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Pulmonology

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
Increased amounts of unsaturated hemoglobin in capillary blood
2 - each wavelength is partially absorbed by hemoglobin
right and left mainstem bronchi
The examiner can clearly distinguish the word that the pt speak or whispers

2. The pattern of breathing refers to...
Right
70%
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
The examiner can clearly distinguish the word that the pt speak or whispers

3. FIO2
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Fraction (%age) of inspired oxygen
Increase the intrathoracic space

4. Tachypnea is an
Diffusion
Brief - discrete - non-musical sounds with a popping quality
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Increased amounts of unsaturated hemoglobin in capillary blood

5. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
results in a lower than normal FEV1%
Alveoli to the blood
Perfusion

6. Factors that influence the oxygen carrying capacity of hemoglobin
Spirometry
No
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

7. The best indicator of adequate ventilation is the...
PaCO2
Altering the respiratory rate and/or the tidal volume
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Lowered carbon dioxide level - results from hyperventilation

8. Continuous lung sounds often audible at the...
Oxygen-Hemoglobin Dissociation Curve
Observing the pattern of breathing
Mouth as well as through the chest wall
Mediastinum

9. Pectoriloquy
Bicarbonate
The examiner can clearly distinguish the word that the pt speak or whispers
Partial pressure of carbon dioxide in the alveoli
Elasticity of the lung - reflects a measure of the ease of its distension - or the volume change resulting from the application of a pressure differential

10. Coarse crackles result from
Hypoventilation or modest changes in the PaO2
Altering the respiratory rate and/or the tidal volume
80 to 120% of predicted value
Air bubbles flowing through secretions or slightly closed airways during respiration

11. The upper airway accounts For what % of airway resistance?
Obstructive lung disease from restrictive lung disease
50%
Blood to the alveoli
Inspiration

12. the lingula is analogous to...
Lung volumes - but no difficulty or delay in exhaling what volume they do have
The right middle lobe
The volume of air that is forcefully expired during the first second after a deep breath - or the portion of the FVC exhaled in one second
'crackles' or 'rales'

13. Rhonchi occur during
Expiration
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Either inspiration or expiration

14. Which lung has a horizontal fissure?
Ventilation
2 - each wavelength is partially absorbed by hemoglobin
right
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

15. Orthopnea is defined as
Heard over the periphery of the lung - are soft - low-pitched sounds - heard throughout inspiration - continue without pause through expiration - fade away about one third of the way through expiration
Partial pressure of O2 in the arterial blood
5 years - to detect obstruction and determine its reversibility
Dyspnea upon assuming a recumbent position

16. vital capacity (VC)
Functional residual capacity (FRC)
50%
The total amount of air that can be exhaled following a maximal inhalation
The amount of air that can be exhaled after expiration

17. Flow-Volume Curve: On a normal graph - the flow-volume curve is...
70%
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Pneumonia - obstructive lung disease - and late pulmonary edema
'crackles' or 'rales'

18. Continuous lung sounds
respiration
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Wheezes - high-pitched - musical sounds - distinct whistling quality
The volume of air that is forcefully expired during the first second after a deep breath - or the portion of the FVC exhaled in one second

19. Spirometry can be used to determine the severity of functional impairment as well as
To assess response to treatment
There is an inverse relationship between pressure and volume
Normal to increased FEV1%
No respiration for > 20 seconds

20. The presence of pressure gradients causes respiratory gases to move from
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Partial pressure of oxygen in the alveoli
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

21. 20.95% Atmospheric Composition
Dullness replaces resonance
Oxygen (O2)
Difficulty breathing or shortness of breath
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

22. Percussion helps you establish whether the underlying tissues are...
right & left
'adventitious' breath sounds
Sternocleidomastoid - Scalene Muscles
Air-filled - fluid-filled - or solid

23. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
5 years - to detect obstruction and determine its reversibility
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Acinus
Diffusion

24. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Inspiration
Alveoli to the blood
A sensor placed over a translucent area of arterial pulsation

25. Pulse Oximetry does not detect
Decreased Hb-O2 affinity
require supplemental oxygenation and possibly ABG analysis
Hypoventilation or modest changes in the PaO2
Ventilation - Diffusion - Perfusion

