Medi Call FCPS – 1 | Physiology - Respiration

Blood pressure ☛ may slight decrease due to decreased peripheral alveoli ➜ decrease in CO2 and an increase in O2 in blood ➜ stimulates
resistance, but it is not a direct CVS response to inspiration chemoreceptors ➜ further diaphragmatic contraction
✦ Guyton, Pg. 498
11. Which of following muscle help in deep inspiration
4. During quiet inspiration, anteroposterior and transverse during yawning and increase cardiac output? (ENT Feb 2023
diameters of thoracic cavity is increased by contraction of (M) +9 in past) - ID: 33701
one of following muscle (Surg 24 May 2023 (M) +31 in past) - ID:
54510 Ⓐ Lateral pterygoid muscle Ⓑ Medial pterygoid muscle
Ⓒ Masseter Ⓓ Buccinators
Ⓐ Diaphragm Ⓑ External intercostal
Ⓒ Pectoralis minor Ⓓ Serratus anterior Ⓐ Lateral pterygoid muscle is active during mastication and during
mandibular movements such as protrusion (forward movement of
Ⓑ AP diameter ➜ mainly by pump-handle movements of sternum ➜ mandible), abduction (depression of mandible), mediotrusion
contraction of external intercostal muscle ➜ elevation of second to (movement of mandibular condyle towards midline), and particularly
sixth ribs during speaking, singing, and clenching
Transverse diameter ➜contraction of external intercostal ➜ bucket- ✦ SNELL, Pg. 574
handle movement 7th to 10th ribs
✦ SNELL, Pg. 49 ✦ BD Chaurasia, Pg. 212, 212 12. When interpreting a capnogram at? (Anesth 30 Nov 2021
(M) +8 in past) - ID: 36013
5. Inspiration is vital process for oxygenation of tissues.
Forceful inspiration occurs via active contraction of which Ⓐ Rise in baseline demonstrates hypocarbia
muscle (Surg 24 May 2023 (M) +15 in past) - ID: 36449 Ⓑ Rise in baseline demonstrates rebreathing
Ⓒ Rise in height demonstrates expiratory obstruction
Ⓐ Diaphragm + External intercostal+ SCM + Serratus anterior + Ⓓ Slow fall in height demonstrates expiratory obstruction
Scalene muscle Ⓔ Slow rise in height demonstrates inspiratory obstruction
Ⓑ Diaphragm + internal intercostal
Ⓒ Diaphragm + SCM + external oblique + Serratus anterior Ⓑ During inspiration, CO2 is essentially zero and thus inspiration is
muscle displayed at zero baseline.
Ⓓ Abdominal muscles ✦ Medscape, Pg.

13. True about Normal cycle of respiration? (Dent 29 Sep 2020

Ⓐ EXPLANATION (E) +4 in past) - ID: 4968
6. Change in cardiac event during inspiration, decrease in Ⓐ 1sec inspiration, 2sec expiration
(Med 23 May 2023 (A.N)) - ID: 84252
Ⓑ 3sec inspiration, 2sec expiration
Ⓐ Right ventricle filling Ⓑ Right ventricle ejection Ⓒ 2sec inspiration, 3sec expiration
Ⓒ Dec heart rate Ⓓ Systemic filling Ⓓ 4sec inspiration, 2sec expiration

Ⓓ Inspiration ➜ decrease in intrathoracic pressure ➜ increased Ⓒ First 2 seconds ➜ Nervous signal increases steadily in a ramp
venous return to right side of heart (right ventricle filling) ➜ less blood manner ➜ transmitted to inspiratory muscles, mainly Diaphragm ➜
in systemic circulation ➜ decreased systemic filling. Inspiration
Next 3 seconds ➜ Excitation turned off ➜ allows elastic recoil of lungs
7. Inspiratory ramp signals are produced from dorsal and chest wall ➜ Expiration.
respiratory neurons.Their rate increases in response to ✦ Guyton, Pg. 539
impulses from (Surg 22 Feb 2023 (M) +14 in past) - ID: 4901
14. Lung expand due to (Med 5 Sep 2018 (E) +4 in past) - ID:
Ⓐ Stretch receptors in lung Ⓑ Pneumotaxic centre in pons 15373
Ⓒ Apneustic center Ⓓ Midbrain
Ⓐ Chest wall Ⓑ Tracheal air pressure
Ⓑ Pneumotaxic center ☛ limit inspiration ➜ increase respiratory Ⓒ Diaphragm Ⓓ Negative Pressure
rate ➜ Increase rate of inspiratory ramp from DRG
✦ BRS Physiology, Pg. 257 Ⓓ During inspiration ☛ intrapleural pressure drops further ➜ ↓
intrathoracic pressure ➜ ↑ airflow from glottis into lung ➜ Lungs
8. During inspiration which prevents overstretching of expand
lung? (Gyn 16 Aug 2022 (M)) - ID: 84076 ✦ Guyton, Pg. 498

