Copyright ©2011, 2001, 1994 by Saunders, an imprint of Elsevier
oo oo oo oo oo oo oo oo oo
Inc.
, Hillegass: Essentials of Cardiopulmonary Physical Therapy, 3rd Edition
oo oo oo oo oo oo oo
Chapter 1: Anatomy of the Cardiovascular and Pulmonary Systems
oo oo oo oo oo oo oo oo
oo Test Bank
oo
MULTIPLE CHOICE oo
1. Which of the following chest wall structures is located level with the second costal
oo oo oo oo oo oo oo oo oo oo oo oo oo
cartilage anteriorly and thoracic vertebra T4 and T5 posteriorly?
oo oo oo oo oo oo oo oo oo
A. Sternal angle oo
B. Jugular notch oo
C. Xiphoid process oo
D. Third costal cartilage oo oo
ANS: A o o o o
The sternal angle of the “angle of Louis” is level with the second costal cartilage anteriorly and
oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo
thoracic vertebrae T4 and T5 posteriorly.
oo oo oo oo oo oo
PTS: 1
2. Pectus excuvatum is BEST described as:
oo oo oo oo oo
A. Deformity of the sternum caused by trauma oo oo oo oo oo oo
B. Caved-in appearance of the chest oo oo oo oo
C. Diminished rib angle anteriorly oo oo oo
D. Conical shape of the thoracic cage oo oo oo oo oo
ANS: B o o o o
Pectus excuvatum is a common congenital deformity of the anterior wall of the chest, in
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
which several ribs and the sternum grow abnormally; it produces a caved-in or sunken
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
appearance of the chest.
oo oo oo oo
PTS: 1
3. The true ribs are BEST defined by which of the following statements?
oo oo oo oo oo oo oo oo oo oo oo
A. Vertebrochondral ribs oo
B. Vertebrosternal ribs oo
C. Ribs 11 and 12 oo oo oo
D. Ribs 8, 9, and 10 oo oo oo oo
ANS: B o o o o
The first seven ribs attach via their costal cartilages to the sternum and are called the true ribs
oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo
(also known as the vertebrosternal ribs).
oo oo oo oo oo oo
PTS: 1
Copyright ©2011, 2001, 1994 by Saunders, an imprint of Elsevier
oo oo oo oo oo oo oo oo oo
Inc.
, Test Bank oo 1-2
4. Which of the following interventions is MOST appropriate for a patient with lower rib fractures?
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
A. Short, shallow breaths oo oo
B. Pursed lip breathing oo oo
C. Deep breaths with splinting oo oo oo
D. Breathing with arms raised oo oo oo
ANS: C o o o o
It is important for all therapists to recommend breathing (deep breathing), splinting (i.e., pillow),
oo oo oo oo oo oo oo oo oo oo oo oo oo
and coughing strategies for patients with rib fractures.
oo oo oo oo oo oo oo oo
PTS: 1
5. Which of the following positions facilitates greater excursion of both hemidiaphragms at rest?
oo oo oo oo oo oo oo oo oo oo oo oo
A. Supine position oo
B. Sidelying position oo
C. Standing position oo
D. Sitting position oo
ANS: A o o o o
In the supine position, without the effects of gravity, the level of the diaphragm in the thoracic
oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo
cavity rises. This allows for a relatively greater excursion.
oo oo oo oo oo oo oo oo oo
PTS: 1
6. Which of the following muscles help to achieve the active process of inspiration at rest?
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
A. Sternocleidomastoid
B. Diaphragm
C. Abdominal muscles oo
D. Trapezius
ANS: B o o o o
The diaphragm and internal intercostals (intercartilaginous portion) are the essential muscles to
oo oo oo oo oo oo oo oo oo oo oo
achieve the active process of inspiration at rest. Abdominal muscles assist with expiration. The
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
sternocleidomastoid and trapezius are accessory muscles and assist with a more forceful
oo oo oo oo oo oo oo oo oo oo oo oo
inspiration.
oo
PTS: 1
7. Which of the following accessory muscles of ventilation function to elevate and fix the first
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
and second ribs?
oo oo oo
A. Sternocleidomastoid muscle oo
B. Serratus anterior oo
C. Latissimus dorsi oo
D. Scalene muscle oo
oo ANS: o o D
Copyright ©2011, 2001, 1994 by Saunders, an imprint of Elsevier
oo oo oo oo oo oo oo oo oo
Inc.