26. A normal volume-time curve rises
Alveoli to the blood
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Blue or bluish-gray discoloration of the skin or mucous membranes
quickly - usually reaching a plateau within 6.0 seconds

27. Apnea is defined as
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
PaCO2
No respiration for > 20 seconds
Lung volumes - but find it difficult to exhale rapidly

28. The trachea is how long/wide?
Expiration
10 to 11 cm long and about 2 cm in diameter
Partial pressure of oxygen (PO2)
Manubrio-sternal junction (angle of Louis)

29. Rhonchi
Partial pressure of O2 in the arterial blood
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Diffusion
Pulse oximetry

30. Restrictive Disease: Expiratory volume is reduced more than
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Speed of airflow - the higher the flow - the greater the resistance
35 to 45 mmHg
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

31. Oximetry readings of < 94%
Diffusion
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
require supplemental oxygenation and possibly ABG analysis
Ventilation - Diffusion - Perfusion

32. Peripheral cyanosis results from
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Either continuous or discontinuous
'scooped out' or bowl-shaped

33. pH
The negative logarithm of hydrogen ions in the blood
Diffusion
A sensor placed over a translucent area of arterial pulsation
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

34. Continuous lung sounds occur when air flows rapidly through bronchi that are...
35 to 45 mmHg
Insufficient oxygenation of hemoglobin in the lungs
Narrowed nearly to the point of closure
No respiration for > 20 seconds

35. Cyanosis is caused by
The amount of air that can be inhaled after normal inspiration
Carboxyhemoglobin
Increased amounts of unsaturated hemoglobin in capillary blood
The total amount of air in the lungs at the end of a maximal inhalation

36. Does lung tissue have pain fibers?
2 - each wavelength is partially absorbed by hemoglobin
No respiration for > 20 seconds
No
Increased work of breathing

37. terminal respiratory unit
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Acinus
80 to 120% of predicted value
Cough

38. FEV1% in obstructive disease
The amount of air that can be inhaled after normal inspiration
results in a lower than normal FEV1%
Partial pressure of CO2 in the arterial blood
Oxygen-Hemoglobin Dissociation Curve

39. Central cyanosis results from
Perfusion
Insufficient oxygenation of hemoglobin in the lungs
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
'crackles' or 'rales'

40. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
quickly - usually reaching a plateau within 6.0 seconds
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
The atmospheric pressure
Increased work of breathing

41. Bronchiovesicular breath sounds
Saturated with oxygen or unsaturated
Partial pressure of O2 in the arterial blood
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

42. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
Difficulty breathing or shortness of breath
Diffusion
Partial pressure of oxygen in the alveoli
Immediate oxygenation with or without intubation

43. Cyanosis
Ventilation
The gas in the conducting airways does not participate in alveolar exchange
80%
Blue or bluish-gray discoloration of the skin or mucous membranes

44. high CO2 = high acidity =
Postero-anterior (PA) and lateral view series
A sensor placed over a translucent area of arterial pulsation
release of O2 from Hb
'adventitious' breath sounds

45. Oxygen moves from the...
Alveoli to the blood
Difficulty breathing or shortness of breath
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Air to move from the upper airway to the farthest alveolar reaches

46. 78.08% Atmospheric Composition
Increase the intrathoracic space
Nitrogen
Pleural space
require supplemental oxygenation and possibly ABG analysis

47. Vesicular breath sounds
Bicarbonate
Oxygen (O2)
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Heard over the periphery of the lung - are soft - low-pitched sounds - heard throughout inspiration - continue without pause through expiration - fade away about one third of the way through expiration

48. What may prevent cyanosis from appearing?
Pulse oximetry
Sternocleidomastoid - Scalene Muscles
70% occlusion of the airway
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

49. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
Diffusion
Manubrio-sternal junction (angle of Louis)
Right
Tongue

50. PaCO2
Partial pressure of CO2 in the arterial blood
Altering the respiratory rate and/or the tidal volume
Saturated with oxygen or unsaturated
Increased work of breathing