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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. pain in lung conditions usually arises from
reduced in size - compared with a normal curve - due to lower lung volume
80 to 120% of predicted value
The rib above it
Inflammation of the adjacent parietal pleura

2. Inspiratory stridor indicates
Narrowed nearly to the point of closure
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Normal to increased FEV1%
Mediastinum

3. Bohr Effect of pH: right shift
Decreased Hb-O2 affinity
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Mediastinum
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli

4. Chest Radiography: The most common chest X-ray series is the...
Excessive secretions and abnormal airway collapsibility
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
Postero-anterior (PA) and lateral view series
results in a lower than normal FEV1%

5. Patients with obstructive disease have normal
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Ventilation - Diffusion - Perfusion
Lung volumes - but find it difficult to exhale rapidly
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve

6. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
The sternal angle of Louis anteriorly - and the T4 spinous process posteriorly
The atmospheric pressure

7. Restrictive Disease: Expiratory volume is reduced more than
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Dullness replaces resonance
Diffusion
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. Orthopnea is defined as
T4 or T5 - and just below the manubrio-sternal joint
Dyspnea upon assuming a recumbent position
quickly - usually reaching a plateau within 6.0 seconds
Right

9. The interspace between two ribs (intercostal space) is numbered by
right
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
10 to 11 cm long and about 2 cm in diameter
The rib above it

10. Coarse crackles are heard in
Difficulty breathing or shortness of breath
results in a lower than normal FEV1%
The gas in the conducting airways does not participate in alveolar exchange
Pneumonia - obstructive lung disease - and late pulmonary edema

11. The presence of pressure gradients causes respiratory gases to move from
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Spirometry
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
require supplemental oxygenation and possibly ABG analysis

12. 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
Decreased Hb-O2 affinity
Spirometry
Lowered carbon dioxide level - results from hyperventilation

13. The trachea divides into right and left mainstem bronchi At what level?
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
T4 or T5 - and just below the manubrio-sternal joint
70%
Bicarbonate

14. FEV1% in obstructive disease
results in a lower than normal FEV1%
Expiration
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Larger airways

15. Stridor is a high-pitched - noisy respiration - Which is indicative of...
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Dyspnea that awakens the patient several hours after going to sleep
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Upper respiratory obstruction - usually in the trachea or larynx

16. Discontinuous lung sounds are also called

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17. Fine crackles are...
Either inspiration or expiration
Partial pressure of carbon dioxide in the alveoli
Soft - high-pitched and crisp
Significant pulmonary impairment

18. Restrictive disease refers to...
Carboxyhemoglobin
Decreased Hb-O2 affinity
A reduction in lung capacity - secondary to scarring or extraneous material
release of O2 from Hb

19. vital capacity (VC)
Mediastinum
The total amount of air that can be exhaled following a maximal inhalation
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Excessive secretions and abnormal airway collapsibility

20. Bronchial breath sounds
Perfusion
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Dyspnea that awakens the patient several hours after going to sleep

21. What chest radiography is used for unstable patients or those unable to stand during the X-ray?
Saturated with oxygen or unsaturated
Total lung capacity (TLC)
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Portable antero-posterior (AP) view

22. Continuous lung sounds occur during...
Diffusion
Either inspiration or expiration
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Oxygen (O2)

23. The main bronchi are divided into smaller branches that begin to subdivide into
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Mouth as well as through the chest wall
Outer surface of each lung
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus

24. Factors that influence the oxygen carrying capacity of hemoglobin
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Obstructive lung disease from restrictive lung disease

25. The visceral pleura lines the...
Blue or bluish-gray discoloration of the skin or mucous membranes
Outer surface of each lung
Overcome some of the problems associated with low blood flow to the probe site
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

26. The pattern of breathing refers to...
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Either inspiration or expiration
Decreased Hb-O2 affinity
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

27. total lung capacity (TLC)
Fraction (%age) of inspired oxygen
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 in the lungs at the end of a maximal inhalation
80 to 120% of predicted value

28. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
Portable antero-posterior (AP) view
Oxygen-Hemoglobin Dissociation Curve
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Carboxyhemoglobin

29. What occurs passively as muscles relax?
Carboxyhemoglobin
Narrowed nearly to the point of closure
Increased Hb-O2 affinity
Expiration

30. The active movement of gases between the ambient air and the lungs
respiration
Pleural space
Perfusion
Ventilation

31. terminal respiratory unit
The examiner can clearly distinguish the word that the pt speak or whispers
Nitrogen
right & left
Acinus

32. At rest - the use of accessory muscles is a sign of...
'scooped out' or bowl-shaped
Significant pulmonary impairment
Increased Hb-O2 affinity
reduced in size - compared with a normal curve - due to lower lung volume

33. Tachypnea is an
80%
The total amount of air in the lungs at the end of a maximal inhalation
Increased rate of breathing and is commonly associated with a decrease in tidal volume
PaCO2

34. Hyperventilation is defined as
Spirometry
Increased minute volume ventilation - which results in a lowered carbon dioxide level
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Normal to increased FEV1%

35. hypocapnia
Partial pressure of CO2 in the arterial blood
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
release of O2 from Hb - as heat is a by-product of metabolism.
Lowered carbon dioxide level - results from hyperventilation

36. Obstructive disease refers to...
Larger airways
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Pressure required to drive air through the airways
Observing the pattern of breathing

37. The purpose of respiration is to...
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
'adventitious' breath sounds
Increased amounts of unsaturated hemoglobin in capillary blood
Inspiration

38. Boyle's Gas Law
There is an inverse relationship between pressure and volume
Spirometry
Obstruction below the vocal cords (subglottic or tracheal obstruction)
Perfusion

39. Egophony

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40. Pectoriloquy
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Perfusion
The examiner can clearly distinguish the word that the pt speak or whispers
The total amount of air in the lungs at the end of a maximal inhalation

41. Central cyanosis results from
Expiration
Insufficient oxygenation of hemoglobin in the lungs
Either continuous or discontinuous
The amount of air that can be exhaled after expiration

42. Late inspiratory crackles result from
right & left
Inspiration
A series of tiny explosions when small airways - deflated during expiration - pop open during inspiration
Increased rate of breathing and is commonly associated with a decrease in tidal volume

43. Spirometry plots
Sternocleidomastoid - Scalene Muscles
A tracing of the lung volume against time in seconds
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Partial pressure of oxygen in the alveoli

44. A means of measuring the movement of air into and out of the lungs during various breathing maneuvers
Postero-anterior (PA) and lateral view series
Spirometry
Difficulty breathing or shortness of breath
Tongue

45. Which lung has an oblique fissure?
Increase the intrathoracic space
right & left
A reliable and consistent classification of auditory findings
Hypoventilation or modest changes in the PaO2

46. Does lung tissue have pain fibers?
No
Either inspiration or expiration
Manubrio-sternal junction (angle of Louis)
Either inspiration or expiration

47. PAO2
Expiratory volume - and there is a prolonged expiratory time
reduced in size - compared with a normal curve - due to lower lung volume
Partial pressure of oxygen in the alveoli
Right

48. the lingula is analogous to...
Larger airways
The right middle lobe
Perfusion
A good effort

49. Discontinuous lung sounds are...
Acinus
Ventilation
Brief - discrete - non-musical sounds with a popping quality
Partial pressure of oxygen in the alveoli

50. Vesicular breath sounds
Inside of the thoracic cavity wall and the upper surface of the diaphragm
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
Total lung capacity (TLC)
The spoken sound 'ee' as in 'bee' is heard by the ascultator as the 'a' in 'bay'