) the exchange of oxygen and carbon dioxide between the lungs and blood by diffusion
C) the transportation of oxygen and carbon dioxide between the lungs and body tissues by the blood
D) the exchange of oxygen and carbon dioxide between the blood and tissues by diffusion
E) the use of oxygen and generation of carbon dioxide by the mitochondria during energy metabolism

E) the use of oxygen and generation of carbon dioxide by the mitochondria during energy metabolism

2) Which of the following specifically describes the movement of air into and out of the lungs?
A) Secondary ventilation
B) Pulmonary ventilation
C) Internal respiration
D) Respiration
E) Expiration

B) Pulmonary ventilation

3) Which of the following is NOT a function of the respiratory system?
A) vocalization
B) electrolyte balance of blood
C) acid-base balance of blood
D) enhancing venous return
E) heat loss

B) electrolyte balance of blood

4) Which of the following statements about respiratory system anatomy is FALSE?
A) Each lung has three lobes.
B) The nasal cavity and oral cavity are parts of the upper airways.
C) Both air and food travel in the pharynx.
D) The trachea remains open at all times.
E) The trachea branches into two bronchi, one of which travels to each lung.

A) Each lung has three lobes.

5. Food is prevented from entering the respiratory tract by the ________, which is/are located in the ________, the entry to the larynx.
A) glottis : pharynx
B) glottis : epiglottis
C) vocal cords : glottis
D) epiglottis : glottis
E) bronchioles : bronchi

D) epiglottis : glottis

6) What structure bifurcates into the bronchi that enter the right and left lungs?
A) trachea
B) larynx
C) glottis
D) pharynx
E) bronchioles

A) trachea

7) What are the smallest (and most distal) structures that remain a component of the conducting zone in the respiratory tract?
A) bronchi
B) secondary bronchi
C) tertiary bronchioles
D) terminal bronchioles
E) respiratory bronchioles

D) terminal bronchioles

8) What is the function of ciliated cells in the conducting zone?
A) provide the rigid support that keeps the conducting zone open
B) produce a viscous solution called mucus
C) engulf foreign material that has been trapped within the mucus
D) propel mucus containing trapped particles toward the glottis
E) move macrophages down the conducting zone toward the respiratory zone

D) propel mucus containing trapped particles toward the glottis

9) Which of the following becomes more abundant deeper into the conducting zone (from bronchi to bronchioles) .
A) Cartilage
B) Type I alveolar cells
C) Cilia
D) Goblet cells
E) Smooth muscle

E) Smooth muscle

10) Which of the following is most abundant in the trachea and bronchi, becoming much less dense (and eventually absent) in the bronchioles.
A) smooth muscle cells
B) cartilage
C) goblet cells
D) macrophages
E) type II alveolar cells

B) cartilage

11) The transition from the conducting to the respiratory zone in the lungs occurs at the ________.
A) alveoli
B) alveolar ducts
C) tertiary bronchi
D) terminal bronchioles
E) respiratory bronchioles

E) respiratory bronchioles

12) What structure is the region of the lungs where the majority of gas exchange occurs?
A) respiratory bronchiole
B) alveolar duct
C) alveolus
D) terminal bronchiole
E) bronchus

C) alveolus

13) What are the most common cells that line the surface of the alveoli and are therefore associated with the exchange of gases within the lungs?
A) Macrophages
B) Goblet cells
C) Type I alveolar cells
D) Type II alveolar cells
E) Type III alveolar cells

C) Type I alveolar cells

14) What is the thin barrier (0.2 μm) that allows for the efficient exchange of gases between the lungs and the blood called?
A) endothelial cell
B) type I alveolar cell
C) type II alveolar cell
D) alveolar macrophage
E) respiratory membrane

E) respiratory membrane

15) What type of cells secrete mucus in the respiratory tract?
A) type I alveolar cells
B) type II alveolar cells
C) goblet cells
D) macrophages
E) ciliated cells

C) goblet cells

16) Which of the following decreases when traveling from upper airways to the conducting zone to the respiratory zone?
A) cilia only
B) smooth muscle only
C) goblet cells only
D) both cilia and goblet cells
E) cilia, goblet cells, and smooth muscle

D) both cilia and goblet cells

17) What type of cell in the respiratory tract functions in phagocytosis of inhaled pathogens and foreign particles?
A) type I alveolar cells
B) type II alveolar cells
C) goblet cells
D) macrophages
E) ciliated cells

D) macrophages

18) Which of the following is NOT a muscle involved in breathing?
A) the pleural muscle
B) the internal intercostal muscle
C) the external intercostal muscle
D) the diaphragm
E) the abdominal muscle

A) the pleural muscle

19) The ________ is bounded by the interior surface of the chest wall and the exterior surface of the lung.
A) interpleural space
B) alveolar space
C) bronchiolar space
D) intraparietal cavity
E) thoracic cavity

A) interpleural space

20) What is the connective tissue surround each lung called?
A) pleural sac
B) visceral sac
C) parietal sac
D) peripulmonary sac
E) alveolar sac

A) pleural sac

21) What is the dome-shaped muscle that separates the thoracic and abdominal cavities and plays an important role in breathing?
A) internal intercostals
B) sternocleidomastoid
C) external intercostals
D) diaphragm
E) scalene

D) diaphragm

22) When air is no longer moving through the respiratory tract and the airway is open to the environment, the pressure within the lung is equal to ________.
A) systolic blood pressure
B) transpulmonary pressure
C) intrapleural pressure
D) atmospheric pressure
E) end-diastolic pressure

D) atmospheric pressure

23) The difference between what two pressures drives air into and out of the lungs?
A) pulmonary venous : atmospheric
B) central venous : intracoronary
C) intrapleural : intra-alveolar
D) atmospheric : intra-alveolar
E) atmospheric : intrapleural

D) atmospheric : intra-alveolar

24) Which of the following occurs when intra-alveolar pressure exceeds atmospheric pressure?
A) air moves into the lung
B) air moves out of the lung
C) the lung collapses
D) the lung must be expanding
E) intrapleural pressure is greater than intra-alveolar pressure

B) air moves out of the lung

25) Which of the following pressure(s) vary rhythmically with respiration?
A) atmospheric pressure only
B) intrapleural pressure only
C) intra-alveolar pressure only
D) both intrapleural pressure and intra-alveolar pressure
E) both atmospheric pressure and intrapleural pressure

D) both intrapleural pressure and intra-alveolar pressure

26) The difference between intrapleural pressure and intra-alveolar pressure is ________.
A) the driving force for air flow into and out of the lungs
B) atmospheric pressure
C) transpulmonary pressure
D) approximately 100 mm Hg
E) zero

C) transpulmonary pressure

27) Which of the following is a measure of the distending force across the lungs?
A) intrapleural pressure
B) intra-alveolar pressure
C) transpulmonary pressure
D) atmospheric pressure
E) difference between intra-alveolar pressure and atmospheric pressure

C) transpulmonary pressure

28) Equilibration of pressure between the intrapleural space and the alveoli will lead to which of the following?
A) air moving out of the lungs
B) air moving into the lungs
C) a pneumothorax (the lung will collapse)
D) chronic obstructive pulmonary disease
E) restrictive pulmonary disease

C) a pneumothorax (the lung will collapse)

29) What is the volume of air present in the lungs when the lungs are at rest (in between breaths)?
A) zero
B) functional residual capacity
C) residual volume
D) total lung capacity
E) tidal volume

B) functional residual capacity

30) Which of the following is true when the lung volume is equal to the functional residual capacity?
A) the elastic recoil of the lungs is balanced by the elastic recoil of the chest wall
B) intra-alveolar pressure is greater than atmospheric pressure
C) intra-alveolar pressure is less than atmospheric pressure
D) intra-alveolar pressure is less than intrapleural pressure
E) intrapleural pressure is zero

A) the elastic recoil of the lungs is balanced by the elastic recoil of the chest wall

31) As the lungs expand, intra-alveolar pressure ________ and air moves ________ the lungs.
A) increases : out of
B) increases : into
C) decreases : out of
D) decreases : into
E) does not change : neither into nor out of

D) decreases : into

32) As the volume of the lung increases, atmospheric pressure ________.
A) will not change
B) increases
C) decreases
D) will follow Starling’s Law
E) will follow the Ideal Gas Law

A) will not change

33) What does contraction of the diaphragm cause?
A) decrease in the volume of the thoracic cavity and therefore a decrease in atmospheric pressure
B) decrease in the volume of the thoracic cavity and therefore a decrease in intra-alveolar pressure
C) increase in the volume of the thoracic cavity and therefore a decrease in intra-alveolar pressure
D) decrease in the volume of the thoracic cavity and therefore an increase in intra-alveolar pressure
E) increase in the volume of the thoracic cavity and therefore an increase in intra-alveolar pressure

C) increase in the volume of the thoracic cavity and therefore a decrease in intra-alveolar pressure

34) What are the primary inspiratory muscles?
A) external and internal intercostals
B) diaphragm and external intercostals
C) diaphragm and internal intercostals
D) diaphragm and the external and internal intercostals
E) diaphragm and abdominal muscles

B) diaphragm and external intercostals

35) The muscles of respiration are ________.
A) skeletal muscle innervated by the somatic nervous system
B) skeletal muscle innervated by the autonomic nervous system
C) smooth muscle innervated by the somatic nervous system
D) smooth muscle innervated by the autonomic nervous system
E) smooth muscle without innervation

A) skeletal muscle innervated by the somatic nervous system

36) As the volume of the chest wall increases, the concomitant expansion of the lungs is due to a(n) ________.
A) increase in atmospheric pressure
B) decrease in intra-alveolar pressure
C) increase in intrapleural pressure
D) decrease in transpulmonary pressure
E) increase in transpulmonary pressure

E) increase in transpulmonary pressure

37) At rest, expiration is a(n) ________ process that involves ________.
A) active : the contraction of the diaphragm
B) passive : relaxation of the diaphragm and external intercostals
C) active : contraction of the internal intercostals
D) passive : relaxation of the internal intercostals
E) active : relaxation of the diaphragm

B) passive : relaxation of the diaphragm and external intercostals

38) Which of the following pressures is lower during inspiration than during expiration?
A) intra-alveolar pressure only
B) transpulmonary pressure only
C) intrapleural pressure only
D) both intra-alveolar and transpulmonary pressures
E) both intra-alveolar and intrapleural pressures

E) both intra-alveolar and intrapleural pressures

39) The compliance of the lungs can be determined by measuring the change in ________ for a given change in ________.
A) lung volume : intra-alveolar pressure
B) lung volume : transpulmonary pressure
C) intra-alveolar pressure : lung volume
D) airway resistance : lung volume
E) lung volume : airway resistance

