TestBankforNeonatalandPediatricRespiratoryCare,
n n n n n n n
6thEdition
n n
byBrianK.Walsh
n n n
,Chapter1:FetalLung n n n
DevelopmentTest Bank
n n n
MULTIPLECHOICE n
1. Which of the following phases of human lung development is characterized by the formationof a
n n n n n n n n n n n n n n n
capillary network around airway passages?
n n n n n
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS: D n
The canalicular phase follows the pseudoglandular phase, lasting from approximately 17 weeks to
n n n n n n n n n n n n
26 weeks of gestation. This phase is so named because of the appearance of vascularchannels, or
n n n n n n n n n n n n n n n n n
capillaries, which begin to grow by forming a capillary network around the air passages. During
n n n n n n n n n n n n n n n
the pseudoglandular stage, which begins at day 52 and extends to week 16 of gestation, the airway
n n n n n n n n n n n n n n n n n
system subdivides extensively and the conducting airway system develops, ending with the
n n n n n n n n n n n n
terminal bronchioles. The saccular stage of development, which takes place from weeks 29 to 36 of
n n n n n n n n n n n n n n n n
gestation, is characterized by the development of sacs thatlater become alveoli. During the
n n n n n n n n n n n n n n
saccular phase, a tremendous increase in the potential
n n n n n n n n
gas-exchanging surface area occurs. The distinction between the saccular stage and the n n n n n n n n n n n
alveolar stage is arbitrary. Thealveolar stage stretches from 39 weeks of gestation to
n n n n n n n n n n n n n n
term.This stageis represented by the establishment of alveoli.
n n n n n n n n n n
REF: pp. 3-5 n nn n
2. Regarding postnatal lung growth, by approximately what agedo most of the alveoli that willbe n n n n n n n n n n n n n n n
present in the lungs for life develop?
n n n n n n n
a. 6 months n
b. 1 year n
c. 1.5 years n
d. 2 years n
ANS: C n
Most of the postnatal formation of alveoli in the infant occurs over the first 1.5 years of life. At 2
n n n n n n n n n n n n n n n n n n n
years of age, the numberof alveoli varies substantially among individuals. After 2 yearsof age,
n n n n n n n n n n n n n n n n
males have more alveoli than do females. After alveolar multiplication ends, the alveoli continue
n n n n n n n n n n n n n n
to increase in size until thoracic growth is completed.
n n n n n n n n n
REF: p. 6 n n
3. Therespiratory therapist is evaluating a newborn with mild respiratory distress due to
n n n n n n n n n n n n
trachealstenosis. During which period of lung development did this problem develop?
n n n n n n n n n n n n
a. Embryonal
b. Saccular
c. Canalicular
d. Alveolar
ANS: A n
, The initial structures of the pulmonary tree develop during the embryonal stage. Errors in
n n n n n n n n n n n n n
development during this time may result in laryngeal, tracheal, or esophageal atresia or stenosis.
n n n n n n n n n n n n n n
Pulmonary hypoplasia, anincompletedevelopment ofthe lungs characterized by anabnormally
n n n n n n n n n n n n
low number and/or size of bronchopulmonary segments and/or alveoli, can develop during the
n n n n n n n n n n n n n
pseudoglandular phase. If the fetus is born during the canalicular phase (i.e., prematurely), severe
n n n n n n n n n n n n n n
respiratory distress can be expected because the inadequately developed airways, along with
n n n n n n n n n n n n
insufficient and immature surfactant production by alveolar type II cells, gives rise to the
n n n n n n n n n n n n n n
constellation of problems known as infant respiratory distress syndrome.
n n n n n n n n n
REF: p. 6 nn n n
4. Whichofthe following mechanisms is (are) responsible for thepossible association
n n n n n n n n n n n
betweenoligohydramnios and lung hypoplasia?
n n n n n
I. Abnormalcarbohydrate metabolism n n
II. Mechanical restriction of thechest wall n n n n n
III. Interferencewith fetal breathing n n n
IV. Failureto produce fetal lung liquid n n n n n
a. Iand III only n n n
b. IIand III only n n n
c. I, II, and IVonly n n n n
d. II, III,and IVonly n n n n
ANS: D n
Oligohydramnios, areduced quantity of amniotic fluid present for an extended period oftime, n n n n n n n n n n n n n
with or without renal anomTaE
n lieSsT
, iB
sAasNsoKcS
iaE
n teLdLwEitR
h.luCnO
gMhypoplasia. The mechanisms by which n n n n n n n n n nn
amniotic fluid volume influences lung growth remain unclear. Possible explanations for
n n n n n n n n n n n
reduced quantity of amniotic fluid include mechanical restriction of the chest wall, interference
n n n n n n n n n n n n
with fetal breathing, or failure to produce fetal lung liquid. These clinical and experimental
n n n n n n n n n n n n n n
observations possibly point to a common denominator, lung stretch, as being amajorgrowth
n n n n n n n n n n n n n n
stimulant.
