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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. The trachea divides into
right and left mainstem bronchi
A reliable and consistent classification of auditory findings
Insufficient oxygenation of hemoglobin in the lungs
Partial pressure of oxygen (PO2)

2. Inspiratory stridor indicates
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Obstructive lung disease from restrictive lung disease
Expiration
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

3. Abnormal lung sounds are classified as
Right
right
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Either continuous or discontinuous

4. tidal volume (Vt)
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

5. FEV1% in restrictive disease
Normal to increased FEV1%
The amount of air that can be exhaled after expiration
Either inspiration or expiration
Blood to the alveoli

6. Rhonchi originate in the...
'crackles' or 'rales'
Air-filled - fluid-filled - or solid
5 years - to detect obstruction and determine its reversibility
Larger airways

7. The primary muscles of respiration are the...
Diaphragm and the intercostal muscles
Contracts
A reduction in lung capacity - secondary to scarring or extraneous material
Sternocleidomastoid - Scalene Muscles

8. Abnormal lung sounds AKA

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9. The use of accessory muscles (contraction of the sternocleidomastoid or supraclavicular muscles during inspiration) indicates
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Increased work of breathing
Oxygen-Hemoglobin Dissociation Curve
T4 or T5 - and just below the manubrio-sternal joint

10. The active movement of gases between the ambient air and the lungs
Blue or bluish-gray discoloration of the skin or mucous membranes
80%
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Ventilation

11. Late inspiratory crackles result from
T4 or T5 - and just below the manubrio-sternal joint
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Pleural space
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

12. the lingula is analogous to...
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
To assess response to treatment
The right middle lobe
'crackles' or 'rales'

13. Bohr Effect of pH: left shift
Increased Hb-O2 affinity
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Decreased pressure
Brief - discrete - non-musical sounds with a popping quality

14. high CO2 = high acidity =
5 years - to detect obstruction and determine its reversibility
A reliable and consistent classification of auditory findings
Partial pressure of oxygen in the alveoli
release of O2 from Hb

15. A normal volume-time curve rises
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Diaphragm - External Intercostals
70% occlusion of the airway
quickly - usually reaching a plateau within 6.0 seconds

16. Auscultation of the chest depends on...
Obstructive lung disease from restrictive lung disease
A tracing of the lung volume against time in seconds
A reliable and consistent classification of auditory findings
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

17. hypocapnia
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
PaCO2
Overcome some of the problems associated with low blood flow to the probe site
Lowered carbon dioxide level - results from hyperventilation

18. Bronchial breath sounds
The total amount of air in the lungs at the end of a maximal inhalation
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Increased amounts of unsaturated hemoglobin in capillary blood
Portable antero-posterior (AP) view

19. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
Increased rate of breathing and is commonly associated with a decrease in tidal volume
2 - each wavelength is partially absorbed by hemoglobin
Partial pressure of CO2 in the arterial blood
A tracing of the lung volume against time in seconds

20. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
70% occlusion of the airway
Perfusion
Manubrio-sternal junction (angle of Louis)
There is an inverse relationship between pressure and volume

21. Paroxysmal nocturnal dyspnea (PND) is...
Obstructive lung disease from restrictive lung disease
Dyspnea that awakens the patient several hours after going to sleep
right & left
Either inspiration or expiration

22. Continuous lung sounds occur in the setting of...
A reliable and consistent classification of auditory findings
Insufficient oxygenation of hemoglobin in the lungs
Difficulty breathing or shortness of breath
Bronchospasm - mucosal edema - or excessive secretions

23. PaO2
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Partial pressure of O2 in the arterial blood
Carboxyhemoglobin
A reduction in lung capacity - secondary to scarring or extraneous material

24. The trachea is how long/wide?
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
10 to 11 cm long and about 2 cm in diameter
Nitrogen
Perfusion

25. Coarse crackles are...
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
Louder - lower-pitched - and slightly longer in duration
Soft - high-pitched and crisp
Mediastinum

26. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
While ascultating remote from the bronchi & larynx - the examiner can hear the speaking pts laryngeal (bronchial) sounds - while not being able to distinguish the words
Inspiration
The total amount of air in the lungs at the end of a maximal inhalation
A good effort

27. Bohr Effect of pH is graphed as
Oxygen-Hemoglobin Dissociation Curve
Altering the respiratory rate and/or the tidal volume
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

28. Orthopnea is quantified by
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Partial pressure of carbon dioxide in the alveoli
Diffusion
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

29. forced expiratory volume in one second (FEV1)
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Partial pressure of oxygen in the alveoli
Overcome some of the problems associated with low blood flow to the probe site
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

30. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Partial pressure of O2 in the arterial blood
Altering the respiratory rate and/or the tidal volume
Either continuous or discontinuous
Saturated with oxygen or unsaturated

31. Cyanosis appears when
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Right
right and left mainstem bronchi
Portable antero-posterior (AP) view

32. Airway resistance refers to...
Pressure required to drive air through the airways
Contracts
Bicarbonate
Oxygen (O2)

33. Rhonchi occur during
results in a lower than normal FEV1%
Either inspiration or expiration
The gas in the conducting airways does not participate in alveolar exchange
The right middle lobe

34. Which lung has a horizontal fissure?
To assess response to treatment
Lung volumes - but no difficulty or delay in exhaling what volume they do have
500 to 800 mL
right

35. within limits - increased temperature =
results in a lower than normal FEV1%
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
release of O2 from Hb - as heat is a by-product of metabolism.

36. What is the potential space between the visceral and parietal pleurae?
Expiration
Pleural space
Diaphragm - External Intercostals
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

37. gas exchange across the alveolar-pulmonary capillary membranes
Cough
Diffusion
Expiration
The amount of air that can be inhaled after normal inspiration

38. The parietal pleura lines the...
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Oxygen-Hemoglobin Dissociation Curve
Inside of the thoracic cavity wall and the upper surface of the diaphragm
A sensor placed over a translucent area of arterial pulsation

39. Oximetry readings of < 94%
Manubrio-sternal junction (angle of Louis)
require supplemental oxygenation and possibly ABG analysis
Diaphragm - External Intercostals
Partial pressure of oxygen (PO2)

40. Compliance
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
The amount of air that can be exhaled after expiration
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
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

41. The trachea bifurcates into its mainstem bronchi at the level of...
Inspiration
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
10 to 11 cm long and about 2 cm in diameter
The total amount of air that can be exhaled following a maximal inhalation

42. PACO2
The total amount of air that can be exhaled following a maximal inhalation
500 to 800 mL
80 to 120% of predicted value
Partial pressure of carbon dioxide in the alveoli

43. Pulse Oximetry is dependent on...
Increased rate of breathing and is commonly associated with a decrease in tidal volume
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Lung volumes - but no difficulty or delay in exhaling what volume they do have
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

44. Which bronchus is more susceptible to aspiration of foreign bodies?
right & left
Right
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Wheezes - high-pitched - musical sounds - distinct whistling quality

45. increased volume results in
Decreased pressure
5 years - to detect obstruction and determine its reversibility
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Functional residual capacity (FRC)

46. Coarse crackles are heard in
Manubrio-sternal junction (angle of Louis)
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Pneumonia - obstructive lung disease - and late pulmonary edema
Perfusion

47. Internationally recognized guidelines for management of asthma and COPD recommend the use of...
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Soft - high-pitched and crisp
Manubrio-sternal junction (angle of Louis)
Spirometry in the diagnosis - severity staging - and monitoring of these conditions

48. FEV1/FVC
The volume of air left in the lungs after maximal expiration that cannot be exhaled due to the limit of elasticity - or because of the trapping of air in disease states
release of O2 from Hb - as heat is a by-product of metabolism.
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)

49. The best indicator of adequate ventilation is the...
Left upper lobe
PaCO2
respiration
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

50. Spirometry: The result is stated as
Tongue
Blood to the alveoli
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height