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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 pattern of breathing refers to...
50%
5 years - to detect obstruction and determine its reversibility
Interstitial diseases or early pulmonary edema
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

2. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Increase the intrathoracic space
Upper respiratory obstruction - usually in the trachea or larynx
Increased work of breathing
Carboxyhemoglobin

3. The trachea bifurcates into its mainstem bronchi at the level of...
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
10 to 11 cm long and about 2 cm in diameter
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
The total amount of air in the lungs at the end of a maximal inhalation

4. Cyanosis appears when
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
Partial pressure of CO2 in the arterial blood
The total amount of air that can be exhaled following a maximal inhalation
Perfusion

5. The external intercostal muscles increase the antero-posterior chest diameter during
quickly - usually reaching a plateau within 6.0 seconds
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Louder - lower-pitched - and slightly longer in duration
Inspiration

6. The best indicator of adequate ventilation is the...
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
PaCO2
A tracing of the lung volume against time in seconds
Dyspnea that awakens the patient several hours after going to sleep

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

8. Apnea is defined as
Blue or bluish-gray discoloration of the skin or mucous membranes
70% occlusion of the airway
Air bubbles flowing through secretions or slightly closed airways during respiration
No respiration for > 20 seconds

9. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
There is an inverse relationship between pressure and volume
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Carboxyhemoglobin

10. FEV1/FVC
The rib above it
The amount of air that can be inhaled after normal inspiration
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Pressure required to drive air through the airways

11. Spirometry plots
Pneumonia - obstructive lung disease - and late pulmonary edema
Brief - discrete - non-musical sounds with a popping quality
Narrowed nearly to the point of closure
A tracing of the lung volume against time in seconds

12. The trachea is how long/wide?
Brief - discrete - non-musical sounds with a popping quality
Inside of the thoracic cavity wall and the upper surface of the diaphragm
10 to 11 cm long and about 2 cm in diameter
Either inspiration or expiration

13. A state-of-the-art - inexpensive - non-invasive - simple method to monitor a patient's percent hemoglobin saturation with oxygen (SaO2) - without having to obtain an arterial blood specimen
Pulse oximetry
No
Manubrio-sternal junction (angle of Louis)
The amount of air that can be exhaled after expiration

14. Egophony

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15. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
The total amount of air in the lungs at the end of a maximal inhalation
require supplemental oxygenation and possibly ABG analysis
Outer surface of each lung
Diffusion

16. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Dullness replaces resonance
Increased rate of breathing and is commonly associated with a decrease in tidal volume
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

17. The most reliable site for detecting central cyanosis is the...
Wheezes - high-pitched - musical sounds - distinct whistling quality
No
Tongue
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

18. Abnormal lung sounds are classified as
The amount of air that can be exhaled after expiration
Either continuous or discontinuous
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Sternocleidomastoid - Scalene Muscles

19. Spirometry can be used to determine the severity of functional impairment as well as
The total amount of air that can be exhaled following a maximal inhalation
Outer surface of each lung
To assess response to treatment
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature

20. pain in lung conditions usually arises from
A reduction in lung capacity - secondary to scarring or extraneous material
Inflammation of the adjacent parietal pleura
Partial pressure of O2 in the arterial blood
The atmospheric pressure

21. increased volume results in
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
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Decreased pressure
respiration

22. The spirometry printout usually includes

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23. The acini consist of the...
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
The gas in the conducting airways does not participate in alveolar exchange
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

24. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
Tongue
Altering the respiratory rate and/or the tidal volume
Inspiration
Decreased Hb-O2 affinity

25. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
Spirometry
70% occlusion of the airway
A reduction in lung capacity - secondary to scarring or extraneous material
No respiration for > 20 seconds

26. Pulse Oximetry is dependent on...
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Air to move from the upper airway to the farthest alveolar reaches
Tongue

27. PAO2
Ventilation
Partial pressure of oxygen in the alveoli
Tongue
Spirometry

28. A normal volume-time curve rises
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
quickly - usually reaching a plateau within 6.0 seconds
5 years - to detect obstruction and determine its reversibility
70% occlusion of the airway

29. Coarse crackles are...
respiration
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Louder - lower-pitched - and slightly longer in duration
Lowered carbon dioxide level - results from hyperventilation

30. Rhonchi are due to...
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Altering the respiratory rate and/or the tidal volume
Excessive secretions and abnormal airway collapsibility
Inspiration

31. inspiratory reserve
The negative logarithm of hydrogen ions in the blood
Louder - lower-pitched - and slightly longer in duration
Lung volumes - but find it difficult to exhale rapidly
The amount of air that can be inhaled after normal inspiration

32. Tachypnea is an
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
5 years - to detect obstruction and determine its reversibility
release of O2 from Hb

33. Orthopnea is defined as
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Dyspnea upon assuming a recumbent position
Diffusion
A reduction in lung capacity - secondary to scarring or extraneous material

34. Pulmonary ventilation is varied by
Altering the respiratory rate and/or the tidal volume
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Overcome some of the problems associated with low blood flow to the probe site
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

35. The trachea divides into
right and left mainstem bronchi
Normal to increased FEV1%
70% occlusion of the airway
Outer surface of each lung

36. Flow-Volume Curve: On a normal graph - the flow-volume curve is...
Dyspnea that awakens the patient several hours after going to sleep
Perfusion
release of O2 from Hb
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

37. What may prevent cyanosis from appearing?
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
quickly - usually reaching a plateau within 6.0 seconds
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Oxygen (O2)

38. Factors that influence the oxygen carrying capacity of hemoglobin
5 years - to detect obstruction and determine its reversibility
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Decreased pressure
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

39. Continuous lung sounds occur in the setting of...
The total amount of air in the lungs at the end of a maximal inhalation
Bronchospasm - mucosal edema - or excessive secretions
Sternocleidomastoid - Scalene Muscles
Obstruction below the vocal cords (subglottic or tracheal obstruction)

40. The main bronchi are divided into smaller branches that begin to subdivide into
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
Partial pressure of oxygen (PO2)
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Spirometry

41. The primary muscles of respiration are the...
Diaphragm and the intercostal muscles
Observing the pattern of breathing
Nitrogen
Alveoli to the blood

42. Chest Radiography: The most common chest X-ray series is the...
Inspiration
Obstructive lung disease from restrictive lung disease
Postero-anterior (PA) and lateral view series
The atmospheric pressure

43. Fine crackles are heard in
Ventilation
Difficulty breathing or shortness of breath
Interstitial diseases or early pulmonary edema
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

44. Pulse Oximetry does not detect
The right middle lobe
Hypoventilation or modest changes in the PaO2
release of O2 from Hb - as heat is a by-product of metabolism.
Obstruction below the vocal cords (subglottic or tracheal obstruction)

45. Vesicular breath sounds
Air bubbles flowing through secretions or slightly closed airways during respiration
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
Inspiration
Decreased pressure

46. Which bronchus is more susceptible to aspiration of foreign bodies?
The total amount of air that can be exhaled following a maximal inhalation
Right
Perfusion
release of O2 from Hb - as heat is a by-product of metabolism.

47. Coarse crackles result from
Air bubbles flowing through secretions or slightly closed airways during respiration
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Left upper lobe
The negative logarithm of hydrogen ions in the blood

48. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
Partial pressure of CO2 in the arterial blood
Manubrio-sternal junction (angle of Louis)
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

49. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
Dyspnea upon assuming a recumbent position
Contracts
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
respiration

50. Internationally recognized guidelines for management of asthma and COPD recommend the use of...
Spirometry
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
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
70% occlusion of the airway