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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. Fine crackles are...
The rib above it
Soft - high-pitched and crisp
The amount of air that can be exhaled after expiration
Obstructive lung disease from restrictive lung disease

2. Which bronchus is wider - shorter - and more vertically placed?
Right
Either continuous or discontinuous
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
A sensor placed over a translucent area of arterial pulsation

3. movement of blood through the capillaries in direct communication with the alveoli
Binding of O2 to Hb
Expiratory volume - and there is a prolonged expiratory time
Diaphragm - External Intercostals
Perfusion

4. The best indicator of adequate ventilation is the...
PaCO2
Interstitial diseases or early pulmonary edema
Mouth as well as through the chest wall
release of O2 from Hb - as heat is a by-product of metabolism.

5. The trachea is how long/wide?
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
5 years - to detect obstruction and determine its reversibility
10 to 11 cm long and about 2 cm in diameter

6. Inspiratory stridor becomes evident at about
Tongue
70% occlusion of the airway
Either continuous or discontinuous
Partial pressure of oxygen (PO2)

7. Factors that influence the oxygen carrying capacity of hemoglobin
80 to 120% of predicted value
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Inflammation of the adjacent parietal pleura
Internal Intercostals - Internal and External Obliques - Transversus Abdominis

8. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Either inspiration or expiration
Air bubbles flowing through secretions or slightly closed airways during respiration
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Increase the intrathoracic space

9. Egophony

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10. Spirometry can be used to determine the severity of functional impairment as well as
Significant pulmonary impairment
To assess response to treatment
Dyspnea upon assuming a recumbent position
Left upper lobe

11. The presence of pressure gradients causes respiratory gases to move from
Partial pressure of oxygen in the alveoli
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Increase the intrathoracic space
Narrowed nearly to the point of closure

12. Does lung tissue have pain fibers?
No
2 - each wavelength is partially absorbed by hemoglobin
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Total lung capacity (TLC)

13. Which lung has a horizontal fissure?
Lung volumes - but find it difficult to exhale rapidly
Partial pressure of oxygen (PO2)
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
right

14. What occurs passively as muscles relax?
Expiration
Fraction (%age) of inspired oxygen
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
A good effort

15. Examples of restrictive disease
Speed of airflow - the higher the flow - the greater the resistance
Partial pressure of carbon dioxide in the alveoli
Spirometry
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax

16. The tracheo-bronchial tree is a tubular system that provides a pathway for
Air to move from the upper airway to the farthest alveolar reaches
Portable antero-posterior (AP) view
No
There is an inverse relationship between pressure and volume

17. The trachea divides into right and left mainstem bronchi At what level?
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Decreased pressure
70%
T4 or T5 - and just below the manubrio-sternal joint

18. pain in lung conditions usually arises from
Increased work of breathing
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
500 to 800 mL
Inflammation of the adjacent parietal pleura

19. Spirometry plots
Pleural space
To assess response to treatment
A tracing of the lung volume against time in seconds
Inside of the thoracic cavity wall and the upper surface of the diaphragm

20. Coarse crackles result from
Air bubbles flowing through secretions or slightly closed airways during respiration
'adventitious' breath sounds
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Inflammation of the adjacent parietal pleura

21. Respiration involves
Larger airways
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Partial pressure of carbon dioxide in the alveoli
Ventilation - Diffusion - Perfusion

22. Abnormal lung sounds are classified as
Pulse oximetry
Increased work of breathing
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Either continuous or discontinuous

23. Auscultation of the chest depends on...
Brief - discrete - non-musical sounds with a popping quality
Outer surface of each lung
Obstruction below the vocal cords (subglottic or tracheal obstruction)
A reliable and consistent classification of auditory findings

24. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
2 - each wavelength is partially absorbed by hemoglobin
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Altering the respiratory rate and/or the tidal volume
No respiration for > 20 seconds

