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Questions and Answers
What is the characteristic finding in a restrictive disease concerning TLC?
What is the characteristic finding in a restrictive disease concerning TLC?
What indicates possible obstruction when assessing FEV1 or FVC?
What indicates possible obstruction when assessing FEV1 or FVC?
In a patient with respiratory acidosis, which of the following would be expected?
In a patient with respiratory acidosis, which of the following would be expected?
Which condition is suggested by a normal PFT with decreased DLCO?
Which condition is suggested by a normal PFT with decreased DLCO?
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What is the normal range for arterial blood pH?
What is the normal range for arterial blood pH?
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Which condition is associated with a PaCO2 greater than 50 mmHg?
Which condition is associated with a PaCO2 greater than 50 mmHg?
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What defines a condition as 'compensated' in acid-base balance?
What defines a condition as 'compensated' in acid-base balance?
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What is indicated by an increase in HCO3 in relation to pH?
What is indicated by an increase in HCO3 in relation to pH?
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What pH and PaCO2 conditions characterize a state of uncompensated respiratory acidosis?
What pH and PaCO2 conditions characterize a state of uncompensated respiratory acidosis?
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Which imaging technique is primarily intended for soft tissue evaluation?
Which imaging technique is primarily intended for soft tissue evaluation?
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What is the volume of Tidal Volume in mL?
What is the volume of Tidal Volume in mL?
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Which lung volume is defined as the total volume of air present in the lungs at maximum inflation?
Which lung volume is defined as the total volume of air present in the lungs at maximum inflation?
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What is a key complication associated with lung transplantation?
What is a key complication associated with lung transplantation?
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What does a bronchoscopy primarily allow for?
What does a bronchoscopy primarily allow for?
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How is severe hypoxemia defined in terms of PaO2 level?
How is severe hypoxemia defined in terms of PaO2 level?
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In which volume is vital capacity typically measured?
In which volume is vital capacity typically measured?
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Which imaging method uses contrast dye to visualize vascular density in lungs?
Which imaging method uses contrast dye to visualize vascular density in lungs?
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What surgical procedure involves the removal of an entire lung?
What surgical procedure involves the removal of an entire lung?
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What is one key reason for early mobilization of postoperative patients?
What is one key reason for early mobilization of postoperative patients?
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What condition is NOT indicated for oxygen therapy?
What condition is NOT indicated for oxygen therapy?
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What type of mechanical ventilation mode allows for both machine and spontaneous breaths?
What type of mechanical ventilation mode allows for both machine and spontaneous breaths?
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During positive pressure ventilation, which variable determines if the machine delivers a breath in Pressure Support mode?
During positive pressure ventilation, which variable determines if the machine delivers a breath in Pressure Support mode?
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What is the primary function of Positive End Expiratory Pressure (PEEP)?
What is the primary function of Positive End Expiratory Pressure (PEEP)?
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Which medication type is used to specifically manage secretions in patients?
Which medication type is used to specifically manage secretions in patients?
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What is the role of Incentive Spirometry in postoperative care?
What is the role of Incentive Spirometry in postoperative care?
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Which of the following accurately describes how Stroke Volume is affected?
Which of the following accurately describes how Stroke Volume is affected?
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In the context of oxygen transport, what does the Oxygen Delivery (DO2) rate depend on?
In the context of oxygen transport, what does the Oxygen Delivery (DO2) rate depend on?
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What does the Oxygen Extraction Ratio (OER) indicate?
What does the Oxygen Extraction Ratio (OER) indicate?
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What is a primary advantage of non-invasive ventilation (NIV)?
What is a primary advantage of non-invasive ventilation (NIV)?
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What indicates that a patient is breathing spontaneously on a mechanical ventilator?
What indicates that a patient is breathing spontaneously on a mechanical ventilator?
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Which of the following is a contraindication for positive pressure intervention?
Which of the following is a contraindication for positive pressure intervention?
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What is a key characteristic of BiPAP compared to CPAP?
What is a key characteristic of BiPAP compared to CPAP?
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What is the primary effect of exercise on oxygen delivery in a healthy individual?
What is the primary effect of exercise on oxygen delivery in a healthy individual?
