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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. Which lobe has an inferior tongue-like projection called the lingula?
Observing the pattern of breathing
Louder - lower-pitched - and slightly longer in duration
Left upper lobe
Air bubbles flowing through secretions or slightly closed airways during respiration

2. Carbon dioxide moves from the...
Overcome some of the problems associated with low blood flow to the probe site
Blood to the alveoli
Either inspiration or expiration
Diaphragm and the intercostal muscles

3. forced expiratory volume in one second (FEV1)
right and left mainstem bronchi
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
Larger airways
Pulse oximetry

4. terminal respiratory unit
Acinus
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
To assess response to treatment
Difficulty breathing or shortness of breath

5. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
10 to 11 cm long and about 2 cm in diameter
respiration
Cough
The gas in the conducting airways does not participate in alveolar exchange

6. Pulse Oximetry is dependent on...
Contracts
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
release of O2 from Hb - as heat is a by-product of metabolism.
Inside of the thoracic cavity wall and the upper surface of the diaphragm

7. PaCO2
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
50%
Partial pressure of CO2 in the arterial blood
Significant pulmonary impairment

8. Coarse crackles result from
Inspiration
Total lung capacity (TLC)
Altering the respiratory rate and/or the tidal volume
Air bubbles flowing through secretions or slightly closed airways during respiration

9. Chest Radiography: The most common chest X-ray series is the...
Partial pressure of CO2 in the arterial blood
The atmospheric pressure
Postero-anterior (PA) and lateral view series
The examiner can clearly distinguish the word that the pt speak or whispers

10. The volume of gas remaining in the lungs at the end of normal expiration is called the...
Functional residual capacity (FRC)
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Partial pressure of carbon dioxide in the alveoli
Dullness replaces resonance

11. 20.95% Atmospheric Composition
5 years - to detect obstruction and determine its reversibility
Lowered carbon dioxide level - results from hyperventilation
Oxygen (O2)
Spirometry in the diagnosis - severity staging - and monitoring of these conditions

12. Spirometry normal range
80 to 120% of predicted value
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Bronchospasm - mucosal edema - or excessive secretions
Tongue

13. The trachea bifurcates into its mainstem bronchi at the level of...
respiration
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
No respiration for > 20 seconds
right and left mainstem bronchi

14. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
50%
Pressure required to drive air through the airways
Diaphragm - External Intercostals
Spirometry

15. inspiratory reserve
Increase the intrathoracic space
The amount of air that can be inhaled after normal inspiration
Manubrio-sternal junction (angle of Louis)
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

16. the lingula is analogous to...
The right middle lobe
'scooped out' or bowl-shaped
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

17. Examples of restrictive disease
Overcome some of the problems associated with low blood flow to the probe site
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Partial pressure of oxygen (PO2)

18. The trachea is how long/wide?
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
Spirometry
Perfusion
10 to 11 cm long and about 2 cm in diameter

19. Bohr Effect of pH is graphed as
2 - each wavelength is partially absorbed by hemoglobin
The right middle lobe
Oxygen-Hemoglobin Dissociation Curve
There is an inverse relationship between pressure and volume

20. most important factor that influences the oxygen carrying capacity of hemoglobin
Partial pressure of oxygen (PO2)
right and left mainstem bronchi
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

21. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
2 - each wavelength is partially absorbed by hemoglobin
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Ventilation

22. Which bronchus is wider - shorter - and more vertically placed?
Right
Significant pulmonary impairment
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve

23. The visceral pleura lines the...
Outer surface of each lung
Dullness replaces resonance
500 to 800 mL
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

24. Central cyanosis results from
Insufficient oxygenation of hemoglobin in the lungs
10 to 11 cm long and about 2 cm in diameter
Normal to increased FEV1%
Difficulty breathing or shortness of breath

25. The vital capacity and the residual volume together constitute the...
Air to move from the upper airway to the farthest alveolar reaches
Total lung capacity (TLC)
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
Mouth as well as through the chest wall

