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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. gas exchange across the alveolar-pulmonary capillary membranes
release of O2 from Hb - as heat is a by-product of metabolism.
Air to move from the upper airway to the farthest alveolar reaches
Diffusion
Immediate oxygenation with or without intubation

2. Dyspnea is defined as
Difficulty breathing or shortness of breath
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
Ventilation

3. 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
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Brief - discrete - non-musical sounds with a popping quality
70% occlusion of the airway

4. Bohr Effect of pH: left shift
Increased Hb-O2 affinity
Pleural space
Dyspnea upon assuming a recumbent position
Partial pressure of carbon dioxide in the alveoli

5. Rhonchi frequently clear after
Cough
Right
Brief - discrete - non-musical sounds with a popping quality
A reliable and consistent classification of auditory findings

6. The parietal pleura lines the...
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Diffusion
Pneumonia - obstructive lung disease - and late pulmonary edema
Inside of the thoracic cavity wall and the upper surface of the diaphragm

7. Fine crackles are...
The total amount of air in the lungs at the end of a maximal inhalation
Dyspnea that awakens the patient several hours after going to sleep
Soft - high-pitched and crisp
Spirometry

8. PaO2
Partial pressure of O2 in the arterial blood
Obstruction below the vocal cords (subglottic or tracheal obstruction)
70% occlusion of the airway
Either inspiration or expiration

9. Continuous lung sounds occur during...
Either inspiration or expiration
The gas in the conducting airways does not participate in alveolar exchange
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Air to move from the upper airway to the farthest alveolar reaches

10. Inspiratory stridor indicates
respiration
quickly - usually reaching a plateau within 6.0 seconds
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Increase the intrathoracic space

11. The purpose of respiration is to...
Partial pressure of O2 in the arterial blood
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Oxygen-Hemoglobin Dissociation Curve
Obstruction below the vocal cords (subglottic or tracheal obstruction)

12. 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
The amount of air that can be inhaled after normal inspiration
Inspiration
Ventilation - Diffusion - Perfusion

13. The pattern of breathing refers to...
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
70%
Total lung capacity (TLC)
Right

14. Boyle's Gas Law
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
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
There is an inverse relationship between pressure and volume
results in a lower than normal FEV1%

15. Oxygen moves from the...
Alveoli to the blood
Lung volumes - but find it difficult to exhale rapidly
release of O2 from Hb - as heat is a by-product of metabolism.
2 - each wavelength is partially absorbed by hemoglobin

16. Continuous lung sounds occur when air flows rapidly through bronchi that are...
Narrowed nearly to the point of closure
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'

17. The acini consist of the...
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Diffusion
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
Air to move from the upper airway to the farthest alveolar reaches

18. pain in lung conditions usually arises from
Inflammation of the adjacent parietal pleura
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
release of O2 from Hb
Air-filled - fluid-filled - or solid

19. Apnea is defined as
Louder - lower-pitched - and slightly longer in duration
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Postero-anterior (PA) and lateral view series
No respiration for > 20 seconds

20. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
respiration
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Expiration

21. Which lobe has an inferior tongue-like projection called the lingula?
Narrowed nearly to the point of closure
Left upper lobe
Excessive secretions and abnormal airway collapsibility
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly

22. Chest Radiography: The most common chest X-ray series is the...
Postero-anterior (PA) and lateral view series
Lung volumes - but find it difficult to exhale rapidly
T4 or T5 - and just below the manubrio-sternal joint
5 years - to detect obstruction and determine its reversibility

23. A normal volume-time curve rises
Manubrio-sternal junction (angle of Louis)
Spirometry
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
quickly - usually reaching a plateau within 6.0 seconds

24. Bohr Effect of pH is graphed as
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Functional residual capacity (FRC)
Oxygen-Hemoglobin Dissociation Curve
The total amount of air in the lungs at the end of a maximal inhalation

25. Egophony

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26. Continuous lung sounds
Bicarbonate
Partial pressure of oxygen in the alveoli
The atmospheric pressure
Wheezes - high-pitched - musical sounds - distinct whistling quality

