Test Bank for Neonatal and Pediatric Respiratory Care, 6th Edition
by Brian K. Walsh
,Chapter 1: Fetal Lung Development
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Test Bank
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MULTIPLE CHOICE oc
1. Which of the following phases of human lung development is characterized by the formatio
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nof a capillary network around airway passages?
oc oc oc oc oc oc oc
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS: D oc
The canalicular phase follows the pseudoglandular phase, lasting from approximately 17 wee
oc oc oc oc oc oc oc oc oc oc oc
ks to 26 weeks of gestation. This phase is so named because of the appearance of vascularchan
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
nels, or capillaries, which begin to grow by forming a capillary network around the air passa
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
ges. During the pseudoglandular stage, which begins at day 52 and extends to week 16 of ge
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
station, the airway system subdivides extensively and the conducting airway system develop
oc oc oc oc oc oc oc oc oc oc oc
s, ending with the terminal bronchioles. The saccular stage of development, which takes plac
oc oc oc oc oc oc oc oc oc oc oc oc oc
e from weeks 29 to 36 of gestation, is characterized by the development of sacs thatlater beco
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
me alveoli. During the saccular phase, a tremendous increase in the potential
oc oc oc oc oc oc oc oc oc oc oc
gas-
exchanging surface area occurs. The distinction between the saccular stage and the alveol
oc oc oc oc oc oc oc oc oc oc oc oc
ar stage is arbitrary. The alveolar stage stretches from 39 weeks of gestation to term.This
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
stage is represented by the establishment of alveoli.
oc oc oc oc oc oc oc oc
REF: pp. 3-5 o c ococo c
2. Regarding postnatal lung growth, by approximately what age do most of the alveoli that wi
oc oc oc oc oc oc oc oc oc oc oc oc oc oc
llbe present in the lungs for life develop?
oc oc oc oc oc oc oc oc
a. 6 months oc
b. 1 year oc
c. 1.5 years oc
d. 2 years oc
ANS: C oc
Most of the postnatal formation of alveoli in the infant occurs over the first 1.5 years of life.
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
At 2 years of age, the number of alveoli varies substantially among individuals. After 2 years
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
of age, males have more alveoli than do females. After alveolar multiplication ends, the alve
oc oc oc oc oc oc oc oc oc oc oc oc oc oc
oli continue to increase in size until thoracic growth is completed.
oc oc oc oc oc oc oc oc oc oc
REF: p. 6 oc oc
3. The respiratory therapist is evaluating a newborn with mild respiratory distress due to trach
oc oc oc oc oc oc oc oc oc oc oc oc oc
ealstenosis. During which period of lung development did this problem develop?
oc oc oc oc oc oc oc oc oc oc oc
a. Embryonal
b. Saccular
c. Canalicular
d. Alveolar
ANS: A oc
, The initial structures of the pulmonary tree develop during the embryonal stage. Errors in
oc oc oc oc oc oc oc oc oc oc oc oc oc oc
development during this time may result in laryngeal, tracheal, or esophageal atresia or steoc oc oc oc oc oc oc oc oc oc oc oc oc
nosis. Pulmonary hypoplasia, an incomplete development of the lungs characterized by anab
oc oc oc oc oc oc oc oc oc oc oc oc
normally low number and/or size of bronchopulmonary segments and/or alveoli, can devel
oc oc oc oc oc oc oc oc oc oc oc
op during the pseudoglandular phase. If the fetus is born during the canalicular phase (i.e., p
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
rematurely), severe respiratory distress can be expected because the inadequately developed
oc oc oc oc oc oc oc oc oc oc
airways, along with insufficient and immature surfactant production by alveolar type II cell
oc oc oc oc oc oc oc oc oc oc oc oc oc
s, gives rise to the constellation of problems known as infant respiratory distress syndrome.
