Respitory Therapy Exam 4

Front 1

Which of the following is the function of the turbinates?

Back 1

Increase the surface area of the nasasl cavity

Front 2

Which function of the nose is lost if a plastic endotracheeal tube is inserted through the nose or mouth and into the trachea?

Back 2

Air- conditioning

Front 3

In a deeply unconscious patient, which of the following is the most common threat to upper airway patency?

Back 3

Soft tissue obstruction

Front 4

Which of the following structures is an important landmark during the insertion of a tube into the trachea?

Back 4

Vallecula

Front 5

What is the narrowest portion of the airway in the infant?

Back 5

Cricoid ring

Front 6

What is the narrowest portion of the airway in the adult larynx?

Back 6

Glottis

Front 7

Which of the folliwng is the term assoicated with a sound created by a high veocity air flowing thru a narrowed glottis?

Back 7

Stridor

Front 8

Which feature of the trachea prevents collapse from external pressure, especially during virgorous coughing?

Back 8

Rigidity

Front 9

If an edoctracheal tube is inserted too far in the process of intubation, it's tip is more likely to enter the left bronchus(T?F)

Back 9

False

Front 10

Which of the following is the best description of the conduction airway mucosal epitehlium?

Back 10

Columnar, ciliated, pseudostratified cells with goblet cells

Front 11

Which group of cells comprises most of the alveolar surface?

Back 11

Type I

Front 12

Which group of cells engulfs microogransims and foregn material in the alveolus?

Back 12

Macrophages

Front 13

What is the term that describes the presences of fluid in the pleural space caused by inflammation?

Back 13

Plueral effusion

Front 14

What is the meaning of the anatomical shunting?

Back 14

That systemic arterial blood can never hanve the same partial pressure of oxygen as the alveolar gas.

Front 15

Which of the following is the source of innervation for the lungs?

Back 15

Autonomic nervous system

Front 16

Which of the following is a good example of slowly adaption strectch receptors?

Back 16

Herring- Breuer reflex

Front 17

You are assisting a PGY-1 surgery resident with the insertion of a chest tube. The resident turns to you aking which border of the rib he should aboid when placing the tube. Your answer should be:

Back 17

The lower border

Front 18

Which of the following parts of the sternum marks the level of the carina?

Back 18

Angle of Louis

Front 19

Which of the following is the primary muscle active in quite breathing

Back 19

Diaphragm

Front 20

If the lungs fail to empty normally during exhalation, because of either weakened elastic recoil forces or high resistance to airflow, the retained volume causes which change in the chest radiograph?

Back 20

Flattening of the diaphragm

Front 21

Although the diaphrgm is the principal muscle of inspiration, it is not essential for survival.

Back 21

True

Front 22

Which are responsible for the creation of the subatmospheric pressure between the lung and chest wall?

Back 22

The lung has a tendency to recoil inward and pull away from the chest wall AND the thorax has a tendency to recoil outward, way from the lung.

Front 23

What causes air to move in or out of the lungs while keeping the lungs in an inflated state?

Back 23

Pressure gradients

Front 24

Change in lung volume resulting from a unit of pressure change is known as which of the following?

Back 24

Lung compliance

Front 25

Which of the following statements is true of stiff lungs or patients with restrictive disorders?

Back 25

The more elastic the lung, the less its' compliance.

Front 26

Which of the following condtions is charracterized by a loss of elastic lung tissue?

Back 26

Emphysema (Floppy lung)

Front 27

Which of the following conditions is characterized by high lung recoil forces?

Back 27

Pulmonary fibrosis

Front 28

Which of the following is the function of the surfactant?

Back 28

Lower surface tension

Front 29

What is the normal CLT?

Back 29

0.1 L/cm/H20

Front 30

What is the normal CL

Back 30

0.2L/ cm H20

Front 31

Which of the following explains the rapid, shllow breathing strategy of patients with pulmonary fibrosis?

Back 31

High elastance

Front 32

VE is the product of which of the following parameters?

Back 32

VTxf

Front 33

Which of the following terms defines the conducting airways from the mourth and nose down to and including terminal bronchioles?

Back 33

Anatomical dead space

Front 34

What is the approximate amount of anatomical dead space in normal adults?

Back 34

1 mL/ pound IBW

Front 35

Which of the following terms describes the rise in PaCO2 above normal?

Back 35

Hypercapnia

Front 36

Normally, approximately what percentage of the inspired Vt remains in conducting airways, never reaching alveoli?

Back 36

30% to 40%

Front 37

What is the primary purpose of the respiratory system?

Back 37

continuous absorption of oxygen and excretion of carbon dioxide

Front 38

what is meant by "internal respiration"?

Back 38

exchange of gases between blood and the tissue

Front 39

By what mechanism does gas exchange across the lung occur?

Back 39

simple diffusion

Front 40

Which chromosome has been found to carry the defective gene responsible for the development of cystic fibrosis?

Back 40

7

Front 41

What genetic disorder has been linked to emphysema?

Back 41

a1-antitrypsin deficiency

Front 42

What is rather unique regarding the blood supply to the lung?

Back 42

It recieves blood from right and left ventricles

Front 43

Running vertically down each himthorax anteriorly is an imaginary line that is used as an anatomical landmark. What is that line called?

Back 43

midclavicular line

Front 44

What is the name of the thin serious membrane that covers the inner layer of the thoracic wall?

Back 44

parietal pleura

Front 45

how far is the diaphragm pulled dlow during tidal breathing?

Back 45

1 to 2 cm

Front 46

What pulmonary disorder could lead to acute flattening of the diaphragm?

Back 46

asthma

Front 47

The diaphragm is innervated by which of the following nerves?

Back 47

phrenic

Front 48

What is the function of the very small amount of pleural fluid that is found in the plueral space?

