Hillegass: Essentials of Cardiopulmonary Physical Therapy, 3rd Edition:

, Hillegass:EssentialsofCardiopulmonaryPhysicalTherapy,3rdEdition

Chapter1:AnatomyoftheCardiovascularandPulmonarySystemsTest

Bank

MULTIPLECHOICE

1. Whichofthefollowingchestwallstructuresislocatedlevelwiththesecondcostalcartilage
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anteriorlyandthoracicvertebraT4andT5posteriorly?
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A. Sternalangle
B. Jugularnotch
C. Xiphoidprocess
D. Thirdcostalcartilage
ANS: A
Thesternalangleofthe“angleofLouis”islevelwiththesecondcostalcartilageanteriorly andthoracic
vertebraeT4andT5posteriorly.

PTS: 1

2. PectusexcuvatumisBESTdescribedas:
A. Deformityofthesternumcausedbytrauma
B. Caved-inappearanceofthechest
C. Diminishedribangleanteriorly
D. Conicalshapeofthethoraciccage
ANS: B
Pectusexcuvatumisacommoncongenitaldeformityoftheanteriorwallofthechest,inwhichseveral
ribsandthesternumgrowabnormally;itproducesacaved-inorsunkenappearanceofthechest.
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PTS: 1

3. ThetrueribsareBESTdefinedbywhichofthefollowingstatements?
A. Vertebrochondralribs
B. Vertebrosternalribs
C. Ribs11and12
D. Ribs8,9,and10
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ANS: B
Thefirstsevenribsattachviatheircostalcartilagestothesternumandarecalledthetrueribs (also
knownasthevertebrosternalribs).
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PTS: 1




Copyright©2011,2001,1994bySaunders,animprintofElsevierInc.
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4. Whichofthefollowinginterventionsis MOSTappropriateforapatientwithlowerribfractures?
A. Short,shallowbreaths
B. Pursedlipbreathing
C. Deepbreathswithsplinting
D. Breathingwitharmsraised
ANS: C
Itisimportantforalltherapiststorecommendbreathing(deepbreathing),splinting(i.e.,pillow),and
coughingstrategiesforpatientswithribfractures.

PTS: 1

5. Whichofthefollowingpositionsfacilitatesgreaterexcursionofbothhemidiaphragms at rest?
A. Supineposition
B. Sidelyingposition
C. Standingposition
D. Sittingposition
ANS: A
Inthesupineposition,withouttheeffectsofgravity,thelevelofthediaphragminthethoraciccavity
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rises.Thisallowsforarelativelygreaterexcursion.

PTS: 1

6. Whichofthefollowingmuscleshelptoachievetheactiveprocessofinspirationatrest?
A. Sternocleidomastoid
B. Diaphragm
C. Abdominalmuscles
D. Trapezius
ANS: B
Thediaphragmandinternalintercostals(intercartilaginousportion)aretheessentialmusclesto
achievetheactiveprocessofinspirationatrest.Abdominalmusclesassistwithexpiration.The
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sternocleidomastoidandtrapeziusareaccessorymusclesandassistwithamoreforcefulinspiration.
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PTS: 1

7. Whichofthefollowingaccessorymusclesofventilationfunctiontoelevateandfixthefirstand
secondribs?
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A. Sternocleidomastoid muscle
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B. Serratusanterior
C. Latissimusdorsi
D. Scalenemuscle
ANS: D




Copyright©2011,2001,1994bySaunders,animprintofElsevierInc.
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Thescalenemusclesliedeeptothesternocleidomastoid,butmaybepalpatedintheposteriortriangle
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oftheneck.Thesemusclesfunctionasaunittoelevateandfixthefirstandsecondribs.The
sternocleidomastoidmuscleelevatesthesternum.
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PTS: 1

8. Whenthearmsandshouldersarefixed,byleaningontheelbowsorgraspingontoatable,this
muscle canuseitsinsertionasitsoriginandfacilitateanincreaseintheA-Pdiameterofthethorax.
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A. Uppertrapezius
B. Pectoralismajor
C. Sternocleidomastoid
D. Serratusanterior
ANS: B
Whentheinsertion andoriginofthepectoralismusclearereversedbyleaningonatabletofixthearms,the
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musclewillpullontheanteriorchestwall,liftingtheribsandsternumtoincreasethe A-Pdiameterofthe
thoraciccage.
PTS: 1
9. Theserous fluid withinthepleuralspaceservestoprovidewhichofthefollowingfunctions?
A. Createaconstantnegativepressure
B. Assist with venous return ofbloodtotheheart
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C. Reducefrictionbetweenthelungsandthoracicwall
D. Servetoallowseparationofthepleurallayers
ANS: C
The serous fluid withinthe pleural space serves to hold the pleural layers together during ventilation
andreducefrictionbetweenthelungsandthethoracicwall.Thespacecreatesthe negative pressure to
maintainlunginflation,notthefluiditself.
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PTS: 1
10. Irritationofthephrenicsuppliedpleuraresultsinwhichofthefollowingpainreferralpatterns?
A. Thoracicwall
B. Abdominalwall
C. Mediasternalregion
D. Lowerneckandshoulder
ANS: D
Irritationofthephrenicsuppliedpleuracanresultinreferredpaininthelowerneckandshoulder,whereas,
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irritationoftheintercostallyinnervatedpleuramayresultinreferralofpaintothethoracicorabdominal
wall.

PTS: 1

11. Anabnormalpleuralfrictionr ubonauscultationBESTindicateswhichofthefollowing?
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A. Infectionwitharesultantinflammatoryresponsewithinthepleura




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