Pulmonary Anatomy and Exam-
Questions and Answers Graded A+
vertical locations - ANSWER-relation to associated rib and interspaces; sternal angle is the best
guide
circumference - ANSWER-imagine a series of vertical lines
each lung is divided in half by what - ANSWER-oblique (major) fissure
the right lung is further divided by - ANSWER-horizontal (minor) fissure
fissures divide the lungs into _______- - ANSWER-lobes
lobes of right lung - ANSWER-right upper, middle and lower
where is the middle lobe of the right lung located - ANSWER-5th ICS MCL on right side
lobes of left lung - ANSWER-left upper, lower
why is location important - ANSWER-- helps give a guide when doing PROCEDURES
what procedure is done in the 2nd ICS - ANSWER-needle insertion for tension PTX
what procedure is done in the 4th ICS - ANSWER-chest tube insertion
- hemothroax, pneoumothorax
inferior tip of scapula - ANSWER-lies at the 7th rib
- stabalization of shoulder movement
T7-8 interspace - ANSWER-location for most thoracentesis
T4 - ANSWER-for lower margin of ET tube placement on CXR (approximately rib #3)
visceral pleura - ANSWER-serous membranes that cover the outer surface of each lung
parietal pleura - ANSWER-serous membrane that covers the inner rib cage and upper surface of the
diaphragm
T/F there are no pain receptors in the visceral pleura - ANSWER-TRUE
how lungs function - ANSWER-- inhale: air enters lungs
- oxygen from air moves into blood
- CO2 moves from blood to lungs and is exhaled
diaphragm - ANSWER-major muscle, separates thoracic cavity from abdominal
inhalation - ANSWER-- diaphragm contracts, gets smaller, decreases pressure in thoracic cavity -->
air able to come in
,exhalation - ANSWER-diaphragm expands, gets bigger, moves up --> air out
pursed lip breathing - ANSWER-- allows for slower release of air with expiration
- improves ventilation
- releases trapped air in lungs by slowing breathing
- keeps airways open longer and decreases work of breathing
- prolongs exhalation and slows breathing rate
- relieves feeling of SOB
when can you see pursed lip breathing - ANSWER-can be seen in COPD, asthma (to help with
dyspnea) normal breathing (relaxation/mediation)
deviated trachea - ANSWER-caused by abnormal pressure in chest cavity or neck
causes of deviated trachea - ANSWER-- PTX (most common)
- trauma to chest wall/lungs/neck
- tumors
- mediastinal lymphoma
- pleural effusion
symptoms associated with deviated trachea - ANSWER-cough, difficulty breathing, wheezing, chest
pain
- using accessory muscles, having retractions
deviated trachea pulled towards pathology - ANSWER-- generally occur with problems inside lungs
- ex: atelectasis (collapse), fibrosis (thickening/scarring), pneumonectomy
deviated trachea pushed away from pathology - ANSWER-- occur outside lungs
- ex: massive pleural effusion, tension PTX, mass (neck or mediastinal in location)
chest expansion - ANSWER-- evaluating for symmetrical movement of the chest wall with inspiration
- more concerned with decreased movement which signifies that the lung is not expanding as normal
when will asymmetry be noted - ANSWER-tumor, pleural effusion, bronchial obstruction
what part of the stethoscope do you use to auscultate lungs - ANSWER-diaphragm
limitations to percussion - ANSWER-- penetrates 5-7 cm deep
- determine if air filled, fluid filled or solid
- this technique will miss deep seated lesions
- sometimes unable to penetrate due to body habitus
"percussion is not about how ______ you strike it but ______ on fingers" - ANSWER-hard, pressure
what can be beneficial when percussing - ANSWER-- have pt lean forward and slightly cross arms
- separates scapular and opens up the available intercostal spaces
resonant - ANSWER-normal, healthy lung
dull/flat - ANSWER-- fluid or solid tissue replace air-filled lungs
- pathological cause: pleural effusion, lobar pneumonia, hemothorax, tumor
hyper-resonate - ANSWER-- increase air in lungs
,- pathological cause: unilateral- PTX, bulla (increased air where not expected)
generalized: COPD or asthma
tympanic - ANSWER-- excessive air in chest
- pathological cause: large PTX
diaphragmatic excursion - ANSWER-- assesses functionality of diaphragm
- evaluate one side to another
- normal excursion: 3-5.5 cm
-decreased: pleural effusion, atelectasis, phrenic nerve paralysis
what does positive egophony signify - ANSWER-consolidation, as the sound transmits through the
area where air-filled space has been replaced with fluid/solid space, it changes the sound heard
what does positive bronchophony signify - ANSWER-air-filled lung space replaced by fluid or solid-
space and this allows sound to be transmitted better
what does positive whispered pectoriloquoy signify - ANSWER-sound has better transmission and
sound is detected
what depends on the loudness of your voice?
a. thickness of vestibular folds
b. length of vocal folds
c. strength of laryngeal muscles
d. force of air rushing across vocal folds - ANSWER-d. force of air rushing across vocal folds
which of the following maintains patency?
