Essentials of Cardiopulmonary Physical Therapy, 3rd Edition: Test Bank – Comprehensive Review for Cardiovascular and Pulmonary Systems

, 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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XTest Bank
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MULTIPLE CHOICE X




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



B. Jugular notch X



C. Xiphoid process X



D. Third costal cartilage X X




ANS: A X X



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 X X X X X X



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



C. Diminished rib angle anteriorly X X X



D. Conical shape of the thoracic cage
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ANS: B X X



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



B. Vertebrosternal ribs X



C. Ribs 11 and 12 X X X



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




ANS: B X X



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




Copyright ©2011, 2001, 1994 by Saunders, an imprint of Elsevier
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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 X X



B. Pursed lip breathing X X



C. Deep breaths with splinting
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D. Breathing with arms raised X X X




ANS: C X X



It is important for all therapists to recommend breathing (deep breathing), splinting (i.e., pillow),
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Xand 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 X



B. Sidelying position X



C. Standing position X



D. Sitting position X




ANS: A X X



In the supine position, without the effects of gravity, the level of the diaphragm in the thoracic
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Xcavity 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 X



D. Trapezius
ANS: B X X



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
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Xand second ribs?
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A. Sternocleidomastoid muscle X



B. Serratus anterior X



C. Latissimus dorsi X



D. Scalene muscle X




XANS: X D



Copyright ©2011, 2001, 1994 by Saunders, an imprint of Elsevier
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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,
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this muscle can use its insertion as its origin and facilitate an increase in the A-P diameter
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of the thorax.
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A. Upper trapezius X



B. Pectoralis major X



C. Sternocleidomastoid
D. Serratus anterior X




ANS: B X X



When the insertion and origin of the pectoralis muscle are reversed by leaning on a table to
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fix the arms, the muscle will pull on the anterior chest wall, lifting the ribs and sternum to
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increase 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 X X X X



B. Assist with venous return of blood to the heart
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C. Reduce friction between the lungs and thoracic wall
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D. Serve to allow separation of the pleural layers
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ANS: C X X



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 X



B. Abdominal wall X



C. Mediasternal region X



D. Lower neck and shoulder X X X




ANS: D X X



Irritation of the phrenic supplied pleura can result in referred pain in the lower neck and
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Xshoulder, whereas, irritation of the intercostally innervated pleura may result in referral of pain
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Xto the 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
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Inc.
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