B) lung volume : transpulmonary pressure

40) The compliance of the lung is determined by the elasticity of the lung and ________.
A) volume
B) transpulmonary pressure
C) airway resistance
D) surface tension
E) intra-alveolar pressure

D) surface tension

41) The surface tension of the alveolus is reduced by surfactants produced by what type of cells?
A) ciliated
B) goblet
C) type I alveolar
D) type II alveolar
E) type III alveolar

D) type II alveolar

42) Which of the following is NOT involved in altering the resistance of the airway to air movement?
A) transpulmonary pressure
B) contractile activity of bronchiolar smooth muscle cells
C) secretion of mucus into the airway
D) pulmonary surfactant concentration
E) tractive forces exerted on the airway by surrounding tissue

D) pulmonary surfactant concentration

43) How do tractive forces affect the airways during inspiration.
A) increase in compliance
B) decrease in compliance
C) increase in airway resistance
D) decrease in airway resistance
E) bronchodilation

D) decrease in airway resistance

44) Which of the following is responsible for changes in airway resistance that occur in a single breath?
A) surrounding atmospheric pressure
B) autonomic nervous system
C) passive forces exerted on the airways
D) contractility of smooth muscle cells
E) sensitivity of smooth muscle cells to allergens

C) passive forces exerted on the airways

45) Which of the following chemicals will NOT result in a decrease in airway resistance?
A) norepinephrine
B) epinephrine
C) carbon dioxide
D) bronchodilators
E) histamine

E) histamine

46) Which of the following is NOT part of the response of an airway to specific allergens that initiate an asthmatic response?
A) increased airway resistance
B) increased inflammatory response
C) increased histamine release
D) increased secretion of mucus
E) increased release of corticosteroids

E) increased release of corticosteroids

47) What benefit are corticosteroids in the treatment of asthma?
A) They induce bronchodilation.
B) They induce bronchoconstriction.
C) They reduce inflammation of the airways.
D) They increase blood flow to the airways.
E) They decrease mucus secretion into the airways.

C) They reduce inflammation of the airways.

48) A(n) ________ is used clinically to measure lung volumes and rates of air flow.
A) spirometer
B) electrocardiograph
C) ratiometer
D) electroencephalogram
E) X-ray

A) spirometer

49) What is the volume of air moved into and out of the lungs in a single breath during unforced breathing called?
A) Total lung capacity
B) Functional residual capacity
C) Tidal volume
D) Vital capacity
E) Minute ventilation

C) Tidal volume

50) The presence of a negative intrapleural pressure at maximum expiration is responsible for which of the following?
A) residual volume
B) functional residual volume
C) tidal volume
D) vital capacity
E) functional residual capacity

A) residual volume

51) The tidal volume and inspiratory reserve volume together make up which of the following?.
A) Residual volume
B) Functional residual capacity
C) Total lung capacity
D) Inspiratory capacity
E) Vital capacity

D) Inspiratory capacity

52) Functional residual capacity is comprised of which of the following?
A) vital capacity and expiratory reserve volume
B) tidal volume and inspiratory reserve volume
C) tidal volume and expiratory reserve volume
D) tidal volume, inspiratory reserve volume, and expiratory reserve volume
E) residual volume and expiratory reserve volume

E) residual volume and expiratory reserve volume

53) Which of the following measurements cannot be determined by a spirometer?
A) vital capacity
B) tidal volume
C) residual volume
D) inspiratory capacity
E) inspiratory reserve volume

C) residual volume

54) A normal tidal volume at rest is approximately ________ mL.
A) 100
B) 500
C) 1,000
D) 5,000
E) 10,000

B) 500

55) A normal vital capacity is approximately ________ mL.
A) 100
B) 500
C) 1,000
D) 4,500
E) 9,000

D) 4,500

56) A healthy person can normally exhale what percentage of his/her vital capacity in one second?
A) 10
B) 20
C) 50
D) 80
E) 100

D) 80

57) In an obstructive disease, the lungs can become overinflated because the difficulty in ________ tends to ________.
A) expiration : increase vital capacity
B) expiration : decrease total lung capacity and vital capacity
C) expiration : increase residual volume and total lung capacity
D) inspiration : decrease total lung capacity and vital capacity
E) inspiration : increase total lung capacity and vital capacity

C) expiration : increase residual volume and total lung capacity

58) A decrease in ________ is indicative of a restrictive pulmonary disease.
A) minute ventilation
B) tidal volume
C) forced expiratory volume
D) residual volume
E) vital capacity

E) vital capacity

59) A decrease in ________ is indicative of an obstructive pulmonary disease.
A) minute ventilation
B) tidal volume
C) forced expiratory volume
D) residual volume
E) forced vital capacity

C) forced expiratory volume

60) What is the term for the volume of air moved into the lungs every minute?
A) alveolar ventilation
B) tidal volume
C) total lung capacity
D) minute ventilation
E) pulmonary ventilation

D) minute ventilation

61) What is the term for the volume of air that reaches the respiratory zone each minute?
A) alveolar ventilation
B) tidal volume
C) total lung capacity
D) minute ventilation
E) pulmonary ventilation

A) alveolar ventilation

62) What is the volume of the respiratory pathway that is not able to exchange gases (conducting pathway) called?
A) dead volume
B) functional dead space
C) anatomical dead space
D) residual volume
E) functional residual volume

C) anatomical dead space

1) The respiratory quotient is calculated as the ________.
A) ratio of the volume of oxygen consumed per volume of carbon dioxide produced
B) ratio of the volume of carbon dioxide produced per volume of oxygen consumed
C) product of the volume of carbon dioxide consumed and the volume of oxygen produced
D) product of the volume of oxygen consumed and the volume of carbon dioxide produced
E) sum of the volume of oxygen consumed and the volume of carbon dioxide produced

B) ratio of the volume of carbon dioxide produced per volume of oxygen consumed

2) If oxygen is consumed by the body cells at a rate of 300 mL per minute, then how much oxygen diffuses from the alveoli into the blood in the pulmonary capillaries?
A) 300 mL per minute
B) more than 300 mL per minute
C) less than 300 mL per minute
D) depends on where the oxygen is being utilized
E) depends on whether or not carbon dioxide is being produced at the same rate

A) 300 mL per minute

3) Oxygenated blood is found in which of the following?
A) right atrium only
B) pulmonary artery only
C) pulmonary vein only
D) both the right atrium and pulmonary artery
E) both the right atrium and pulmonary vein

C

4) Movement of oxygen and carbon dioxide between alveoli and blood occurs by what process?
A) simple diffusion
B) facilitated diffusion
C) osmosis
D) primary active transport
E) secondary active transport

A) simple diffusion

5) Which of the following is NOT part of the pathway that must be crossed by oxygen on its way to binding with hemoglobin?
A) alveolar epithelial cell
B) basement membrane
C) alveolar mucosal barrier
D) endothelial cell
E) red blood cell membrane

C

6) Which of the following does NOT contribute to the rapid movement of gases into and out of the blood within the lungs?
A) rapid blood flow
B) thin membrane
C) large surface area
D) concentration gradient
E) permeability of the membrane

A

7) In a mixture of gases, the driving force for the movement of an individual gas within that mixture is ultimately the ________.
A) solubility of the gas
B) total pressure of the gases
C) fractional concentration of that gas
D) partial pressure of that gas
E) volume of the gas

D

8) What is the most abundant gas in the air that we breathe?
A) oxygen
B) carbon dioxide
C) water vapor
D) argon
E) nitrogen

E

9) What percentage of air is oxygen?
A) < 1%
B) 6%
C) 12%
D) 21%
E) 79%

D

10) What percentage of air is carbon dioxide?
A) < 1%
B) 6%
C) 12%
D) 21%
E) 79%

A

11) What is the partial pressure of oxygen in a gas mixture that is 40% oxygen, 40% argon, and 20% helium, when the total pressure of the gas is 1,000 mm Hg?
A) 100 mm Hg
B) 200 mm Hg
C) 333 mm Hg
D) 400 mm Hg
E) 600 mm Hg

D

12) What is the partial pressure of oxygen in air at sea level?
A) 60 mm Hg
B) 160 mm Hg
C) 210 mm Hg
D) 400 mm Hg
E) 600 mm Hg

B

13) As humidity increases, the partial pressure of oxygen in air ________.
A) increases as the total pressure of air remains the same
B) increases as the total pressure of air increases
C) decreases as the total pressure of air remains the same
D) decreases as the total pressure of air increases
E) does not change

C) decreases as the total pressure of air remains the same

14) As the air is saturated with water vapor (humidified) upon entry into the conducting pathway, there will be ________.
A) a selective increase in the partial pressure of nitrogen
B) a selective decrease in the partial pressure of nitrogen
C) no change in the partial pressure of the remaining gases
D) a decrease in the partial pressure of the remaining gases
E) an increase in the partial pressure of the remaining gases

D) a decrease in the partial pressure of the remaining gases

15) At equilibrium, the gas molecules that dissolve in solution and those that remain in the gaseous phase are, by definition, at the same ________.
A) temperature
B) concentration
C) partial pressure
D) volume
E) humidity

C) partial pressure

16) The relationship between the concentration of a gas in solution and the partial pressure of that gas can be described by ________.
A) Boyle’s Law
B) Fick’s Law
C) Dalton’s Law
D) Henry’s Law
E) Poiseuille’s Law

D) Henry’s Law

17) Which of the following can increase the concentration of a particular gas in a solution?
A) increase the partial pressure of that gas exposed to the solution
B) increase the volume of the container containing the gas and solution
C) increase the volume of the gas only
D) increase the volume of the solution only
E) decrease the concentration of other gases in the solution

A

18) At equilibrium, which of the following statements is true when helium and nitrogen are present in a gas at equal partial pressures over water?
A) The concentrations of helium and nitrogen in the gas are equal.
B) The partial pressures of helium and nitrogen in the water are equal.
C) The concentrations of helium and nitrogen in the water are equal.
D) The concentrations of helium and nitrogen in BOTH the water and gas are equal.
E) The partial pressure of nitrogen is greater than the partial pressure of helium.

B) The partial pressures of helium and nitrogen in the water are equal.