a. surfactant
b. surface tension of water
c. cartilage rings
d. pseudostratified ciliated epithelium - ANSWER-c. cartilage rings
nerve impulses from where will result in inspiration?
a. ventral respiratory group
b. chemoreceptor center
c. broca's center
d. pre-optic nucleus of hypothalamus - ANSWER-a. ventral respiratory group
where is the actual site of gas exchange?
a. conducting zone
b. cellular respiration
c. pulmonary ventilation
d. respiratory zone - ANSWER-d. respiratory zone
What are the Type 2 cells that secrete fluid containing detergent like substance?
a. goblet cells
b. surfactant
c. alveolar sacs
d. alveolar ducts - ANSWER-b. surfactant
What makes up the respiratory membrane?
, a. bronchopulmonary segments and alveoli
b. alveolar, capillary walls, fused basement membranes
c. capillary walls, alveoli
d. respiratory bronchioles/alveolar - ANSWER-b. alveolar, capillary walls, fused basement
membranes
the relationship between pressure/volume is what law?
a. boyle's law
b. henry's law
c. charles's law
d. dalton's law - ANSWER-a. boyle's law
in the plasma, the quantity of oxygen in solution is
a. only 1.5% of oxygen is in its dissolved form
b. equal amount of oxygen combined with hemoglobin
c. 3.5% of oxygen is in its dissolved form
d. greater than the oxygen combined with hemoglobin - ANSWER-a. only 1.5% of oxygen is in its
dissolved form
what is hypoxia?
a. inadequate oxygen delivery to body tissues
b. too much oxygen delivery to body tissues
c. too much hemoglobin delivery to body
d. even number of oxygen and hemoglobin - ANSWER-a. inadequate oxygen delivery to body
tissues
what is another name for trachea?
a. pharynx
b. vocal folds
c. windpipe
d. vocal box - ANSWER-c. windpipe
a flap over the trachea to keep out things that could clog it is
a. larynx
b. epiglottis
c. pharynx
d. esophagus - ANSWER-b. epiglottis
which carries air into the lungs?
a. alveoli
b. sinuses
c. bronchi/bronchiole tubes
d. arteries - ANSWER-c. bronchi/bronchiole tubes
what is another name for larynx?
a. voice box
b. vocal chords
c. trachea
d. vocal amplifier - ANSWER-a. voice box
what is a sinus?
a. resonating chamber for speech
b. tube for air flow
Questions and Answers Graded A+
vertical locations - ANSWER-relation to associated rib and interspaces; sternal angle is the best
guide
circumference - ANSWER-imagine a series of vertical lines
each lung is divided in half by what - ANSWER-oblique (major) fissure
the right lung is further divided by - ANSWER-horizontal (minor) fissure
fissures divide the lungs into _______- - ANSWER-lobes
lobes of right lung - ANSWER-right upper, middle and lower
where is the middle lobe of the right lung located - ANSWER-5th ICS MCL on right side
lobes of left lung - ANSWER-left upper, lower
why is location important - ANSWER-- helps give a guide when doing PROCEDURES
what procedure is done in the 2nd ICS - ANSWER-needle insertion for tension PTX
what procedure is done in the 4th ICS - ANSWER-chest tube insertion
- hemothroax, pneoumothorax
inferior tip of scapula - ANSWER-lies at the 7th rib
- stabalization of shoulder movement
T7-8 interspace - ANSWER-location for most thoracentesis
T4 - ANSWER-for lower margin of ET tube placement on CXR (approximately rib #3)
visceral pleura - ANSWER-serous membranes that cover the outer surface of each lung
parietal pleura - ANSWER-serous membrane that covers the inner rib cage and upper surface of the
diaphragm
T/F there are no pain receptors in the visceral pleura - ANSWER-TRUE
how lungs function - ANSWER-- inhale: air enters lungs
- oxygen from air moves into blood
- CO2 moves from blood to lungs and is exhaled
diaphragm - ANSWER-major muscle, separates thoracic cavity from abdominal
inhalation - ANSWER-- diaphragm contracts, gets smaller, decreases pressure in thoracic cavity -->
air able to come in
,exhalation - ANSWER-diaphragm expands, gets bigger, moves up --> air out
pursed lip breathing - ANSWER-- allows for slower release of air with expiration
- improves ventilation
- releases trapped air in lungs by slowing breathing
- keeps airways open longer and decreases work of breathing
- prolongs exhalation and slows breathing rate
- relieves feeling of SOB
when can you see pursed lip breathing - ANSWER-can be seen in COPD, asthma (to help with
dyspnea) normal breathing (relaxation/mediation)
deviated trachea - ANSWER-caused by abnormal pressure in chest cavity or neck
causes of deviated trachea - ANSWER-- PTX (most common)
- trauma to chest wall/lungs/neck
- tumors
- mediastinal lymphoma
- pleural effusion
symptoms associated with deviated trachea - ANSWER-cough, difficulty breathing, wheezing, chest
pain
- using accessory muscles, having retractions
