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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 tracheo-bronchial tree is a tubular system that provides a pathway for
Soft - high-pitched and crisp
Air to move from the upper airway to the farthest alveolar reaches
500 to 800 mL
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

2. The accessory muscles are the...
Sternocleidomastoid - Scalene Muscles
Lowered carbon dioxide level - results from hyperventilation
Perfusion
Diffusion

3. The muscles of expiration are the...
Diaphragm and the intercostal muscles
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Dullness replaces resonance
Significant pulmonary impairment

4. The vital capacity and the residual volume together constitute the...
Increase the intrathoracic space
Diffusion
Total lung capacity (TLC)
Obstruction below the vocal cords (subglottic or tracheal obstruction)

5. The muscles of inspiration are the...
Diaphragm - External Intercostals
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Partial pressure of oxygen (PO2)
80 to 120% of predicted value

6. Oxygen moves from the...
Alveoli to the blood
Oxygen-Hemoglobin Dissociation Curve
Wheezes - high-pitched - musical sounds - distinct whistling quality
Pneumonia - obstructive lung disease - and late pulmonary edema

7. Fine crackles are heard in
Interstitial diseases or early pulmonary edema
Upper respiratory obstruction - usually in the trachea or larynx
Lowered carbon dioxide level - results from hyperventilation
Total lung capacity (TLC)

8. Resistance is dependent upon
release of O2 from Hb - as heat is a by-product of metabolism.
Speed of airflow - the higher the flow - the greater the resistance
Larger airways
right and left mainstem bronchi

9. The acini consist of the...
The negative logarithm of hydrogen ions in the blood
Insufficient oxygenation of hemoglobin in the lungs
Dyspnea that awakens the patient several hours after going to sleep
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

10. tidal volume (Vt)
Right
Manubrio-sternal junction (angle of Louis)
The gas in the conducting airways does not participate in alveolar exchange
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

11. The trachea bifurcates into its mainstem bronchi at the level of...
Altering the respiratory rate and/or the tidal volume
Pressure required to drive air through the airways
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
Right

12. forced expiratory volume in one second (FEV1)
Portable antero-posterior (AP) view
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
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Left upper lobe

13. Normal lung sounds
Diaphragm - External Intercostals
Lowered carbon dioxide level - results from hyperventilation
Cough
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

14. FIO2
Diaphragm - External Intercostals
Expiration
Fraction (%age) of inspired oxygen
quickly - usually reaching a plateau within 6.0 seconds

15. normal adult tidal volume
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Interstitial diseases or early pulmonary edema
PaCO2
500 to 800 mL

16. What may prevent cyanosis from appearing?
Binding of O2 to Hb
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration
Partial pressure of carbon dioxide in the alveoli
Altering the respiratory rate and/or the tidal volume

17. Normal range of PaCO2
Increased Hb-O2 affinity
35 to 45 mmHg
Bicarbonate
Soft - high-pitched and crisp

18. FEV1% in obstructive disease
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Insufficient oxygenation of hemoglobin in the lungs
Fraction (%age) of inspired oxygen
results in a lower than normal FEV1%

19. high CO2 = high acidity =
Expiration
Interstitial diseases or early pulmonary edema
release of O2 from Hb
Inspiration

20. pain in lung conditions usually arises from
Expiration
Inflammation of the adjacent parietal pleura
results in a lower than normal FEV1%
Spirometry

21. Bohr Effect of pH is graphed as
5 years - to detect obstruction and determine its reversibility
Oxygen-Hemoglobin Dissociation Curve
Pleural space
70%

22. 78.08% Atmospheric Composition
Obstructive lung disease from restrictive lung disease
Left upper lobe
Nitrogen
Spirometry

23. Fine crackles are...
Nitrogen
Partial pressure of oxygen in the alveoli
Either inspiration or expiration
Soft - high-pitched and crisp

24. At rest - the use of accessory muscles is a sign of...
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
right and left mainstem bronchi
Significant pulmonary impairment