19) The mixing of atmospheric air within the dead space of the conducting zone of the lung upon inspiration results in a partial pressure of ________.
A) water vapor in the alveoli that is lower than atmospheric
B) nitrogen in the alveoli that is higher than atmospheric
C) oxygen in the alveoli that is lower than atmospheric
D) carbon dioxide in the alveoli that is lower than atmospheric
E) oxygen in the alveoli that is higher than atmospheric

C) oxygen in the alveoli that is lower than atmospheric

20) Which of the following causes a decrease in the PO2 of air as it enters the conducting zone of the lungs?
A) humidifying the air
B) warming of the air
C) the increasing PCO2
D) the consumption of oxygen
E) decreasing alveolar PO2

A) humidifying the air

21) Pulmonary edema describes a condition where the uptake of oxygen and unloading of carbon dioxide is reduced as a consequence of a(n) ________.
A) thickening of the diffusion barrier by fluid accumulation in the pulmonary blood
B) thickening of the diffusion barrier by fluid accumulation in the alveoli
C) decrease in the partial pressure of oxygen in the alveolus
D) decrease in the partial pressure of carbon dioxide in the alveolus
E) increase in the partial pressure of oxygen in the blood

B) thickening of the diffusion barrier by fluid accumulation in the alveoli

22) At sea level, what is the normal partial pressure of oxygen in alveolar air?
A) 21 mm Hg
B) 40 mm Hg
C) 46 mm Hg
D) 100 mm Hg
E) 160 mm Hg

D) 100 mm Hg

23) At sea level, what is the normal partial pressure of carbon dioxide in alveolar air?
A) 21 mm Hg
B) 40 mm Hg
C) 46 mm Hg
D) 100 mm Hg
E) 160 mm Hg

B) 40 mm Hg

24) At sea level, what is the normal partial pressure of oxygen in the pulmonary veins?
A) 21 mm Hg
B) 40 mm Hg
C) 46 mm Hg
D) 100 mm Hg
E) 160 mm Hg

D) 100 mm Hg

25) At sea level, what is the normal partial pressure of carbon dioxide in pulmonary arteries?
A) 21 mm Hg
B) 40 mm Hg
C) 46 mm Hg
D) 100 mm Hg
E) 160 mm Hg

C) 46 mm Hg

26) At sea level, what is the normal partial pressure of oxygen in the systemic veins?
A) 21 mm Hg
B) 40 mm Hg
C) 46 mm Hg
D) 100 mm Hg
E) 160 mm Hg

B) 40 mm Hg

27) At sea level, what is the normal partial pressure of carbon dioxide in systemic veins?
A) 21 mm Hg
B) 40 mm Hg
C) 46 mm Hg
D) 100 mm Hg
E) 160 mm Hg

C) 46 mm Hg

28) During intense exercise, the metabolic activity of muscle causes a ________ in the partial pressure of oxygen in the tissue, ________ the movement of oxygen into the tissue.
A) decrease : reducing
B) decrease : facilitating
C) increase : reducing
D) increase : facilitating
E) does not change : facilitating

B

29) A typical value for blood PO2 in the pulmonary vein is ________, whereas PCO2 is ________.
A) 150 mm Hg : 0.3 mm Hg
B) 46 mm Hg : 100 mm Hg
C) 40 mm Hg : 46 mm Hg
D) 40 mm Hg : 100 mm Hg
E) 100 mm Hg : 40 mm Hg

E) 100 mm Hg : 40 mm Hg

30) Under resting conditions, equilibration between alveolar PO2 and PCO2 with blood PO2 and PCO2 in the pulmonary capillaries occurs in approximately how many seconds?
A) 3
B) 2
C) 1
D) 0.5
E) 0.25

E

31) Under resting conditions, equilibration between alveolar PO2 and PCO2 with blood PO2 and PCO2 in the pulmonary capillaries is completed by the time the blood has traveled what portion of the distance of the pulmonary capillaries?
A) 1/10
B) 1/8
C) 1/4
D) 1/3
E) 1/2

D) 1/3

32) Mixed venous blood samples can be taken from which of the following blood vessels?
A) pulmonary vein
B) pulmonary artery
C) inferior vena cava
D) aorta
E) superior vena cava

B) pulmonary artery

33) The venous blood in the right ventricle is referred to as "mixed" because the blood that enters the heart ________.
A) has a low PO2
B) contains a mixture of oxygen and carbon dioxide
C) comes from tissue with differing metabolic activities
D) has a high PCO2
E) is drained from the body

C) comes from tissue with differing metabolic activities

34) What is an increase in alveolar ventilation to match the demands of increased metabolic activity in the cells called?
A) hyperventilation
B) hypoventilation
C) hyperpnea
D) hypopnea
E) dyspnea

C) hyperpnea

35) Hyperventilation would lead to a(n) ________ within the systemic arteries.
A) selective decrease in PO2
B) selective increase in PO2
C) selective decrease in PCO2
D) increase in PO2 and decrease in PCO2
E) decrease in PO2 and increase in PCO2

D) increase in PO2 and decrease in PCO2

36) What is a decrease in carbon dioxide within the blood called?
A) hypoxia
B) hypoxemia
C) hypocapnia
D) hypercapnia
E) hyperpnea

C) hypocapnia

37) The majority of oxygen present within the blood is ________.
A) bound to hemoglobin within the plasma
B) bound to hemoglobin in red blood cells
C) dissolved within the plasma
D) in the plasma as HCO3-
E) bound to plasma proteins

B) bound to hemoglobin in red blood cells

38) Each ________ on the hemoglobin subunit is capable of binding an oxygen molecule, thereby allowing ________ oxygen to bind with one hemoglobin molecule.
A) heme : four
B) heme : three
C) globin : four
D) globin : three
E) free iron : one

A

39) What is the primary driving force for the binding of oxygen to hemoglobin?
A) PCO2
B) PO2
C) pH
D) temperature
E) 2,3-bisphosphoglycerate (2,3-BPG)

B) PO2

40) If hemoglobin is saturated (1.3 mL of oxygen per gram) and there are 150 grams of hemoglobin per liter of blood, how much oxygen can be delivered to the tissue if cardiac output is 15 liters per minute?
A) 650 g O2/min
B) 1300 mL O2/min
C) 1300 g O2/min
D) 2925 mL O2/min
E) 2925 g O2/min

D) 2925 mL O2/min

41) What is the definition of anemia?
A) a decrease in PO2
B) a increase in PCO2
C) a decrease in hemoglobin
D) a decrease in the oxygen carrying capacity of the blood
E) a decrease in the affinity of hemoglobin for oxygen

D) a decrease in the oxygen carrying capacity of the blood

42) What is labored or difficult breathing called?
A) hyperpnea
B) dyspnea
C) hypopnea
D) eupnea
E) apnea

B) dyspnea

43) What is a deficiency of oxygen in the tissues called?
A) apnea
B) hypoxia
C) hypoxemia
D) hypocapnia
E) hypercapnia

B) hypoxia

44) What is rapid shallow breathing called?
A) tachypnea
B) apnea
C) dyspnea
D) hyperpnea
E) eupnea

A) tachypnea

45) What is a decrease in oxygen in the blood called?
A) hypoxia
B) hypoxemia
C) anemia
D) hypocapnia
E) dysnemia

B) hypoxemia

46) As oxygen binds to hemoglobin, the ________ of the hemoglobin molecule will change through a process of ________ such that the binding of oxygen is enhanced.
A) amino acid sequence : phosphorylation
B) cooperativity : negativity
C) cooperativity : positivity
D) affinity : negative cooperativity
E) affinity : positive cooperativity

E) affinity : positive cooperativity

47) Which of the following statements is FALSE of a leftward shift in the hemoglobin-oxygen dissociation curve?
A) Affinity for oxygen is increased.
B) Oxygen loading onto the hemoglobin is increased.
C) Hemoglobin is more saturated at a given PO2.
D) It can be caused by an increase in blood pH.
E) It can be caused by an increase in PCO2.

E) It can be caused by an increase in PCO2.

48) Which of the following statements is FALSE of a rightward shift in the hemoglobin-oxygen dissociation curve?
A) Affinity for oxygen is decreased.
B) A rightward shift usually occurs in active tissue.
C) Hemoglobin unloading of oxygen is increased.
D) Oxygen loading onto hemoglobin is decreased.
E) It can be caused by a decrease in 2, 3-BPG.

E) It can be caused by a decrease in 2, 3-BPG.

49) Which of the following will cause a shift in the hemoglobin-oxygen dissociation curve to the right?
A) increase in temperature only
B) increase in plasma pH only
C) increase in 2,3-BPG (2,3-bisphosphoglycerate) only
D) both an increase in temperature and an increase in 2, 3-BPG
E) both an increase in temperature and an increase in plasma pH

D) both an increase in temperature and an increase in 2, 3-BPG

50) As it leaves the lung in the pulmonary vein, blood is ________ saturated with oxygen.
A) 75%
B) 90%
C) 98%
D) completely (100%)
E) supersaturated (108%)

C) 98%

51) Which of the following increases oxygen unloading from hemoglobin?
A) increased carbon dioxide in the tissue
B) increased oxygen levels in the tissue
C) increased blood pH
D) decreased metabolism
E) decreased temperature

A) increased carbon dioxide in the tissue

52) Which of the following will increase the unloading of oxygen within the tissue?
A) increased hydrogen ion concentration only
B) increased PCO2 only
C) increased body temperature only
D) both increased hydrogen ion concentration and increased body temperature
E) increased hydrogen ion concentration, increased body temperature, and increased PCO2

E) increased hydrogen ion concentration, increased body temperature, and increased PCO2

53) Which of the following will increase the loading of oxygen onto the hemoglobin molecule within the lungs?
A) decreased hydrogen ion concentration
B) increased PCO2
C) decreased pH
D) increased 2,3-bishosphoglycerate (2,3-BPG)
E) increased body temperature

A) decreased hydrogen ion concentration

54) In the systemic arteries, the partial pressure of oxygen is approximately ________, and hemoglobin is approximately ________ saturated with oxygen.
A) 40 mm Hg : 75%
B) 60 mm Hg : 50%
C) 100 mm Hg : 75%
D) 40 mm Hg : 50%
E) 100 mm Hg : 98%

E) 100 mm Hg : 98%

55) In the pulmonary arteries, the partial pressure of oxygen is approximately ________, and hemoglobin is approximately ________ saturated with oxygen.
A) 25 mm Hg : 50%
B) 40 mm Hg : 75%
C) 60 mm Hg : 80%
D) 80 mm Hg : 90%
E) 100 mm Hg : 98%

B) 40 mm Hg : 75%

56) The carbamino effect describes a change in the conformation of hemoglobin that is induced by ________.
A) an increase in pH
B) a decrease in temperature
C) an increase in temperature
D) an increase in CO2
E) a decrease in pH

D) an increase in CO2

57) Which of the following statements about 2,3-BPG is FALSE?
A) 2,3-BPG is an intermediate of glycolysis.
B) 2,3-BPG produces a rightward shift in the hemoglobin-oxygen dissociation curve.
C) 2,3-BPG synthesis is inhibited by high levels of oxyhemoglobin.
D) 2,3-BPG increases the affinity of hemoglobin for oxygen.
E) 2,3-BPG is produced by red blood cells.

