Deck 2: Ventilation

Question 1

What is the term for the pressure difference that occurs across the airway wall ?

A) Transmural pressure
B) Transrespiratory pressure
C) Transpulmonary pressure
D) Transthoracic pressure

Answer 1

A

Question 2

What is the general term for a pressure difference between two points in a system?

A) diffusion
B) osmotic gradient
C) pressure gradient
D) system pressure variation

Answer 2

C

Question 3

At sea level, what would the alveolar pressure at end-expiration equal?

A) 760 mm Hg
B) 0 mm Hg
C) 764 mmHg
D) 756 mm Hg

Answer 3

A

Question 4

Which sequence represents one respiratory cycle? ?
I. Inspiration, expiration
II. Inspiration, end-inspiration, expiration, and end-expiration
III. Expiration, end-expiration, inspiration, end-inspiration
IV. End-inspiration, inspiration, end-expiration, expiration

A) II only
B) IV only
C) 1 and III only
D) II and IV only

Question 5

What of the following is used to calculate lung compliance?

A) P=(2ST) / r
B) Δ V/ Δ P
C) P1V1=P2V2
D) Δ P/ Δ V

Question 6

What instrument is used to measure Patm?

A) dynameter
B) altimeter
C) barometer
D) hygrometer

Question 7

What is the term for the difference between the alveolar pressure and the pleural pressure?

A) transmural pressure
B) transthoracic pressure
C) transrespiratory pressure
D) transpulmonary pressure

Question 8

At sea level under standard conditions, what would the P_B equal in mm Hg ?

A) 29.9
B) 1034
C) 14.7
D) 760

Question 9

Which clinical measurement is used to evaluate the elastic forces of the lungs?

A) elastance
B) lung compliance
C) surface tension
D) airway resistance

Question 10

At what point in the ventilatory cycle would the intra-alveolar pressure be higher than the atmospheric pressure?

A) pre-inspiration
B) inspiration
C) expiration
D) end-expiration

Question 11

Which pressure is represented by P_rs = P_B - P_alv ?

A) transmural pressure
B) transpulmonary pressure
C) transthoracic pressure
D) transrespiratory pressure

Question 12

What is the movement of air from one lung to another?

A) seesaw effect
B) pendulluft
C) flail chest
D) diaphragm paralysis

Question 13

Which abnormal breathing pattern is a result of diaphragm fatigue or paralysis?

A) partial inspiration
B) abdominal paradox
C) respiratory distress
D) abdominal protrusion

Question 14

What is the general term for the inward movement of tissue between the ribs during inspiration due to increased negative intrapleural pressure generated during respiratory distress?

A) dyspnea
B) intercostal retractions
C) supraclavicular retractions
D) pectus excavatum

Question 15

Reversible bronchospasm, airways inflammation, mucous plugging, and hyperinflation of the alveoli are characteristics of what pulmonary disorder?

A) cystic fibrosis
B) emphysema
C) flail chest
D) asthma

Question 16

What is the general term for the force required to move gas or fluid through a tube or vessel?

A) transthoracic pressure
B) driving pressure
C) transpulmonary pressure
D) transmural pressure

Question 17

What would the lung compliance equal if a pressure change of 4 cm H20 resulted in a volume change of 600 mL?

A) 0.15L/cm H20
B) 1.5 L/cm H20
C) 0.24 L/cm H20
D) 0.066 L/cm H20

Question 18

What is the term for the movement of gas from the external environment to the alveoli?

A) external respiration
B) ventilation
C) internal respiration
D) osmosis

Question 19

Which gas law states that at constant temperature, a volume of gas varies inversely proportional to its pressure?

A) Henry's
B) Charles
C) Boyle's
D) Gay-Lussac's

Question 20

How do obstructive lung diseases that cause air trapping affect lung compliance?

A) Lung compliance remains normal.
B) Lung compliance is reduced.
C) Lung compliance is increased.
D) Lung compliance is unaffected by air trapping.

Question 21

When the average alveolus is fully distended, what is the approximate surface tension?

A) 5-15 dynes/cm
B) 50 dynes/cm
C) 5-15 cm H20
D) 50 cm H20

Question 22

When a tension pneumothorax occurs during positive pressure ventilation, how will the cardiac output and blood pressure affected?

