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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. Apnea is defined as
require supplemental oxygenation and possibly ABG analysis
No respiration for > 20 seconds
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Larger airways

2. What change occurs when fluid or solid tissue replaces air-containing lung or occupies the pleural space beneath your percussing fingers?
Air to move from the upper airway to the farthest alveolar reaches
Dullness replaces resonance
Portable antero-posterior (AP) view
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase

3. Respiration involves
Larger airways
Ventilation - Diffusion - Perfusion
Inspiration
The gas in the conducting airways does not participate in alveolar exchange

4. residual volume
Ventilation
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
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
Tongue

5. The active movement of gases between the ambient air and the lungs
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Oxygen (O2)
Increased work of breathing
Ventilation

6. movement of blood through the capillaries in direct communication with the alveoli
Perfusion
Overcome some of the problems associated with low blood flow to the probe site
Observing the pattern of breathing
Expiratory volume - and there is a prolonged expiratory time

7. Airway resistance refers to...
Pressure required to drive air through the airways
Left upper lobe
Diaphragm - External Intercostals
A tracing of the lung volume against time in seconds

8. forced vital capacity (FVC)
Contracts
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
The maximum volume of air that can be expelled from the lungs following a maximal inspiration - performed as rapidly and forcefully as possible
2 - each wavelength is partially absorbed by hemoglobin

9. Paroxysmal nocturnal dyspnea (PND) is...
An area of higher concentration to that of a lower concentration passively - with no expenditure of energy
Pneumonia - obstructive lung disease - and late pulmonary edema
The gas in the conducting airways does not participate in alveolar exchange
Dyspnea that awakens the patient several hours after going to sleep

10. Auscultation of the chest depends on...
Fraction (%age) of inspired oxygen
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
The gas in the conducting airways does not participate in alveolar exchange
A reliable and consistent classification of auditory findings

11. Rhonchi frequently clear after
reduced in size - compared with a normal curve - due to lower lung volume
Cough
Expiratory airflow - the expiratory time is very short - and chest expansion is poor
Fraction (%age) of inspired oxygen

12. 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
Either inspiration or expiration
Louder and higher in pitch - with a short silence between inspiratory and expiratory sounds - the expiratory phase lasting longer than inspiratory phase
Spirometry

13. The movement of air back and forth from the deepest reaches of the alveoli to the outside environment
Dyspnea upon assuming a recumbent position
respiration
Pleural space
10 to 11 cm long and about 2 cm in diameter

14. What is the potential space between the visceral and parietal pleurae?
Pleural space
Spirometry in the diagnosis - severity staging - and monitoring of these conditions
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration
Normal to increased FEV1%

15. Which lobe has an inferior tongue-like projection called the lingula?
Mouth as well as through the chest wall
Left upper lobe
Diffusion
Soft - high-pitched and crisp

16. Tachypnea is an
Increased rate of breathing and is commonly associated with a decrease in tidal volume
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Either inspiration or expiration
10 to 11 cm long and about 2 cm in diameter

17. The lungs are paired - cone-shaped organs in the thoracic cavity separated By what space?
Mediastinum
A good effort
right & left
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle

18. the lingula is analogous to...
The right middle lobe
right and left mainstem bronchi
Overcome some of the problems associated with low blood flow to the probe site
Anemia - since the oxygen saturation at which cyanosis becomes clinically apparent is a function of hemoglobin concentration

19. Bronchophony
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
right
Normal to increased FEV1%
'scooped out' or bowl-shaped

20. Rhonchi occur during
Decreased Hb-O2 affinity
Inflammation of the adjacent parietal pleura
Blue or bluish-gray discoloration of the skin or mucous membranes
Either inspiration or expiration

21. Rhonchi
Nitrogen
Narrowed nearly to the point of closure
reduced in size - compared with a normal curve - due to lower lung volume
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality

22. inspiratory reserve
The amount of air that can be inhaled after normal inspiration
Diffusion
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
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

23. vital capacity (VC)
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
The total amount of air that can be exhaled following a maximal inhalation
Partial pressure of oxygen (PO2)
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

24. A normal volume-time curve rises
quickly - usually reaching a plateau within 6.0 seconds
Observing the pattern of breathing
The ratio of the FEV1 to the forced vital capacity - and it is expressed as a percentage (FEV1%)
The rib above it

25. Discontinuous lung sounds are also called

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26. Restrictive disease refers to...
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
Ventilation
respiratory rate and rhythm - the depth of breathing - and the relative amount of time spent in inspiration and expiration

