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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. Continuous lung sounds occur during...
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
A tracing of the lung volume against time in seconds
Either inspiration or expiration
Oxygen (O2)

2. What may prevent cyanosis from appearing?
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Lung volumes - but find it difficult to exhale rapidly
Portable antero-posterior (AP) view

3. the lingula is analogous to...
Binding of O2 to Hb
The right middle lobe
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
Normal to increased FEV1%

4. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Insufficient oxygenation of hemoglobin in the lungs
Hypoventilation or modest changes in the PaO2
Decreased Hb-O2 affinity
Saturated with oxygen or unsaturated

5. Resistance is dependent upon
Either inspiration or expiration
Pressure required to drive air through the airways
70%
Speed of airflow - the higher the flow - the greater the resistance

6. The primary muscles of respiration are the...
Bronchospasm - mucosal edema - or excessive secretions
500 to 800 mL
Diaphragm and the intercostal muscles
reduced in size - compared with a normal curve - due to lower lung volume

7. At rest - the use of accessory muscles is a sign of...
reduced in size - compared with a normal curve - due to lower lung volume
Bicarbonate
Significant pulmonary impairment
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

8. PaCO2
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Manubrio-sternal junction (angle of Louis)
Partial pressure of CO2 in the arterial blood
The gas in the conducting airways does not participate in alveolar exchange

9. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
Mediastinum
PaCO2
Either continuous or discontinuous
Carboxyhemoglobin

10. Pulse Oximetry is dependent on...
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Dyspnea that awakens the patient several hours after going to sleep
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Lung volumes - but no difficulty or delay in exhaling what volume they do have

11. Fine crackles are heard in
Inspiration
Interstitial diseases or early pulmonary edema
Soft - high-pitched and crisp
Outer surface of each lung

12. office-based spirometry is recommended for patients as young as
Pleural space
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
5 years - to detect obstruction and determine its reversibility
Diffusion

13. Bronchophony
Either inspiration or expiration
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
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Partial pressure of O2 in the arterial blood

14. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
Portable antero-posterior (AP) view
The right middle lobe
Increased Hb-O2 affinity
The total amount of air in the lungs at the end of a maximal inhalation

15. Coarse crackles are...
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Excessive secretions and abnormal airway collapsibility
Louder - lower-pitched - and slightly longer in duration
35 to 45 mmHg

16. Central cyanosis results from
Insufficient oxygenation of hemoglobin in the lungs
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'
Diffusion
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

17. forced vital capacity (FVC)
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
The total amount of air that can be exhaled following a maximal inhalation
Partial pressure of carbon dioxide in the alveoli
Spirometry

18. The volume of gas remaining in the lungs at the end of normal expiration is called the...
Partial pressure of O2 in the arterial blood
Functional residual capacity (FRC)
Either inspiration or expiration
Nitrogen

19. What occurs passively as muscles relax?
Expiration
Bronchospasm - mucosal edema - or excessive secretions
The rib above it
Pneumonia - obstructive lung disease - and late pulmonary edema

20. Restrictive disease refers to...
Total lung capacity (TLC)
A reduction in lung capacity - secondary to scarring or extraneous material
'scooped out' or bowl-shaped
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)

21. Vesicular breath sounds
The amount of air that can be exhaled after expiration
Increased amounts of unsaturated hemoglobin in capillary blood
Manubrio-sternal junction (angle of Louis)
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

22. Oximetry readings of < 94%
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
require supplemental oxygenation and possibly ABG analysis
Hypoventilation or modest changes in the PaO2
No

23. Cyanosis
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Blue or bluish-gray discoloration of the skin or mucous membranes
Pulse oximetry
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

24. The active movement of gases between the ambient air and the lungs
Dullness replaces resonance
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Ventilation
Increased work of breathing

25. The main bronchi are divided into smaller branches that begin to subdivide into
Increased work of breathing
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
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
Partial pressure of O2 in the arterial blood

