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Pulmonology

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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 diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Increase the intrathoracic space
The amount of air that can be exhaled after expiration
Total lung capacity (TLC)
Dyspnea that awakens the patient several hours after going to sleep

2. Normal lung sounds
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Bicarbonate
Blood to the alveoli
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

3. Pulmonary ventilation is varied by
Pulse oximetry
35 to 45 mmHg
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Altering the respiratory rate and/or the tidal volume

4. The tracheo-bronchial tree is a tubular system that provides a pathway for
Bronchospasm - mucosal edema - or excessive secretions
Air to move from the upper airway to the farthest alveolar reaches
Nitrogen
Bicarbonate

5. Stridor is a high-pitched - noisy respiration - Which is indicative of...
'scooped out' or bowl-shaped
Upper respiratory obstruction - usually in the trachea or larynx
'crackles' or 'rales'
A sensor placed over a translucent area of arterial pulsation

6. Spirometry can be used to determine the severity of functional impairment as well as
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Manubrio-sternal junction (angle of Louis)
To assess response to treatment
A reliable and consistent classification of auditory findings

7. the lingula is analogous to...
The right middle lobe
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
5 years - to detect obstruction and determine its reversibility
Postero-anterior (PA) and lateral view series

8. Fine crackles are...
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
2 - each wavelength is partially absorbed by hemoglobin
Narrowed nearly to the point of closure
Soft - high-pitched and crisp

9. Apnea is defined as
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
No respiration for > 20 seconds
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Narrowed nearly to the point of closure

10. PACO2
Partial pressure of oxygen in the alveoli
Partial pressure of carbon dioxide in the alveoli
Either inspiration or expiration
Spirometry

11. Inspiratory stridor becomes evident at about
To assess response to treatment
Contracts
A sensor placed over a translucent area of arterial pulsation
70% occlusion of the airway

12. The acini consist of the...
Interstitial diseases or early pulmonary edema
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
35 to 45 mmHg

13. movement of blood through the capillaries in direct communication with the alveoli
Increased Hb-O2 affinity
Contracts
Perfusion
Difficulty breathing or shortness of breath

14. office-based spirometry is recommended for patients as young as
Mouth as well as through the chest wall
5 years - to detect obstruction and determine its reversibility
PaCO2
Ventilation - Diffusion - Perfusion

15. within limits - increased temperature =
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
Air-filled - fluid-filled - or solid
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
release of O2 from Hb - as heat is a by-product of metabolism.

16. Discontinuous lung sounds are also called

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17. Pectoriloquy
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Air-filled - fluid-filled - or solid
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
The examiner can clearly distinguish the word that the pt speak or whispers

18. Rhonchi occur during
Blood to the alveoli
Either inspiration or expiration
Ventilation - Diffusion - Perfusion
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

19. Normal range of PaCO2
35 to 45 mmHg
Soft - high-pitched and crisp
Oxygen (O2)
Manubrio-sternal junction (angle of Louis)

20. The vital capacity and the residual volume together constitute the...
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
A reduction in lung capacity - secondary to scarring or extraneous material
70% occlusion of the airway
Total lung capacity (TLC)

21. The interspace between two ribs (intercostal space) is numbered by
Partial pressure of O2 in the arterial blood
35 to 45 mmHg
The rib above it
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

22. Carbon dioxide moves from the...
Blood to the alveoli
There is an inverse relationship between pressure and volume
5 years - to detect obstruction and determine its reversibility
The amount of air that can be inhaled after normal inspiration

23. Coarse crackles result from
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Air bubbles flowing through secretions or slightly closed airways during respiration
Overcome some of the problems associated with low blood flow to the probe site
Soft - high-pitched and crisp

24. Respiration involves
release of O2 from Hb - as heat is a by-product of metabolism.
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Ventilation - Diffusion - Perfusion
Acinus

25. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
Decreased pressure
Saturated with oxygen or unsaturated
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Diffusion