A) The BP will increase but the BP will decrease
B) Both will increase
C) The cardiac output will increase but the BP will decrease
D) Both will decrease

Question 23

Which physical law explains elastance?

A) Gay-Lussac's law
B) Charles' law
C) Boyle's law
D) Hooke's law

Question 24

Which substance in the alveoli is responsible for lowering the surface tension?

A) saline
B) pulmonary surfactant
C) plasma
D) mucus

Question 25

When Poiseuille's law is rearranged for flow with pressure remaining constant, what impact would reducing the radius of a tube by 50% have on the gas flow?

A) It would be reduced to 1/16 of the original flow
B) It would increase to 16 times more than the original flow
C) It would be reduced to 1/4 the original flow
D) It would increase to 16 times more than the original flow

Question 26

What effect do restrictive lung diseases have on lung compliance?

A) Restrictive lung diseases do not affect lung compliance.
B) Lung compliance decreases
C) Lung compliance remains normal
D) Lung compliance increases

Question 27

What is the term for the molecular cohesive force at a liquid-gas interface?

A) compliance
B) elastance
C) resistance
D) surface tension

Question 28

Which of the following can cause pulmonary surfactant deficiency? ?
I. Pulmonary embolism
II. Pulmonary edema
III. Atelectasis
IV. ARDS

A) I, II, III, and IV
B) II and III only
C) I , II, and III only
D) II and IV only

Question 29

What term is used in respiratory care to describe the movement of gas in and out of the lung and the pressure changes required to move the gas?

A) passive
B) respiration
C) static
D) dynamic

Question 30

What percentage of pulmonary surfactant is composed of phospholipids?

A) 75
B) 90
C) 50
D) 20

Question 31

What is the treatment of choice for the early stages of RDS in premature infants?

A) oxygen therapy
B) CPAP
C) long acting bronchodilators
D) steroids

Question 32

When Poiseuille's law is rearranged for pressure, what adjustment must be made in driving pressure to maintain the same flowrate when the radius of the tube is reduced by 50 percent?

A) The pressure must be increased to 4 times the original pressure
B) The pressure must be increased to 16 times the original
C) The pressure must be doubled
D) The pressure must be reduced by 50 percent

Question 33

Who is credited with the following equation: P = (2ST)/r ?

A) Hooke
B) LaPlace
C) Dalton
D) Boyle

Question 34

When the radius of the bronchial airways decreases during exhalation, what change must occur to maintain a constant gas flow?

A) The transthoracic pressure must remain constant
B) The transthoracic pressure must vary inversely with the second power of the radius
C) The transthoracic pressure must vary directly with the fourth power of the radius
D) The transthoracic pressure must vary inversely with the fourth power of the radius

Question 35

What is the reciprocal of compliance?

A) elastance
B) viscosity
C) resistance
D) surface tension

Question 36

Which of the following would shift the volume-pressure curve to the right? ?
I. Acute asthma episode
II. Pneumothorax
III. Pleural effusion
IV. Pulmonary edema

A) II, II, and IV only
B) I. III and IV only
C) I, II, and IV only
D) Ii and IV only

Question 37

What is derived when the pressure difference between the mouth and alveoli is divided by the flowrate?

A) airway resistance
B) lung compliance
C) chest wall compliance
D) surface tension

Question 38

Which law best explains the basic operation of the negative pressure ventilator?

A) Charles'
B) Boyle's
C) Hooke's
D) Dalton's

Question 39

When a positive pressure breath is delivered from a mechanical ventilator, how would intra-alveolar and intrapleural pressures be affected during inspiration?

A) The intra-alveolar pressure would rise while the intrapleural pressure remains subatmospheric
B) Both would remain constant at their resting levels
C) Both would decrease
D) Both would increase

Question 40

Which of the following are periods of no gas flow during negative-pressure ventilation?
I. Inspiration
II. End-inspiration
III. Expiration
IV. End-expiration

A) II only
B) I and III only
C) IV only
D) II and IV only

Question 41

If an individual generates a flow rate of 4 L/sec by generating a transrespiratory pressure of 6 cm H20, what would Raw equal?