26. PACO2
Fraction (%age) of inspired oxygen
Partial pressure of carbon dioxide in the alveoli
50%
Acinus

27. 20.95% Atmospheric Composition
Expiration
The amount of air that can be inhaled after normal inspiration
Oxygen (O2)
The amount of air that can be exhaled after expiration

28. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Diaphragm and the intercostal muscles
Air to move from the upper airway to the farthest alveolar reaches
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Dullness replaces resonance

29. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Increase the intrathoracic space
Partial pressure of oxygen (PO2)
500 to 800 mL
Speed of airflow - the higher the flow - the greater the resistance

30. Bohr Effect of pH is graphed as
Diaphragm - External Intercostals
Wheezes - high-pitched - musical sounds - distinct whistling quality
Dyspnea that awakens the patient several hours after going to sleep
Oxygen-Hemoglobin Dissociation Curve

31. Peripheral cyanosis results from
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Diffusion
Right
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature

32. Abnormal lung sounds AKA

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33. The trachea divides into right and left mainstem bronchi At what level?
reduced in size - compared with a normal curve - due to lower lung volume
T4 or T5 - and just below the manubrio-sternal joint
Pulse oximetry
Outer surface of each lung

34. The spirometry printout usually includes

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35. Dyspnea is defined as
Mediastinum
Blue or bluish-gray discoloration of the skin or mucous membranes
Pleural space
Difficulty breathing or shortness of breath

36. The tracheo-bronchial tree is a tubular system that provides a pathway for
Diffusion
Partial pressure of carbon dioxide in the alveoli
Air to move from the upper airway to the farthest alveolar reaches
Mouth as well as through the chest wall

37. Coarse crackles result from
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Air bubbles flowing through secretions or slightly closed airways during respiration
Insufficient oxygenation of hemoglobin in the lungs
A sensor placed over a translucent area of arterial pulsation

38. Orthopnea is quantified by
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
require supplemental oxygenation and possibly ABG analysis
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
80 to 120% of predicted value

39. Bronchial breath sounds
Decreased pressure
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Pneumonia - obstructive lung disease - and late pulmonary edema
2 - each wavelength is partially absorbed by hemoglobin

40. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
reduced in size - compared with a normal curve - due to lower lung volume
Pneumonia - obstructive lung disease - and late pulmonary edema
To assess response to treatment
2 - each wavelength is partially absorbed by hemoglobin

41. inspiratory reserve
The amount of air that can be inhaled after normal inspiration
Increase the intrathoracic space
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Expiratory volume - and there is a prolonged expiratory time

42. Auscultation of the chest depends on...
50%
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
A reliable and consistent classification of auditory findings

43. Abnormal lung sounds are classified as
T4 or T5 - and just below the manubrio-sternal joint
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Either continuous or discontinuous
Nitrogen

44. Rhonchi originate in the...
Air-filled - fluid-filled - or solid
Larger airways
A reliable and consistent classification of auditory findings
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax

45. FEV1% in obstructive disease
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Perfusion
Interstitial diseases or early pulmonary edema
results in a lower than normal FEV1%

46. Factors that influence the oxygen carrying capacity of hemoglobin
require supplemental oxygenation and possibly ABG analysis
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Functional residual capacity (FRC)
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

47. The trachea bifurcates into its mainstem bronchi at the level of...
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
require supplemental oxygenation and possibly ABG analysis
Tongue
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

48. The internal intercostals decrease the transverse diameter of the chest during
Ventilation
Air bubbles flowing through secretions or slightly closed airways during respiration
Portable antero-posterior (AP) view
Expiration

49. Which lung has a horizontal fissure?
Diaphragm - External Intercostals
The atmospheric pressure
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
right

50. The interspace between two ribs (intercostal space) is numbered by
A reliable and consistent classification of auditory findings
Acinus
The rib above it
No