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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. Hyperventilation is defined as
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
No
Increased minute volume ventilation - which results in a lowered carbon dioxide level
release of O2 from Hb

2. movement of blood through the capillaries in direct communication with the alveoli
Perfusion
results in a lower than normal FEV1%
right & left
'scooped out' or bowl-shaped

3. Pulmonary ventilation is varied by
Altering the respiratory rate and/or the tidal volume
Increased Hb-O2 affinity
Blue or bluish-gray discoloration of the skin or mucous membranes
Dyspnea that awakens the patient several hours after going to sleep

4. normal subjects expel approximately how much of the FVC in the 1st second?
results in a lower than normal FEV1%
Air to move from the upper airway to the farthest alveolar reaches
80%
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

5. Inspiratory stridor indicates
A reduction in lung capacity - secondary to scarring or extraneous material
Expiration
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Inside of the thoracic cavity wall and the upper surface of the diaphragm

6. increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
Overcome some of the problems associated with low blood flow to the probe site
Diffusion
Sternocleidomastoid - Scalene Muscles
Inspiration

7. high CO2 = high acidity =
10 to 11 cm long and about 2 cm in diameter
70% occlusion of the airway
release of O2 from Hb
Lung volumes - but find it difficult to exhale rapidly

8. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
Lowered carbon dioxide level - results from hyperventilation
Alveoli to the blood
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Portable antero-posterior (AP) view

9. Pectoriloquy
Lowered carbon dioxide level - results from hyperventilation
No respiration for > 20 seconds
The gas in the conducting airways does not participate in alveolar exchange
The examiner can clearly distinguish the word that the pt speak or whispers

10. PAO2
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Oxygen-Hemoglobin Dissociation Curve
Partial pressure of oxygen in the alveoli
Alveoli to the blood

11. Central cyanosis results from
80%
Insufficient oxygenation of hemoglobin in the lungs
Increased work of breathing
Inside of the thoracic cavity wall and the upper surface of the diaphragm

12. 78.08% Atmospheric Composition
right
50%
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Nitrogen

13. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
The amount of air that can be inhaled after normal inspiration
Diffusion
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
Fraction (%age) of inspired oxygen

14. Chest Radiography: The most common chest X-ray series is the...
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
Wheezes - high-pitched - musical sounds - distinct whistling quality
right and left mainstem bronchi
Postero-anterior (PA) and lateral view series

15. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
Blood to the alveoli
Ventilation
Carboxyhemoglobin
Perfusion

16. The main bronchi are divided into smaller branches that begin to subdivide into
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Observing the pattern of breathing
Total lung capacity (TLC)
Lung volumes - but find it difficult to exhale rapidly

17. inspiratory reserve
Dullness replaces resonance
The amount of air that can be inhaled after normal inspiration
Functional residual capacity (FRC)
A tracing of the lung volume against time in seconds

18. gas exchange across the alveolar-pulmonary capillary membranes
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Diffusion

19. Tachypnea is an
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Outer surface of each lung
Increased work of breathing
Increased rate of breathing and is commonly associated with a decrease in tidal volume

20. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
The total amount of air in the lungs at the end of a maximal inhalation
respiration
Ventilation
'adventitious' breath sounds

21. The external intercostal muscles increase the antero-posterior chest diameter during
Carboxyhemoglobin
Inspiration
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Perfusion

22. What may prevent cyanosis from appearing?
Postero-anterior (PA) and lateral view series
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Binding of O2 to Hb
70% occlusion of the airway

23. Fine crackles are...
Partial pressure of O2 in the arterial blood
Soft - high-pitched and crisp
A reliable and consistent classification of auditory findings
Partial pressure of oxygen (PO2)

24. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
A good effort
Contracts
Increase the intrathoracic space
'scooped out' or bowl-shaped

25. The tracheo-bronchial tree is a tubular system that provides a pathway for
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
Increased work of breathing
Partial pressure of carbon dioxide in the alveoli
Air to move from the upper airway to the farthest alveolar reaches

26. The internal intercostals decrease the transverse diameter of the chest during
Left upper lobe
Partial pressure of oxygen (PO2)
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Expiration

27. Stridor is a high-pitched - noisy respiration - Which is indicative of...
Air to move from the upper airway to the farthest alveolar reaches
80%
release of O2 from Hb - as heat is a by-product of metabolism.
Upper respiratory obstruction - usually in the trachea or larynx

28. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Pressure required to drive air through the airways
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Perfusion

29. Expiratory stridor indicates
Portable antero-posterior (AP) view
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Mediastinum
Obstruction below the vocal cords (subglottic or tracheal obstruction)

30. Late inspiratory crackles result from
Left upper lobe
No respiration for > 20 seconds
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
70%

31. Spirometry is useful in distinguishing
Obstructive lung disease from restrictive lung disease
Carboxyhemoglobin
PaCO2
Blood to the alveoli

32. Abnormal lung sounds AKA

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33. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
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
Expiration
Spirometry
A good effort

34. Rhonchi originate in the...
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
The right middle lobe
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Larger airways

35. 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
Either inspiration or expiration
Spirometry
Increased work of breathing

36. The upper airway accounts For what % of airway resistance?
50%
No
Increase the intrathoracic space
Blue or bluish-gray discoloration of the skin or mucous membranes

37. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
Diffusion
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
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
A sensor placed over a translucent area of arterial pulsation

38. Bronchial breath sounds
Expiration
Postero-anterior (PA) and lateral view series
The amount of air that can be inhaled after normal inspiration
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

39. Spirometry plots
Contracts
500 to 800 mL
A tracing of the lung volume against time in seconds
Manubrio-sternal junction (angle of Louis)

40. total lung capacity (TLC)
Increased amounts of unsaturated hemoglobin in capillary blood
Expiration
The total amount of air in the lungs at the end of a maximal inhalation
Blood to the alveoli

41. Airway resistance refers to...
Partial pressure of CO2 in the arterial blood
Mouth as well as through the chest wall
Spirometry
Pressure required to drive air through the airways

42. Oximetry readings of < 94%
Increased rate of breathing and is commonly associated with a decrease in tidal volume
A sensor placed over a translucent area of arterial pulsation
require supplemental oxygenation and possibly ABG analysis
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

43. Examples of restrictive disease
Either inspiration or expiration
require supplemental oxygenation and possibly ABG analysis
Manubrio-sternal junction (angle of Louis)
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax

44. Restrictive disease refers to...
Normal to increased FEV1%
A reduction in lung capacity - secondary to scarring or extraneous material
Diaphragm - External Intercostals
Pressure required to drive air through the airways

45. Which bronchus is wider - shorter - and more vertically placed?
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Right
Inspiration
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

46. PaCO2
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Partial pressure of CO2 in the arterial blood
Total lung capacity (TLC)
release of O2 from Hb

47. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Expiration
Saturated with oxygen or unsaturated
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

48. Abnormal lung sounds are classified as
Either continuous or discontinuous
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
50%
Manubrio-sternal junction (angle of Louis)

49. The accessory muscles are the...
Sternocleidomastoid - Scalene Muscles
A sensor placed over a translucent area of arterial pulsation
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Pneumonia - obstructive lung disease - and late pulmonary edema

50. Rhonchi frequently clear after
Cough
Air bubbles flowing through secretions or slightly closed airways during respiration
right & left
Diaphragm - External Intercostals