26. total lung capacity (TLC)
The total amount of air in the lungs at the end of a maximal inhalation
Partial pressure of oxygen (PO2)
Carboxyhemoglobin
Increase the intrathoracic space

27. pain in lung conditions usually arises from
Inflammation of the adjacent parietal pleura
80%
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Lung volumes - but no difficulty or delay in exhaling what volume they do have

28. Oxygen moves from the...
Significant pulmonary impairment
Alveoli to the blood
35 to 45 mmHg
'adventitious' breath sounds

29. Continuous lung sounds occur during...
No
Partial pressure of CO2 in the arterial blood
Either inspiration or expiration
Increased Hb-O2 affinity

30. Apnea is defined as
Either inspiration or expiration
No respiration for > 20 seconds
Inspiration
50%

31. Patients with obstructive disease have normal
Partial pressure of oxygen (PO2)
Lung volumes - but find it difficult to exhale rapidly
Obstructive lung disease from restrictive lung disease
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

32. Continuous lung sounds occur in the setting of...
Bronchospasm - mucosal edema - or excessive secretions
Partial pressure of CO2 in the arterial blood
80 to 120% of predicted value
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

33. Rhonchi occur during
Bronchospasm - mucosal edema - or excessive secretions
'crackles' or 'rales'
Either inspiration or expiration
Speed of airflow - the higher the flow - the greater the resistance

34. Hyperventilation is defined as
Pleural space
'adventitious' breath sounds
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve

35. normal subjects expel approximately how much of the FVC in the 1st second?
80%
10 to 11 cm long and about 2 cm in diameter
quickly - usually reaching a plateau within 6.0 seconds
respiration

36. Airway resistance refers to...
Pressure required to drive air through the airways
Right
Tongue
Alveoli to the blood

37. Peripheral cyanosis results from
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Left upper lobe
A tracing of the lung volume against time in seconds
The amount of air that can be exhaled after expiration

38. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Brief - discrete - non-musical sounds with a popping quality
Saturated with oxygen or unsaturated
Increased work of breathing
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax

39. PAO2
Diffusion
Partial pressure of oxygen in the alveoli
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

40. Expiratory stridor indicates
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Obstruction below the vocal cords (subglottic or tracheal obstruction)
The amount of air that can be exhaled after expiration

41. The interspace between two ribs (intercostal space) is numbered by
The rib above it
Upper respiratory obstruction - usually in the trachea or larynx
Air bubbles flowing through secretions or slightly closed airways during respiration
Excessive secretions and abnormal airway collapsibility

42. The muscles of inspiration are the...
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Diaphragm - External Intercostals
80 to 120% of predicted value
Fraction (%age) of inspired oxygen

43. The external intercostal muscles increase the antero-posterior chest diameter during
Inspiration
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
Total lung capacity (TLC)
Air-filled - fluid-filled - or solid

44. Restrictive Disease: Expiratory volume is reduced more than
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
70%
Hypoventilation or modest changes in the PaO2
Partial pressure of O2 in the arterial blood

45. Discontinuous lung sounds are...
Brief - discrete - non-musical sounds with a popping quality
Difficulty breathing or shortness of breath
5 years - to detect obstruction and determine its reversibility
Dullness replaces resonance

46. forced vital capacity (FVC)
Oxygen-Hemoglobin Dissociation Curve
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
The examiner can clearly distinguish the word that the pt speak or whispers
Right

47. The internal intercostals decrease the transverse diameter of the chest during
Difficulty breathing or shortness of breath
The amount of air that can be inhaled after normal inspiration
Expiration
Decreased Hb-O2 affinity

48. 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
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Outer surface of each lung
Louder - lower-pitched - and slightly longer in duration

49. Orthopnea is defined as
Right
Dyspnea upon assuming a recumbent position
Partial pressure of CO2 in the arterial blood
Pleural space

50. Bohr Effect of pH: right shift
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Louder - lower-pitched - and slightly longer in duration
Decreased Hb-O2 affinity
Upper respiratory obstruction - usually in the trachea or larynx