oc oc oc oc oc oc oc oc oc oc oc oc oc
REF: p. 6 ococo c oc
4. Which of the following mechanisms is (are) responsible for the possible association between
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oligohydramnios and lung hypoplasia? oc oc oc
I. Abnormal carbohydrate metabolism oc oc
II. Mechanical restriction of the chest wall oc oc oc oc oc
III. Interference with fetal breathing oc oc oc
IV. Failure to produce fetal lung liquid oc oc oc oc oc
a. I and III only oc oc oc
b. II and III only oc oc oc
c. I, II, and IV only oc oc oc oc
d. II, III, and IV only oc oc oc oc
ANS: D oc
Oligohydramnios, a reduced quantity of amniotic fluid present for an extended period of time, oc oc oc oc oc oc oc oc oc oc oc oc oc
with or without renal anomTaE
oc lieSsT
, iB
sAasNsoKcS
iaE
octeLdLwEitR
hlu
. CnO
gMhypoplasia. The mechanisms by w oc oc oc oc oc oc oc oc oc ococ
hich amniotic fluid volume influences lung growth remain unclear. Possible explanations for
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reduced quantity of amniotic fluid include mechanical restriction of the chest wall, interfere
oc oc oc oc oc oc oc oc oc oc oc oc
nce with fetal breathing, or failure to produce fetal lung liquid. These clinical and experime
oc oc oc oc oc oc oc oc oc oc oc oc oc oc
ntal observations possibly point to a common denominator, lung stretch, as being amajor g
oc oc oc oc oc oc oc oc oc oc oc oc oc oc
rowth stimulant. oc
REF: pp. 6-7 oc oc
5. What is the purpose of the substance secreted by the type II pneumocyte?
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a. To increase the gas exchange surface area
oc oc oc oc oc oc
b. To reduce surface tension oc oc oc
c. To maintain lung elasticity oc oc oc
d. To preserve the volume of the amniotic fluid
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ANS: B oc
The primary role of mammalian surfactant is to lower the surface tension within the alveolus
oc oc oc oc oc oc oc oc oc oc oc oc oc oc
, specifically at the air–
oc oc oc oc
liquid interface. This allows the delicate structure of the alveolus to expand when filled with
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
air. Without surfactant, the alveolus remains collapsed because of thehigh surface tension of t
oc oc oc oc oc oc oc oc oc oc oc oc oc oc
he moist alveolar surface. Surfactant is composed predominantly of an intricate blend of phos
oc oc oc oc oc oc oc oc oc oc oc oc oc
pholipids, neutral lipids, and proteins. oc oc oc oc
REF: p. 8 oc oc
, 6. Which of the following tests of the amniotic fluid have been shown to be sensitive indicators
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
of lung maturity?
oc oc
a. Levels of prednisone oc oc
b. Levels of epidermal growth factor oc oc oc oc
c. Levels of prostaglandins oc oc
d. Levels of phosphatidylglycerol and phosphatidylcholine oc oc oc oc
ANS: D oc
Of clinical relevance during late gestation, analysis of amniotic fluid for the concentration of
oc oc oc oc oc oc oc oc oc oc oc oc oc oc
phosphatidylglycerol and phosphatidylcholine has been shown to be a sensitive indicator of oc oc oc oc oc oc oc oc oc oc oc oc
the state of fetal lung maturity.
oc oc oc oc oc
REF: p. 8 oc oc
7. Approximately how much fetal lung fluid is secreted daily?
oc oc oc oc oc oc oc oc oc
a. About 150 to 200 ml
oc oc oc oc oc
b. About 250 to 300 ml
oc oc oc oc oc
c. About 350 to 400 ml
oc oc oc oc oc
d. About 450 to 500 ml
oc oc oc oc oc
ANS: B oc
Fetal lungs are secretory organs that make breathing-
oc oc oc oc oc oc oc
like movements but serve no respiratory function before birth. They secrete
oc oc oc oc oc oc oc oc oc oc oc
about 250 to 300 ml of liquid per day.
oc oc oc oc oc oc oc oc
8. The lung bud emerges from which of the following structures?
oc oc oc oc oc oc oc oc oc oc oc
a. The pharynx
oc oc
b. The foregut
oc oc
c. The mesenchyme
oc oc
d. The tubular epithelium
oc oc oc
ANS: A oc
The embryonal phase includes primitive lung development and is generally regarded to encompass the first 2 mo
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
nths of gestation. oc oc oc
The lung begins to emerge as a bud from the pharynx 26 days after conception.