Ⓐ Dorsal Ⓑ Ventral 15. A patient presented with injury to chest and and this
Ⓒ Pneumotaxic center Ⓓ Chemoreceptor injury has led to failure in Inc. of thoracic vol and
Ⓔ Apneustic centre respiratory distress and loss of inspiration. Which of
following is damaged? (Med 29 Aug 2021 (A.N) +8 in past) - ID:
Ⓒ Pneumotaxic center ☛ limit inspiration ➜ increase respiratory 22918
rate ➜ Increase rate of inspiratory ramp from DRG
Ⓐ Diaphragm Ⓑ Internal intercostal
✦ BRS Physiology, Pg. 257
Ⓒ SCM Ⓓ External intercostal
9. During inspiration 2/3 increase in lung volume and area
for expansion by which of following? (Radio 15 Nov 2022 (M) +5 Ⓐ ➤ Diaphragm is Major muscle of Queit inspiration ( 70-80% )
in past) - ID: 38334 Penetrating wound to chest below level of nipples should be
suspected of causing damage to diaphragm leading to respiratory
Ⓐ Internal intercostal Ⓑ Diaphragm
distress
Ⓒ Scalene anterior Ⓓ External intercostal

Ⓑ EXPLANATION
✦ SNELL, Pg. 46, 45 ✦ Guyton, Pg. 497 ✦ BD Chaurasia, Pg. 212
10. During inspiration what causes diaphragmatic
expansion (Med 23 Feb 2023 (A.N)) - ID: 83532 16. Person ascends > 15000 feet ☛ Inspiration to total lung capacity

Ⓐ Arterial pO2 Ⓑ Arterial PcO2 17. Reflex decreasing inspiratory rate is ☛ Hering breuer reflex (Stops
Ⓒ Temperature Ⓓ Dec CO2 increase O2 further inspiration)
18. Herring bruer reflex prevent ☛ Overinflation (Stops further
Ⓓ During inspiration, ➜ diaphragm contracts and moves downward inspiration)
➜ volume of thoracic cavity increases ➜ pressure inside lungs relative
19. During Inspiration, there is lung expansion due to negative fall in ☛
to atmosphere decreased ➜ causing air to flow inwards.
Intrapleural pressure (↑ airflow)
Inhaled air ☛ higher O2 and lower conc. of CO2 compared to air in

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Medi Call FCPS – 1 | Physiology - Respiration

