TEST BANK
All Chapters Included
,Neonatal and pediatric respiratory care
6th edition by brian
Chapter 1: Fetal Lung Development
Test B ank
MULTIPLE CHOICE
1. Which ofvthe following phasesvofvhuman lung development is characterized by the
formationof a capillary network around airway passages?
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
Answer: v D
The canalicular phase follows the pseudoglandular phase, lasting from approximately 17
weeks to 26 weeks of gestation. This phase is so named because of the appearance of
vascularchannels, or capillaries, which begin to grow by forming a capillary network around
the air passages. Durin g the pseudoglandular stage, which begins atvday 52 and extends to
week 16 of gestation, the ai rway system subdivides extensively and the conducting airway
system develops, ending with the t erminal bronchioles. The saccular stage ofvdevelopment,
which takesvplace from weeks 29 to 36 o fvgestation, is characterized by the development of
sacsvthatlater become alveoli. During the sacc ular phase, a tremendous increase in the
potential
gas-
exchanging surface area occurs. The distinction between the saccular stage and the
alveolar s tage is arbitrary. The alveolar stage stretches from 39 weeks of gestation to
term.This stage is represented by the establishment of alveoli.
REF: pp. 3-5
2. Regarding postnatal lung growth, by approximately what age do most of the alveoli that
willbe present in the lungs for life develop?
a. 6 months
b. 1 year
c. 1.5 years
d. 2 years
Answer: v C
Most of the postnatal formation ofvalveoli in the infantvoccurs over the firstv1.5 years of
life. At 2 years of age, the number of alveoli variesvsubstantially among individuals.
After 2 yearsof age, males have more alveoli than do females. After alveolar multiplication
ends, the alveoli continue to increase in size until thoracic growth is completed.
REF: p. 6
3. The respiratory therapist is evaluating a newborn with mild respiratory distress due to
trachealste nosis. During which period ofvlung development did this problem develop?
a. Embryonal
b. Saccular
c. Canalicular
d. Alveola
, Answer:v A
The initial structures of the pulmonary tree develop during the embryonal stage. Errors in
develo pment during thisvtime may result in laryngeal, tracheal, or esophageal atresia or
stenosis. Pulmo nary hypoplasia, an incomplete development of the lungs characterized by
anabnormally low n umber and/or size of bronchopulmonary segments and/or alveoli,
can develop during the pseu doglandular phase. If the fetus is born during the canalicular
phase (i.e.,vprematurely), severe re spiratory distress can be expected because the
inadequately developed airways, along with ins ufficient and immature surfactant
production by alveolar type II cells, gives rise to the constellati on of problems known as
infantvrespiratory distress syndrome.
REF: p. 6
4. Which of the following mechanisms is (are) responsible for the possible association
betweenoligo hydramnios and lung hypoplasia?
I. Abnormal carbohydrate metabolism
II. Mechanical restriction of the chest wall
III. Interference with fetal breathing
IV. Failure to produce fetal lung liquid
a. I and III only
b. II and III only
c. I, II, and IV only
d. II,vIII, and IV only
Answer: v D
Oligohydramnios, a reduced quantity of amniotic fluid present for an extended period of time,
with or without renal anomTalEieSs,Tv isBvaA sNsoKciSatEeLdw
LEithR l. uCnO
g vM
hypoplasia. The mechanismsvby which
amniotic flu id volume influences lung growth remain unclear. Possible explanations for
reduced quantity of amniotic fluid include mechanical restriction of the chest wall,
interference w ith fetal breathing, or failure to produce fetal lung liquid. These clinical
and experimental obser vations possibly point to a common denominator, lung stretch, as
being amajor growth stimulant.
REF: pp. 6-7
5. What isvthe purpose of the substance secreted by the type II pneumocyte?
a. To increase the gas exchange surface area
b. To reduce surface tension
c. To maintain lung elasticity
d. To preserve the volume of the amniotic fluid
Answer: v B
The primary role of mammalian surfactant is to lower the surface tension within the alveolus,
specif ically at the air–
liquid interface. This allowsvthe delicate structure of the alveolus to expand when filled with
air. W ithout surfactant, the alveolus remains collapsed because of thehigh surface tension of
the moist al veolar surface. Surfactant isvcomposed predominantly of an intricate blend of
phospholipids,vneut ral lipids, and proteins.
REF: p. 8
, 6. Which of the following testsvof the amniotic fluid have been shown to be sensitive
indicatorsof lun g maturity?
a. Levels of prednisone
b. Levels of epidermal growth factor
c. Levels of prostaglandins
d. Levels of phosphatidylglycerol and phosphatidylcholine
Answer: v D
Ofclinical relevance during late gestation, analysis of amniotic fluid for the concentration
ofphos phatidylglycerol and phosphatidylcholine has been shown to be a sensitive indicator
of the state of fetal lung maturity.
REF: p. 8
7. Approximately how much fetal lung fluid is secreted daily?
a. About 150 to 200 ml
b. About 250 to 300 ml
c. About 350 to 400 ml
d. About 450 to 500 ml
Answer: B
Fetal lungs are secretory organs that make breathing-
like movements but serve no respiratory function before birth. They
secrete about 250 to 300 ml of liquid per day.
8.The lung bud emerges from which of the following structures?
a. The pharynx
b. The foregut
c. The mesenchyme
d. The tubular epithelium
Answer: A
The embryonal phase includes primitive lung development and is generally regarded to encompass the
firstv2 months of gestation.
The lung begins to emerge as a bud from the pharynx 26 days after conception.