D) 2,3-BPG increases the affinity of hemoglobin for oxygen.

58) Where in blood does the conversion of CO2 to bicarbonate occur?
A) erythrocytes
B) platelets
C) capillary endothelial cells
D) leukocytes
E) plasma

A) erythrocytes

59) What is the primary mechanism of carbon dioxide transport in blood?
A) dissolved in the plasma
B) dissolved in the red blood cells
C) bound to hemoglobin
D) as bicarbonate dissolved in the plasma
E) as bicarbonate dissolved in the red blood cells

D) as bicarbonate dissolved in the plasma

60) The presence of bicarbonate ions in the blood has an important direct effect, aside from the transport of CO2, that involves ________.
A) stimulating the proliferation of alveolar epithelial cells
B) altering the activity of several receptors
C) altering the affinity of hemoglobin for oxygen
D) maintaining acid-base balance
E) altering the activity of carbonic anhydrase

D) maintaining acid-base balance

61) Within an erythrocyte, the conversion of CO2 to bicarbonate is prevented from reaching equilibrium by the ________.
A) absence of a nucleus
B) presence of oxygen
C) temperature of the body
D) presence of hydrogen ions
E) efflux of bicarbonate from the erythrocyte via the chloride shift

E) efflux of bicarbonate from the erythrocyte via the chloride shift

62) The hydrogen ions released by the dissociation of carbonic acid are buffered by their ________.
A) transport out of the erythrocyte as a sodium ion moves in
B) binding to DNA within the nucleus
C) transport into the erythrocyte as sodium ions move out
D) binding to hemoglobin
E) active transport out of the erythrocyte

D) binding to hemoglobin

63) The Haldane effect describes the increase in the affinity of hemoglobin for CO2 in the presence of a lowered ________.
A) PCO2
B) concentration of bicarbonate (HCO3-)
C) PO2
D) pH
E) temperature

C) PO2

64) During quiet breathing, a person’s breathing cycle consists of ________.
A) contraction of inspiratory muscles
B) contraction and relaxation of inspiratory muscles
C) contraction and relaxation of inspiratory and expiratory muscles
D) contraction of expiratory muscles
E) contraction of inspiratory muscles and relaxation of expiratory muscles

B) contraction and relaxation of inspiratory muscles

65) Which of the following nerves have activity during quiet inspiration?
A) phrenic nerve only
B) internal intercostal nerve only
C) external intercostal nerve only
D) both the phrenic nerve and internal intercostal nerves
E) both the phrenic nerve and external intercostal nerves

E) both the phrenic nerve and external intercostal nerves

66) During active breathing, bursts of action potentials are observed to occur ________.
A) exclusively in the inspiratory motor neurons
B) simultaneously in the inspiratory and expiratory motor neurons
C) exclusively in the expiratory motor neurons
D) asynchronously in the inspiratory and expiratory motor neurons
E) synchronously in the inspiratory and expiratory motor neurons

D) asynchronously in the inspiratory and expiratory motor neurons

67) The ________ is the respiratory center that appears to facilitate the transition between inspiration and expiration.
A) medullary respiratory group
B) pontine respiratory group
C) dorsal respiratory group
D) ventral respiratory group
E) central pattern generator

B) pontine respiratory group

68) Inspiratory neurons are located in the ________.
A) dorsal respiratory group only
B) ventral respiratory group only
C) pontine respiratory group only
D) both dorsal and ventral respiratory groups
E) dorsal, ventral, and pontine respiratory groups

E) dorsal, ventral, and pontine respiratory groups

69) In the model of quiet breathing, the breathing rhythm originated by the central pattern generator activates the ________.
A) inspiratory neurons in the dorsal respiratory center
B) expiratory neurons in the dorsal respiratory center
C) inspiratory neurons in the ventral respiratory center
D) both expiratory neurons in the ventral respiratory center
E) both inspiratory neurons in the dorsal and ventral respiratory center

E) both inspiratory neurons in the dorsal and ventral respiratory center

70) In the model for quiet breathing, expiration is induced by ________.
A) abrupt termination of inspiration
B) activation of expiratory neurons in the dorsal respiratory center
C) activation of inspiratory neurons in the ventral respiratory center
D) activation of expiratory neurons in the ventral respiratory center
E) activation of inspiratory neurons in the dorsal respiratory center

A) abrupt termination of inspiration

71) Which of the following is NOT one of the sensory receptors that alter the output from the central pattern generator?
A) peripheral chemoreceptor
B) central chemoreceptor
C) pulmonary stretch receptor
D) pulmonary baroreceptors
E) irritant receptors

D) pulmonary baroreceptors

72) Coughing is initiated by ________ located in the ________.
A) chemoreceptors : trachea
B) irritant receptors : nose and pharynx
C) irritant receptors : trachea
D) chemoreceptors : nose and pharynx
E) stretch receptor : trachea

C) irritant receptors : trachea

73) Peripheral chemoreceptors are specialized cells in contact with arterial blood that respond directly to changes in blood ________.
A) pH
B) PO2
C) PCO2
D) PCO2 and PO2
E) PO2, pH, and PCO2

E) PO2, pH, and PCO2

74) Central chemoreceptors are neurons in the medulla that respond directly to changes in ________.
A) cerebrospinal fluid pH
B) blood pH
C) cerebrospinal fluid PO2 and pH
D) blood pH and PO2
E) cerebrospinal fluid PO2

A) cerebrospinal fluid pH

75) Chemoreceptors respond primarily to changes in PCO2 indirectly by its effect on ________.
A) 2,3-diphosphoglycerate (2,3-DPG) concentration
B) PO2
C) lactic acid concentration
D) hydrogen ion concentration
E) hemoglobin concentration

D) hydrogen ion concentration

76) Hyperventilation will cause changes in PCO2 that are detected by the chemoreceptors which causes a(n) ________.
A) decrease in breathing rate only
B) increase in depth of breathing only
C) increase in breathing rate only
D) increase in breathing rate and depth of breathing
E) decrease in breathing rate and depth of breathing

E) decrease in breathing rate and depth of breathing

77) Where are the peripheral chemoreceptors in humans?
A) aortic bodies only
B) carotid bodies only
C) medulla oblongata only
D) both aortic and carotid bodies
E) both carotid bodies and medulla oblongata

B) carotid bodies only

78) Which of the following BEST describes a chemoreceptor response to PO2?
A) Peripheral chemoreceptors respond to small changes in PO2.
B) Central chemoreceptors respond to only large decreases in PO2.
C) Peripheral chemoreceptors respond only indirectly to PO2.
D) Central chemoreceptors do not respond to changes in PO2.
E) Peripheral chemoreceptors respond to oxyhemoglobin.

D) Central chemoreceptors do not respond to changes in PO2.

79) A decrease in PCO2 within the lung will result in a ________ in the pulmonary vasculature and a ________ in the bronchioles.
A) vasoconstriction : lack of change
B) weak vasoconstriction : bronchodilation
C) vasodilation : weak bronchodilation
D) weak vasodilation : bronchoconstriction
E) lack of change : weak bronchoconstriction

D) weak vasodilation : bronchoconstriction

80) A local bronchodilation within the alveolus will result in a(n) ________ in the ventilation-perfusion ratio in that region, whereas a vasoconstriction will result in a(n) ________ in the ventilation-perfusion ratio.
A) increase : increase
B) increase : decrease
C) decrease : increase
D) decrease : decrease
E) lack of change : increase

A) increase : increase

81) The primary effect of increased PO2 in the lungs is to cause ________ which ________ the ventilation-perfusion ratio.
A) bronchoconstriction : decreases
B) bronchodilation : increases
C) vasoconstriction : decreases
D) vasodilation : decreases
E) vasoconstriction : increases

D) vasodilation : decreases

82) The primary effect of increased PCO2 in the lungs is to cause ________ which ________ the ventilation-perfusion ratio.
A) bronchoconstriction : decreases
B) bronchodilation : increases
C) vasoconstriction : decreases
D) vasodilation : decreases
E) vasoconstriction : increases

B) bronchodilation : increases

83) When the blood becomes ________, it can lead to a depression in the activity of the central nervous system.
A) hypoxic
B) hypocapnic
C) pH 7.4
D) acidic
E) alkaline

D) acidic

84) The buffering capacity of hemoglobin is directly related to its ability to bind with ________.
A) oxygen
B) carbon dioxide
C) carbon monoxide
D) hydrogen ions
E) nitrogen

D) hydrogen ions

85) Bicarbonate is an important buffer in blood, whose concentration is regulated by the ________.
A) kidneys
B) lungs
C) heart
D) liver
E) pancreas

A) kidneys

86) A change in the ratio of bicarbonate to carbon dioxide concentration in the blood will ________.
A) change blood potassium concentration
B) change blood chloride concentration
C) cause a bronchodilation
D) cause a vasodilation of systemic arterioles
E) change blood pH

E) change blood pH

87) Respiratory acidosis will result from a(n) ________.
A) increase in blood CO2 concentration
B) decrease in blood CO2 concentration
C) increase in blood bicarbonate
D) decrease in blood bicarbonate
E) increase in carbon monoxide

A) increase in blood CO2 concentration

CH 19
11) Kidneys compensate for changes in plasma volume and osmolarity by adjusting the rate of water ________.
A) reabsorption only
B) secretion only
C) resorption only
D) reabsorption and secretion
E) secretion and resorption

A) reabsorption only

CH 19
12) Which of the following mechanisms is NOT important in the maintenance of the osmotic gradient within the proximal tubule that drives water movement?
A) cotransport of chloride
B) cotransport of amino acids
C) cotransport of glucose
D) active reabsorption of sodium
E) diffusion of urea

E) diffusion of urea

CH 19
13) Which of the following accurately describes the thick ascending limb of the loop of Henle?
A) permeable to water in the presence of specific hormones
B) permeable to water and does NOT contain Na+/K+/Cl- cotransporters
C) impermeable to water and does NOT contain Na+/K+/Cl- cotransporters
D) impermeable to water and contains Na+/K+/Cl- cotransporters
E) permeable to water and contains Na+/K+/Cl- cotransporters

D) impermeable to water and contains Na+/K+/Cl- cotransporters

CH 19
14) In the ascending limb of the loop of Henle, the filtrate will always be ________.
A) in equilibrium with the the medullary interstitial fluid
B) of a lower osmolarity than the medullary interstitial fluid
C) a higher osmolarity than the medullary interstitial fluid
D) the same osmolarity as the filtrate in the descending limb of the loop of Henle
E) a higher osmolarity than the filtrate in the descending limb of the loop of Henle

B) of a lower osmolarity than the medullary interstitial fluid

CH 19
15) The osmotic gradient in the medullary region of the kidneys is established and maintained by which of the following?
A) Na+/K+/Cl- cotransporters in the ascending limb of the loop of Henle
B) Na+/K+/Cl- cotransporters in the descending limb of the loop of Henle
C) efflux of water from the ascending limb of the loop of Henle
D) efflux of water from the descending limb of the loop of Henle
E) efflux of Na+ from the descending limb of the loop of Henle

A) Na+/K+/Cl- cotransporters in the ascending limb of the loop of Henle

CH 19
16) Which of the following comparisons of osmolarity within the kidneys is INCORRECT?
A) The fluid in the proximal tubule is iso-osmotic with cortical interstitial fluid.
B) Osmolarity of the ascending limb of the loop of Henle is greater than that of the descending limb.
C) Osmolarity of the descending limb of the loop of Henle is iso-osmotic with the medullary interstitial fluid.
D) The osmolarity of plasma in the vasa recta varies with its location in the renal medulla.
E) Osmolarity of fluid in the proximal tubule is greater than the osmolarity of fluid in the end of the loop of Henle as it enters the distal tubule

B) Osmolarity of the ascending limb of the loop of Henle is greater than that of the descending limb.