n
REF: pp.6-7 n n
5. What is the purpose of the substance secreted by the type IIpneumocyte?
n n n n n n n n n n n n
a. Toincreasethe gas exchangesurface area n n n n n n
b. To reduce surface tension n n n
c. To maintain lung elasticity n n n
d. To preserve the volume of the amniotic fluid
n n n n n n n
ANS: B n
The primary role of mammalian surfactant is to lower the surface tension within the alveolus,
n n n n n n n n n n n n n n
specifically at the air–liquid interface. This allows the delicate structure of the alveolus to expand
n n n n n n n n n n n n n n n
when filled with air. Without surfactant, the alveolus remains collapsed because ofthehigh surface
n n n n n n n n n n n n n n n
tension of the moist alveolar surface. Surfactant is composed predominantly of an intricate blend
n n n n n n n n n n n n n n
of phospholipids, neutral lipids, and proteins.
n n n n n n
REF: p. 8 n n
, 6. Which of the following tests of the amniotic fluid have been shown to be sensitive indicatorsof
n n n n n n n n n n n n n n n n
lung maturity?
n n
a. Levels of prednisone n n
b. Levelsof epidermal growthfactor n n n n
c. Levels ofprostaglandins n n
d. Levelsof phosphatidylglycerol andphosphatidylcholine n n n n
ANS: D n
Ofclinical relevanceduring lategestation, analysis of amnioticfluid for the concentration
n n n n n n n n n n n n
ofphosphatidylglycerol and phosphatidylcholine has been shown to be a sensitive indicator of
n n n n n n n n n n n n n
the state of fetal lung maturity.
n n n n n n
REF: p. 8 n n
7. Approximately how much fetal lung fluid is secreted daily?
n n n n n n n n n
a. About 150 to 200 ml
n n n n n
b. About 250 to 300 ml
n n n n n
c. About 350 to 400 ml
n n n n n
d. About 450 to 500 ml
n n n n n
ANS: B n
Fetal lungs are secretory organs that make breathing-like movements but serve no respiratory function before birth.
n n n n n n n n n n n n n n n
They secrete
n n n
about 250 to 300 ml of liquid per day.
n n n n n n n n
8. The lung bud emerges from which of the following structures?
n n n n n n n n n n n
a. The pharynx
n n
b. The foregut
n n
c. The mesenchyme
n n
d. The tubular epithelium
n n n
ANS: A n
The embryonal phase includes primitive lung development and is generally regarded to encompass the first 2 months of
n n n n n n n n n n n n n n n n n
gestation.
n n
The lung begins to emerge as a bud from the pharynx 26 days after conception.
n n n n n n n n n n n n n n
n n n n n n n
6thEdition
n n
byBrianK.Walsh
n n n
,Chapter1:FetalLung n n n
DevelopmentTest Bank
n n n
MULTIPLECHOICE n
1. Which of the following phases of human lung development is characterized by the formationof a
n n n n n n n n n n n n n n n
capillary network around airway passages?
n n n n n
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS: D n
The canalicular phase follows the pseudoglandular phase, lasting from approximately 17 weeks to
n n n n n n n n n n n n
26 weeks of gestation. This phase is so named because of the appearance of vascularchannels, or
n n n n n n n n n n n n n n n n n
capillaries, which begin to grow by forming a capillary network around the air passages. During
n n n n n n n n n n n n n n n
the pseudoglandular stage, which begins at day 52 and extends to week 16 of gestation, the airway
n n n n n n n n n n n n n n n n n
system subdivides extensively and the conducting airway system develops, ending with the
n n n n n n n n n n n n
terminal bronchioles. The saccular stage of development, which takes place from weeks 29 to 36 of
n n n n n n n n n n n n n n n n
gestation, is characterized by the development of sacs thatlater become alveoli. During the
n n n n n n n n n n n n n n
saccular phase, a tremendous increase in the potential
n n n n n n n n
gas-exchanging surface area occurs. The distinction between the saccular stage and the n n n n n n n n n n n
alveolar stage is arbitrary. Thealveolar stage stretches from 39 weeks of gestation to
n n n n n n n n n n n n n n
term.This stageis represented by the establishment of alveoli.
n n n n n n n n n n
REF: pp. 3-5 n nn n
2. Regarding postnatal lung growth, by approximately what agedo most of the alveoli that willbe n n n n n n n n n n n n n n n
present in the lungs for life develop?
n n n n n n n
a. 6 months n
b. 1 year n
c. 1.5 years n
d. 2 years n
ANS: C n
Most of the postnatal formation of alveoli in the infant occurs over the first 1.5 years of life. At 2
n n n n n n n n n n n n n n n n n n n
years of age, the numberof alveoli varies substantially among individuals. After 2 yearsof age,
n n n n n n n n n n n n n n n n
males have more alveoli than do females. After alveolar multiplication ends, the alveoli continue
n n n n n n n n n n n n n n
to increase in size until thoracic growth is completed.
n n n n n n n n n
REF: p. 6 n n
3. Therespiratory therapist is evaluating a newborn with mild respiratory distress due to
n n n n n n n n n n n n
trachealstenosis. During which period of lung development did this problem develop?