All Chapters Included
,Neonatal and pediatric respiratory care
6th edition by brian
Chapter 1: Fetal Lung Development
Test B ank
MULTIPLE CHOICE
1. Which ofvthe following phasesvofvhuman lung development is characterized by the
formationof a capillary network around airway passages?
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
Answer: v D
The canalicular phase follows the pseudoglandular phase, lasting from approximately 17
weeks to 26 weeks of gestation. This phase is so named because of the appearance of
vascularchannels, or capillaries, which begin to grow by forming a capillary network around
the air passages. Durin g the pseudoglandular stage, which begins atvday 52 and extends to
week 16 of gestation, the ai rway system subdivides extensively and the conducting airway
system develops, ending with the t erminal bronchioles. The saccular stage ofvdevelopment,
which takesvplace from weeks 29 to 36 o fvgestation, is characterized by the development of
sacsvthatlater become alveoli. During the sacc ular phase, a tremendous increase in the
potential
gas-
exchanging surface area occurs. The distinction between the saccular stage and the
alveolar s tage is arbitrary. The alveolar stage stretches from 39 weeks of gestation to
term.This stage is represented by the establishment of alveoli.
REF: pp. 3-5
2. Regarding postnatal lung growth, by approximately what age do most of the alveoli that
willbe present in the lungs for life develop?
a. 6 months
b. 1 year
c. 1.5 years
d. 2 years
Answer: v C
Most of the postnatal formation ofvalveoli in the infantvoccurs over the firstv1.5 years of
life. At 2 years of age, the number of alveoli variesvsubstantially among individuals.
After 2 yearsof age, males have more alveoli than do females. After alveolar multiplication
ends, the alveoli continue to increase in size until thoracic growth is completed.
REF: p. 6
3. The respiratory therapist is evaluating a newborn with mild respiratory distress due to
trachealste nosis. During which period ofvlung development did this problem develop?
a. Embryonal
b. Saccular
c. Canalicular
d. Alveola
, Answer:v A
The initial structures of the pulmonary tree develop during the embryonal stage. Errors in
develo pment during thisvtime may result in laryngeal, tracheal, or esophageal atresia or
stenosis. Pulmo nary hypoplasia, an incomplete development of the lungs characterized by
anabnormally low n umber and/or size of bronchopulmonary segments and/or alveoli,
can develop during the pseu doglandular phase. If the fetus is born during the canalicular
phase (i.e.,vprematurely), severe re spiratory distress can be expected because the
inadequately developed airways, along with ins ufficient and immature surfactant
production by alveolar type II cells, gives rise to the constellati on of problems known as
infantvrespiratory distress syndrome.
REF: p. 6
4. Which of the following mechanisms is (are) responsible for the possible association
betweenoligo hydramnios and lung hypoplasia?
I. Abnormal carbohydrate metabolism
II. Mechanical restriction of the chest wall
III. Interference with fetal breathing
IV. Failure to produce fetal lung liquid
a. I and III only
b. II and III only
c. I, II, and IV only
d. II,vIII, and IV only
Answer: v D
Oligohydramnios, a reduced quantity of amniotic fluid present for an extended period of time,
with or without renal anomTalEieSs,Tv isBvaA sNsoKciSatEeLdw
LEithR l. uCnO
g vM
hypoplasia. The mechanismsvby which
amniotic flu id volume influences lung growth remain unclear. Possible explanations for
reduced quantity of amniotic fluid include mechanical restriction of the chest wall,
interference w ith fetal breathing, or failure to produce fetal lung liquid. These clinical
and experimental obser vations possibly point to a common denominator, lung stretch, as
being amajor growth stimulant.
REF: pp. 6-7
5. What isvthe purpose of the substance secreted by the type II pneumocyte?
a. To increase the gas exchange surface area
b. To reduce surface tension
c. To maintain lung elasticity
d. To preserve the volume of the amniotic fluid
Answer: v B
The primary role of mammalian surfactant is to lower the surface tension within the alveolus,
specif ically at the air–
liquid interface. This allowsvthe delicate structure of the alveolus to expand when filled with
air. W ithout surfactant, the alveolus remains collapsed because of thehigh surface tension of
the moist al veolar surface. Surfactant isvcomposed predominantly of an intricate blend of
phospholipids,vneut ral lipids, and proteins.
REF: p. 8
, 6. Which of the following testsvof the amniotic fluid have been shown to be sensitive
indicatorsof lun g maturity?
a. Levels of prednisone
b. Levels of epidermal growth factor
c. Levels of prostaglandins
d. Levels of phosphatidylglycerol and phosphatidylcholine
Answer: v D
Ofclinical relevance during late gestation, analysis of amniotic fluid for the concentration
ofphos phatidylglycerol and phosphatidylcholine has been shown to be a sensitive indicator
of the state of fetal lung maturity.
REF: p. 8
7. Approximately how much fetal lung fluid is secreted daily?
a. About 150 to 200 ml
b. About 250 to 300 ml
c. About 350 to 400 ml
d. About 450 to 500 ml
Answer: B
Fetal lungs are secretory organs that make breathing-
like movements but serve no respiratory function before birth. They
secrete about 250 to 300 ml of liquid per day.
8.The lung bud emerges from which of the following structures?
a. The pharynx
b. The foregut
c. The mesenchyme
d. The tubular epithelium
Answer: A
The embryonal phase includes primitive lung development and is generally regarded to encompass the
firstv2 months of gestation.
The lung begins to emerge as a bud from the pharynx 26 days after conception.