25. FEV1% in obstructive disease
Manubrio-sternal junction (angle of Louis)
quickly - usually reaching a plateau within 6.0 seconds
results in a lower than normal FEV1%
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

26. Rhonchi frequently clear after
Air bubbles flowing through secretions or slightly closed airways during respiration
Interstitial diseases or early pulmonary edema
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Cough

27. The accessory muscles are the...
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
Sternocleidomastoid - Scalene Muscles
A reduction in lung capacity - secondary to scarring or extraneous material
Oxygen (O2)

28. Restrictive Disease: Expiratory volume is reduced more than
Significant pulmonary impairment
2 - each wavelength is partially absorbed by hemoglobin
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Partial pressure of carbon dioxide in the alveoli

29. Dyspnea is defined as
'scooped out' or bowl-shaped
Difficulty breathing or shortness of breath
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Spirometry

30. A normal volume-time curve rises
Increase the intrathoracic space
Pressure required to drive air through the airways
quickly - usually reaching a plateau within 6.0 seconds
There is an inverse relationship between pressure and volume

31. 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 CO2 in the arterial blood
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
release of O2 from Hb - as heat is a by-product of metabolism.

32. Late inspiratory crackles result from
Oxygen (O2)
Expiration
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

33. Central cyanosis results from
Either continuous or discontinuous
Insufficient oxygenation of hemoglobin in the lungs
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Lung volumes - but find it difficult to exhale rapidly

34. Examples of obstructive disease
Pressure required to drive air through the airways
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
A tracing of the lung volume against time in seconds
Ventilation

35. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Either continuous or discontinuous
'crackles' or 'rales'
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Saturated with oxygen or unsaturated

36. Normal lung sounds
Pulse oximetry
Increased amounts of unsaturated hemoglobin in capillary blood
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
reduced in size - compared with a normal curve - due to lower lung volume

37. Spirometry normal range
Lung volumes - but find it difficult to exhale rapidly
reduced in size - compared with a normal curve - due to lower lung volume
80 to 120% of predicted value
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

38. The interspace between two ribs (intercostal space) is numbered by
The rib above it
No respiration for > 20 seconds
A reliable and consistent classification of auditory findings
The negative logarithm of hydrogen ions in the blood

39. The use of accessory muscles (contraction of the sternocleidomastoid or supraclavicular muscles during inspiration) indicates
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Nitrogen
Diaphragm - External Intercostals
Increased work of breathing

40. tidal volume (Vt)
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Partial pressure of carbon dioxide in the alveoli
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

41. Pulse Oximetry is dependent on...
'scooped out' or bowl-shaped
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Alveoli to the blood
Acinus

42. Orthopnea is defined as
Dyspnea upon assuming a recumbent position
Increased amounts of unsaturated hemoglobin in capillary blood
Insufficient oxygenation of hemoglobin in the lungs
Acinus

43. vital capacity (VC)
Increased rate of breathing and is commonly associated with a decrease in tidal volume
The total amount of air that can be exhaled following a maximal inhalation
Altering the respiratory rate and/or the tidal volume
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

44. hypocapnia
Partial pressure of carbon dioxide in the alveoli
Either inspiration or expiration
Lowered carbon dioxide level - results from hyperventilation
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

45. The muscles of expiration are the...
right & left
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Immediate oxygenation with or without intubation
Right

46. Bronchial breath sounds
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 find it difficult to exhale rapidly
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Oxygen (O2)

47. The acini consist of the...
The atmospheric pressure
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Lung volumes - but no difficulty or delay in exhaling what volume they do have
80%

48. Patients with restrictive disease have low
reduced in size - compared with a normal curve - due to lower lung volume
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Decreased Hb-O2 affinity
Either inspiration or expiration

49. The trachea bifurcates into its mainstem bronchi at the level of...
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Alveoli to the blood
The negative logarithm of hydrogen ions in the blood
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

50. terminal respiratory unit
There is an inverse relationship between pressure and volume
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Acinus
reduced in size - compared with a normal curve - due to lower lung volume