Updated/Latest Essentials of Cardiopulmonary Physical Therapy 3rd Edition Comprehensive Cardiopulmonary Rehabilitation Test Bank Practice Questions Answers Rationales Respiratory and Cardiac Rehabilitation Exercise Physiology Clinical Decision Making Phys

, Hillegass: Essentials of Cardiopulmonary Physical Therapy, 3rd Edition
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Chapter 1: Anatomy of the Cardiovascular and Pulmonary Systems
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MULTIPLE CHOICE L




1. Which of the following chest wall structures is located level with the second costal cartilage
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anteriorly and thoracic vertebra T4 and T5 posteriorly?
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A. Sternal angle L



B. Jugular notch L



C. Xiphoid process L



D. Third costal cartilage L L




ANS: A L L



The sternal angle of the “angle of Louis” is level with the second costal cartilage anteriorly and
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thoracic vertebrae T4 and T5 posteriorly.
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PTS: 1

2. Pectus excuvatum is BEST described as:
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A. Deformity of the sternum caused by trauma L L L L L L



B. Caved-in appearance of the chest L L L L



C. Diminished rib angle anteriorly L L L



D. Conical shape of the thoracic cage L L L L L




ANS: B L L



Pectus excuvatum is a common congenital deformity of the anterior wall of the chest, in which
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several ribs and the sternum grow abnormally; it produces a caved-in or sunken appearance of
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the chest.
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PTS: 1

3. The true ribs are BEST defined by which of the following statements?
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A. Vertebrochondral ribs L



B. Vertebrosternal ribs L



C. Ribs 11 and 12 L L L



D. Ribs 8, 9, and 10 L L L L




ANS: B L L



The first seven ribs attach via their costal cartilages to the sternum and are called the true ribs (also
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known as the vertebrosternal ribs).
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PTS: 1




Copyright ©2011, 2001, 1994 by Saunders, an imprint of Elsevier Inc.
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4. Which of the following interventions is MOST appropriate for a patient with lower rib fractures?
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A. Short, shallow breaths L L



B. Pursed lip breathing L L



C. Deep breaths with splinting L L L



D. Breathing with arms raised L L L




ANS: C L L



It is important for all therapists to recommend breathing (deep breathing), splinting (i.e., pillow),
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and coughing strategies for patients with rib fractures.
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PTS: 1

5. Which of the following positions facilitates greater excursion of both hemidiaphragms at rest?
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A. Supine position L



B. Sidelying position L



C. Standing position L



D. Sitting position L




ANS: A L L



In the supine position, without the effects of gravity, the level of the diaphragm in the thoracic
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cavity rises. This allows for a relatively greater excursion.
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PTS: 1

6. Which of the following muscles help to achieve the active process of inspiration at rest?
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A. Sternocleidomastoid
B. Diaphragm
C. Abdominal muscles L



D. Trapezius
ANS: B L L



The diaphragm and internal intercostals (intercartilaginous portion) are the essential muscles to
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achieve the active process of inspiration at rest. Abdominal muscles assist with expiration. The
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sternocleidomastoid and trapezius are accessory muscles and assist with a more forceful
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inspiration.
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PTS: 1

7. Which of the following accessory muscles of ventilation function to elevate and fix the first and
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second ribs?
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A. Sternocleidomastoid muscle L



B. Serratus anterior L



C. Latissimus dorsi L



D. Scalene muscle L




L ANS: D L




Copyright ©2011, 2001, 1994 by Saunders, an imprint of Elsevier Inc.
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The scalene muscles lie deep to the sternocleidomastoid, but may be palpated in the posterior
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triangle of the neck. These muscles function as a unit to elevate and fix the first and second ribs.
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The sternocleidomastoid muscle elevates the sternum.
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PTS: 1

8. When the arms and shoulders are fixed, by leaning on the elbows or grasping onto a table, this
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muscle can use its insertion as its origin and facilitate an increase in the A-P diameter of the
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thorax.
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A. Upper trapezius L



B. Pectoralis major L



C. Sternocleidomastoid
D. Serratus anterior L




ANS: B L L



When the insertion and origin of the pectoralis muscle are reversed by leaning on a table to fix
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the arms, the muscle will pull on the anterior chest wall, lifting the ribs and sternum to increase
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the A-P diameter of the thoracic cage.
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PTS: 1
9. The serous fluid within the pleural space serves to provide which of the following functions?
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A. Create a constant negative pressure L L L L



B. Assist with venous return of blood to the heart
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C. Reduce friction between the lungs and thoracic wall L L L L L L L



D. Serve to allow separation of the pleural layers
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ANS: C L L



The serous fluid within the pleural space serves to hold the pleural layers together during
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ventilation and reduce friction between the lungs and the thoracic wall. The space creates the
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negative pressure to maintain lung inflation, not the fluid itself.
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PTS: 1
10. Irritation of the phrenic supplied pleura results in which of the following pain referral patterns?
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A. Thoracic wall L



B. Abdominal wall L



C. Mediasternal region L



D. Lower neck and shoulder L L L




ANS: D L L



Irritation of the phrenic supplied pleura can result in referred pain in the lower neck and shoulder,
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whereas, irritation of the intercostally innervated pleura may result in referral of pain to the
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thoracic or abdominal wall.
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PTS: 1

11. An abnormal pleural friction rub on auscultation BEST indicates which of the following?
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A. Infection with a resultant inflammatory response within the pleura
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Copyright ©2011, 2001, 1994 by Saunders, an imprint of Elsevier Inc.
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