n n n n n n n n n n n n
a. Embryonal
b. Saccular
c. Canalicular
d. Alveolar
ANS: A n
, The initial structures of the pulmonary tree develop during the embryonal stage. Errors in
n n n n n n n n n n n n n
development during this time may result in laryngeal, tracheal, or esophageal atresia or stenosis.
n n n n n n n n n n n n n n
Pulmonary hypoplasia, anincompletedevelopment ofthe lungs characterized by anabnormally
n n n n n n n n n n n n
low number and/or size of bronchopulmonary segments and/or alveoli, can develop during the
n n n n n n n n n n n n n
pseudoglandular phase. If the fetus is born during the canalicular phase (i.e., prematurely), severe
n n n n n n n n n n n n n n
respiratory distress can be expected because the inadequately developed airways, along with
n n n n n n n n n n n n
insufficient and immature surfactant production by alveolar type II cells, gives rise to the
n n n n n n n n n n n n n n
constellation of problems known as infant respiratory distress syndrome.
n n n n n n n n n
REF: p. 6 nn n n
4. Whichofthe following mechanisms is (are) responsible for thepossible association
n n n n n n n n n n n
betweenoligohydramnios and lung hypoplasia?
n n n n n
I. Abnormalcarbohydrate metabolism n n
II. Mechanical restriction of thechest wall n n n n n
III. Interferencewith fetal breathing n n n
IV. Failureto produce fetal lung liquid n n n n n
a. Iand III only n n n
b. IIand III only n n n
c. I, II, and IVonly n n n n
d. II, III,and IVonly n n n n
ANS: D n
Oligohydramnios, areduced quantity of amniotic fluid present for an extended period oftime, n n n n n n n n n n n n n
with or without renal anomTaE
n lieSsT
, iB
sAasNsoKcS
iaE
n teLdLwEitR
h.luCnO
gMhypoplasia. The mechanisms by which n n n n n n n n n nn
amniotic fluid volume influences lung growth remain unclear. Possible explanations for
n n n n n n n n n n n
reduced quantity of amniotic fluid include mechanical restriction of the chest wall, interference
n n n n n n n n n n n n
with fetal breathing, or failure to produce fetal lung liquid. These clinical and experimental
n n n n n n n n n n n n n n
observations possibly point to a common denominator, lung stretch, as being amajorgrowth
n n n n n n n n n n n n n n
stimulant.
n
REF: pp.6-7 n n
5. What is the purpose of the substance secreted by the type IIpneumocyte?
n n n n n n n n n n n n
a. Toincreasethe gas exchangesurface area n n n n n n
b. To reduce surface tension n n n
c. To maintain lung elasticity n n n
d. To preserve the volume of the amniotic fluid
n n n n n n n
ANS: B n
The primary role of mammalian surfactant is to lower the surface tension within the alveolus,
n n n n n n n n n n n n n n
specifically at the air–liquid interface. This allows the delicate structure of the alveolus to expand
n n n n n n n n n n n n n n n
when filled with air. Without surfactant, the alveolus remains collapsed because ofthehigh surface
n n n n n n n n n n n n n n n
tension of the moist alveolar surface. Surfactant is composed predominantly of an intricate blend
n n n n n n n n n n n n n n
of phospholipids, neutral lipids, and proteins.
n n n n n n
REF: p. 8 n n
, 6. Which of the following tests of the amniotic fluid have been shown to be sensitive indicatorsof
n n n n n n n n n n n n n n n n
lung maturity?
n n
a. Levels of prednisone n n
b. Levelsof epidermal growthfactor n n n n
c. Levels ofprostaglandins n n
d. Levelsof phosphatidylglycerol andphosphatidylcholine n n n n
ANS: D n
Ofclinical relevanceduring lategestation, analysis of amnioticfluid for the concentration
n n n n n n n n n n n n
ofphosphatidylglycerol and phosphatidylcholine has been shown to be a sensitive indicator of
n n n n n n n n n n n n n
the state of fetal lung maturity.
n n n n n n
REF: p. 8 n n
7. Approximately how much fetal lung fluid is secreted daily?
n n n n n n n n n
a. About 150 to 200 ml
n n n n n
b. About 250 to 300 ml
n n n n n
c. About 350 to 400 ml
n n n n n
d. About 450 to 500 ml
n n n n n
ANS: B n
Fetal lungs are secretory organs that make breathing-like movements but serve no respiratory function before birth.
n n n n n n n n n n n n n n n
They secrete
n n n
about 250 to 300 ml of liquid per day.
n n n n n n n n
8. The lung bud emerges from which of the following structures?
n n n n n n n n n n n
a. The pharynx
n n
b. The foregut
n n
c. The mesenchyme
n n
d. The tubular epithelium
n n n
ANS: A n
The embryonal phase includes primitive lung development and is generally regarded to encompass the first 2 months of
n n n n n n n n n n n n n n n n n
gestation.
n n
The lung begins to emerge as a bud from the pharynx 26 days after conception.
n n n n n n n n n n n n n n