oc oc oc oc oc oc oc oc oc oc oc oc oc oc
by Brian K. Walsh
,Chapter 1: Fetal Lung Development
oc oc oc oc co
Test Bank
oc
MULTIPLE CHOICE oc
1. Which of the following phases of human lung development is characterized by the formatio
oc oc oc oc oc oc oc oc oc oc oc oc oc
nof a capillary network around airway passages?
oc oc oc oc oc oc oc
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS: D oc
The canalicular phase follows the pseudoglandular phase, lasting from approximately 17 wee
oc oc oc oc oc oc oc oc oc oc oc
ks to 26 weeks of gestation. This phase is so named because of the appearance of vascularchan
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
nels, or capillaries, which begin to grow by forming a capillary network around the air passa
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
ges. During the pseudoglandular stage, which begins at day 52 and extends to week 16 of ge
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
station, the airway system subdivides extensively and the conducting airway system develop
oc oc oc oc oc oc oc oc oc oc oc
s, ending with the terminal bronchioles. The saccular stage of development, which takes plac
oc oc oc oc oc oc oc oc oc oc oc oc oc
e from weeks 29 to 36 of gestation, is characterized by the development of sacs thatlater beco
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
me alveoli. During the saccular phase, a tremendous increase in the potential
oc oc oc oc oc oc oc oc oc oc oc
gas-
exchanging surface area occurs. The distinction between the saccular stage and the alveol
oc oc oc oc oc oc oc oc oc oc oc oc
ar stage is arbitrary. The alveolar stage stretches from 39 weeks of gestation to term.This
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
stage is represented by the establishment of alveoli.
oc oc oc oc oc oc oc oc
REF: pp. 3-5 o c ococo c
2. Regarding postnatal lung growth, by approximately what age do most of the alveoli that wi
oc oc oc oc oc oc oc oc oc oc oc oc oc oc
llbe present in the lungs for life develop?
oc oc oc oc oc oc oc oc
a. 6 months oc
b. 1 year oc
c. 1.5 years oc
d. 2 years oc
ANS: C oc
Most of the postnatal formation of alveoli in the infant occurs over the first 1.5 years of life.
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
At 2 years of age, the number of alveoli varies substantially among individuals. After 2 years
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
of age, males have more alveoli than do females. After alveolar multiplication ends, the alve
oc oc oc oc oc oc oc oc oc oc oc oc oc oc
oli continue to increase in size until thoracic growth is completed.
oc oc oc oc oc oc oc oc oc oc
REF: p. 6 oc oc
3. The respiratory therapist is evaluating a newborn with mild respiratory distress due to trach
oc oc oc oc oc oc oc oc oc oc oc oc oc
ealstenosis. During which period of lung development did this problem develop?
oc oc oc oc oc oc oc oc oc oc oc
a. Embryonal
b. Saccular
c. Canalicular
d. Alveolar
ANS: A oc
, The initial structures of the pulmonary tree develop during the embryonal stage. Errors in
oc oc oc oc oc oc oc oc oc oc oc oc oc oc
development during this time may result in laryngeal, tracheal, or esophageal atresia or steoc oc oc oc oc oc oc oc oc oc oc oc oc
nosis. Pulmonary hypoplasia, an incomplete development of the lungs characterized by anab
oc oc oc oc oc oc oc oc oc oc oc oc
normally low number and/or size of bronchopulmonary segments and/or alveoli, can devel
oc oc oc oc oc oc oc oc oc oc oc
op during the pseudoglandular phase. If the fetus is born during the canalicular phase (i.e., p
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
rematurely), severe respiratory distress can be expected because the inadequately developed
oc oc oc oc oc oc oc oc oc oc
airways, along with insufficient and immature surfactant production by alveolar type II cell
oc oc oc oc oc oc oc oc oc oc oc oc oc
s, gives rise to the constellation of problems known as infant respiratory distress syndrome.