Back 48

reduces friction

Front 49

What will most commonly blunt the costophrenic angle as seen on chest radiograph in an upright individual?

Back 49

excess fluids

Front 50

Which of the follwing statements describe a normal adult lung?

Back 50

the right lung has three lobes and two fissures.

Front 51

The pulmonary arterial circulation does which of the following?

Back 51

devlievers unoxygenated blood to the lungs and orginates on the right side of the heart

Front 52

The pulmonary venous circulation does what?

Back 52

delievers oxygenated blood back to the heart and empties into the left atrium

Front 53

Compared with the systemic circulation, pressure in the normal pulmonary circulation is:

Back 53

lower

Front 54

The upper respiratory tract traditionally ends at what point?

Back 54

inferior border of the larynx

Front 55

What is your primary concern if you discover that a patient does not have a gag reflex?

Back 55

fear of aspiration of bacteria or food

Front 56

The subdivisions of the pharynx are

Back 56

nasopharynx, oropharynx, laryngopharynx

Front 57

What is the leaf-shape carilage that extends from the based of the tongue and is attached by lgaments to the throid cartilage?

Back 57

epiglottis

Front 58

What is the space that separates the true vocal cords?

Back 58

glottis

Front 59

What position is used to open the airway in an unconscious patient?

Back 59

sniff position

Front 60

At what point does the trachea branch into two mainstrem bronchi?

Back 60

carina

Front 61

What portion of the left lung corresponds anatomically to the middle lobe of the right lung?

Back 61

lingula

Front 62

What is the name given to the action produced by the forward stroking of millions of cilia?

Back 62

mucocilliary escalator

Front 63

What is the common name given to classify the airway from the nares to the terminal bronchioles?

Back 63

conducting airways

Front 64

What is called the "functional unit of the lungs"?

Back 64

acinus

Front 65

Pulmonary surfactant is secreted by which type of lung cells?

Back 65

type II pneumocytes

Front 66

Most of the muscle mass of the heart is located in which chamber?

Back 66

left ventricle (LV)

Front 67

The mitral (bicuspid) valve does which of the following?

Back 67

prevents atrial backflow during ventricular contraction

Front 68

What is the ability of myocardial tissue to propagate electrical impulses?

Back 68

automaticity

Front 69

Which of the following represent the normal order of structures encountered by blood flowing from the vena cava to the aorta?

Back 69

RA, tricuspid valve, RV, pulmonary valve, pulmonary artery, pulmonary veins, LA, mitral valve, LV, aortic valve

Front 70

Which of the following formulas is used to calculate the total amount of blood pumped by the heart per minute, or cardiac output?

Back 70

Rate x stroke volume

Front 71

The first heart sound is associated with what mechanical event of the cardiac cycle?

Back 71

atrioventricular valve closure

Front 72

The second heart sound is associated with what mechanical event of the cardiac cycle?

Back 72

semilunar valve closure

Front 73

During each cycle of normal resting ventilation, a volume of gas is moved into and out of the respiratory tract. The cyclical volume is called the:

Back 73

tidal volume (Vt)

Front 74

What pressures vary throughout the normal breathing cycle?

Back 74

alveolar pressure (Palv) and pleural pressure (Ppl)

Front 75

Which of the pressure gradients is responsible for the actual flow of gas into and out of the lungs during breathing?

Back 75

transrespiratory pressure gradient (Palv-Pao)

Front 76

Which of the following pressure gradients is responsible for maintinaing alveolar inflation?

Back 76

transpulmonary pressure gradient (Palv-Ppl)

Front 77

During expiration, why does gas flow out from the lungs to the atmosphere?

Back 77

Palv is greater than at the airway opening

Front 78

What term is used to note the difference between inspiratory lung volume and expiratory lung volume at any given pressure?

Back 78

hysterisis

Front 79

The presence of surfactant in the alveoli tends to do which of the following?

Back 79

decrease surface tension

Front 80

What occurs at a lung volume equivalent to the functional residual capacity (FRC)?

Back 80

The forces of the chest wall and lungs are in balance, chest wall expansion is offset by lung contraction, and opposing chest wall-lung forces generate negative Ppl.

Front 81

What is the term for the impedance to ventilation caused by the movement of gas through the conducting system of the lungs?

Back 81

airway resistance

Front 82

How is airway resistance (Raw) computed?

Back 82

change in pressure/ change in volume

Front 83

Normal Raw is approximately which of the following?

Back 83

0.5 to 2.5 cm H2O/L/sec

Front 84

If a patient has Vt of 370 ml and repiratory rate of 20 breaths per minute, what is the minute ventilation?

Back 84

7.40 L/ min

Front 85

A patient has a Vt of 625 ml and physiological dead space of 275 ml and is breathing at a frequency of 16 per minute. what is the alveolar ventilation (VA)?

Back 85

5600 ml/min

Front 86

A normal 150 lb man is breathing at a rate of 17 with a tidal volume of 450 ml. By estimation, what is his approximate alveolar ventilation?

Back 86

5.10 L/ min

Front 87

In what portion of the lungs does alvelolar dead space normally occur?

Back 87

apices

Front 88

Which is the correct formula to calculate the alvelar minute ventilation of spontaneously breathing subject?

Back 88

fx(Vt-VDSphys)

Front 89

In clinical practice measuring the physiologic dead space ventilation is achieved by using which formula?

Back 89

modified Bohr equation

Front 90

Given a constant cabon dioxide production, how will changing the level of VA affect the PaCO2?

Back 90

an increase in Va will decrease PaCO2

Front 91

What is ventilation in excess of metabolic needs called?

Back 91

hyperventilation

Front 92

What is the single best indicator of the adequacy or effectiveness of VA?

Back 92

PaCO2