20. Action of external intercostal muscle ☛ Elevate ribs (Inc thorax Ⓐ 1% Ⓑ 5%

diameters) Ⓒ 10% Ⓓ 15%
21. During Deep inspiration ☛ Pulmonary compliance
increases (Viscoelasticity) Ⓑ Quiet breathing ☛ expenditure out of total body energy is 3-5%
Heavy exercise ☛ energy required can increase as much as 50 -fold
22. Damage to peumotaxic centre leads to ☛ Deep inspiration (↓ ✦ Guyton, Pg. 501
respiratory rate)
31. Male person breaths 7500ml per minute ,have 12
23. Inspiration is stimulated by ☛ Apneustic center (Lower pons )
breath per minute , if his intrathoracic pressure increase
Expiration 5cm H2O while breathing , how much energy consumed
(Med 17 May 2022 (E)) - ID: 79390
24. Normal quiet expiration is brought about by recoil of
(Anesth 15 Feb 2022 (M) +5 in past) - ID: 21404 Ⓐ 4000 joul/min Ⓑ 3000
Ⓒ 2000 Ⓓ 2500
Ⓐ Diaphragm
Ⓑ Elastic tissue in thoracic and lung wall
Ⓓ Energy consumed = pressure × volume / time.
Ⓒ Abdominal muscles Ⓓ Sternicleidomastoid
pressure = 5cm H2O = 5 × 0.0980665 = 0.4903325 kPa.
Volume = 7500 ml/min = 0.0075 m³/min.
Ⓑ Normal expiration ☛ passive Elastic recoil of lungs expells air
Energy = 0.4903325 × 0.0075 = 0.00367 kJ/min or 3670 J/min, which
Forced expiration ☛ Elastic Recoil + Abdominal Recti ＞ Internal
is approximately 2500 J/min.
intercostals
✦ Guyton, Pg. 497 32. A healthy 45 years old man was sitting relaxed in his
lawn reading newspaper on Sunday morning. muscles he
25. Muscle of Forced Expiration along with abdominal
is using for quiet breathing during this relaxed state
Recti are (ENT 15 Nov 2022 (M) +7 in past) - ID: 5322
is/are: (Surg 22 Feb 2023 (M)) - ID: 84216
Ⓐ Internal Intercostal Ⓑ External Intercostal
Ⓐ Diaphragm
Ⓒ Sternoceidomastoid Ⓓ Scalenus anterior
Ⓑ Diaphragm and external intercostais
Ⓒ Diaphragm and internal intercostais
Ⓐ During Forcefull Expiration Main muscles
Ⓓ Internal intercostais and rectus abdominis
➊ Abdominal recti ☛ Lower ribs, at same time they also
Ⓔ Sternocleidomastoid and scalene
compress abdominal contents upward against diaphragm
➋ Internal intercostals ☛ Lower rib cage and decrease thoracic
Ⓑ Quiet relaxed breathing :
volume
✦ SNELL, Pg. 49, 78 ✦ Guyton, Pg. 497
1. Diaphragm contracts and flattens ➜ increases vertical diameter of
thoracic cavity
26. Young man sustained RTA with multiple rib fractures 2. External intercostals contract Simultaneously ➜ raising ribs and
He has difficulty in breathing.You noticed that his further increasing volume of thoracic cavity ➜ reduces pressure inside
abdomen is moving more during breathing Which of ➜ air flow into lungs
muscle is helping him in breathing ? (Med 17 Nov 2022 (A.N)
+12 in past) - ID: 21140 33. While inhalation if air flow is constant in trachea ☛ Velocity
decreases (Poiseuille’s Law)
Ⓐ External intercostal Ⓑ Internal intercostal
34. Positive expiratory force given to a man on ventilator ☛ Gas
Ⓒ Diaphragm Ⓓ Transversus abdominis
redistribution (Keeps alveoli open )
Ⓔ External oblique
35. Almost 70 % of work of breathing is to ☛ overcome elastic recoil of
Ⓔ Ribs fractured ➜ cant use ribs and Diagphram for respiratory chest lungs (Expand lungs )
movements ( Least usage of Intercostals ) ➜ Main role of Abdominal 36. Decrease total airway resistance ☛ will decrease oxygen demand
muscles in Respiration then by respiratory muscles (↑ Energy required)
External oblique ☛ functions to pull chest downwards and compress
37. Elastic fibers main function ☛ Cover alveolar sacs
abdominal cavity ➜ increases intra-abdominal pressure ➜ forced
expiration in breathing. 38. At quiet respiration pulmonary system uses energy of total ☛ 5%
Transversus abdominis ☛ plays important role in maintaining 39. pt of recent Ischemic Stroke has increased breathing due to ☛
abdominal wall tension ( No major role in breathing ) Increased PC02
✦ Guyton, Pg. 497 ✦ SNELL, Pg. 124
40. Pulmonary vascular resistance increased by ☛ High altitude
27. A lab boy giving demonstration on pulmonary function
test He inspire and then forcefull expired. Strong
Gas Exchange
expiratory muscle for Forced Expiration are ? (Surg 24 May Partial Pressure
2023 (A.N) +19 in past) - ID: 19383
1. Which one of following decreases during pregnancy (Med
Ⓐ Diaphragm Ⓑ Quadratus Lumborum 21 Feb 2023 (A.N) +10 in past) - ID: 4729
Ⓒ External intercostal Ⓓ Abdominal recti
Ⓐ Minute ventilation Ⓑ Tidal Volume
Ⓓ Forced Expiration Ⓒ GFR Ⓓ PCO2
✪ Active process ➜ ● forcible contraction of musculature of anterior
abdominal wall(External oblique, internal oblique, Rectus Abdominis) ● Ⓓ Pregnancy ➜ ↑ Progesterone (respiratory stimulant) ➜ ↑ Minute
quadratus lumborum(pulls down 12th rib) ● Depression of ribs by Ventilation (upto 50%) ➜ ↑ carbon dioxide production ( ↑ 30%) ➜ ➊
contraction of internal inter costal ↓ PCO2 and ↑ PaO2 ➋ ↑ Tidal Volume (40%) ➌ ↑ pH ( Respiratory
✪ Minor role ➜ serratus posterior inferior + latissimus dorsi Alkalosis ) and ↓ HCO3 ( renal compensation ) ➍ ↑ GFR (50%)
✦ SNELL, Pg. ✦ Guyton, Pg. 497
✦ Guyton, Pg. 1063
28. Accessory muscle of expiration ☛ Rectus abdomens
2. A mountaineer is feeling difficulty in breathing at 12000
29. Muscle of expiration ☛ Accessory muscles of expiration (Abdominal
feet . Due to which of following conditions his Arterial
recti ＞ intercostals )
PaO2 is decreased? (Gynae 29 Aug 2021 (M) +5 in past) - ID:
----- 20303

