Test Bank for Essentials of Cardiopulmonary Physical Therapy 3rd Edition by Hillegass – Complete Exam Prep Resource

Copyright ©2011, 2001, 1994 by Saunders, an imprint of
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Elsevier Inc.
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, 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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gh Test Bank
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MULTIPLE CHOICE gh




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


B. Jugular notch gh


C. Xiphoid process gh


D. Third costal cartilage gh gh




ANS: A gh gh


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


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


C. Diminished rib angle anteriorly gh gh gh


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




ANS: B gh gh


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 gh


B. Vertebrosternal ribs gh


C. Ribs 11 and 12 gh gh gh


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




ANS: B gh gh


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




Copyright ©2011, 2001, 1994 by Saunders, an imprint of
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Elsevier Inc.
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, Test Bank gh 1-2



4. Which of the following interventions is MOST appropriate for a patient with lower rib
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fractures?
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A. Short, shallow breaths gh gh


B. Pursed lip breathing gh gh


C. Deep breaths with splinting gh gh gh


D. Breathing with arms raised gh gh gh




ANS: C gh gh


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


B. Sidelying position gh


C. Standing position gh


D. Sitting position gh




ANS: A gh gh


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


D. Trapezius
ANS: B gh gh


The diaphragm and internal intercostals (intercartilaginous portion) are the essential muscles
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to achieve the active process of inspiration at rest. Abdominal muscles assist with
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expiration. The sternocleidomastoid and trapezius are accessory muscles and assist with a
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more forceful inspiration.
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PTS: 1

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


B. Serratus anterior gh


C. Latissimus dorsi gh


D. Scalene muscle gh




gh ANS: g h D


Copyright ©2011, 2001, 1994 by Saunders, an imprint of
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Elsevier Inc.
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, Test Bank gh 1-3


The scalene muscles lie deep to the sternocleidomastoid, but may be palpated in the
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posterior triangle of the neck. These muscles function as a unit to elevate and fix the first
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and second ribs. 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
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table, this muscle can use its insertion as its origin and facilitate an increase in the A-P
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diameter of the thorax.
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A. Upper trapezius gh


B. Pectoralis major gh


C. Sternocleidomastoid
D. Serratus anterior gh




ANS: B gh gh


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


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
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the 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
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patterns?
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A. Thoracic wall gh


B. Abdominal wall gh


C. Mediasternal region gh


D. Lower neck and shoulder gh gh gh




ANS: D gh gh


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