CH 19
17) A long loop of Henle would result in which of the following?
A) a higher osmolarity in the deeper regions of the renal medulla and the ability to produce a more concentrated urine
B) a lower osmolarity in the deeper regions of the renal medulla and the ability to produce a more concentrated urine
C) a higher osmolarity in the deeper regions of the renal medulla and the ability to produce a more dilute urine
D) a lower osmolarity in the deeper regions of the renal medulla and the ability to produce a more dilute urine
E) a higher osmolarity in the renal cortex and the ability to produce a more dilute urine

A) a higher osmolarity in the deeper regions of the renal medulla and the ability to produce a more concentrated urine

CH 19
18) The hormone-induced increases in water permeability of the distal tubule and collecting ducts is mediated by a(n) ________.
A) increase in aquaporin-2 activity
B) increase in aquaporin-3 activity
C) increase in paracellular permeability
D) decrease in "tightness" of tight junctions
E) decrease in paracellular permeability

A) increase in aquaporin-2 activity

CH 19
19) What keeps the capillaries of the vasa recta from dissipating the medullary osmotic gradient?
A) the smooth muscle cells contain Na+/K+/Cl- cotransporters
B) the smooth muscle cells are impermeable to water and ions
C) the vascular endothelial cells are impermeable to water and ions
D) capillary blood enters and exits the medulla at a similar osmolarity
E) the vascular endothelial cells contain Na+/K+/Cl- cotransporters

D) capillary blood enters and exits the medulla at a similar osmolarity

CH 19
20) If nothing else is removed from the filtrate once it reaches the late distal tubules, the urine excreted would have which of the following properties?
A) devoid of ions and large volume
B) high osmolarity and low volume
C) low osmolarity and low volume
D) low osmolarity and large volume
E) high osmolarity and large volume

D) low osmolarity and large volume

CH 19
21) What solute maintains the medullary interstitial fluid osmotic gradient?
A) urea
B) sodium ions
C) potassium ions
D) water
E) glucose

A) urea

CH 19
42) Which of the following is an effect of aldosterone on principal cells?
A) decreased number of open Na+ and K+ channels in the basolateral membrane
B) decreased number of Na+/K+ pumps in the basolateral membrane
C) increased number of open Na+ and K+ channels in the basolateral membrane
D) increased number of open Na+ and K+ channels in the apical membrane
E) increased number of Na+/K+ pumps in the apical membrane

D) increased number of open Na+ and K+ channels in the apical membrane

CH 19
43) Which of the following is associated with actions of aldosterone on principal cells?
A) increased sodium secretion
B) increased potassium secretion
C) decreased blood pressure
D) decreased plasma osmolarity
E) increased calcium reabsorption

B) increased potassium secretion

CH 19
44) Renin is released by ________ cells of the ________.
A) principal : afferent arteriole
B) granular : afferent arteriole
C) principal : distal tubule
D) granular : distal tubule
E) intercalated : afferent arteriole

B) granular : afferent arteriole

CH 19
45) What enzyme converts angiotensinogen into angiotensin I.
A) Carbonic anhydrase
B) Atrial natriuretic peptide
C) Angiotensin converting enzyme (ACE)
D) Renin
E) Mucin

D) Renin

CH 19
46) What enzyme converts angiotensin I into angiotensin II.
A) Carbonic anhydrase
B) Atrial natriuretic peptide
C) Angiotensin converting enzyme (ACE)
D) Renin
E) Mucin

C) Angiotensin converting enzyme (ACE)

CH 19
47) Which of the following is NOT one of the functions of angiotensin II?
A) vasoconstriction
B) stimulate aldosterone secretion
C) stimulate antidiuretic hormone (ADH) secretion
D) increased thirst
E) stimulate renin secretion

E) stimulate renin secretion

CH 19
48) Angiotensin II acts directly in the hypothalamus to stimulate what?
A) an increase in thirst
B) the release of oxytocin
C) an increase in body temperature
D) the release of aldosterone
E) a systemic increase in blood pressure

A) an increase in thirst

CH 19
49) Which of the following conditions is NOT responsible for stimulating the release of renin?
A) decreased pressure within the afferent arteriole
B) increase in sympathetic nerve activity
C) decrease in sodium and chloride in the distal tubule
D) increased glomerular filtration rate
E) decreased mean arterial pressure

D) increased glomerular filtration rate

CH 19
50) Angiotensinogen is synthesized by what organ?
A) kidney
B) bone marrow
C) liver
D) adrenal gland
E) pituitary gland

C) liver

CH 19
51) What role do the macula densa cells have in controlling renin release?
A) They release renin in response to an increase in mean arterial pressure.
B) They release renin in response to a decrease in mean arterial pressure.
C) They detect changes in the pressure of afferent arterioles, and communicate these changes to juxtaglomerular cells, which secrete renin.
D) They detect changes in the pressure of efferent arterioles, and communicate these changes to juxtaglomerular cells, which secrete renin.
E) They detect changes in the amount of sodium and chloride in the distal tubules, and communicate these changes to juxtaglomerular cells, which secrete renin.

E) They detect changes in the amount of sodium and chloride in the distal tubules, and communicate these changes to juxtaglomerular cells, which secrete renin.

CH 19
78) Which of the following is NOT one of the effects of changes in pH on the body?
A) alterations in protein function
B) alterations in central nervous system activity
C) alterations in potassium homeostasis
D) alteration in water balance
E) alterations in cardiac rhythm

D) alteration in water balance

CH 19
79) The activity of the respiratory system can increase pH by ________.
A) a hyperventilation-induced increase in PCO2
B) a hypoventilation-induced increase in PCO2
C) a hyperventilation-induced decrease in PCO2
D) a hypoventilation-induced decrease in PCO2
E) increasing amount of carbonic acid in the blood

C) a hyperventilation-induced decrease in PCO2

CH 19
80) What is the normal range of blood pH?
A) 6.80-7.20
B) 6.90-7.10
C) 6.75-6.95
D) 7.20-7.60
E) 7.35-7.45

E) 7.35-7.45

CH 19
81) During hyperventilation, why do some people detect a tingling sensation in their hands and feet?
A) due to hyperexcitability of afferent neurons
B) due to a decrease in blood flow to the distal extremities
C) due to a decrease in carbon dioxide in blood
D) due to an increase in carbon dioxide in blood
E) due to widespread release of catecholamines

A) due to hyperexcitability of afferent neurons

CH 19
82) Which of the following is NOT a metabolic disturbance that can result in a metabolic acidosis?
A) high protein diet
B) high fat diet
C) heavy exercise
D) excessive vomiting
E) severe diarrhea

D) excessive vomiting

CH 19
83) What is the most rapid defense against changes in blood pH?
A) respiratory compensation
B) buffering of hydrogen ions
C) renal compensation
D) cardiac compensation
E) hepatic compensation

B) buffering of hydrogen ions

CH 19
84) How does severe diarrhea cause a metabolic acidosis?
A) production of bicarbonate
B) production of hydrogen ions
C) loss of hydrogen ions
D) loss of phosphate
E) loss of bicarbonate

E) loss of bicarbonate

CH 19
85) How does severe vomiting cause a metabolic alkalosis?
A) production of bicarbonate
B) production of hydrogen ions
C) loss of hydrogen ions
D) loss of phosphate
E) loss of bicarbonate

C) loss of hydrogen ions

CH 19
86) Which of the following ions acts as a buffer to minimize changes in intracellular pH?
A) phosphate
B) bicarbonate
C) chloride
D) potassium
E) sodium

A) phosphate

CH 19
87) The role of a buffer is to ________.
A) reduce the reabsorption of hydrogen ions in the kidneys
B) limit the change in pH with changing hydrogen ion concentrations
C) reduce the secretion of hydrogen ions in the kidneys
D) reduce the secretion of bicarbonate ions in the kidneys
E) enhance the ability of an increase in hydrogen ions to increase pH

B) limit the change in pH with changing hydrogen ion concentrations

CH 19
88) What is the secondary defense against changes in pH that requires minutes to be activated?
A) respiratory compensation
B) buffering of hydrogen ions
C) renal compensation
D) cardiac compensation
E) hepatic compensation

A) respiratory compensation

CH 19
89) Respiratory compensation for changes in pH are originated by ________.
A) proprioceptors
B) baroreceptors
C) central chemoreceptors
D) peripheral chemoreceptors
E) directly affecting the activity of the diaphragm

D) peripheral chemoreceptors

CH 19
90) When an increase in hydrogen ions remains after one hour, this will lead to a(n) ________.
A) decrease in bicarbonate reabsorption in the kidneys
B) increased hydrogen reabsorption in the kidneys
C) increase in bicarbonate secretion in the kidneys
D) increase in hydrogen ion secretion from the kidneys
E) failure of the kidneys to filter any more hydrogen ions

D) increase in hydrogen ion secretion from the kidneys

CH 19
91) Which of the following is an effect of the transporters in the proximal tubules?
A) secretion of urea
B) secretion of potassium
C) reabsorption of hydrogen
D) secretion of sodium
E) reabsorption of bicarbonate