, Test Bank oo 1-3
The scalene muscles lie deep to the sternocleidomastoid, but may be palpated in the posterior
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
triangle of the neck. These muscles function as a unit to elevate and fix the first and second
oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo
ribs. The sternocleidomastoid muscle elevates the sternum.
oo oo oo oo oo oo oo
PTS: 1
8. When the arms and shoulders are fixed, by leaning on the elbows or grasping onto a table,
oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo
this muscle can use its insertion as its origin and facilitate an increase in the A-P diameter
oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo
of the thorax.
oo oo oo
A. Upper trapezius oo
B. Pectoralis major oo
C. Sternocleidomastoid
D. Serratus anterior oo
ANS: B o o o o
When the insertion and origin of the pectoralis muscle are reversed by leaning on a table to
oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo
fix the arms, the muscle will pull on the anterior chest wall, lifting the ribs and sternum to
oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo
increase the A-P diameter of the thoracic cage.
oo oo oo oo oo oo oo oo
PTS: 1
9. The serous fluid within the pleural space serves to provide which of the following functions?
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
A. Create a constant negative pressure oo oo oo oo
B. Assist with venous return of blood to the heart
oo oo oo oo oo oo oo oo
C. Reduce friction between the lungs and thoracic wall
oo oo oo oo oo oo oo
D. Serve to allow separation of the pleural layers
oo oo oo oo oo oo oo
ANS: C o o o o
The serous fluid within the pleural space serves to hold the pleural layers together during
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
ventilation and reduce friction between the lungs and the thoracic wall. The space creates the
oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo
negative pressure to maintain lung inflation, not the fluid itself.
oo oo oo oo oo oo oo oo oo oo
PTS: 1
10. Irritation of the phrenic supplied pleura results in which of the following pain referral patterns?
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
A. Thoracic wall oo
B. Abdominal wall oo
C. Mediasternal region oo
D. Lower neck and shoulder oo oo oo
ANS: D o o o o
Irritation of the phrenic supplied pleura can result in referred pain in the lower neck and
oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo
shoulder, whereas, irritation of the intercostally innervated pleura may result in referral of pain
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
to the thoracic or abdominal wall.
oo oo oo oo oo oo
PTS: 1
11. An abnormal pleural friction rub on auscultation BEST indicates which of the following?
oo oo oo oo oo oo oo oo oo oo oo oo
A. Infection with a resultant inflammatory response within the pleura
oo oo oo oo oo oo oo oo
Copyright ©2011, 2001, 1994 by Saunders, an imprint of Elsevier
oo oo oo oo oo oo oo oo oo
Inc.
oo oo oo oo oo oo oo oo oo
Inc.
, Hillegass: Essentials of Cardiopulmonary Physical Therapy, 3rd Edition
oo oo oo oo oo oo oo
Chapter 1: Anatomy of the Cardiovascular and Pulmonary Systems
oo oo oo oo oo oo oo oo
oo Test Bank
oo
MULTIPLE CHOICE oo
1. Which of the following chest wall structures is located level with the second costal
oo oo oo oo oo oo oo oo oo oo oo oo oo
cartilage anteriorly and thoracic vertebra T4 and T5 posteriorly?
oo oo oo oo oo oo oo oo oo
A. Sternal angle oo
B. Jugular notch oo
C. Xiphoid process oo
D. Third costal cartilage oo oo
ANS: A o o o o
The sternal angle of the “angle of Louis” is level with the second costal cartilage anteriorly and
oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo
thoracic vertebrae T4 and T5 posteriorly.
oo oo oo oo oo oo
PTS: 1
2. Pectus excuvatum is BEST described as:
oo oo oo oo oo
A. Deformity of the sternum caused by trauma oo oo oo oo oo oo
B. Caved-in appearance of the chest oo oo oo oo
C. Diminished rib angle anteriorly oo oo oo
D. Conical shape of the thoracic cage oo oo oo oo oo
ANS: B o o o o
Pectus excuvatum is a common congenital deformity of the anterior wall of the chest, in
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
which several ribs and the sternum grow abnormally; it produces a caved-in or sunken
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
appearance of the chest.
oo oo oo oo
PTS: 1
3. The true ribs are BEST defined by which of the following statements?
oo oo oo oo oo oo oo oo oo oo oo
A. Vertebrochondral ribs oo
B. Vertebrosternal ribs oo
C. Ribs 11 and 12 oo oo oo
D. Ribs 8, 9, and 10 oo oo oo oo
ANS: B o o o o
The first seven ribs attach via their costal cartilages to the sternum and are called the true ribs
oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo
(also known as the vertebrosternal ribs).
oo oo oo oo oo oo
PTS: 1
Copyright ©2011, 2001, 1994 by Saunders, an imprint of Elsevier
oo oo oo oo oo oo oo oo oo
Inc.