30. During Quite breathing, expenditure out of total body Ⓐ Decreased Atm CO2 concentration
energy is? (Surg 17 Feb 2022 (A.N) +7 in past) - ID: 4909 Ⓑ Increased Atm O2 concentration
Ⓒ Decreased Atm O2 concentration and resp. alkalosis
Ⓓ None of above

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Medi Call FCPS – 1 | Physiology - Respiration

Ⓒ ↑ Altitude ➜ ↓ Barometric Pressure ➜ ↓ ↓ pO2 in Air ➜ ↓ ↓ pO2
Alveolar ➜↑ ventilation ➜ ↓ pCO2 ➜ respiratory alkalosis ➜ altitude
sickness
Sea level to 10,000 ft ➜ 50 mm/hg fall in PO2 in Air ( 159 to 110 )
➜ 37 mm/hg fall in Alveolar pO2 ( 104 to 67 )
✦ Guyton, Pg. 561, 562
Ⓒ Umbilical artery ☛ carries deoxygenated blood from fetus to
placenta ➜ carries waste products and carbon dioxide away from fetus
➜ has lowest oxygen content.
SVC ☛ blood in SVC is mixed but it still has more oxygen than blood in
Umbilical artery
✦ First Aid, Pg. 282

3. High PCO2 what other occur? (Med 15 Feb 2022 (A.N)) - ID: 10. Blood in which of following vessels normally has
72546 lowest PO2 in fetal circulation? (Med 22 Feb 2023 (A.N) +6 in
past) - ID: 4983
Ⓐ Tachycardia Ⓑ Hypotension
Ⓒ Bradycardia Ⓐ Umbilical artery Ⓑ Umbilical vein
Ⓒ Maternal artery Ⓓ Maternal femoral vein
Ⓐ Hypercarbia ☛ causes ↑ HR, myocardial contractility, respiratory
rate, ↓ systemic vascular resistance ➜ ↑ systolic blood pressure, wider Ⓐ In fetus, deoxygenated blood arrives at placenta via umbilical
pulse pressure, tachycardia, greater cardiac output, higher pulmonary arteries and is returned to fetus in umbilical vein so Oxygen content in
pressures and tachypnea are common clinical findings. umbilical arteries is lowest
✔ O2 Sat in umbilical vein ➜ about 80% ✔ Arterial O2 Sat in
4. Most saturated vessel of infant (Surg 16 Feb 2022 (E)) - ID: Adult ➜ 98%
77897
✦ Ganong, Pg.
Ⓐ Umbilical vein Ⓑ Umbilical artery 11. PO2 of Fetal blood leaving placenta is (Gynae 24 May 2023
Ⓒ Right arterium Ⓓ Right ventricle (M) +6 in past) - ID: 4722

