, Hillegass:EssentialsofCardiopulmonaryPhysicalTherapy,3rdEdition
Chapter1:AnatomyoftheCardiovascularandPulmonarySystemsTest
Bank
MULTIPLECHOICE
1. Whichofthefollowingchestwallstructuresislocatedlevelwiththesecondcostalcartilage
n
anteriorlyandthoracicvertebraT4andT5posteriorly?
n n
A. Sternalangle
B. Jugularnotch
C. Xiphoidprocess
D. Thirdcostalcartilage
ANS: A
Thesternalangleofthe“angleofLouis”islevelwiththesecondcostalcartilageanteriorly andthoracic
vertebraeT4andT5posteriorly.
PTS: 1
2. PectusexcuvatumisBESTdescribedas:
A. Deformityofthesternumcausedbytrauma
B. Caved-inappearanceofthechest
C. Diminishedribangleanteriorly
D. Conicalshapeofthethoraciccage
ANS: B
Pectusexcuvatumisacommoncongenitaldeformityoftheanteriorwallofthechest,inwhichseveral
ribsandthesternumgrowabnormally;itproducesacaved-inorsunkenappearanceofthechest.
n n
PTS: 1
3. ThetrueribsareBESTdefinedbywhichofthefollowingstatements?
A. Vertebrochondralribs
B. Vertebrosternalribs
C. Ribs11and12
D. Ribs8,9,and10
n
ANS: B
Thefirstsevenribsattachviatheircostalcartilagestothesternumandarecalledthetrueribs (also
knownasthevertebrosternalribs).
n
PTS: 1
Copyright©2011,2001,1994bySaunders,animprintofElsevierInc.
n n
, TestBank
n 1-2
4. Whichofthefollowinginterventionsis MOSTappropriateforapatientwithlowerribfractures?
A. Short,shallowbreaths
B. Pursedlipbreathing
C. Deepbreathswithsplinting
D. Breathingwitharmsraised
ANS: C
Itisimportantforalltherapiststorecommendbreathing(deepbreathing),splinting(i.e.,pillow),and
coughingstrategiesforpatientswithribfractures.
PTS: 1
5. Whichofthefollowingpositionsfacilitatesgreaterexcursionofbothhemidiaphragms at rest?
A. Supineposition
B. Sidelyingposition
C. Standingposition
D. Sittingposition
ANS: A
Inthesupineposition,withouttheeffectsofgravity,thelevelofthediaphragminthethoraciccavity
n
rises.Thisallowsforarelativelygreaterexcursion.
PTS: 1
6. Whichofthefollowingmuscleshelptoachievetheactiveprocessofinspirationatrest?
A. Sternocleidomastoid
B. Diaphragm
C. Abdominalmuscles
D. Trapezius
ANS: B
Thediaphragmandinternalintercostals(intercartilaginousportion)aretheessentialmusclesto
achievetheactiveprocessofinspirationatrest.Abdominalmusclesassistwithexpiration.The
n
sternocleidomastoidandtrapeziusareaccessorymusclesandassistwithamoreforcefulinspiration.
n n n n
PTS: 1
7. Whichofthefollowingaccessorymusclesofventilationfunctiontoelevateandfixthefirstand
secondribs?
n
A. Sternocleidomastoid muscle
v
B. Serratusanterior
C. Latissimusdorsi
D. Scalenemuscle
ANS: D
Copyright©2011,2001,1994bySaunders,animprintofElsevierInc.
n n
, TestBank
n 1-3
Thescalenemusclesliedeeptothesternocleidomastoid,butmaybepalpatedintheposteriortriangle
n n
oftheneck.Thesemusclesfunctionasaunittoelevateandfixthefirstandsecondribs.The
sternocleidomastoidmuscleelevatesthesternum.
n
PTS: 1
8. Whenthearmsandshouldersarefixed,byleaningontheelbowsorgraspingontoatable,this
muscle canuseitsinsertionasitsoriginandfacilitateanincreaseintheA-Pdiameterofthethorax.
n n n
A. Uppertrapezius
B. Pectoralismajor
C. Sternocleidomastoid
D. Serratusanterior
ANS: B
Whentheinsertion andoriginofthepectoralismusclearereversedbyleaningonatabletofixthearms,the
n n n
musclewillpullontheanteriorchestwall,liftingtheribsandsternumtoincreasethe A-Pdiameterofthe
thoraciccage.
PTS: 1
9. Theserous fluid withinthepleuralspaceservestoprovidewhichofthefollowingfunctions?
A. Createaconstantnegativepressure
B. Assist with venous return ofbloodtotheheart
v
C. Reducefrictionbetweenthelungsandthoracicwall
D. Servetoallowseparationofthepleurallayers
ANS: C
The serous fluid withinthe pleural space serves to hold the pleural layers together during ventilation
andreducefrictionbetweenthelungsandthethoracicwall.Thespacecreatesthe negative pressure to
maintainlunginflation,notthefluiditself.
n n
PTS: 1
10. Irritationofthephrenicsuppliedpleuraresultsinwhichofthefollowingpainreferralpatterns?
A. Thoracicwall
B. Abdominalwall
C. Mediasternalregion
D. Lowerneckandshoulder
ANS: D
Irritationofthephrenicsuppliedpleuracanresultinreferredpaininthelowerneckandshoulder,whereas,
n n n n
irritationoftheintercostallyinnervatedpleuramayresultinreferralofpaintothethoracicorabdominal
wall.
