Essentials of Cardiopulmonary Physical Therapy 3rd Edition by Hillegass - Test Bank

, Hillegass: Essentials of Cardiopulmonary Physical Therapy, 3rd Edition
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Chapter 1: Anatomy of the Cardiovascular and Pulmonary Systems Test
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k Bank

MULTIPLE CHOICE k




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




B. Jugular notch k




C. Xiphoid process k




D. Third costal cartilage k k




ANS: A k k




The sternal angle of the “angle of Louis” is level with the second costal cartilage anteriorly and thoracic
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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 k k k k k k




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




C. Diminished rib angle anteriorly k k k




D. Conical shape of the thoracic cage k k k k k




ANS: B k k




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




B. Vertebrosternal ribs k




C. Ribs 11 and 12 k k k




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




ANS: B k k




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




Copyright ©2011, 2001, 1994 by Saunders, an imprint of Elsevier Inc.
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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 k k




B. Pursed lip breathing k k




C. Deep breaths with splinting k k k




D. Breathing with arms raised k k k




ANS: C k k




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




B. Sidelying position k




C. Standing position k




D. Sitting position k




ANS: A k k




In the supine position, without the effects of gravity, the level of the diaphragm in the thoracic cavity
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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 k




D. Trapezius
ANS: B k k




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 inspiration.
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PTS: 1

7. Which of the following accessory muscles of ventilation function to elevate and fix the first and
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second ribs?
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A. Sternocleidomastoid muscle k




B. Serratus anterior k




C. Latissimus dorsi k




D. Scalenemuscle k




k ANS: D k




Copyright ©2011, 2001, 1994 by Saunders, an imprint of Elsevier Inc.
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The scalene muscles lie deep to the sternocleidomastoid, but may be palpated in the posterior triangle
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of the neck. These muscles function as a unit to elevate and fix the first and second ribs. The
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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, this
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muscle can use its insertion as its origin and facilitate an increase in the A-P diameter of the thorax.
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A. Upper trapezius k




B. Pectoralis major k




C. Sternocleidomastoid
D. Serratus anterior k




ANS: B k k




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




B. Assist with venous return of blood to the heart
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C. Reduce friction between the lungs and thoracic wall k k k k k k k




D. Serve to allow separation of the pleural layers
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ANS: C k k




The serous fluid within the pleural space serves to hold the pleural layers together during ventilation
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and reduce friction between the lungs and the thoracic wall. The space creates the negative pressure to
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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 k




B. Abdominal wall k




C. Mediasternal region k




D. Lower neck and shoulder k k k




ANS: D k k




Irritation of the phrenic supplied pleura can result in referred pain in the lower neck and shoulder,
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whereas, irritation of the intercostally innervated pleura may result in referral of pain to the thoracic or
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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 k k k k k k k k




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