Ⓐ O2 Sat in umbilical vein ➜ about 80% ✔ Arterial O2 Sat in Ⓐ 10 mmhg Ⓑ 20 mmhg

Adult ➜ 98% Ⓒ 30 mmhg Ⓓ 50 mmhg
✦ Ganong, Pg.
Ⓒ PO2 mother’s blood in placental sinuses ➜ 50 mm Hg
5. PCO2 at time of birth (Anesth 15 Aug 2022 (M)) - ID: 82440 PO2 fetal blood after oxygenation in placenta ➜ 30 mm Hg
✦ Guyton, Pg. 1058
Ⓐ 15 Ⓑ 18
Ⓒ 30 Ⓓ 35 12. Under physiological conditions highest partial pressure
of oxygen is observed In which part of respiratory system?
Ⓒ PCO2 in Neonates ☛ first few hours after birth,between 30-40 (Surg 24 May 2023 (A.N) +3 in past) - ID: 9017
As neonate's respiratory system matures, PCO2 gradually decreases to
adult levels, which are typically between 35-45 mmHg. Ⓐ Pulmonary arteries Ⓑ Pulmonary capillaries
Ⓒ Pulmonary veins Ⓓ Aorta
6. Umbilical vein has % of oxygen (Anesth 17 May 2022 (M)) -
ID: 79496 Ⓑ Pulmonary Capillaries (104) ➜ Shunting and venous admixture
occur in Pulmonary Vein ( 95 mmHg )➜ Left Atrium ( 95 mmHg )
Ⓐ 20% Ⓑ 30%
➜ Left Ventricle and Aorta ( 95 mmHg )
Ⓒ 40% Ⓓ 60%
Ⓔ 80% All ONE LINERS Below and other CONTROVERSIAL MCQs
are present on MediCall App in Full MCQ form !
Ⓔ In fetus, deoxygenated blood arrives at placenta via umbilical Just search relevant Keyword in App search bar and
arteries and is returned to fetus in umbilical vein so Oxygen content in find Full MCQ with Explanation & Reference
umbilical arteries is lowest
✔ O2 Sat in umbilical vein ➜ about 80% ✔ Arterial O2 Sat in 13. A decrease in plasma pCO2 causes (Med 25 May 2023 (A.N)
Adult ➜ 98% +4 in past) - ID: 36640
✦ Ganong, Pg.
Ⓐ Decrease in cerebral blood flow
7. In a patient with completely blocked blood flow to left Ⓑ Increase in cerebral blood flow
lung due to sudden pulmonary artery embolism, which of Ⓒ No change in cerebral blood flow
following is true? (Gynae 1 Dec 2021 (M) +5 in past) - ID: 4905
Ⓐ EXPLANATION
Ⓐ V/Q ratio in left lung will be zero
Ⓑ Systemic arterial PO2 will be elevated 14. If arterial pCO2 is increased ☛ Increase HCO3- secretion
Ⓒ V/Q ratio in left lung will be lower than Right lung (Compensate resp. acidosis )
Ⓓ Alveolar PO2 in left lung will be raised, equal to PO2 in inspired 15. Partial pressure of oxygen PO2 in arterial blood depends on ☛
air Oxygen dissolved in plasma (Keep Hb saturated)
16. Increase PCO2 in venous blood, will lead to: ☛ Decrease chloride
Ⓓ ✔ Left lung Blood flow is blocked but Ventilation is Normal
concentration in RBC’s (due to chloride shift)
☛ If perfusion is 0 then V/Q will be infinite
☛ Systemic PO2 will be low due to left lung failure 17. Safe system depends on: ☛ PO2
☛ V/Q ratio will be more in left lung than right 18. Partial pressure of gases when atm pressure 700 mmHg ☛ PaO2
✦ Kaplan Physiology, Pg. 162 147, Nitrogen 553 (21% O2 and 79% N2)21% O2= 700 × 21/100 =
147 mmHg (21% O2 and 79% N2)79% N2= 700 × 79/100 = 553
8. POa in blood at which Hb is 50% saturated with oxygen
mmHg (21% O2 and 79% N2)
is about: (Gynae 16 Nov 2022 (A.N) +1 in past) - ID: 83911
19. Arterial blood pH activate breathing by ☛ decreasing PCO2
Ⓐ 11 mmHg Ⓑ 26 mmHg
20. Arterial blood paCO2 45mmHg, excreted alveolar CO2 30mmHg
Ⓒ 35 mmHg Ⓓ 50 mmHg
(PeCO2), calculate Vd/Vt ☛ 0.3 ((PaCO2 - PECO2)/PaCO2)
Ⓔ 6 mmHg
21. If V/Q is increased blood p02 and pc02 will be same in ☛
Ⓑ P50 value ☛ PO2 in blood at which hemoglobin is 50% saturated Humidified inspired air
with oxygen is ➜ approx 26 mmHg ➜ measure of how readily 22. Reason for Increased Cerebral Flow in pt with recent stroke ☛
hemoglobin binds or releases oxygen. Increased pC02
9. Which of following having low O2 in fetus? (Radio 15 Nov 23. Pulmonary vasoconstruction occurs due to: ☛ Reduced systemic
2022 (M) +2 in past) - ID: 72292 PO2 (＜ 73 mm Hg)
Ⓐ Pulmonary artery Ⓑ Umbilical vein 24. Partial pressure of oxygen in alveoli at height of 14000 feet where
Ⓒ Umbilical artery Ⓓ SVC barometric pressure is 450 mm Hg ☛ 84

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