, Hillegass: Essentials Of Cardiopulmonary Physical Therapy, 5th Edition
Chapter 1: Anatomy Of The Cardiovascular And Pulmonary Systems
Test Bank
MULTIPLE CHOICE
1. Which Of The Following Chest Wall Structures Is Located Level With The Second Costal
Cartilage Anteriorly And Thoracic Vertebra T4 And T5 Posteriorly?
A. Sternal Angle
B. Jugular Notch
C. Xiphoid Process
D. Third Costal Cartilage
ANSWER:A
The Sternal Angle Of The “Angle Of Louis” Is Level With The Second Costal Cartilage
Anteriorly And Thoracic Vertebrae T4 And T5 Posteriorly.
PTS: 1
2. Pectus Excuvatum Is BEST Described As:
A. Deformity Of The Sternum Caused By Trauma
B. Caved-In Appearance Of The Chest
C. Diminished Rib Angle Anteriorly
D. Conical Shape Of The Thoracic Cage
ANSWER:B
Pectus Excuvatum Is A Common Congenital Deformity Of The Anterior Wall Of The Chest,
In Which Several Ribs And The Sternum Grow Abnormally; It Produces A Caved-In Or
Sunken Appearance Of The Chest.
PTS: 1
3. The True Ribs Are BEST Defined By Which Of The Following Statements?
A. Vertebrochondral Ribs
B. Vertebrosternal Ribs
C. Ribs 11 And 12
D. Ribs 8, 9, And 10
ANSWER:B
The First Seven Ribs Attach Via Their Costal Cartilages To The Sternum And Are Called The
True Ribs (Also Known As The Vertebrosternal Ribs).
PTS: 1
.
, Test Bank 1-2
4. Which Of The Following Interventions Is MOST Appropriate For A Patient With Lower Rib
Fractures?
A. Short, Shallow Breaths
B. Pursed Lip Breathing
C. Deep Breaths With Splinting
D. Breathing With Arms Raised
ANSWER:C
It Is Important For All Therapists To Recommend Breathing (Deep Breathing), Splinting (I.E.,
Pillow), And Coughing Strategies For Patients With Rib Fractures.
PTS: 1
5. Which Of The Following Positions Facilitates Greater Excursion Of Both Hemidiaphragms At
Rest?
A. Supine Position
B. Sidelying Position
C. Standing Position
D. Sitting Position
ANSWER:A
In The Supine Position, Without The Effects Of Gravity, The Level Of The Diaphragm In The
Thoracic Cavity Rises. This Allows For A Relatively Greater Excursion.
PTS: 1
6. Which Of The Following Muscles Help To Achieve The Active Process Of Inspiration At Rest?
A. Sternocleidomastoid
B. Diaphragm
C. Abdominal Muscles
D. Trapezius
ANSWER:B
The Diaphragm And Internal Intercostals (Intercartilaginous Portion) Are The Essential Muscles
To Achieve The Active Process Of Inspiration At Rest. Abdominal Muscles Assist With
Expiration. The Sternocleidomastoid And Trapezius Are Accessory Muscles And Assist With A
More Forceful Inspiration.
PTS: 1
7. Which Of The Following Accessory Muscles Of Ventilation Function To Elevate And Fix The
First And Second Ribs?
A. Sternocleidomastoid Muscle
B. Serratus Anterior
C. Latissimus Dorsi
D. Scalene
Muscle ANS: D
..
, Test Bank 1-3
The Scalene Muscles Lie Deep To The Sternocleidomastoid, But May Be Palpated In The
Posterior Triangle Of The Neck. These Muscles Function As A Unit To Elevate And Fix The
First And Second Ribs. The Sternocleidomastoid Muscle Elevates The Sternum.
PTS: 1
8. When The Arms And Shoulders Are Fixed, By Leaning On The Elbows Or Grasping Onto A
Table, This Muscle Can Use Its Insertion As Its Origin And Facilitate An Increase In The A-P
Diameter Of The Thorax.
A. Upper Trapezius
B. Pectoralis Major
C. Sternocleidomastoid
D. Serratus Anterior
ANSWER:B
When The Insertion And Origin Of The Pectoralis Muscle Are Reversed By Leaning On A
Table To Fix The Arms, The Muscle Will Pull On The Anterior Chest Wall, Lifting The Ribs
And Sternum To Increase The A-P Diameter Of The Thoracic Cage.
PTS: 1
9. The Serous Fluid Within The Pleural Space Serves To Provide Which Of The Following
Functions?
A. Create A Constant Negative Pressure
B. Assist With Venous Return Of Blood To The Heart
C. Reduce Friction Between The Lungs And Thoracic Wall
D. Serve To Allow Separation Of The Pleural Layers
ANSWER:C
The Serous Fluid Within The Pleural Space Serves To Hold The Pleural Layers Together During
Ventilation And Reduce Friction Between The Lungs And The Thoracic Wall. The Space Creates
The Negative Pressure To Maintain Lung Inflation, Not The Fluid Itself.
PTS: 1
10. Irritation Of The Phrenic Supplied Pleura Results In Which Of The Following Pain Referral
Patterns?
A. Thoracic Wall
B. Abdominal Wall
C. Mediasternal Region
D. Lower Neck And Shoulder
ANSWER:D
Irritation Of The Phrenic Supplied Pleura Can Result In Referred Pain In The Lower Neck And
Shoulder, Whereas, Irritation Of The Intercostally Innervated Pleura May Result In Referral Of
Pain To The Thoracic Or Abdominal Wall.
PTS: 1
11. An Abnormal Pleural Friction Rub On Auscultation BEST Indicates Which Of The Following?
A. Infection With A Resultant Inflammatory Response Within The Pleura
..