27. The volume of gas remaining in the lungs at the end of normal expiration is called the...
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma
Carboxyhemoglobin
Keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
Functional residual capacity (FRC)

28. Pulse Oximetry: The amount of absorption differs depending on whether the hemoglobin is...
Saturated with oxygen or unsaturated
require supplemental oxygenation and possibly ABG analysis
Pulse oximetry
Bicarbonate

29. PAO2
Perfusion
Partial pressure of oxygen in the alveoli
Fraction (%age) of inspired oxygen
Vesicular breath sounds - Bronchiovesicular breath sounds - Bronchial breath sounds

30. Cyanosis
Blue or bluish-gray discoloration of the skin or mucous membranes
A good effort
Fraction (%age) of inspired oxygen
release of O2 from Hb

31. total lung capacity (TLC)
50%
The total amount of air in the lungs at the end of a maximal inhalation
Outer surface of each lung
Diffusion

32. Carbon dioxide moves from the...
Blood to the alveoli
A tracing of the lung volume against time in seconds
A reduction in lung capacity - secondary to scarring or extraneous material
Oxygen-Hemoglobin Dissociation Curve

33. Boyle's Gas Law
An increase in airway resistance as a result of a reduction of elastic recoil and /or compromise of the air passage
There is an inverse relationship between pressure and volume
'scooped out' or bowl-shaped
Pulse oximetry

34. During expiration - thoracic cavity volume decreases - and the intrapulmonary pressure becomes greater than
The atmospheric pressure
The gas in the conducting airways does not participate in alveolar exchange
Expiration
Inspiration

35. Abnormal lung sounds are classified as
A site of obstruction above the vocal cords (supraglottic or glottic obstruction)
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
80 to 120% of predicted value
Either continuous or discontinuous

36. PACO2
results in a lower than normal FEV1%
'crackles' or 'rales'
Partial pressure of carbon dioxide in the alveoli
Chronic obstructive pulmonary disease (COPD) - chronic bronchitis - emphysema - and asthma

37. Rhonchi originate in the...
Outer surface of each lung
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
Immediate oxygenation with or without intubation
Larger airways

38. Orthopnea is quantified by
Total lung capacity (TLC)
Oxygen-Hemoglobin Dissociation Curve
80 to 120% of predicted value
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up

39. Simple - objective - noninvasive diagnostic test can be performed with relative ease on patients who present with respiratory-related symptoms
Partial pressure of CO2 in the arterial blood
Alveolar and interstitial processes such as edema - fibrosis - and infection; large - space-occupying lesions; atelectasis; pleural effusion; and pneumothorax
Spirometry
Bronchospasm - mucosal edema - or excessive secretions

40. Which lung has an oblique fissure?
right & left
Shaped like a sail - rising rapidly to a sharp peak - then descending in a straight line at about a 45˚ angle
Lung volumes - but no difficulty or delay in exhaling what volume they do have
Spirometry

41. Bohr Effect of pH: right shift
Speed of airflow - the higher the flow - the greater the resistance
right
Decreased Hb-O2 affinity
Right

42. the process by which gases in the alveoli and the blood exchange by way of the alveolar-capillary membrane
Cough
Mouth as well as through the chest wall
Diffusion
35 to 45 mmHg

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

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44. dead space ventilation
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
Dyspnea that awakens the patient several hours after going to sleep
Increased rate of breathing and is commonly associated with a decrease in tidal volume
The gas in the conducting airways does not participate in alveolar exchange

45. The parietal pleura lines the...
Inside of the thoracic cavity wall and the upper surface of the diaphragm
Number of pillows the patient uses for sleeping - or by the fact that the patient needs to sleep sitting up
Partial pressure of oxygen (PO2)
Dullness replaces resonance

46. Examples of restrictive disease
Increase the intrathoracic space
Terminal - and ultimately into respiratory bronchioles so small that each is associated with one acinus
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

47. Spirometry plots
A tracing of the lung volume against time in seconds
Manubrio-sternal junction (angle of Louis)
Blood to the alveoli
Decreased Hb-O2 affinity

48. Continuous lung sounds
Wheezes - high-pitched - musical sounds - distinct whistling quality
The negative logarithm of hydrogen ions in the blood
Mediastinum
Diffusion

49. Abnormal lung sounds AKA

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50. PaO2
70% occlusion of the airway
Continuous lung sound - lower-pitched - snoring sounds - may have a gurgling quality
Partial pressure of O2 in the arterial blood
Inside of the thoracic cavity wall and the upper surface of the diaphragm