oc oc oc oc oc oc oc oc oc oc oc oc oc
REF: p. 6 ococo c oc
4. Which of the following mechanisms is (are) responsible for the possible association between
oc oc oc oc oc oc oc oc oc oc oc oc oc
oligohydramnios and lung hypoplasia? oc oc oc
I. Abnormal carbohydrate metabolism oc oc
II. Mechanical restriction of the chest wall oc oc oc oc oc
III. Interference with fetal breathing oc oc oc
IV. Failure to produce fetal lung liquid oc oc oc oc oc
a. I and III only oc oc oc
b. II and III only oc oc oc
c. I, II, and IV only oc oc oc oc
d. II, III, and IV only oc oc oc oc
ANS: D oc
Oligohydramnios, a reduced quantity of amniotic fluid present for an extended period of time, oc oc oc oc oc oc oc oc oc oc oc oc oc
with or without renal anomTaE
oc lieSsT
, iB
sAasNsoKcS
iaE
octeLdLwEitR
hlu
. CnO
gMhypoplasia. The mechanisms by w oc oc oc oc oc oc oc oc oc ococ
hich amniotic fluid volume influences lung growth remain unclear. Possible explanations for
oc oc oc oc oc oc oc oc oc oc oc
reduced quantity of amniotic fluid include mechanical restriction of the chest wall, interfere
oc oc oc oc oc oc oc oc oc oc oc oc
nce with fetal breathing, or failure to produce fetal lung liquid. These clinical and experime
oc oc oc oc oc oc oc oc oc oc oc oc oc oc
ntal observations possibly point to a common denominator, lung stretch, as being amajor g
oc oc oc oc oc oc oc oc oc oc oc oc oc oc
rowth stimulant. oc
REF: pp. 6-7 oc oc
5. What is the purpose of the substance secreted by the type II pneumocyte?
oc oc oc oc oc oc oc oc oc oc oc oc
a. To increase the gas exchange surface area
oc oc oc oc oc oc
b. To reduce surface tension oc oc oc
c. To maintain lung elasticity oc oc oc
d. To preserve the volume of the amniotic fluid
oc oc oc oc oc oc oc
ANS: B oc
The primary role of mammalian surfactant is to lower the surface tension within the alveolus
oc oc oc oc oc oc oc oc oc oc oc oc oc oc
, specifically at the air–
oc oc oc oc
liquid interface. This allows the delicate structure of the alveolus to expand when filled with
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
air. Without surfactant, the alveolus remains collapsed because of thehigh surface tension of t
oc oc oc oc oc oc oc oc oc oc oc oc oc oc
he moist alveolar surface. Surfactant is composed predominantly of an intricate blend of phos
oc oc oc oc oc oc oc oc oc oc oc oc oc
pholipids, neutral lipids, and proteins. oc oc oc oc
REF: p. 8 oc oc
, 6. Which of the following tests of the amniotic fluid have been shown to be sensitive indicators
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
of lung maturity?
oc oc
a. Levels of prednisone oc oc
b. Levels of epidermal growth factor oc oc oc oc
c. Levels of prostaglandins oc oc
d. Levels of phosphatidylglycerol and phosphatidylcholine oc oc oc oc
ANS: D oc
Of clinical relevance during late gestation, analysis of amniotic fluid for the concentration of
oc oc oc oc oc oc oc oc oc oc oc oc oc oc
phosphatidylglycerol and phosphatidylcholine has been shown to be a sensitive indicator of oc oc oc oc oc oc oc oc oc oc oc oc
the state of fetal lung maturity.
oc oc oc oc oc
REF: p. 8 oc oc
7. Approximately how much fetal lung fluid is secreted daily?
oc oc oc oc oc oc oc oc oc
a. About 150 to 200 ml
oc oc oc oc oc
b. About 250 to 300 ml
oc oc oc oc oc
c. About 350 to 400 ml
oc oc oc oc oc
d. About 450 to 500 ml
oc oc oc oc oc
ANS: B oc
Fetal lungs are secretory organs that make breathing-
oc oc oc oc oc oc oc
like movements but serve no respiratory function before birth. They secrete
oc oc oc oc oc oc oc oc oc oc oc
about 250 to 300 ml of liquid per day.
oc oc oc oc oc oc oc oc
8. The lung bud emerges from which of the following structures?
oc oc oc oc oc oc oc oc oc oc oc
a. The pharynx
oc oc
b. The foregut
oc oc
c. The mesenchyme
oc oc
d. The tubular epithelium
oc oc oc
ANS: A oc
The embryonal phase includes primitive lung development and is generally regarded to encompass the first 2 mo
oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc oc
nths of gestation. oc oc oc
The lung begins to emerge as a bud from the pharynx 26 days after conception.
oc oc oc oc oc oc oc oc oc oc oc oc oc oc
