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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 interspace between two ribs (intercostal space) is numbered by
The rib above it
Pressure required to drive air through the airways
The right middle lobe
Cough

2. Abnormal lung sounds are classified as
Either continuous or discontinuous
Total lung capacity (TLC)
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
2 - each wavelength is partially absorbed by hemoglobin

3. The use of accessory muscles (contraction of the sternocleidomastoid or supraclavicular muscles during inspiration) indicates
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
Mediastinum
Increased work of breathing
Total lung capacity (TLC)

4. Restrictive Disease: Expiratory volume is reduced more than
Significant pulmonary impairment
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Diffusion
Hypoventilation or modest changes in the PaO2

5. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Dullness replaces resonance
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
The amount of air that can be exhaled after expiration
Postero-anterior (PA) and lateral view series

6. Rhonchi occur during
Blood to the alveoli
Mediastinum
80 to 120% of predicted value
Either inspiration or expiration

7. terminal respiratory unit
Acinus
Right
Either continuous or discontinuous
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

8. Rhonchi are due to...
Pneumonia - obstructive lung disease - and late pulmonary edema
Either inspiration or expiration
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
Excessive secretions and abnormal airway collapsibility

9. PaO2
results in a lower than normal FEV1%
Partial pressure of O2 in the arterial blood
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Expiratory volume - and there is a prolonged expiratory time

10. Central cyanosis results from
80%
Insufficient oxygenation of hemoglobin in the lungs
Expiration
Increased minute volume ventilation - which results in a lowered carbon dioxide level

11. residual volume
70%
Lung volumes - but no difficulty or delay in exhaling what volume they do have
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
Expiratory volume - and there is a prolonged expiratory time

12. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Obstructive lung disease from restrictive lung disease
Spirometry
quickly - usually reaching a plateau within 6.0 seconds

13. Bohr Effect of pH is graphed as
Oxygen-Hemoglobin Dissociation Curve
Saturated with oxygen or unsaturated
Cough
Brief - discrete - non-musical sounds with a popping quality

14. Typically - in the presence of obstructive disease - the flow-volume curve looks

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15. 78.08% Atmospheric Composition
results in a lower than normal FEV1%
Insufficient oxygenation of hemoglobin in the lungs
Nitrogen
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)

16. Respiration involves
The total amount of air in the lungs at the end of a maximal inhalation
Air to move from the upper airway to the farthest alveolar reaches
Diffusion
Ventilation - Diffusion - Perfusion

17. Spirometry is useful in distinguishing
Obstructive lung disease from restrictive lung disease
right
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Acinus

18. Cyanosis
Tongue
Difficulty breathing or shortness of breath
Blue or bluish-gray discoloration of the skin or mucous membranes
Right

19. Pulse Oximetry: The oximeter's probe has a source of light of How many wavelengths?
right & left
Upper respiratory obstruction - usually in the trachea or larynx
2 - each wavelength is partially absorbed by hemoglobin
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

20. The main bronchi are divided into smaller branches that begin to subdivide into
Obstructive lung disease from restrictive lung disease
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Partial pressure of carbon dioxide in the alveoli

21. Which lung has a horizontal fissure?
Bicarbonate
results in a lower than normal FEV1%
right
A tracing of the lung volume against time in seconds

22. During inspiration the diaphragm
Blue or bluish-gray discoloration of the skin or mucous membranes
'crackles' or 'rales'
Contracts
Lung volumes - but no difficulty or delay in exhaling what volume they do have

23. What occurs passively as muscles relax?
Expiration
Perfusion
Air bubbles flowing through secretions or slightly closed airways during respiration
Dyspnea upon assuming a recumbent position

24. most important factor that influences the oxygen carrying capacity of hemoglobin
10 to 11 cm long and about 2 cm in diameter
Partial pressure of oxygen (PO2)
Significant pulmonary impairment
Cough