A) 1.5 L/sec/cm H20
B) 2.4 L/sec/ cm H20
C) 1.5 cm H20/L/sec
D) 0.67 cm H20/L/sec

Question 42

What effect will increased R_aw and increased C_L have on the time constants in the affected lung regions?

A) Time constants are unaffected by C_L. but will require more time to inflate in the affected region due to the increased R_aw
B) Both factors require less time for the affected lung region to inflate
C) Time constants are unaffected by R_aw but will require less time to inflate due to the increased C_L.
D) Both factors require more time for the affected region to inflate.

Question 43

When lung compliance is reduced by half, how will time constants be affected?

A) The time constants will double
B) The time constant will be reduced by half
C) The time constant will increase to four times the original
D) The time constant will be reduced to one-fourth of the original

Question 44

What is the average respiratory rate for a healthy toddler at rest?

A) 15-24 breaths/min
B) 25-40 breaths/min
C) 12-20 breaths/min
D) 30-60 breaths/min

Question 45

Which flow pattern occurs in airways at high flow rates and high pressure gradients?

A) laminar flow
B) turbulent flow
C) transitional flow
D) tracheobronchial flow

Question 46

With the end expiratory pause is factored in, what is the normal I:E ratio for an adult at rest?

A) 1 : 3
B) 1 : 2.5
C) 1 : 1
D) 1 : 2

Question 47

What is the term for alveolar ventilation without pulmonary capillary perfusion?

A) alveolar dead space
B) physiologic dead space
C) minute alveolar ventilation
D) anatomic dead space

Question 48

If a patient who generates an intrapleural pressure of -4 mmHg to inhale 450 mL experiences inflammation and bronchospasm that reduce the radius of the bronchial airways to one-half of their original size, what pressure must the patient generate to inhale the same tidal volume?

A) 16 mm Hg
B) 64 mm Hg
C) 20 mm Hg
D) 48 mm Hg

Question 49

Which flow pattern occurs in airways at low flow rates and low pressure-gradients?

A) turbulent flow
B) laminar flow
C) tracheobronchial flow
D) transitional flow

Question 50

What changes in breathing patterns do patients with obstructive pulmonary disorders with increased R_aw and increased time constants typically adopt?

A) They increase their respiratory rate and tidal volume
B) They increase their respiratory rate and decrease their tidal volume
C) They decrease their respiratory rate and increase their tidal volume
D) The decrease their respiratory rate and tidal volume

Question 51

What is the approximate volume of anatomic dead space?

A) 2.2 mL/lb of ideal body weight
B) 2.2 mL/kg actual body weight
C) 1 mL/lb of ideal body weight
D) 1 mL/kg of ideal body weight

Question 52

When rapid ventilatory rates occur, what is the term for the condition in which positive pressure remains in the alveoli during exhalation due to the insufficient expiratory time?

A) auto-PEEP
B) WOB
C) frequency dependence
D) pendulluft

Question 53

In the presence of restrictive lung disorders, how do patients typically offset the decreased time constants?

A) They adopt a decreased respiratory rate and add a breath hold
B) They adopt a decreased respiratory rate
C) They adopt a decreased respiratory rate with an increased tidal volume
D) They adopt an increased respiratory rate

Question 54

What term is defined as "the change in volume of the lungs divided by the change in transpulmonary pressure during the time required for one breath'?

A) static compliance
B) time constant
C) airway resistance
D) dynamic compliance

Question 55

A 5 ft tall female who weighs 300 lb requires mechanical ventilation. If the prescribed tidal volume for this patient's condition is 6 mL/kg IBW, where should the set tidal volume be set?

A) approximately 520 mL
B) approximately 380 mL
C) approximately 820 mL
D) approximately 290 mL

Question 56

What is defined as "the time required to inflate a lung region to 60% of its filling capacity"?

A) inspiratory time
B) maximum inspiratory time
C) dynamic compliance
D) time constant

Question 57

What is the average respiratory rate for a newborn infant?

A) 19-26 breaths/min
B) 25-40 breaths/min
C) 30-60 breaths/min
D) 50-80 breaths/min

Question 58

What are the boundaries of anatomic dead space?