26. PaCO2
2 - each wavelength is partially absorbed by hemoglobin
Partial pressure of CO2 in the arterial blood
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
The gas in the conducting airways does not participate in alveolar exchange

27. The muscles of inspiration are the...
Diaphragm - External Intercostals
Observing the pattern of breathing
A tracing of the lung volume against time in seconds
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

28. Cyanosis is caused by
Difficulty breathing or shortness of breath
Insufficient oxygenation of hemoglobin in the lungs
Increased amounts of unsaturated hemoglobin in capillary blood
PaCO2

29. What is the potential space between the visceral and parietal pleurae?
Ventilation - Diffusion - Perfusion
Air bubbles flowing through secretions or slightly closed airways during respiration
The total amount of air in the lungs at the end of a maximal inhalation
Pleural space

30. expiratory reserve
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Diaphragm and the intercostal muscles
The amount of air that can be exhaled after expiration
Air bubbles flowing through secretions or slightly closed airways during respiration

31. Pulse Oximetry is dependent on...
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction

32. Which bronchus is wider - shorter - and more vertically placed?
Increased Hb-O2 affinity
Right
Speed of airflow - the higher the flow - the greater the resistance
Perfusion

33. residual volume
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
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Manubrio-sternal junction (angle of Louis)
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature

34. Airway resistance refers to...
Mediastinum
Pressure required to drive air through the airways
right and left mainstem bronchi
70%

35. Factors that influence the oxygen carrying capacity of hemoglobin
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
'scooped out' or bowl-shaped
Pulse oximetry
10 to 11 cm long and about 2 cm in diameter

36. The accessory muscles are the...
Sternocleidomastoid - Scalene Muscles
Louder - lower-pitched - and slightly longer in duration
Tongue
Interstitial diseases or early pulmonary edema

37. Paroxysmal nocturnal dyspnea (PND) is...
Dyspnea that awakens the patient several hours after going to sleep
Partial pressure of carbon dioxide in the alveoli
Diaphragm - External Intercostals
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

38. Central cyanosis results from
results in a lower than normal FEV1%
Immediate oxygenation with or without intubation
Obstructive lung disease from restrictive lung disease
Insufficient oxygenation of hemoglobin in the lungs

39. The best indicator of adequate ventilation is the...
PaCO2
Dyspnea that awakens the patient several hours after going to sleep
Perfusion
Lung volumes - but find it difficult to exhale rapidly

40. The parietal pleura lines the...
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Perfusion
Expiration
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

41. The trachea bifurcates into its mainstem bronchi at the level of...
Increase the intrathoracic space
Immediate oxygenation with or without intubation
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

42. pH
Inflammation of the adjacent parietal pleura
Obstruction below the vocal cords (subglottic or tracheal obstruction)
The negative logarithm of hydrogen ions in the blood
Postero-anterior (PA) and lateral view series

43. The external intercostal muscles increase the antero-posterior chest diameter during
Inspiration
No respiration for > 20 seconds
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
10 to 11 cm long and about 2 cm in diameter

44. The upper airway accounts For what % of airway resistance?
50%
Expiration
Dullness replaces resonance
Binding of O2 to Hb

45. The active movement of gases between the ambient air and the lungs
Ventilation
Either continuous or discontinuous
Tongue
A reliable and consistent classification of auditory findings

46. forced expiratory volume in one second (FEV1)
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
Difficulty breathing or shortness of breath
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

47. Pulse Oximetry does not detect
Outer surface of each lung
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
Hypoventilation or modest changes in the PaO2
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

48. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
Inspiration
The amount of air that can be inhaled after normal inspiration
The rib above it
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'

49. most important factor that influences the oxygen carrying capacity of hemoglobin
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Partial pressure of oxygen (PO2)
Observing the pattern of breathing
Spirometry in the diagnosis - severity staging - and monitoring of these conditions

50. Peripheral cyanosis results from
The rib above it
Spirometry
A sensor placed over a translucent area of arterial pulsation
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature

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Pulmonology

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