Deck 2: Ventilation

Question 1

Which pressure is represented by .

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

Answer 1

A

Question 2

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

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

Answer 2

A

Question 3

What of the following is used to calculate lung compliance?

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

Answer 3

A

Question 4

In a flail chest,which pressure gradients are responsible for the inward movement on inspiration of the section of unattached ribs?
I)Transpulmonary
II)Transmural
III)Transthoracic
IV)Transrespiratory

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

Question 5

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) 0.066 L/cm H20
C) 1.5 L/cm H20
D) 0.24 L/cm H20

Question 6

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

Question 7

At what point in the respiratory cycle is the equilibrium point reached?
I)Inspiration
II)End-inspiration
III)Expiration
IV)End-expiration

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

Question 8

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

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

Question 9

What is the term for the difference between the alveolar pressure and the body surface pressure?

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

Question 10

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

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

Question 11

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

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

Question 12

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

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

Question 13

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

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

Question 14

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

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

Question 15

How does air trapping and hyperinflation of the lungs affect lung compliance?

A) lung compliance is reduced
B) lung compliance is increased
C) lung compliance is normal
D) lung compliance is unaffected by hyperinflation

Question 16

What instrument is used to measure Pₐtm ?

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

Question 17

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

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

Question 18

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

Question 19

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

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

Question 20

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

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

Question 21

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) dynamic
B) static
C) passive
D) respiration

Question 22

What is the primary surface tension lowering chemical in pulmonary surfactant?

A) DPPC
B) CPPD
C) PCP
D) BPD

Question 23

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

Question 24

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

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

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

Question 26

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

Question 27

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

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

Question 28

What effect do restrictive lung diseases have on lung compliance?

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

Question 29

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

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

Question 30

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

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

Question 31

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

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

Question 32

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

Question 33

Which physical law explains elastance?

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

Question 34

What is the reciprocal of compliance?

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

Question 35

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

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

Question 36

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

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

Question 37

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

Question 38

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

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

Question 39

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

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

Question 40

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% ?

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

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

Question 42

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

Question 43

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

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

Question 44

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) pendulluft
D) frequency dependence

Question 45

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

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

Question 46

What are the boundaries of anatomic dead space?

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

Question 47

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

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

Question 48

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

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

Question 49

What effect will increased Rₐw and increasedCL have on the time constants in the affected lung regions?

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

Question 50

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

A) alveolar deadspace
B) anatomic deadspace
C) physiologic deadspace
D) minute alveolar ventilation

Question 51

What is the average respiratory rate for an adult at rest?

A) 12-18 breaths/min
B) 5-12 breaths/min
C) 14-24 breath/min
D) 19-26 breaths/min

Question 52

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

Question 53

What is the approximate volume of anatomic deadspace?

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

Question 54

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

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

Question 55

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

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

Question 56

What does frequency multiplied by (VT-VD)equal?

A) minute alveolar ventilation
B) minute ventilation
C) physiologic deadspace ventilation
D) alveolar deadspace

Question 57

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

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

Question 58

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

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

Question 59

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

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

Question 60

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

Question 61

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 62

Which abnormal breathing pattern is most commonly associated with ketoacidosis?

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

Question 63

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

Question 64

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) x 11 = 4.18 L
B) (550 + 170) x 11 = 7.9 L
C) 550 + (170 x 11) = 1.87 L
D) 550 - (170/2.2) x 11= 4.65 L

Question 65

What is the term for a rapid respiratory rate?

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

Question 66

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

Question 67

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

Question 68

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

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

Question 69

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

Question 70

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

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

Question 71

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

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

Question 72

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

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

Question 73

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

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

Question 74

What does the sum of anatomic deadspace and alveolar deadspace equal?

A) physiologic deadspace
B) minute ventilation
C) alveolar ventilaion
D) total gas exchange

Question 75

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

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

Question 76

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

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

Question 77

What is the only absolute way of confirming hyperventilation?

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