A) nose and mouth to the alveolar sacs
B) nose and mouth through the terminal bronchioles
C) nose and mouth to the segmental bronchi
D) nose and mouth to the bronchioles

Question 59

What is the term for the volume of gas that is typically measured during exhalation of one quiet breath?

A) expiratory reserve volume
B) minute volume
C) tidal volume
D) expiration

Question 60

What does frequency multiplied by (V_T-V_D) equal?

A) alveolar dead space
B) physiologic dead space ventilation
C) minute alveolar ventilation
D) minute ventilation

Question 61

Which ventilatory pattern is defined as the complete absence of spontaneous breathing?

A) apnea
B) dyspnea
C) apneusis
D) eupnea

Question 62

Which abnormal breathing pattern is most commonly associated with ketoacidosis?

A) Cheyne Stokes
B) Hypopnea
C) Biot's
D) Kussmaul's

Question 63

What is the term for a rapid respiratory rate?

A) hyperpnea
B) hyperventilation
C) eupnea
D) tachypnea

Question 64

What is the term for alteration of the ventilatory pattern to minimize dead space ventilation?

A) metabolic efficiency
B) hyperventilation
C) ventilatory efficiency
D) Hyperefficiency

Question 65

What is the term for the breathing condition in which short episodes of rapid, uniform deep breaths are followed by 10-30 seconds of apnea?

A) Levy's
B) Cheyne-Stokes
C) Biot's
D) Kussmaul's

Question 66

Which of the following can cause pulmonary emboli? ?
I. Prolonged inactivity
II. Pregnancy and childbirth
III. Obesity
IV. Hypercoagulation disorders

A) I, II, III, and IV
B) I, III, and IV only
C) I and IV only
D) I, II, and III only

Question 67

In which breathing pattern is an individual only able to breathe comfortably in the upright position?

A) tachypnea
B) orthopnea
C) eupnea
D) hyperpnea

Question 68

How does the normal adult's respiratory pattern change when lung compliance decreases?

A) respiratory rate and tidal volume increase
B) respiratory rate and tidal volume decrease.
C) respiratory rate increases and tidal volume decreases
D) respiratory rate decreases and tidal volume increase

Question 69

How would the addition of a length of tubing between a ventilator and the endotracheal tube affect on dead space?

A) It would have no effect on dead space
B) It would have no effect on dead space but would increase the tidal volume
C) It would decrease the dead space
D) It would increase the dead space

Question 70

What is the term for the breathing pattern in which the depth of breathing increases?

A) hyperpnea
B) Kussmaul's
C) hyperventilation
D) tachypnea

Question 71

In a healthy adult at rest, what portion of the total energy output is required for the work of breathing?

A) 5%
B) 15 %
C) 25%
D) 35%

Question 72

What would the minute alveolar ventilation equal if a 6 ft tall, 170 lb male has a VT of 550 mL and a respiratory rate of 11 breaths/min?

A) 550 - (170/2.2) x 11= 4.65 L
B) 550 - (170/2.2) x 11= 4.65 L
C) (550 + 170) x 11 = 7.9 L
D) 550 + (170 x 11) = 1.87 L

Question 73

What does the sum of anatomic dead space and alveolar dead space equal?

A) minute ventilation
B) alveolar ventilation
C) physiologic dead space
D) total gas exchange

Question 74

In the upright position, which portion of the lungs has the most negative pleural pressure?

A) hilum
B) base
C) apex
D) intrapleural pressure is uniform throughout all lung areas

Question 75

In the upright lung, how does compliance vary across the lung?

A) The compliance in the apices is lower than in the bases
B) The compliance is higher at the hilum than in the apices or bases.
C) The compliance in the bases is lower than in the apices
D) The compliance is uniform in all regions of the lung

Question 76

What is the only absolute way of confirming hyperventilation?

A) assess the tidal volume
B) ask the patient
C) monitor the PaCO₂
D) assess the respiratory rate

Question 77

How does the breathing pattern change when a patient with COPD develops a secondary restrictive lung condition such as pneumonia?

A) respiratory rate increases
B) no breathing pattern changes would occur.
C) respiratory rate and tidal volume decrease.
D) respiratory rate decreases and tidal volume increase