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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. 20.95% Atmospheric Composition
Spirometry
reduced in size - compared with a normal curve - due to lower lung volume
Oxygen (O2)
A reliable and consistent classification of auditory findings

2. Tachypnea is an
500 to 800 mL
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Pulse oximetry
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature

3. Compliance
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
Perfusion
Partial pressure of O2 in the arterial blood
Mouth as well as through the chest wall

4. The accessory muscles are the...
Graphic representations of the patient's efforts in the form of a flow-volume curve and a volume-time curve
Sternocleidomastoid - Scalene Muscles
The atmospheric pressure
Louder - lower-pitched - and slightly longer in duration

5. The circulatory system transport of oxygen to - and carbon dioxide from - the peripheral tissues
Expiration
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Perfusion
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing

6. Restrictive disease refers to...
'scooped out' or bowl-shaped
reduced in size - compared with a normal curve - due to lower lung volume
A reduction in lung capacity - secondary to scarring or extraneous material
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

7. Peripheral cyanosis results from
Pneumonia - obstructive lung disease - and late pulmonary edema
Either continuous or discontinuous
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Inflammation of the adjacent parietal pleura

8. Bronchial breath sounds
Perfusion
The right middle lobe
respiration
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

9. The tracheo-bronchial tree is a tubular system that provides a pathway for
Tongue
From insufficient cardiac output - obstruction of blood flow - or vasoconstriction due to cold temperature
Inflammation of the adjacent parietal pleura
Air to move from the upper airway to the farthest alveolar reaches

10. Factors that influence the oxygen carrying capacity of hemoglobin
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
500 to 800 mL
Internal Intercostals - Internal and External Obliques - Transversus Abdominis
Inside of the thoracic cavity wall and the upper surface of the diaphragm

11. Spirometry: The result is stated as
Partial pressure of carbon dioxide in the alveoli
80%
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
Contracts

12. forced vital capacity (FVC)
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
No respiration for > 20 seconds
Total lung capacity (TLC)

13. low CO2 = low acidity =
35 to 45 mmHg
Binding of O2 to Hb
release of O2 from Hb
Either inspiration or expiration

14. Stridor is a high-pitched - noisy respiration - Which is indicative of...
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Upper respiratory obstruction - usually in the trachea or larynx
Either inspiration or expiration
A sensor placed over a translucent area of arterial pulsation

15. Boyle's Gas Law
Oxygen (O2)
Expiration
There is an inverse relationship between pressure and volume
Inspiration

16. The visceral pleura lines the...
Outer surface of each lung
Speed of airflow - the higher the flow - the greater the resistance
The right middle lobe
Increased work of breathing

17. Rhonchi originate in the...
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Larger airways
Spirometry in the diagnosis - severity staging - and monitoring of these conditions

18. Continuous lung sounds often audible at the...
Mouth as well as through the chest wall
Ventilation - Diffusion - Perfusion
5 years - to detect obstruction and determine its reversibility
Larger airways

19. Fine crackles are heard in
A good effort
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Decreased pressure
Interstitial diseases or early pulmonary edema

20. Which lobe has an inferior tongue-like projection called the lingula?
The negative logarithm of hydrogen ions in the blood
right and left mainstem bronchi
Left upper lobe
Overcome some of the problems associated with low blood flow to the probe site

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

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22. tidal volume (Vt)
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
right
The volume of air inhaled and exhaled with each resting breath during normal - quiet breathing
10 to 11 cm long and about 2 cm in diameter

23. Inspiratory stridor indicates
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
Diffusion
Dyspnea that awakens the patient several hours after going to sleep
Brief - discrete - non-musical sounds with a popping quality

24. PACO2
A percentage of predicted values - which are derived from normal individuals grouped by gender - age - and height
The amount of air that can be inhaled after normal inspiration
Partial pressure of carbon dioxide in the alveoli
Saturated with oxygen or unsaturated