deviated trachea pulled towards pathology - ANSWER-- generally occur with problems inside lungs
- ex: atelectasis (collapse), fibrosis (thickening/scarring), pneumonectomy
deviated trachea pushed away from pathology - ANSWER-- occur outside lungs
- ex: massive pleural effusion, tension PTX, mass (neck or mediastinal in location)
chest expansion - ANSWER-- evaluating for symmetrical movement of the chest wall with inspiration
- more concerned with decreased movement which signifies that the lung is not expanding as normal
when will asymmetry be noted - ANSWER-tumor, pleural effusion, bronchial obstruction
what part of the stethoscope do you use to auscultate lungs - ANSWER-diaphragm
limitations to percussion - ANSWER-- penetrates 5-7 cm deep
- determine if air filled, fluid filled or solid
- this technique will miss deep seated lesions
- sometimes unable to penetrate due to body habitus
"percussion is not about how ______ you strike it but ______ on fingers" - ANSWER-hard, pressure
what can be beneficial when percussing - ANSWER-- have pt lean forward and slightly cross arms
- separates scapular and opens up the available intercostal spaces
resonant - ANSWER-normal, healthy lung
dull/flat - ANSWER-- fluid or solid tissue replace air-filled lungs
- pathological cause: pleural effusion, lobar pneumonia, hemothorax, tumor
hyper-resonate - ANSWER-- increase air in lungs
,- pathological cause: unilateral- PTX, bulla (increased air where not expected)
generalized: COPD or asthma
tympanic - ANSWER-- excessive air in chest
- pathological cause: large PTX
diaphragmatic excursion - ANSWER-- assesses functionality of diaphragm
- evaluate one side to another
- normal excursion: 3-5.5 cm
-decreased: pleural effusion, atelectasis, phrenic nerve paralysis
what does positive egophony signify - ANSWER-consolidation, as the sound transmits through the
area where air-filled space has been replaced with fluid/solid space, it changes the sound heard
what does positive bronchophony signify - ANSWER-air-filled lung space replaced by fluid or solid-
space and this allows sound to be transmitted better
what does positive whispered pectoriloquoy signify - ANSWER-sound has better transmission and
sound is detected
what depends on the loudness of your voice?
a. thickness of vestibular folds
b. length of vocal folds
c. strength of laryngeal muscles
d. force of air rushing across vocal folds - ANSWER-d. force of air rushing across vocal folds
which of the following maintains patency?
a. surfactant
b. surface tension of water
c. cartilage rings
d. pseudostratified ciliated epithelium - ANSWER-c. cartilage rings
nerve impulses from where will result in inspiration?
a. ventral respiratory group
b. chemoreceptor center
c. broca's center
d. pre-optic nucleus of hypothalamus - ANSWER-a. ventral respiratory group
where is the actual site of gas exchange?
a. conducting zone
b. cellular respiration
c. pulmonary ventilation
d. respiratory zone - ANSWER-d. respiratory zone
What are the Type 2 cells that secrete fluid containing detergent like substance?
a. goblet cells
b. surfactant
c. alveolar sacs
d. alveolar ducts - ANSWER-b. surfactant
What makes up the respiratory membrane?
, a. bronchopulmonary segments and alveoli
b. alveolar, capillary walls, fused basement membranes
c. capillary walls, alveoli
d. respiratory bronchioles/alveolar - ANSWER-b. alveolar, capillary walls, fused basement
membranes
the relationship between pressure/volume is what law?
a. boyle's law
b. henry's law
c. charles's law
d. dalton's law - ANSWER-a. boyle's law
in the plasma, the quantity of oxygen in solution is
a. only 1.5% of oxygen is in its dissolved form
b. equal amount of oxygen combined with hemoglobin
c. 3.5% of oxygen is in its dissolved form
d. greater than the oxygen combined with hemoglobin - ANSWER-a. only 1.5% of oxygen is in its
dissolved form
what is hypoxia?
a. inadequate oxygen delivery to body tissues
b. too much oxygen delivery to body tissues
c. too much hemoglobin delivery to body
d. even number of oxygen and hemoglobin - ANSWER-a. inadequate oxygen delivery to body
tissues
what is another name for trachea?
a. pharynx
b. vocal folds
c. windpipe
d. vocal box - ANSWER-c. windpipe
a flap over the trachea to keep out things that could clog it is
a. larynx
b. epiglottis
c. pharynx
d. esophagus - ANSWER-b. epiglottis
which carries air into the lungs?
a. alveoli
b. sinuses
c. bronchi/bronchiole tubes
d. arteries - ANSWER-c. bronchi/bronchiole tubes
what is another name for larynx?
a. voice box
b. vocal chords
c. trachea
d. vocal amplifier - ANSWER-a. voice box
what is a sinus?
a. resonating chamber for speech
b. tube for air flow
