test bank for neonatal and pediatric respiratory care 6th edition by brian.

6th E
h




ditionbyBrian
h h

,Chapterh1:hFetalhLunghDevelopmentTesthBh
ank
MULTIPLEh CHOICE

1. Whichhofvthehfollowinghphasesvofvhumanhlunghdevelopmenthishcharacterizedhbyhthehformationofhah ca
pillaryhnetworkharoundhairwayhpassages?
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS:vh D
Thehcanalicularhphasehfollowshthehpseudoglandularhphase,hlastinghfromhapproximatelyh17hweeksht
oh26hweekshofhgestation.hThishphasehishsohnamedhbecausehofhthehappearancehofhvascularchannels,horh
capillaries,hwhichhbeginhtohgrowhbyhforminghahcapillaryhnetworkharoundhtheh airhpassages.hDurinh ghthe
hpseudoglandularhstage,hwhichhbeginshatvdayh52handhextendsh tohweekh16hofhgestation,hthehaihrwayhsyst

emhsubdivideshextensivelyhandhthehconductinghairwayhsystemhdevelops,hendinghwithhthehtherminalhbro
nchioles.hThehsaccularhstagehofvdevelopment,hwhichhtakesvplacehfromhweeksh29htoh36hohfvgestation,hish
characterizedhbyhthehdevelopmenthofhsacsvthatlaterhbecomehalveoli.hDuringhthehsacchularhphase,hahtre
mendoushincreasehinhthehpotential
gas-
exchanginghsurfacehareahoccurs.hThehdistinctionhbetweenhthehsaccularhstagehandhthehalveolarhshta
gehisharbitrary.hThehalveolarhstagehstretcheshfromh39hweekshofhgestationhtohterm.Thishstagehishrepr
esentedhbyhthehestablishmenthofhalveoli.

REF:hpp.h 3-5

2. Regardinghpostnatalhlunghgrowth,hbyhapproximatelyhwhathagehdohmosthofhthehalveolihthathwillbehp
resenthinhthehlungshforhlifehdevelop?
a. 6hmonths
b. 1hyear
c. 1.5hyears
d. 2hyears
ANS:vh C
Mosthofhthehpostnatalhformationhofvalveolihinhthehinfantvoccurshoverhthehfirstv1.5hyearshofhlife.hAth2hy
earshofhage,hthehnumberhofhalveolihvariesvsubstantiallyhamonghindividuals.hAfterh2hyearsofhage,hm
aleshhavehmorehalveolihthanhdohfemales.hAfterhalveolarhmultiplicationhends,hthehalveolihcontinueh tohin
creasehinhsizehuntilhthoracichgrowthhishcompleted.

REF:hp.h6

3. Thehrespiratoryhtherapisthishevaluatinghahnewbornhwithhmildhrespiratoryhdistresshduehtohtrachealsteh no
sis.hDuringhwhichhperiodhofvlunghdevelopmenthdidhthishproblemhdevelop?
a. Embryonal
b. Saccular
c. Canalicular
d. Alveolar

ANS:vhA
h

, Thehinitialhstructureshofhthehpulmonaryhtreehdevelophduringhthehembryonalhstage.hErrorshinhdevelohpme
nthduringhthisvtimehmayhresulthinhlaryngeal,htracheal,horhesophagealhatresiahorhstenosis.hPulmohnaryhhy
poplasia,hanhincompletehdevelopmenthofhthehlungshcharacterizedhbyhanabnormallyhlowhnhumberhan
d/orhsizehofhbronchopulmonaryhsegmentshand/orhalveoli,hcanhdevelophduringhthehpseuhdoglandularh
phase.hIfhthehfetushishbornhduringhthehcanalicularhphaseh(i.e.,vprematurely),hseverehrehspiratoryhdistres
shcanhbehexpectedhbecausehthehinadequatelyhdevelopedhairways,halonghwithhinshufficienthandhimma
turehsurfactanthproductionhbyhalveolarhtypehIIhcells,hgiveshrisehtohthehconstellatihonhofhproblemshknown
hashinfantvrespiratoryhdistresshsyndrome.