25. normal adult tidal volume
PaCO2
The negative logarithm of hydrogen ions in the blood
500 to 800 mL
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval

26. The primary muscles of respiration are the...
Diaphragm and the intercostal muscles
The gas in the conducting airways does not participate in alveolar exchange
Either inspiration or expiration
'scooped out' or bowl-shaped

27. pain in lung conditions usually arises from
Inflammation of the adjacent parietal pleura
Contracts
Inspiration
Larger airways

28. Abnormal lung sounds AKA

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29. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
A good effort
'scooped out' or bowl-shaped
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
The atmospheric pressure

30. Which bronchus is more susceptible to aspiration of foreign bodies?
50%
Right
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

31. FEV1% in restrictive disease
Partial pressure of CO2 in the arterial blood
Carboxyhemoglobin
T4 or T5 - and just below the manubrio-sternal joint
Normal to increased FEV1%

32. Dyspnea is defined as
500 to 800 mL
Difficulty breathing or shortness of breath
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Right

33. Auscultation of the chest depends on...
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Contracts
The negative logarithm of hydrogen ions in the blood
A reliable and consistent classification of auditory findings

34. Pectoriloquy
The examiner can clearly distinguish the word that the pt speak or whispers
Dullness replaces resonance
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
PaCO2

35. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
Left upper lobe
respiration
50%
Louder - lower-pitched - and slightly longer in duration

36. Examples of restrictive disease
Sternocleidomastoid - Scalene Muscles
The total amount of air in the lungs at the end of a maximal inhalation
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
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax

37. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
Lowered carbon dioxide level - results from hyperventilation
Carboxyhemoglobin
Excessive secretions and abnormal airway collapsibility
80%

38. Nitroglycerin applied to the probe area has been reported to...
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Overcome some of the problems associated with low blood flow to the probe site
Mouth as well as through the chest wall

39. Continuous lung sounds occur during...
Partial pressure of oxygen in the alveoli
Altering the respiratory rate and/or the tidal volume
The negative logarithm of hydrogen ions in the blood
Either inspiration or expiration

40. 20.95% Atmospheric Composition
Oxygen (O2)
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Wheezes - high-pitched - musical sounds - distinct whistling quality
Lung volumes - but no difficulty or delay in exhaling what volume they do have

41. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
The total amount of air that can be exhaled following a maximal inhalation
A reliable and consistent classification of auditory findings
Portable antero-posterior (AP) view
Spirometry

42. PACO2
Partial pressure of carbon dioxide in the alveoli
Interstitial diseases or early pulmonary edema
Air to move from the upper airway to the farthest alveolar reaches
Expiration

43. The best indicator of adequate ventilation is the...
Overcome some of the problems associated with low blood flow to the probe site
Expiratory volume - and there is a prolonged expiratory time
PaCO2
Lung volumes - but find it difficult to exhale rapidly

44. Which lobe has an inferior tongue-like projection called the lingula?
Left upper lobe
Larger airways
Saturated with oxygen or unsaturated
Overcome some of the problems associated with low blood flow to the probe site

45. total lung capacity (TLC)
The total amount of air in the lungs at the end of a maximal inhalation
T4 or T5 - and just below the manubrio-sternal joint
The amount of air that can be inhaled after normal inspiration
require supplemental oxygenation and possibly ABG analysis

46. hypocapnia
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Inspiration
Lowered carbon dioxide level - results from hyperventilation
Immediate oxygenation with or without intubation

47. Bronchial breath sounds
No
PaCO2
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

48. Rhonchi originate in the...
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Wheezes - high-pitched - musical sounds - distinct whistling quality
Lowered carbon dioxide level - results from hyperventilation
Larger airways

49. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
Partial pressure of oxygen (PO2)
Mediastinum
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

50. Cyanosis is caused by
Increased amounts of unsaturated hemoglobin in capillary blood
No respiration for > 20 seconds
Fraction (%age) of inspired oxygen
Partial pressure of carbon dioxide in the alveoli