E) reabsorption of bicarbonate

CH 19
92) In the basolateral membrane of proximal tubular cells, bicarbonate is moved out of the cells by ________.
A) K+/HCO3- countertransporters only
B) HCO3-/Cl- countertransporters only
C) Na+/HCO3- cotransporters only
D) both K+ HCO3- and HCO3- /CI- countertransporters
E) both HCO3- /CI- countertransporters and Na+ / HCO3- cotransporters

E) both HCO3- /CI- countertransporters and Na+ / HCO3- cotransporters

CH 19
93) In the proximal tubule, hydrogen ions are transported into the filtrate by ________.
A) Na+/H+ countertransporters only
B) H+ primary active transporters only
C) H+/Cl- cotransporters only
D) both Na+/H+ countertransporters and H+ primary active transporters
E) both Na+/H+ countertransporters and H+/Cl- cotransporters

D) both Na+/H+ countertransporters and H+ primary active transporters

CH 19
94) Bicarbonate crosses the apical membrane of the proximal tubule by ________.
A) HCO3-/Cl- countertransporters
B) Na+/HCO3- cotransporters
C) conversion to carbon dioxide
D) HCO3- active transporters
E) Na+/HCO3- countertransporters

C) conversion to carbon dioxide

CH 19
95) Which of the following transporters is NOT found embedded in the membrane of the intercalated cells of the late distal tubule and collecting ducts?
A) HCO3-/Cl- countertransporters in the basolateral membrane
B) Na+/HCO3- cotransporters in the basolateral membrane
C) chloride channels in the basolateral membrane
D) H+ pumps in the apical membrane
E) K+/H+ countertransporters in the apical membrane

B) Na+/HCO3- cotransporters in the basolateral membrane

CH 19
96) What is the normal source of the new bicarbonate in the late distal tubule and collecting ducts?
A) carbon monoxide produced in the distal tubule
B) catabolism of lysine
C) catabolism of glutamine
D) carbon dioxide from the system circulation
E) carbon dioxide produced by the tubule cells

E) carbon dioxide produced by the tubule cells

CH 19
97) Under severe acidic conditions, the proximal tubules can convert ________ into bicarbonate.
A) glutamate
B) carbon monoxide
C) lysine
D) glutamine
E) glycine

D) glutamine

CH 19
98) Hydrogen ions in the filtrate within the collecting ducts are buffered by the presence of ________.
A) phosphate
B) bicarbonate
C) carbon dioxide
D) glutamine
E) proteins

A) phosphate

CH 19
99) In order to compensate for a hyperventilation, the ________.
A) kidneys decrease the reabsorption of bicarbonate
B) kidneys increase the conversion of glutamine to bicarbonate
C) kidneys increase the secretion of hydrogen ions
D) lungs increase ventilation rate
E) kidneys increase the reabsorption of hydrogen ions

A) kidneys decrease the reabsorption of bicarbonate

CH 19
100) Which of the following is NOT a compensation that would occur in response to a metabolic acidosis?
A) increased excretion of hydrogen ions
B) increased ventilation
C) decreased tidal volume
D) increased bicarbonate production
E) increased conversion of glutamine to bicarbonate

C) decreased tidal volume

CH 19
101) A patient is exhibiting several signs of acid-base imbalance. Blood tests reveal that blood pH is 7.3, and bicarbonate and carbon dioxide levels in blood are both low. What is the state of this patient?
A) metabolic acidosis with respiratory compensation
B) respiratory acidosis with renal compensation
C) metabolic alkalosis with respiratory compensation
D) respiratory alkalosis with renal compensation
E) blood pH is normal

A) metabolic acidosis with respiratory compensation

CH 19
102) A patient is exhibiting several signs of acid-base imbalance. Blood tests reveal that blood pH is 7.5, and bicarbonate and carbon dioxide levels in blood are both low. What is the state of this patient?
A) metabolic acidosis with respiratory compensation
B) respiratory acidosis with renal compensation
C) metabolic alkalosis with respiratory compensation
D) respiratory alkalosis with renal compensation
E) blood pH is normal

D) respiratory alkalosis with renal compensation

CH 18
1) Which of the following is NOT a function of the kidneys?
A) regulation of plasma ionic concentration
B) regulation of plasma osmolarity
C) regulation of plasma temperature
D) regulation of plasma volume
E) regulation of plasma hydrogen concentration

C) regulation of plasma temperature

CH 18
2) The primary function of the kidneys involves regulating the ________ and the ________ of plasma and interstitial fluid.
A) volume : temperature
B) volume : composition
C) temperature : composition
D) pressure : volume
E) composition : osmolarity

B) volume : composition

CH 18
3) Once produced, urine travels through the ________ until it reaches the bladder, from which it is released into the external environment through the ________.
A) ureter : urethra
B) urethra : ureter
C) collecting duct : ureter
D) collecting duct : urethra
E) renal hilus : ureter

A) ureter : urethra

CH 18
4) Which of the following is NOT part of the urinary system?
A) kidneys
B) liver
C) ureters
D) urethra
E) bladder

B) liver

CH 18
5) Despite being less than 1% of body weight, the kidneys receive what percent of resting cardiac output?
A) 1%
B) 5%
C) 15%
D) 20%
E) 35%

D) 20%

CH 18
6) What are the conical sections of the renal medulla called?
A) renal cortex
B) renal pelvis
C) renal pyramids
D) minor calyces
E) major calyces

C) renal pyramids

CH 18
7) Where do the collecting ducts of the renal tubules drain?
A) ureters
B) minor calyces
C) major calyces
D) renal pelvis
E) glomerulus

B) minor calyces

CH 18
8) What is the functional unit of the kidney?
A) loop of Henle
B) proximal tubule
C) collecting ducts
D) nephron
E) glomerulus

D) nephron

CH 18
9) What two structures make up the renal corpuscle?
A) afferent and efferent arterioles
B) major and minor calyces
C) nephron and collecting duct
D) Bowman’s capsule and glomerulus
E) proximal straight and proximal convoluted tubules

D) Bowman’s capsule and glomerulus

CH 18
10) Blood leaves the ________ and enters the glomerulus.
A) afferent arteriole
B) efferent arteriole
C) peritubular capillary
D) vasa recta
E) Bowman’s capsule

A) afferent arteriole

CH 18
11) Where does blood leaving the glomerulus go to next?
A) afferent arteriole
B) efferent arteriole
C) peritubular capillary
D) vasa recta
E) Bowman’s capsule

B) efferent arteriole

CH 18
12) After fluid passes through the entire proximal tubule, the fluid will enter the ________.
A) loop of Henle
B) distal tubule
C) connecting tubule
D) collecting duct
E) Bowman’s capsule

A) loop of Henle

CH 18
13) What type of nephrons are located within the outer region of the kidney and comprise nearly 80% of the nephrons?
A) peritubular
B) medullary
C) juxtaglomerular
D) juxtamedullary
E) cortical

E) cortical

CH 18
14) The juxtaglomerular apparatus describes the unique region of the nephron where ________.
A) the efferent arteriole is in contact with the distal tubule
B) the afferent arteriole is in contact with the distal tubule
C) the afferent and efferent arterioles are in contact with the distal tubule
D) the afferent arteriole is in contact with the proximal tubule
E) the afferent and efferent arterioles are in contact with the proximal tubule

C) the afferent and efferent arterioles are in contact with the distal tubule

CH 18
15) What capillaries come off of the efferent arterioles associated with cortical nephrons?
A) glomerulus
B) peritubular
C) vasa recta
D) arcuate
E) lobular

B) peritubular

CH 18
16) What capillaries come off of the efferent arterioles associated with juxtamedullary nephrons?
A) glomerulus
B) peritubular
C) vasa recta
D) arcuate
E) lobular

C) vasa recta

CH 18
17) Which of the following is the correct order of blood supply to the kidneys?
A) renal artery interlobar arteries arcuate arteries segmental arteries interlobular arteries efferent arteriole glomerulus afferent arteriole
B) renal artery segmental arteries interlobar arteries arcuate arteries interlobular arteries afferent arteriole glomerulus efferent arteriole
C) renal artery arcuate arteries interlobular arteries segmental arteries afferent arteriole glomerulus efferent arteriole interlobar arteries
D) renal artery segmental arteries interlobular arteries arcuate arteries interlobar arteries efferent arteriole glomerulus afferent arteriole
E) renal artery interlobar arteries interlobular arteries arcuate arteries segmental arteries afferent arteriole glomerulus efferent arteriole

B) renal artery segmental arteries interlobar arteries arcuate arteries interlobular arteries afferent arteriole glomerulus efferent arteriole

CH 18
18) During what renal process are molecules selectively removed from the tubule lumen, moved into the interstitial space, and removed from the kidneys by the peritubular capillaries and the vasa recta?
A) filtration
B) secretion
C) excretion
D) reabsorption
E) absorption

D) reabsorption

CH 18
19) The peritubular capillaries and vasa recta drain into hat veins?
A) interlobular
B) interlobar
C) arcuate
D) efferent
E) segmental

A) interlobular

CH 18
20) As fluid moves out of the glomerular capillaries, it passes through gaps in the podocytes called slit pores, whose size is regulated by what?
A) fenestrations
B) slit diaphragm
C) slit muscle
D) corpuscle
E) glomerular capillary

B) slit diaphragm

CH 18
21) What is the process whereby molecules are selectively transported from the peritubular fluid to the lumen of the renal tubules?
A) glomerular filtration
B) reabsorption
C) absorption
D) secretion
E) excretion

D) secretion

CH 18
22) What is the process whereby protein-free plasma moves by bulk flow from the glomerulus into Bowman’s capsules?
A) glomerular filtration
B) reabsorption
C) absorption
D) secretion
E) excretion

A) glomerular filtration

CH 18
23) Which of the following forms the filtration barrier?
A) capillary endothelial cells only
B) podocytes only
C) basement membrane only
D) both capillary endothelial cells and basement membrane
E) capillary endothelial cells, basement membrane, and podocytes

E) capillary endothelial cells, basement membrane, and podocytes

CH 18
24) What is the sum of Starling’s forces within the renal corpuscle called?
A) glomerular filtration pressure
B) glomerular filtration rate
C) glomerular filtration volume
D) glomerular oncotic pressure
E) glomerular capillary hydrostatic pressure

A) glomerular filtration pressure

CH 18
25) What Starling force, which drives fluid out of the glomerulus, is relatively high (~60 mm Hg) due to the resistance of the efferent arterioles.
A) Bowman’s capsule oncotic
B) Glomerular capillary hydrostatic
C) Bowman’s capsule hydrostatic
D) Glomerular oncotic
E) Glomerular filtration