27. dead space ventilation
Lung volumes - but find it difficult to exhale rapidly
right
The gas in the conducting airways does not participate in alveolar exchange
Obstructive lung disease from restrictive lung disease

28. total lung capacity (TLC)
Air bubbles flowing through secretions or slightly closed airways during respiration
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
The total amount of air in the lungs at the end of a maximal inhalation
right

29. FIO2
Partial pressure of carbon dioxide in the alveoli
Wheezes - high-pitched - musical sounds - distinct whistling quality
Larger airways
Fraction (%age) of inspired oxygen

30. low CO2 = low acidity =
Binding of O2 to Hb
Brief - discrete - non-musical sounds with a popping quality
Difficulty breathing or shortness of breath
Increased Hb-O2 affinity

31. The trachea divides into
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
Narrowed nearly to the point of closure
Dullness replaces resonance
right and left mainstem bronchi

32. Peripheral cyanosis results from
70% occlusion of the airway
Diaphragm and the intercostal muscles
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

33. Resistance is dependent upon
Dullness replaces resonance
Right
Speed of airflow - the higher the flow - the greater the resistance
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

34. PaCO2
To assess response to treatment
Partial pressure of CO2 in the arterial blood
Decreased pressure
Partial pressure of O2 in the arterial blood

35. 20.95% Atmospheric Composition
Oxygen (O2)
Nitrogen
Fraction (%age) of inspired oxygen
Increased work of breathing

36. Rhonchi are due to...
Insufficient oxygenation of hemoglobin in the lungs
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Excessive secretions and abnormal airway collapsibility
Increase the intrathoracic space

37. The use of accessory muscles (contraction of the sternocleidomastoid or supraclavicular muscles during inspiration) indicates
Upper respiratory obstruction - usually in the trachea or larynx
respiration
Increased work of breathing
Spirometry

38. The diaphragm contracts and moves downward during inspiration - lowering the abdominal contents to...
Right
Partial pressure of oxygen in the alveoli
Increase the intrathoracic space
Louder - lower-pitched - and slightly longer in duration

39. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
The atmospheric pressure
5 years - to detect obstruction and determine its reversibility
Decreased Hb-O2 affinity
To assess response to treatment

40. Which lung has an oblique fissure?
Increased amounts of unsaturated hemoglobin in capillary blood
Total lung capacity (TLC)
right & left
Increased minute volume ventilation - which results in a lowered carbon dioxide level

41. The normal FEV1 /FVC ratio is...
The amount of air that can be inhaled after normal inspiration
release of O2 from Hb - as heat is a by-product of metabolism.
70%
No respiration for > 20 seconds

42. most important factor that influences the oxygen carrying capacity of hemoglobin
Spirometry
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Perfusion
Partial pressure of oxygen (PO2)

43. PACO2
Larger airways
Partial pressure of carbon dioxide in the alveoli
Portable antero-posterior (AP) view
To assess response to treatment

44. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
Brief - discrete - non-musical sounds with a popping quality
Diffusion
A reduction in lung capacity - secondary to scarring or extraneous material
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

45. Respiration involves
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Increase the intrathoracic space
Ventilation - Diffusion - Perfusion
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

46. What occurs passively as muscles relax?
Left upper lobe
Expiration
Inflammation of the adjacent parietal pleura
Obstructive lung disease from restrictive lung disease

47. Abnormal lung sounds are classified as
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
Oxygen (O2)
5 years - to detect obstruction and determine its reversibility
Either continuous or discontinuous

48. What may prevent cyanosis from appearing?
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Hypoventilation or modest changes in the PaO2
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Expiratory airflow - the expiratory time is very short - and chest expansion is poor

49. 78.08% Atmospheric Composition
Ventilation - Diffusion - Perfusion
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Nitrogen
PaCO2

50. Cyanosis
Observing the pattern of breathing
Blue or bluish-gray discoloration of the skin or mucous membranes
The amount of air that can be exhaled after expiration
The total amount of air that can be exhaled following a maximal inhalation