25. What occurs passively as muscles relax?
Air to move from the upper airway to the farthest alveolar reaches
Fraction (%age) of inspired oxygen
Expiration
Portable antero-posterior (AP) view

26. The purpose of respiration is to...
Cough
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
The negative logarithm of hydrogen ions in the blood
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

27. PaCO2
Partial pressure of CO2 in the arterial blood
Partial pressure of oxygen in the alveoli
70% occlusion of the airway
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

28. Coarse crackles are...
Inspiratory and expiratory sounds - about equal in length - sometimes separated by a silent interval
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
Louder - lower-pitched - and slightly longer in duration
Pressure required to drive air through the airways

29. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
Air to move from the upper airway to the farthest alveolar reaches
Tongue
Spirometry
Increased rate of breathing and is commonly associated with a decrease in tidal volume

30. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Dullness replaces resonance
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Ventilation
Oxygen-Hemoglobin Dissociation Curve

31. Which lung has a horizontal fissure?
Alveoli to the blood
right
reduced in size - compared with a normal curve - due to lower lung volume
A reduction in lung capacity - secondary to scarring or extraneous material

32. expiratory reserve
The amount of air that can be exhaled after expiration
Diffusion
Observing the pattern of breathing
Either continuous or discontinuous

33. terminal respiratory unit
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
Postero-anterior (PA) and lateral view series
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

34. Inspiratory stridor indicates
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Spirometry
Hypoventilation or modest changes in the PaO2

35. Egophony

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36. Rhonchi are due to...
Fraction (%age) of inspired oxygen
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
Excessive secretions and abnormal airway collapsibility
Lung volumes - but no difficulty or delay in exhaling what volume they do have

37. a visible and palpable angulation of the sternum - and the point at which the second rib articulates with the sternum
Mouth as well as through the chest wall
Bicarbonate
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Manubrio-sternal junction (angle of Louis)

38. Examples of restrictive disease
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
respiration
No respiration for > 20 seconds
Inspiration

39. Inspiratory stridor becomes evident at about
Obstructive lung disease from restrictive lung disease
70% occlusion of the airway
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
Speed of airflow - the higher the flow - the greater the resistance

40. Spirometry normal range
right & left
Hypoventilation or modest changes in the PaO2
Partial pressure of carbon dioxide in the alveoli
80 to 120% of predicted value

41. Nitroglycerin applied to the probe area has been reported to...
Saturated with oxygen or unsaturated
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Overcome some of the problems associated with low blood flow to the probe site
Either inspiration or expiration

42. Patients with obstructive disease have normal
Partial pressure of O2 in the arterial blood
Pleural space
Lung volumes - but find it difficult to exhale rapidly
70% occlusion of the airway

43. The volume of gas remaining in the lungs at the end of normal expiration is called the...
Functional residual capacity (FRC)
There is an inverse relationship between pressure and volume
50%
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

44. 20.95% Atmospheric Composition
Pulse oximetry
Oxygen (O2)
Pleural space
Normal to increased FEV1%

45. gas exchange across the alveolar-pulmonary capillary membranes
Diffusion
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
A sensor placed over a translucent area of arterial pulsation
PaO2 is less than 40 mm Hg - and the unsaturated hemoglobin is 5 grams/dL

46. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
Air to move from the upper airway to the farthest alveolar reaches
Larger airways
Mediastinum
The amount of air that can be exhaled after expiration

47. inspiratory reserve
Difficulty breathing or shortness of breath
Overcome some of the problems associated with low blood flow to the probe site
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
The amount of air that can be inhaled after normal inspiration

48. vital capacity (VC)
The atmospheric pressure
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
The total amount of air that can be exhaled following a maximal inhalation
A good effort

49. Continuous lung sounds occur during...
Total lung capacity (TLC)
Either inspiration or expiration
Alveoli to the blood
Air bubbles flowing through secretions or slightly closed airways during respiration

50. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
Portable antero-posterior (AP) view
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
Upper respiratory obstruction - usually in the trachea or larynx
Spirometry