B) Glomerular capillary hydrostatic

CH 18
26) Which of the following pressures across the glomerular capillaries approaches zero?
A) glomerular filtration pressure
B) glomerular oncotic pressure
C) glomerular capillary hydrostatic pressure
D) Bowman’s capsule oncotic pressure
E) Bowman’s capsule hydrostatic pressure

D) Bowman’s capsule oncotic pressure

CH 18
27) Which of the forces across the glomerular capillaries tends to increase from the afferent to the efferent arteriole ends?
A) glomerular filtration pressure
B) Bowman’s capsule hydrostatic pressure
C) Bowman’s capsule oncotic pressure
D) glomerular capillary hydrostatic pressure
E) glomerular oncotic pressure

E) glomerular oncotic pressure

CH 18
28) Which of the equations below describes the calculation of glomerular filtration pressure (BC = Bowman’s capsule and GC = glomerular capillary)?
A) (PGC + πBC) – (PBC + πGC)
B) (PBC + πBC) – (PGC + πGC)
C) (PGC + πGC) – (PBC + πBC)
D) (PGC + PBC) – (πGC + πBC)
E) (PBC + πGC) – (PGC + πBC)

A) (PGC + πBC) – (PBC + πGC)

CH 18
29) Which of the following conditions would increase glomerular filtration pressure?
A) decreased resistance of the efferent arterioles
B) increased protein in Bowman’s space
C) increased resistance of the afferent arteriole
D) increased protein content in the blood
E) increased Bowman’s capsule pressure

B) increased protein in Bowman’s space

CH 18
30) Which of the following equations is correct for calculating the filtered load?
A) glomerular filtration pressure × plasma concentration of solvent
B) glomerular filtration pressure / renal plasma flow
C) glomerular filtration rate / renal plasma flow
D) glomerular filtration pressure × plasma concentration of solute
E) glomerular filtration rate × plasma concentration of solute

E) glomerular filtration rate × plasma concentration of solute

CH 18
31) Changes in mean arterial pressure have the potential to alter glomerular filtration rate by directly altering which of the following?
A) glomerular oncotic pressure
B) glomerular capillary hydrostatic pressure
C) Bowman’s capsule oncotic pressure
D) Bowman’s capsule hydrostatic pressure
E) efferent arteriole resistance

B) glomerular capillary hydrostatic pressure

CH 18
32) What is the normal glomerular filtration rate?
A) 125 mL/min
B) 625 mL/min
C) 3 L/day
D) 30 L/day
E) 1 gallon/day

A) 125 mL/min

CH 18
33) If the glomerular filtration rate is 150 mL/min, renal blood flow is 750 mL/min, and the plasma concentration of solute X is 10 ng/mL, then what is the filtration fraction?
A) 10%
B) 20%
C) 50 ng/min
D) 1500 ng/min
E) 75 ng/min

B) 20%

CH 18
34) If the glomerular filtration rate is 150 mL/min, renal blood flow is 750 mL/min, and the plasma concentration of solute X is 10 ng/mL, then what is the filtered load of X?
A) 10%
B) 20%
C) 50 ng/min
D) 1500 ng/min
E) 7500 ng/min

D) 1500 ng/min

CH 18
35) Which of the following can increase the filtered load of a particular solute?
A) increasing the glomerular filtration rate
B) increasing the rate of reabsorption
C) decreasing the plasma concentration of the solute
D) increasing the rate of secretion
E) decreasing the rate of excretion

D) increasing the rate of secretion

CH 18
36) Over what range of mean arterial pressure does glomerular filtration rate remain stable due to intrinsic regulation?
A) 50-150 mm Hg
B) 80-180 mm Hg
C) 70-110 mm Hg
D) 80-100 mm Hg
E) 80-120 mm Hg

B) 80-180 mm Hg

CH 18
37) During myogenic regulation of glomerular filtration rate, an increase in mean arterial pressure will ________.
A) cause the efferent arterioles to constrict and thereby maintain a relatively constant glomerular filtration pressure
B) cause the afferent arterioles to constrict and thereby maintain a relatively constant glomerular filtration pressure
C) cause the efferent arterioles to dilate and thereby maintain a relatively constant glomerular filtration pressure
D) cause the afferent arterioles to dilate and thereby maintain a relatively constant glomerular filtration pressure
E) cause the afferent arterioles to dilate and thereby allow glomerular filtration pressure to increase

B) cause the afferent arterioles to constrict and thereby maintain a relatively constant glomerular filtration pressure

CH 18
38) In tubuloglomerular feedback, an increase in glomerular filtration rate would increase the ________, thereby stimulating the release of a paracrine factor from the macula densa that would ________.
A) afferent arteriolar pressure : constrict the afferent arteriole
B) afferent arteriolar pressure : increase filtrate flow
C) flow of tubular fluid : dilate the afferent arteriole
D) flow of tubular fluid : constrict the efferent arteriole
E) flow of tubular fluid : constrict the afferent arteriole

E) flow of tubular fluid : constrict the afferent arteriole

CH 18
39) Contraction of mesangial cells results in a ________, which decreases glomerular filtration.
A) decrease in surface area of capillaries available for filtration
B) increase in surface area of capillaries available for filtration
C) constriction of the afferent arterioles
D) dilation of the afferent arterioles
E) dilation of the efferent arterioles

A) decrease in surface area of capillaries available for filtration

CH 18
40) Which of the following is NOT a mechanism whereby glomerular filtration rate is regulated?
A) tubuloglomerular feedback
B) myogenic regulation
C) mesangial cell contraction
D) granular cell contraction
E) sympathetic nervous system

D) granular cell contraction

CH 18
41) A hemorrhage-induced decrease in mean arterial pressure will decrease glomerular filtration rate by intrinsic and extrinsic mechanisms; the extrinsic mechanisms act through ________.
A) tubuloglomerular feedback
B) the parasympathetic nervous system
C) the sympathetic nervous system
D) myogenic responses
E) mesangial cells

C) the sympathetic nervous system

CH 18
42) How does the sympathetic nervous system decrease glomerular filtration rate?
A) stimulates constriction of the afferent arteriole only
B) stimulates constriction of the efferent arteriole only
C) stimulates constriction of both the afferent and efferent arterioles
D) stimulates relaxation of the mesangial cells
E) stimulates contraction of mesangial cells

C) stimulates constriction of both the afferent and efferent arterioles

CH 18
43) What is the primary barrier to reabsorption in the renal tubules?
A) capillary endothelial cell
B) tubule epithelial cell
C) capillary basement membrane
D) tubule basement membrane
E) peritubular space

B) tubule epithelial cell

CH 18
44) What condition(s) must exist for a solute to be passively reabsorbed from the renal tubules?
A) The solute must be able to permeate the membrane of the tubule epithelial cells, and the solute must be in greater concentration in the plasma than tubule fluid.
B) The solute must be able to permeate the membrane of the capillary endothelial cells, and the solute must be in greater concentration in the plasma than tubule fluid.
C) The solute must be able to permeate the membrane of the capillary endothelial cells, and the solute must be in greater concentration in the tubule fluid than plasma.
D) The solute must be able to permeate the membrane of the tubule epithelial cells, and the solute must be in greater concentration in the tubule fluid than plasma.
E) The solute must be able to permeate the membrane of the tubule epithelial cells and capillary endothelial cells. Its concentration is irrelevant.

D) The solute must be able to permeate the membrane of the tubule epithelial cells, and the solute must be in greater concentration in the tubule fluid than plasma.

CH 18
45) Within the kidneys, what membrane has microvillli?
A) apical membrane of renal tubule epithelial cells
B) basolateral membrane of renal tubule epithelial cells
C) basolateral membrane of peritubular capillary endothelial cells
D) apical membrane of vasa recta endothelial cells
E) glomerulus

A) apical membrane of renal tubule epithelial cells

CH 18
46) The apical membranes of the tubular epithelial cells contain ________ that increase the surface area for reabsorption.
A) mitochondria
B) loose junctions
C) a basement membrane
D) microvilli
E) tight junctions

D) microvilli

CH 18
47) The diffusion of water across a tubule is driven by differences in ________ across the membrane.
A) osmolarity
B) partial pressure
C) active transport
D) volume
E) potassium concentration

A) osmolarity

CH 18
48) When the solute concentration is high enough in the lumen of the renal tubules such that all of the carrier proteins or pumps for that solute are occupied, the system is operating at ________.
A) diffusional saturation
B) tubular threshold
C) renal threshold
D) transport maximum
E) tubular maximum

D) transport maximum

CH 18
49) The concentration of glucose in tubular epithelial cells is maintained in an elevated state by what type of transporter on the apical membrane?
A) ion channel
B) carrier protein
C) glucose-linked secondary active transporter
D) potassium-linked secondary active transporter
E) sodium-linked secondary active transporter

E) sodium-linked secondary active transporter

CH 18
50) Which of the following is FALSE concerning glucose transport across the proximal tubule?
A) Glucose is normally 100% reabsorbed.
B) Glucose is actively transported across the apical membrane by cotransport with sodium.
C) Glucose is passively transported across the basolateral membrane by facilitated diffusion.
D) Glucose transport requires energy.
E) Glucose moves by paracellular transport.

E) Glucose moves by paracellular transport.

CH 18
51) Which of the following is FALSE concerning renal handling of glucose?
A) The maximum rate of glucose reabsorption is 375 mg/min.
B) The maximum rate of glucose filtration is 375 mg/min.
C) Once glucose concentration in the plasma exceeds the renal threshold, glucose will be excreted in the urine.
D) Glucose is completely reabsorbed when its plasma concentration is 100 mg/dL.
E) Glucose is actively reabsorbed in the proximal tubule.

B) The maximum rate of glucose filtration is 375 mg/min.