, Test Bank oo 1-2
4. Which of the following interventions is MOST appropriate for a patient with lower rib fractures?
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
A. Short, shallow breaths oo oo
B. Pursed lip breathing oo oo
C. Deep breaths with splinting oo oo oo
D. Breathing with arms raised oo oo oo
ANS: C o o o o
It is important for all therapists to recommend breathing (deep breathing), splinting (i.e., pillow),
oo oo oo oo oo oo oo oo oo oo oo oo oo
and coughing strategies for patients with rib fractures.
oo oo oo oo oo oo oo oo
PTS: 1
5. Which of the following positions facilitates greater excursion of both hemidiaphragms at rest?
oo oo oo oo oo oo oo oo oo oo oo oo
A. Supine position oo
B. Sidelying position oo
C. Standing position oo
D. Sitting position oo
ANS: A o o o o
In the supine position, without the effects of gravity, the level of the diaphragm in the thoracic
oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo
cavity rises. This allows for a relatively greater excursion.
oo oo oo oo oo oo oo oo oo
PTS: 1
6. Which of the following muscles help to achieve the active process of inspiration at rest?
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
A. Sternocleidomastoid
B. Diaphragm
C. Abdominal muscles oo
D. Trapezius
ANS: B o o o o
The diaphragm and internal intercostals (intercartilaginous portion) are the essential muscles to
oo oo oo oo oo oo oo oo oo oo oo
achieve the active process of inspiration at rest. Abdominal muscles assist with expiration. The
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
sternocleidomastoid and trapezius are accessory muscles and assist with a more forceful
oo oo oo oo oo oo oo oo oo oo oo oo
inspiration.
oo
PTS: 1
7. Which of the following accessory muscles of ventilation function to elevate and fix the first
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
and second ribs?
oo oo oo
A. Sternocleidomastoid muscle oo
B. Serratus anterior oo
C. Latissimus dorsi oo
D. Scalene muscle oo
oo ANS: o o D
Copyright ©2011, 2001, 1994 by Saunders, an imprint of Elsevier
oo oo oo oo oo oo oo oo oo
Inc.
, Test Bank oo 1-3
The scalene muscles lie deep to the sternocleidomastoid, but may be palpated in the posterior
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
triangle of the neck. These muscles function as a unit to elevate and fix the first and second
oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo
ribs. The sternocleidomastoid muscle elevates the sternum.
oo oo oo oo oo oo oo
PTS: 1
8. When the arms and shoulders are fixed, by leaning on the elbows or grasping onto a table,
oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo
this muscle can use its insertion as its origin and facilitate an increase in the A-P diameter
oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo
of the thorax.
oo oo oo
A. Upper trapezius oo
B. Pectoralis major oo
C. Sternocleidomastoid
D. Serratus anterior oo
ANS: B o o o o
When the insertion and origin of the pectoralis muscle are reversed by leaning on a table to
oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo
fix the arms, the muscle will pull on the anterior chest wall, lifting the ribs and sternum to
oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo
increase the A-P diameter of the thoracic cage.
oo oo oo oo oo oo oo oo
PTS: 1
9. The serous fluid within the pleural space serves to provide which of the following functions?
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
A. Create a constant negative pressure oo oo oo oo
B. Assist with venous return of blood to the heart
oo oo oo oo oo oo oo oo
C. Reduce friction between the lungs and thoracic wall
oo oo oo oo oo oo oo
D. Serve to allow separation of the pleural layers
oo oo oo oo oo oo oo
ANS: C o o o o
The serous fluid within the pleural space serves to hold the pleural layers together during
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
ventilation and reduce friction between the lungs and the thoracic wall. The space creates the
oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo
negative pressure to maintain lung inflation, not the fluid itself.
oo oo oo oo oo oo oo oo oo oo
PTS: 1
10. Irritation of the phrenic supplied pleura results in which of the following pain referral patterns?
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
A. Thoracic wall oo
B. Abdominal wall oo
C. Mediasternal region oo
D. Lower neck and shoulder oo oo oo
ANS: D o o o o
Irritation of the phrenic supplied pleura can result in referred pain in the lower neck and
oo oo oo oo oo oo oo oo oo oo oo oo oo oo oo
shoulder, whereas, irritation of the intercostally innervated pleura may result in referral of pain
oo oo oo oo oo oo oo oo oo oo oo oo oo oo
to the thoracic or abdominal wall.
oo oo oo oo oo oo
PTS: 1
11. An abnormal pleural friction rub on auscultation BEST indicates which of the following?
oo oo oo oo oo oo oo oo oo oo oo oo
A. Infection with a resultant inflammatory response within the pleura
oo oo oo oo oo oo oo oo
Copyright ©2011, 2001, 1994 by Saunders, an imprint of Elsevier
oo oo oo oo oo oo oo oo oo
Inc.
