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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 bronchus is more susceptible to aspiration of foreign bodies?
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Blood to the alveoli
Right
The rib above it

2. The vital capacity and the residual volume together constitute the...
Expiratory volume - and there is a prolonged expiratory time
Total lung capacity (TLC)
The gas in the conducting airways does not participate in alveolar exchange
35 to 45 mmHg

3. The trachea divides into right and left mainstem bronchi At what level?
Altering the respiratory rate and/or the tidal volume
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
T4 or T5 - and just below the manubrio-sternal joint
Spirometry

4. inspiratory reserve
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Saturated with oxygen or unsaturated
The amount of air that can be inhaled after normal inspiration

5. An efficient approach to examination of the patient begins with
Pneumonia - obstructive lung disease - and late pulmonary edema
Observing the pattern of breathing
Significant pulmonary impairment
Blue or bluish-gray discoloration of the skin or mucous membranes

6. The normal FEV1 /FVC ratio is...
Air-filled - fluid-filled - or solid
Ventilation
70%
right & left

7. Cyanosis
right & left
The examiner can clearly distinguish the word that the pt speak or whispers
Blue or bluish-gray discoloration of the skin or mucous membranes
A reduction in lung capacity - secondary to scarring or extraneous material

8. The acini consist of the...
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Inspiration
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Altering the respiratory rate and/or the tidal volume

9. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
2 - each wavelength is partially absorbed by hemoglobin
Decreased pressure
Significant pulmonary impairment
Expiration

10. The trachea bifurcates into its mainstem bronchi at the level of...
Postero-anterior (PA) and lateral view series
Excessive secretions and abnormal airway collapsibility
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Hypoventilation or modest changes in the PaO2

11. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
A reduction in lung capacity - secondary to scarring or extraneous material
Spirometry
Interstitial diseases or early pulmonary edema
Oxygen (O2)

12. During inspiration the diaphragm
Fraction (%age) of inspired oxygen
Contracts
Either continuous or discontinuous
Upper respiratory obstruction - usually in the trachea or larynx

13. PaCO2
Partial pressure of CO2 in the arterial blood
Functional residual capacity (FRC)
Brief - discrete - non-musical sounds with a popping quality
Soft - high-pitched and crisp

14. Egophony

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15. Tachypnea is an
Manubrio-sternal junction (angle of Louis)
Increase the intrathoracic space
Partial pressure of oxygen in the alveoli
Increased rate of breathing and is commonly associated with a decrease in tidal volume

16. The parietal pleura lines the...
quickly - usually reaching a plateau within 6.0 seconds
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Functional residual capacity (FRC)
Oxygen-Hemoglobin Dissociation Curve

17. Continuous lung sounds often audible at the...
Mouth as well as through the chest wall
No
Air-filled - fluid-filled - or solid
A good effort

18. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
results in a lower than normal FEV1%
Either continuous or discontinuous
The atmospheric pressure

19. The upper airway accounts For what % of airway resistance?
50%
No
Increase the intrathoracic space
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

20. Cyanosis appears when
Inflammation of the adjacent parietal pleura
Perfusion
Lung volumes - but find it difficult to exhale rapidly
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

21. Spirometry can be used to determine the severity of functional impairment as well as
Increased amounts of unsaturated hemoglobin in capillary blood
Expiration
To assess response to treatment
Larger airways

22. Hyperventilation is defined as
Diffusion
'adventitious' breath sounds
Increased minute volume ventilation - which results in a lowered carbon dioxide level
require supplemental oxygenation and possibly ABG analysis

23. FIO2
Bronchospasm - mucosal edema - or excessive secretions
Fraction (%age) of inspired oxygen
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
Ventilation

24. Rhonchi
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Ventilation
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Air bubbles flowing through secretions or slightly closed airways during respiration

25. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
70% occlusion of the airway
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
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Saturated with oxygen or unsaturated

26. Normal range of PaCO2
35 to 45 mmHg
Expiration
Diffusion
Oxygen (O2)

27. With restrictive disease - the flow-volume curve is...
80%
Ventilation - Diffusion - Perfusion
reduced in size - compared with a normal curve - due to lower lung volume
Partial pressure of oxygen (PO2)

28. Carbon dioxide moves from the...
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL
PaCO2
Blood to the alveoli
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve

29. The spirometry printout usually includes

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30. Bohr Effect of pH is graphed as
Total lung capacity (TLC)
Oxygen-Hemoglobin Dissociation Curve
To assess response to treatment
There is an inverse relationship between pressure and volume

31. The pattern of breathing refers to...
Obstruction below the vocal cords (subglottic or tracheal obstruction)
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Tongue
Difficulty breathing or shortness of breath

32. Pulmonary ventilation is varied by
Outer surface of each lung
Altering the respiratory rate and/or the tidal volume
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Fraction (%age) of inspired oxygen

33. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Manubrio-sternal junction (angle of Louis)
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

34. pain in lung conditions usually arises from
Observing the pattern of breathing
require supplemental oxygenation and possibly ABG analysis
Inflammation of the adjacent parietal pleura
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

35. What is the potential space between the visceral and parietal pleurae?
Blue or bluish-gray discoloration of the skin or mucous membranes
Pleural space
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
release of O2 from Hb - as heat is a by-product of metabolism.

36. hypocapnia
Ventilation - Diffusion - Perfusion
Lowered carbon dioxide level - results from hyperventilation
50%
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide

37. The use of accessory muscles (contraction of the sternocleidomastoid or supraclavicular muscles during inspiration) indicates
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Increased work of breathing
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Either continuous or discontinuous

38. Dyspnea is defined as
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Difficulty breathing or shortness of breath
Mediastinum
Oxygen (O2)

39. Respiration involves
Ventilation - Diffusion - Perfusion
Inspiration
Bicarbonate
respiration

40. Cyanosis is caused by
Overcome some of the problems associated with low blood flow to the probe site
require supplemental oxygenation and possibly ABG analysis
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Increased amounts of unsaturated hemoglobin in capillary blood

41. Continuous lung sounds occur in the setting of...
Left upper lobe
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Bronchospasm - mucosal edema - or excessive secretions
Decreased pressure

42. Fine crackles are heard in
Spirometry
Partial pressure of CO2 in the arterial blood
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Interstitial diseases or early pulmonary edema

43. 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
The amount of air that can be exhaled after expiration
Pulse oximetry
Narrowed nearly to the point of closure
Postero-anterior (PA) and lateral view series

44. most important factor that influences the oxygen carrying capacity of hemoglobin
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
right
reduced in size - compared with a normal curve - due to lower lung volume
Partial pressure of oxygen (PO2)

45. Expiratory stridor indicates
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Overcome some of the problems associated with low blood flow to the probe site
Diffusion
The gas in the conducting airways does not participate in alveolar exchange

46. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
Decreased Hb-O2 affinity
respiration
Expiration
Inspiration

47. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
Mediastinum
PaCO2
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Diffusion

48. Nitroglycerin applied to the probe area has been reported to...
Altering the respiratory rate and/or the tidal volume
Obstructive lung disease from restrictive lung disease
Diaphragm and the intercostal muscles
Overcome some of the problems associated with low blood flow to the probe site

49. increased volume results in
Increased Hb-O2 affinity
Ventilation - Diffusion - Perfusion
Decreased pressure
Either continuous or discontinuous

50. Airway resistance refers to...
2 - each wavelength is partially absorbed by hemoglobin
respiration
Pulse oximetry
Pressure required to drive air through the airways