CH 18
52) Which of the following substances is NOT secreted at any point into the renal tubules?
A) choline
B) creatinine
C) potassium
D) hydrogen
E) sodium

E) sodium

CH 18
53) By the time filtrate reaches the loop of Henle, what percentage of the sodium and water has been reabsorbed?
A) 1%
B) 50%
C) 70%
D) 90%
E) 100%

C) 70%

CH 18
54) By the time the filtrate reaches the loop of Henle, the reabsorption of water and ions has ________.
A) left the filtrate iso-osmotic
B) left the filtrate hyperosmotic
C) left the filtrate hypoosmotic
D) removed all of the potassium from the filtrate
E) removed all of the sodium from the filtrate

A) left the filtrate iso-osmotic

CH 18
55) Which of the following is NOT an accurate description of differences between epithelial cells of the proximal and distal tubules?
A) less prominent microvilli in the epithelial cells of the distal tubule
B) greater paracellular transport in the epithelial cells of the distal tubule
C) fewer mitochondria in the epithelial cells of the distal tubule
D) receptors for hormones on the epithelial cells of the distal tubule
E) less permeable tight junctions between the epithelial cells of the distal tubule

B) greater paracellular transport in the epithelial cells of the distal tubule

CH 18
56) In diabetes mellitus, why does polyuria occur?
A) a lack of ADH decreases water reabsorption
B) a lack of insulin decreases water reabsorption
C) hyperglycemia causes increased permeability of the renal tubules to water
D) hyperglycemia causes some glucose to remain in the renal tubules which pulls water with it by osmosis
E) hypoglycemia causes the excretion of a dilute urine

D) hyperglycemia causes some glucose to remain in the renal tubules which pulls water with it by osmosis

CH 18
57) What is the brush border?
A) the epithelial cells of the renal corpuscle
B) microvilli on the apical membrane of Bowman’s capsule
C) tight junctions between epithelial cells of the loops of Henle
D) microvilli on the apical membrane of the proximal tubule
E) tight junctions between epithelial cells of the distal tubule

D) microvilli on the apical membrane of the proximal tubule

CH 18
58) Most reabsorption occurs in the ________ and is ________.
A) proximal tubule : regulated
B) proximal tubule : not regulated
C) distal tubule and collecting duct : regulated
D) distal tubule and collecting duct : not regulated
E) loop of Henle : regulated

B) proximal tubule : not regulated

CH 18
59) Tubular epithelial cells of the collecting duct and distal tubule contain receptors for what hormone that stimulates sodium reabsorption?
A) antidiuretic hormone
B) renin
C) aldosterone
D) atrial natriuretic peptide
E) erythropoietin

C) aldosterone

CH 18
60) Tubular epithelial cells of the collecting duct and distal tubule contain receptors for what hormone that stimulates water reabsorption.
A) antidiuretic hormone
B) renin
C) aldosterone
D) atrial natriuretic peptide
E) erythropoietin

A) antidiuretic hormone

CH 18
61) What creates the osmotic gradient in the renal medulla?
A) active transport of solute out of the proximal tubule
B) special transport systems of the loops of Henle of juxtamedullary nephrons
C) special transport systems of the loops of Henle of cortical nephrons
D) active transport of solute out of the distal tubules and collecting ducts
E) passive transport of solute out of the distal tubules and collecting ducts

B) special transport systems of the loops of Henle of juxtamedullary nephrons

CH 18
62) Substances can enter the renal tubules by what renal processes?
A) filtration only
B) reabsorption only
C) secretion only
D) both filtration and secretion
E) both reabsorption and secretion

D) both filtration and secretion

CH 18
63) The amount of a substance excreted from the kidneys is calculated by which of the following equations?
A) filtration + secretion + reabsorption
B) filtration – secretion – reabsorption
C) filtration + secretion – reabsorption
D) filtration + (secretion × reabsorption)
E) filtration – (secretion × reabsorption)

C) filtration + secretion – reabsorption

CH 18
64) Solutes that enter the lumen of the renal tubules are excreted unless they are ________.
A) secreted
B) reabsorbed
C) filtered
D) degraded
E) bound to receptors

B) reabsorbed

CH 18
65) If the amount of solute excreted per minute is greater than the filtered load, then the NET effect on the solute is ________.
A) a combination of reabsorption and secretion in the renal tubules
B) an absence of secretion in the renal tubules
C) an absence of reabsorption in the renal tubules
D) secretion into the renal tubules
E) reabsorption from the renal tubules

D) secretion into the renal tubules

CH 18
66) Which of the following equations for determining clearance is correct?
A) Clearance = filtered load/glomerular filtration rate
B) Clearance = filtered load × glomerular filtration rate
C) Clearance = excretion rate/plasma concentration
D) Clearance = excretion rate × plasma concentration
E) Clearance = excretion rate/glomerular filtration rate

C) Clearance = excretion rate/plasma concentration

CH 18
67) Which of the following equations for determining clearance is correct?
A) Clearance = (plasma concentration x urine flow rate) / urine concentration
B) Clearance = (urine concentration x urine flow rate) / plasma concentration
C) Clearance = plasma concentration / (urine flow rate x urine concentration)
D) Clearance = urine concentration / (urine flow rate x plasma concentration)
E) Clearance = GRF × urine concentration

B) Clearance = (urine concentration x urine flow rate) / plasma concentration

CH 18
68) Calculate renal clearance of X given the following information: GFR = 100 mL/min, urine flow rate = 5 mL/min, plasma concentration of X = 10 mg/mL, urine concentration of X = 50 mg/mL.
A) 50 mg/min
B) 25 mg/min
C) 4 mg/min
D) 50 mL/min
E) 25 mL/min

E) 25 mL/min

CH 18
69) Given that GFR is 125 mL/min and the clearance of substance Y is 200 mL/min, which of the following MUST be true of the renal handling of substance Y.
A) Y is freely filterable.
B) Y is reabsorbed.
C) Y is secreted.
D) Y is neither reabsorbed nor secreted.
E) Y is not freely filtered.

B) Y is reabsorbed.

CH 18
70) The clearance of what substance provides the best estimate of glomerular filtration rate?
A) sodium
B) glucose
C) inulin
D) creatine
E) PAH

C) inulin

CH 18
71) The clearance of what substance provides the best estimate of renal blood flow rate?
A) sodium
B) glucose
C) inulin
D) creatine
E) PAH

E) PAH

CH 18
72) The clearance of which of the following substances is normally zero?
A) sodium
B) glucose
C) inulin
D) creatine
E) PAH

B) glucose

CH 18
73) If a substance is neither reabsorbed nor secreted, then its excretion rate is equal to the ________.
A) glomerular filtration rate
B) filtered load
C) glomerular filtration rate
D) plasma concentration of the substance
E) renal threshold

B) filtered load

CH 18
74) What structure is formed by the thickening of the smooth muscle cell wall surrounding the bladder that regulates the flow of urine from the bladder.
A) bladder sphincter
B) urethral muscle
C) detrusor muscle
D) internal urethral sphincter
E) external urethral sphincter

D) internal urethral sphincter

CH 18
75) How is urine moved through the ureter?
A) pressure created within the renal pelvis
B) contraction of the internal urethral sphincter
C) wavelike contractions of the ureter
D) contraction of the detrusor muscle
E) contraction of the external urethral sphincter

C) wavelike contractions of the ureter

CH 18
76) Which muscle(s) that regulates micturition is under involuntary control?
A) detrusor
B) internal urethral sphincter
C) external urethral sphincter
D) detrusor and the internal urethral sphincter
E) detrusor and the external urethral sphincter

D) detrusor and the internal urethral sphincter

CH 18
77) Which of the following occurs during micturition?
A) The detrusor muscles relax, muscles of the internal urethral sphincter relax, and muscles of the external urethral sphincter relax.
B) The detrusor muscles contract, muscles of the internal urethral sphincter contract, and muscles of the external urethral sphincter contract.
C) The detrusor muscles relax, muscles of the internal urethral sphincter contract, and muscles of the external urethral sphincter contract.
D) The detrusor muscles relax, muscles of the internal urethral sphincter contract, and muscles of the external urethral sphincter relax.
E) The detrusor muscles contract, muscles of the internal urethral sphincter relax, and muscles of the external urethral sphincter relax.

E) The detrusor muscles contract, muscles of the internal urethral sphincter relax, and muscles of the external urethral sphincter relax.

CH 18
78) Stretching of the bladder reflexively causes all of the following EXCEPT ________.
A) excitation of parasympathetic neurons, causing the detrusor muscles to contract
B) excitation of sympathetic neurons, causing the internal urethral sphincter to relax
C) inhibition of somatic neurons to the external urethral sphincter, causing the sphincter to open
D) micturition
E) opening of the urethral sphincters

B) excitation of sympathetic neurons, causing the internal urethral sphincter to relax

CH 18
79) What effect does the sympathetic nervous system have on micturition?
A) Sympathetic activity excites muscles of the internal urethral sphincter inhibiting micturition.
B) Sympathetic activity inhibits muscles of the internal urethral sphincter inhibiting micturition.
C) Sympathetic activity excites muscles of the external urethral sphincter allowing micturition.
D) Sympathetic activity inhibits muscles of the external urethral sphincter inhibiting micturition.
E) Sympathetic activity excites muscles of the internal urethral sphincter allowing micturition.

A) Sympathetic activity excites muscles of the internal urethral sphincter inhibiting micturition.

CH 18
80) Which of the following is smooth muscle?
A) internal urethral sphincter only
B) external urethral sphincter only
C) detrusor muscle only
D) both the internal urethral sphincter and detrusor muscle
E) both internal and external urethral sphincters

D) both the internal urethral sphincter and detrusor muscle

CH 18
81) To voluntarily control urination, the ________ nervous system innervates the ________.
A) somatic : internal urethral sphincter
B) somatic : external urethral sphincter
C) somatic : detrusor muscle
D) autonomic : internal urethral sphincter
E) autonomic : external urethral sphincter

B) somatic : external urethral sphincter

CH 18
82) During micturition, neural activity to sphincters or detrusor muscles from which of the following is increased?
A) parasympathetic nervous system only
B) sympathetic nervous system only
C) somatic nervous system only
D) both parasympathetic and somatic nervous systems
E) both sympathetic and somatic nervous systems

A) parasympathetic nervous system only

CH 18
83) In older children and adults, the cerebral cortex is able to block micturition by inhibiting nerve activity to the ________.
A) detrusor muscle only
B) internal urethral sphincter only
C) external urethral sphincter only
D) detrusor muscle and external urethral sphincter
E) internal and external urethral sphincters

D) detrusor muscle and external urethral sphincter

CH 18
84) Substance X is freely filtered at the glomerulus. 3 mmole X is filtered, 2 mmole X is reabsorbed, and 2 mmole X is secreted per minute. How much X is excreted per minute?
A) 1 mmole
B) 2 mmole
C) 3 mmole
D) 4 mmole
E) 5 mmole

C) 3 mmole

CH 18
85) During tubuloglomerular feedback of glomerular filtration rate, paracrines secreted from what structure cause constriction of the afferent arteriole?
A) glomerulus
B) macula densa
C) mesangial cells
D) proximal tubule
E) juxtaglomerular cells

B) macula densa

CH 18
86) In comparison to the distal tubule, the proximal tubule has a ________.
A) leakier epithelium and a larger apical surface area
B) leakier epithelium and is more responsive to hormones
C) tighter epithelium and a larger apical surface area
D) tighter epithelium and is more responsive to hormones
E) small apical surface area and is more responsive to hormones

A) leakier epithelium and a larger apical surface area

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