REF:h p.h6

4. Whichhofhthehfollowinghmechanismshish(are)hresponsiblehforhthehpossiblehassociationhbetweenoligohh
ydramnioshandhlunghhypoplasia?

I. Abnormalhcarbohydratehmetabolism
II. Mechanicalhrestrictionhofhthehchesthwall
III. Interferencehwithhfetalhbreathing
IV. Failurehtohproducehfetalhlunghliquid
a. IhandhIIIhonly
b. IIhandhIIIhonly
c. I,hII,handhIVhonly
d. II,vIII,handhIVhonly
ANS:vh D
Oligohydramnios,hahreducedhquantityhofhamniotichfluidhpresenthforhanhextendedhperiodhofhtime,
withh orh withouth renalh ano mTalEieSs,Tv isBvaA sNsoKciSatEeLdw
LEithRl. uCnO
g vM
hypoplasia. h Theh mechanismsvbyh whichh amniotich fluhi
dhvolumehinfluenceshlunghgrowthhremainhunclear.hPossiblehexplanationshfor
reducedhquantityhofhamniotichfluidhincludehmechanicalhrestrictionhofhthehchesthwall,hinterferencehwhithh
fetalhbreathing,horhfailurehtohproducehfetalhlunghliquid.hThesehclinicalhandhexperimentalhobserhvati
onshpossiblyhpointhtohahcommonhdenominator,hlunghstretch,hashbeinghamajorhgrowthhstimulant.

REF:hpp.h6-7

5. WhathisvthehpurposehofhthehsubstancehsecretedhbyhthehtypehIIhpneumocyte?
a. Tohincreasehthehgashexchangehsurfaceharea
b. Tohreducehsurfacehtension
c. Tohmaintainhlunghelasticity
d. Tohpreservehthehvolumehofhthehamniotichfluid
ANS:vh B
Thehprimaryhrolehofhmammalianhsurfactanthishtohlowerhthehsurfacehtensionhwithinhthehalveolus,hspecifhic
allyhaththehair–
liquidhinterface.hThishallowsvthehdelicatehstructurehofhthehalveolushtohexpandhwhenhfilledhwithhair.hWhitho
uthsurfactant,hthehalveolushremainshcollapsedhbecausehofhthehighhsurfacehtensionhofhthehmoisthalhveola
rhsurface.hSurfactanthisvcomposedhpredominantlyhofhanhintricatehblendhofhphospholipids,vneuth ralhlipid
s,handhproteins.

REF:hp.h8

, 6. Whichhofhthehfollowinghtestsvofhthehamniotichfluidhhavehbeenhshownhtohbehsensitivehindicatorsofhlunhgh
maturity?
a. Levelshofhprednisone
b. Levelshofhepidermalh growthhfactor
c. Levelshofhprostaglandins
d. Levelshofhphosphatidylglycerol h andhphosphatidylcholine
ANS:vh D
Ofclinicalhrelevancehduringhlatehgestation,hanalysishofhamniotichfluidhforhthehconcentrationhofphoshpha
tidylglycerolhandhphosphatidylcholinehhashbeenhshownhtohbehahsensitivehindicatorhofhthehstateh ofhfet
alhlunghmaturity.

REF:hp.h8

7. Approximatelyh howhmuchhfetalhlunghfluidhishsecretedhdaily?
a. Abouth150htoh200hml
b. Abouth250htoh300hml
c. Abouth350htoh400hml
d. Abouth450htoh500hml

ANS:hB

Fetalhlungsharehsecretoryhorganshthathmakehbreathing-
likehmovementshbuthservehnohrespiratoryhfunctionhbeforehbirth.hTheyhsecretehabo
uth250htoh300hmlhofhliquidhperhday.


8. Thehlunghbudhemergeshfromhwhichhofhthehfollowinghstructures?
a. Thehpharynx
b. Thehforegut
c. Thehmesenchyme
d. Thehtubularhepithelium

ANS:hA

Thehembryonalhphasehincludeshprimitivehlunghdevelopmenthandhishgenerallyhregardedhtohencompasshthehfirstv2h
monthshofhgestation.
Thehlunghbeginshtohemergehashahbudhfromhthehpharynxh26hdayshafterhconception.