Chapter 1: Anatomy Of The Cardiovascular And Pulmonary Systems
Test Bank
MULTIPLE CHOICE
1. Which Of The Following Chest Wall Structures Is Located Level With The Second Costal
Cartilage Anteriorly And Thoracic Vertebra T4 And T5 Posteriorly?
A. Sternal Angle
B. Jugular Notch
C. Xiphoid Process
D. Third Costal Cartilage
ANSWER:A
The Sternal Angle Of The “Angle Of Louis” Is Level With The Second Costal Cartilage
Anteriorly And Thoracic Vertebrae T4 And T5 Posteriorly.
PTS: 1
2. Pectus Excuvatum Is BEST Described As:
A. Deformity Of The Sternum Caused By Trauma
B. Caved-In Appearance Of The Chest
C. Diminished Rib Angle Anteriorly
D. Conical Shape Of The Thoracic Cage
ANSWER:B
Pectus Excuvatum Is A Common Congenital Deformity Of The Anterior Wall Of The Chest,
In Which Several Ribs And The Sternum Grow Abnormally; It Produces A Caved-In Or
Sunken Appearance Of The Chest.
PTS: 1
3. The True Ribs Are BEST Defined By Which Of The Following Statements?
A. Vertebrochondral Ribs
B. Vertebrosternal Ribs
C. Ribs 11 And 12
D. Ribs 8, 9, And 10
ANSWER:B
The First Seven Ribs Attach Via Their Costal Cartilages To The Sternum And Are Called The
True Ribs (Also Known As The Vertebrosternal Ribs).
PTS: 1
.
, Test Bank 1-2
4. Which Of The Following Interventions Is MOST Appropriate For A Patient With Lower Rib
Fractures?
A. Short, Shallow Breaths
B. Pursed Lip Breathing
C. Deep Breaths With Splinting
D. Breathing With Arms Raised
ANSWER:C
It Is Important For All Therapists To Recommend Breathing (Deep Breathing), Splinting (I.E.,
Pillow), And Coughing Strategies For Patients With Rib Fractures.
PTS: 1
5. Which Of The Following Positions Facilitates Greater Excursion Of Both Hemidiaphragms At
Rest?
A. Supine Position
B. Sidelying Position
C. Standing Position
D. Sitting Position
ANSWER:A
In The Supine Position, Without The Effects Of Gravity, The Level Of The Diaphragm In The
Thoracic Cavity Rises. This Allows For A Relatively Greater Excursion.
PTS: 1
6. Which Of The Following Muscles Help To Achieve The Active Process Of Inspiration At Rest?
A. Sternocleidomastoid
B. Diaphragm
C. Abdominal Muscles
D. Trapezius
ANSWER:B
The Diaphragm And Internal Intercostals (Intercartilaginous Portion) Are The Essential Muscles
To Achieve The Active Process Of Inspiration At Rest. Abdominal Muscles Assist With
Expiration. The Sternocleidomastoid And Trapezius Are Accessory Muscles And Assist With A
More Forceful Inspiration.
PTS: 1
7. Which Of The Following Accessory Muscles Of Ventilation Function To Elevate And Fix The
First And Second Ribs?
A. Sternocleidomastoid Muscle
B. Serratus Anterior
C. Latissimus Dorsi
D. Scalene
Muscle ANS: D
..
, Test Bank 1-3
The Scalene Muscles Lie Deep To The Sternocleidomastoid, But May Be Palpated In The
Posterior Triangle Of The Neck. These Muscles Function As A Unit To Elevate And Fix The
First And Second Ribs. The Sternocleidomastoid Muscle Elevates The Sternum.
PTS: 1
8. When The Arms And Shoulders Are Fixed, By Leaning On The Elbows Or Grasping Onto A
Table, This Muscle Can Use Its Insertion As Its Origin And Facilitate An Increase In The A-P
Diameter Of The Thorax.
A. Upper Trapezius
B. Pectoralis Major
C. Sternocleidomastoid
D. Serratus Anterior
ANSWER:B
When The Insertion And Origin Of The Pectoralis Muscle Are Reversed By Leaning On A
Table To Fix The Arms, The Muscle Will Pull On The Anterior Chest Wall, Lifting The Ribs
And Sternum To Increase The A-P Diameter Of The Thoracic Cage.
PTS: 1
9. The Serous Fluid Within The Pleural Space Serves To Provide Which Of The Following
Functions?
A. Create A Constant Negative Pressure
B. Assist With Venous Return Of Blood To The Heart
C. Reduce Friction Between The Lungs And Thoracic Wall
D. Serve To Allow Separation Of The Pleural Layers
ANSWER:C
The Serous Fluid Within The Pleural Space Serves To Hold The Pleural Layers Together During
Ventilation And Reduce Friction Between The Lungs And The Thoracic Wall. The Space Creates
The Negative Pressure To Maintain Lung Inflation, Not The Fluid Itself.
PTS: 1
10. Irritation Of The Phrenic Supplied Pleura Results In Which Of The Following Pain Referral
Patterns?
A. Thoracic Wall
B. Abdominal Wall
C. Mediasternal Region
D. Lower Neck And Shoulder
ANSWER:D
Irritation Of The Phrenic Supplied Pleura Can Result In Referred Pain In The Lower Neck And
Shoulder, Whereas, Irritation Of The Intercostally Innervated Pleura May Result In Referral Of
Pain To The Thoracic Or Abdominal Wall.
PTS: 1
11. An Abnormal Pleural Friction Rub On Auscultation BEST Indicates Which Of The Following?
A. Infection With A Resultant Inflammatory Response Within The Pleura
..
