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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...
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Fraction (%age) of inspired oxygen
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

2. The volume of gas remaining in the lungs at the end of normal expiration is called the...
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Functional residual capacity (FRC)
Alveoli to the blood
Bicarbonate

3. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Decreased pressure
T4 or T5 - and just below the manubrio-sternal joint
Saturated with oxygen or unsaturated
Oxygen-Hemoglobin Dissociation Curve

4. Oximetry readings of < 94%
Larger airways
Ventilation
Portable antero-posterior (AP) view
require supplemental oxygenation and possibly ABG analysis

5. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
Mouth as well as through the chest wall
Portable antero-posterior (AP) view
PaCO2
Significant pulmonary impairment

6. Bronchial breath sounds
Obstruction below the vocal cords (subglottic or tracheal obstruction)
right
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

7. Pulse Oximetry is dependent on...
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Insufficient oxygenation of hemoglobin in the lungs
The amount of air that can be exhaled after expiration

8. Pectoriloquy
Partial pressure of carbon dioxide in the alveoli
The examiner can clearly distinguish the word that the pt speak or whispers
Larger airways
Expiratory volume - and there is a prolonged expiratory time

9. Nitroglycerin applied to the probe area has been reported to...
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Overcome some of the problems associated with low blood flow to the probe site
Increased work of breathing
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

10. forced vital capacity (FVC)
70% occlusion of the airway
Cough
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Diaphragm - External Intercostals

11. The vital capacity and the residual volume together constitute the...
Total lung capacity (TLC)
The right middle lobe
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Pressure required to drive air through the airways

12. increased volume results in
Decreased pressure
'scooped out' or bowl-shaped
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Air-filled - fluid-filled - or solid

13. FEV1/FVC
reduced in size - compared with a normal curve - due to lower lung volume
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
quickly - usually reaching a plateau within 6.0 seconds
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

14. PACO2
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Partial pressure of carbon dioxide in the alveoli
Spirometry
Ventilation - Diffusion - Perfusion

15. The accessory muscles are the...
35 to 45 mmHg
Significant pulmonary impairment
Sternocleidomastoid - Scalene Muscles
Postero-anterior (PA) and lateral view series

16. An efficient approach to examination of the patient begins with
Normal to increased FEV1%
Either inspiration or expiration
Difficulty breathing or shortness of breath
Observing the pattern of breathing

17. At rest - the use of accessory muscles is a sign of...
Fraction (%age) of inspired oxygen
Louder - lower-pitched - and slightly longer in duration
Speed of airflow - the higher the flow - the greater the resistance
Significant pulmonary impairment

18. Cyanosis is caused by
Increased amounts of unsaturated hemoglobin in capillary blood
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Outer surface of each lung
A sensor placed over a translucent area of arterial pulsation

19. Discontinuous lung sounds are also called

20. HCO3
Bicarbonate
Upper respiratory obstruction - usually in the trachea or larynx
Manubrio-sternal junction (angle of Louis)
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

21. A normal volume-time curve rises
The gas in the conducting airways does not participate in alveolar exchange
Total lung capacity (TLC)
quickly - usually reaching a plateau within 6.0 seconds
Contracts

22. Pulse oximetry determines the percent of hemoglobin saturated with oxygen by way of...
The rib above it
Insufficient oxygenation of hemoglobin in the lungs
A sensor placed over a translucent area of arterial pulsation
No respiration for > 20 seconds

23. Rhonchi occur during
Either inspiration or expiration
Obstructive lung disease from restrictive lung disease
Narrowed nearly to the point of closure
Contracts

24. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
Overcome some of the problems associated with low blood flow to the probe site
Manubrio-sternal junction (angle of Louis)
Oxygen-Hemoglobin Dissociation Curve
The examiner can clearly distinguish the word that the pt speak or whispers

25. Spirometry: The result is stated as
Mediastinum
Excessive secretions and abnormal airway collapsibility
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height

26. dead space ventilation
70%
Outer surface of each lung
reduced in size - compared with a normal curve - due to lower lung volume
The gas in the conducting airways does not participate in alveolar exchange

27. 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
Saturated with oxygen or unsaturated
Larger airways
Ventilation
Pulse oximetry

28. The presence of pressure gradients causes respiratory gases to move from
Diffusion
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
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
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy

29. Hyperventilation is defined as
The total amount of air that can be exhaled following a maximal inhalation
Diaphragm - External Intercostals
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Increased minute volume ventilation - which results in a lowered carbon dioxide level

30. residual volume
Dullness replaces resonance
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 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
Increased minute volume ventilation - which results in a lowered carbon dioxide level

31. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
right
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Increase the intrathoracic space
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration

32. Auscultation of the chest depends on...
A reliable and consistent classification of auditory findings
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Observing the pattern of breathing
Partial pressure of oxygen in the alveoli

33. The internal intercostals decrease the transverse diameter of the chest during
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Expiration
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
Lung volumes - but find it difficult to exhale rapidly

34. Respiration involves
Significant pulmonary impairment
Partial pressure of oxygen in the alveoli
Ventilation - Diffusion - Perfusion
Overcome some of the problems associated with low blood flow to the probe site

35. FEV1% in restrictive disease
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Interstitial diseases or early pulmonary edema
Normal to increased FEV1%
A sensor placed over a translucent area of arterial pulsation

36. The interspace between two ribs (intercostal space) is numbered by
Blood to the alveoli
Tongue
70% occlusion of the airway
The rib above it

37. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Increase the intrathoracic space
500 to 800 mL
Mediastinum

38. pH
Blood to the alveoli
Increased work of breathing
The negative logarithm of hydrogen ions in the blood
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

39. Normal lung sounds
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Increase the intrathoracic space
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

40. Pulse Oximetry does not detect
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Difficulty breathing or shortness of breath
Blue or bluish-gray discoloration of the skin or mucous membranes
Hypoventilation or modest changes in the PaO2

41. Restrictive disease refers to...
10 to 11 cm long and about 2 cm in diameter
respiration
The total amount of air that can be exhaled following a maximal inhalation
A reduction in lung capacity - secondary to scarring or extraneous material

42. An SaO2 of 90% correlates with a PaO2 as low as 59 and requires
Expiration
Immediate oxygenation with or without intubation
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
respiration

43. The visceral pleura lines the...
Oxygen (O2)
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Outer surface of each lung
Total lung capacity (TLC)

44. Orthopnea is quantified by
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
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
The examiner can clearly distinguish the word that the pt speak or whispers

45. Peripheral cyanosis results from
Interstitial diseases or early pulmonary edema
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Partial pressure of CO2 in the arterial blood
Diaphragm - External Intercostals

46. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
T4 or T5 - and just below the manubrio-sternal joint
Dullness replaces resonance
Tongue

47. Abnormal lung sounds are classified as
Speed of airflow - the higher the flow - the greater the resistance
Either continuous or discontinuous
Brief - discrete - non-musical sounds with a popping quality
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

48. hypocapnia
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
The right middle lobe
Dullness replaces resonance
Lowered carbon dioxide level - results from hyperventilation

49. Chest Radiography: The most common chest X-ray series is the...
Larger airways
Inspiration
Postero-anterior (PA) and lateral view series
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

50. the lingula is analogous to...
Oxygen-Hemoglobin Dissociation Curve
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
The right middle lobe