25. Which lung has an oblique fissure?
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
right & left
Narrowed nearly to the point of closure
Pneumonia - obstructive lung disease - and late pulmonary edema

26. Sharp peaks and smooth descents on the flow-volume curves - and a flat plateau at the end of the volume-time curve suggests
A good effort
Diffusion
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
Lung volumes - but find it difficult to exhale rapidly

27. pH
Wheezes - high-pitched - musical sounds - distinct whistling quality
Postero-anterior (PA) and lateral view series
Perfusion
The negative logarithm of hydrogen ions in the blood

28. PAO2
Wheezes - high-pitched - musical sounds - distinct whistling quality
Narrowed nearly to the point of closure
Partial pressure of oxygen in the alveoli
release of O2 from Hb

29. Percussion helps you establish whether the underlying tissues are...
Air-filled - fluid-filled - or solid
Pressure required to drive air through the airways
Partial pressure of oxygen (PO2) - Bohr effect of pH - Temperature
quickly - usually reaching a plateau within 6.0 seconds

30. normal adult tidal volume
Oxygen (O2)
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
500 to 800 mL
Pleural space

31. Coarse crackles are heard in
Increased minute volume ventilation - which results in a lowered carbon dioxide level
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
Increase the intrathoracic space
Pneumonia - obstructive lung disease - and late pulmonary edema

32. Central cyanosis results from
Narrowed nearly to the point of closure
Contracts
Insufficient oxygenation of hemoglobin in the lungs
release of O2 from Hb - as heat is a by-product of metabolism.

33. The trachea is how long/wide?
Sternocleidomastoid - Scalene Muscles
Saturated with oxygen or unsaturated
respiratory bronchioles - alveolar ducts - alveolar sacs - and alveoli
10 to 11 cm long and about 2 cm in diameter

34. Rhonchi frequently clear after
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Binding of O2 to Hb
Cough
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible

35. Bohr Effect of pH: left shift
Diaphragm and the intercostal muscles
Increased Hb-O2 affinity
Diffusion
Tongue

36. During inspiration the diaphragm
Diffusion
Contracts
50%
Altering the respiratory rate and/or the tidal volume

37. Normal lung sounds
Cough
Alveoli to the blood
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
80%

38. HCO3
Oxygen-Hemoglobin Dissociation Curve
Bicarbonate
Pulse oximetry
Diffusion

39. What occurs passively as muscles relax?
Either inspiration or expiration
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds
2 - each wavelength is partially absorbed by hemoglobin
Expiration

40. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
Saturated with oxygen or unsaturated
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
respiration

41. Continuous lung sounds occur during...
Pressure required to drive air through the airways
A tracing of the lung volume against time in seconds
Either inspiration or expiration
70%

42. Does lung tissue have pain fibers?
Partial pressure of oxygen in the alveoli
No
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Oxygen (O2)

43. The vital capacity and the residual volume together constitute the...
Mouth as well as through the chest wall
Observing the pattern of breathing
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Total lung capacity (TLC)

44. increased volume results in
The negative logarithm of hydrogen ions in the blood
Decreased pressure
Air bubbles flowing through secretions or slightly closed airways during respiration
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

45. An efficient approach to examination of the patient begins with
A pulsatile blood flow - therefore it may be inaccurate in situations that result in peripheral vasoconstriction
Observing the pattern of breathing
Blood to the alveoli
results in a lower than normal FEV1%

46. Obstructive disease refers to...
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
Air-filled - fluid-filled - or solid
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
The atmospheric pressure

47. Oxygen moves from the...
Alveoli to the blood
Total lung capacity (TLC)
A good effort
Right

48. Pulse oximetry limitations: what may be misinterpreted as oxygenated hemoglobin?
Oxygen-Hemoglobin Dissociation Curve
No
Carboxyhemoglobin
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

49. The use of accessory muscles (contraction of the sternocleidomastoid or supraclavicular muscles during inspiration) indicates
Total lung capacity (TLC)
Increased work of breathing
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
50%

50. The spirometry printout usually includes

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