PTS: 1
11. Anabnormalpleuralfrictionr ubonauscultationBESTindicateswhichofthefollowing?
n m n
A. Infectionwitharesultantinflammatoryresponsewithinthepleura
Copyright©2011,2001,1994bySaunders,animprintofElsevierInc.
n n
Chapter1:AnatomyoftheCardiovascularandPulmonarySystemsTest
Bank
MULTIPLECHOICE
1. Whichofthefollowingchestwallstructuresislocatedlevelwiththesecondcostalcartilage
n
anteriorlyandthoracicvertebraT4andT5posteriorly?
n n
A. Sternalangle
B. Jugularnotch
C. Xiphoidprocess
D. Thirdcostalcartilage
ANS: A
Thesternalangleofthe“angleofLouis”islevelwiththesecondcostalcartilageanteriorly andthoracic
vertebraeT4andT5posteriorly.
PTS: 1
2. PectusexcuvatumisBESTdescribedas:
A. Deformityofthesternumcausedbytrauma
B. Caved-inappearanceofthechest
C. Diminishedribangleanteriorly
D. Conicalshapeofthethoraciccage
ANS: B
Pectusexcuvatumisacommoncongenitaldeformityoftheanteriorwallofthechest,inwhichseveral
ribsandthesternumgrowabnormally;itproducesacaved-inorsunkenappearanceofthechest.
n n
PTS: 1
3. ThetrueribsareBESTdefinedbywhichofthefollowingstatements?
A. Vertebrochondralribs
B. Vertebrosternalribs
C. Ribs11and12
D. Ribs8,9,and10
n
ANS: B
Thefirstsevenribsattachviatheircostalcartilagestothesternumandarecalledthetrueribs (also
knownasthevertebrosternalribs).
n
PTS: 1
Copyright©2011,2001,1994bySaunders,animprintofElsevierInc.
n n
, TestBank
n 1-2
4. Whichofthefollowinginterventionsis MOSTappropriateforapatientwithlowerribfractures?
A. Short,shallowbreaths
B. Pursedlipbreathing
C. Deepbreathswithsplinting
D. Breathingwitharmsraised
ANS: C
Itisimportantforalltherapiststorecommendbreathing(deepbreathing),splinting(i.e.,pillow),and
coughingstrategiesforpatientswithribfractures.
PTS: 1
5. Whichofthefollowingpositionsfacilitatesgreaterexcursionofbothhemidiaphragms at rest?
A. Supineposition
B. Sidelyingposition
C. Standingposition
D. Sittingposition
ANS: A
Inthesupineposition,withouttheeffectsofgravity,thelevelofthediaphragminthethoraciccavity
n
rises.Thisallowsforarelativelygreaterexcursion.
PTS: 1
6. Whichofthefollowingmuscleshelptoachievetheactiveprocessofinspirationatrest?
A. Sternocleidomastoid
B. Diaphragm
C. Abdominalmuscles
D. Trapezius
ANS: B
Thediaphragmandinternalintercostals(intercartilaginousportion)aretheessentialmusclesto
achievetheactiveprocessofinspirationatrest.Abdominalmusclesassistwithexpiration.The
n
sternocleidomastoidandtrapeziusareaccessorymusclesandassistwithamoreforcefulinspiration.
n n n n
PTS: 1
7. Whichofthefollowingaccessorymusclesofventilationfunctiontoelevateandfixthefirstand
secondribs?
n
A. Sternocleidomastoid muscle
v
B. Serratusanterior
C. Latissimusdorsi
D. Scalenemuscle
ANS: D
Copyright©2011,2001,1994bySaunders,animprintofElsevierInc.
n n
, TestBank
n 1-3
Thescalenemusclesliedeeptothesternocleidomastoid,butmaybepalpatedintheposteriortriangle
n n
oftheneck.Thesemusclesfunctionasaunittoelevateandfixthefirstandsecondribs.The
sternocleidomastoidmuscleelevatesthesternum.
n
PTS: 1
8. Whenthearmsandshouldersarefixed,byleaningontheelbowsorgraspingontoatable,this
muscle canuseitsinsertionasitsoriginandfacilitateanincreaseintheA-Pdiameterofthethorax.
n n n
A. Uppertrapezius
B. Pectoralismajor
C. Sternocleidomastoid
D. Serratusanterior
ANS: B
Whentheinsertion andoriginofthepectoralismusclearereversedbyleaningonatabletofixthearms,the
n n n
musclewillpullontheanteriorchestwall,liftingtheribsandsternumtoincreasethe A-Pdiameterofthe
thoraciccage.
PTS: 1
9. Theserous fluid withinthepleuralspaceservestoprovidewhichofthefollowingfunctions?
A. Createaconstantnegativepressure
B. Assist with venous return ofbloodtotheheart
v
C. Reducefrictionbetweenthelungsandthoracicwall
D. Servetoallowseparationofthepleurallayers
ANS: C
The serous fluid withinthe pleural space serves to hold the pleural layers together during ventilation
andreducefrictionbetweenthelungsandthethoracicwall.Thespacecreatesthe negative pressure to
maintainlunginflation,notthefluiditself.
n n
PTS: 1
10. Irritationofthephrenicsuppliedpleuraresultsinwhichofthefollowingpainreferralpatterns?
A. Thoracicwall
B. Abdominalwall
C. Mediasternalregion
D. Lowerneckandshoulder
ANS: D
Irritationofthephrenicsuppliedpleuracanresultinreferredpaininthelowerneckandshoulder,whereas,
n n n n
irritationoftheintercostallyinnervatedpleuramayresultinreferralofpaintothethoracicorabdominal
wall.
PTS: 1
11. Anabnormalpleuralfrictionr ubonauscultationBESTindicateswhichofthefollowing?
n m n
A. Infectionwitharesultantinflammatoryresponsewithinthepleura
Copyright©2011,2001,1994bySaunders,animprintofElsevierInc.
n n