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What happens to VO2 if DO2 declines in critically ill individuals?
What happens to VO2 if DO2 declines in critically ill individuals?
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Which of the following is NOT one of the tasks required after strenuous exercise?
Which of the following is NOT one of the tasks required after strenuous exercise?
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What is the primary function of percussion in respiratory therapy?
What is the primary function of percussion in respiratory therapy?
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Which breathing technique involves 'unsticking' mucus by breathing at low lung volumes?
Which breathing technique involves 'unsticking' mucus by breathing at low lung volumes?
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What is the purpose of a splinted cough?
What is the purpose of a splinted cough?
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What effect does gravitational stress have on oxygen transport?
What effect does gravitational stress have on oxygen transport?
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Which equation is used to determine Target HR using the Karvonen method?
Which equation is used to determine Target HR using the Karvonen method?
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In the context of inspiratory muscle training, what is considered the best practice for patients with a tidal volume less than 500?
In the context of inspiratory muscle training, what is considered the best practice for patients with a tidal volume less than 500?
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Which phase in an effective cough involves a momentary glottal closure to increase intrathoracic pressure?
Which phase in an effective cough involves a momentary glottal closure to increase intrathoracic pressure?
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What is the primary aim of paced breathing techniques?
What is the primary aim of paced breathing techniques?
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In the context of the 6-Minute Walk Test, how is VO2Max calculated?
In the context of the 6-Minute Walk Test, how is VO2Max calculated?
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What distinguishes the closed technique from the open suctioning technique?
What distinguishes the closed technique from the open suctioning technique?
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What type of breath sound is characterized by loud and high-pitched sound with equal inspiratory and expiratory phases?
What type of breath sound is characterized by loud and high-pitched sound with equal inspiratory and expiratory phases?
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Which abnormal breath sound indicates fluid or alveolar popping and is associated with conditions like pneumonia and heart failure?
Which abnormal breath sound indicates fluid or alveolar popping and is associated with conditions like pneumonia and heart failure?
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Which type of lung disease is characterized as obstructive and involves inflammation of the airways?
Which type of lung disease is characterized as obstructive and involves inflammation of the airways?
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What is indicated by diminished or absent breath sounds over involved areas and is characterized by the partial or total collapse of lung segments?
What is indicated by diminished or absent breath sounds over involved areas and is characterized by the partial or total collapse of lung segments?
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Which method of percussion sound is heard over hollow organs, such as the stomach?
Which method of percussion sound is heard over hollow organs, such as the stomach?
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What type of breath sound is typically continuous and high-pitched, usually heard during exhalation?
What type of breath sound is typically continuous and high-pitched, usually heard during exhalation?
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Which lung condition is indicated by the presence of fluid in the pleural space, causing decreased breath sounds?
Which lung condition is indicated by the presence of fluid in the pleural space, causing decreased breath sounds?
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Crackling and wheezing sounds accompanied by a chronic cough and purulent sputum are indicative of which lung condition?
Crackling and wheezing sounds accompanied by a chronic cough and purulent sputum are indicative of which lung condition?
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What is a common characteristic feature of emphysema, a type of obstructive lung disease?
What is a common characteristic feature of emphysema, a type of obstructive lung disease?
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What abnormal finding is associated with pneumonia when auscultating breath sounds?
What abnormal finding is associated with pneumonia when auscultating breath sounds?
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Which of the following conditions is characterized by sharp crackles and diminished breath sounds due to inflammation of the alveolar wall?
Which of the following conditions is characterized by sharp crackles and diminished breath sounds due to inflammation of the alveolar wall?
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Which of the following statements about stridor is correct?
Which of the following statements about stridor is correct?
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Which lung condition is commonly diagnosed based on a sputum culture and is characterized by crackles and low-pitched wheezing?
Which lung condition is commonly diagnosed based on a sputum culture and is characterized by crackles and low-pitched wheezing?
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Which restrictive lung disease results from fluid accumulation in the alveoli, indicated by diffuse crackles during auscultation?
Which restrictive lung disease results from fluid accumulation in the alveoli, indicated by diffuse crackles during auscultation?
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All pulmonary breath sounds are indicative of normal lung function.
All pulmonary breath sounds are indicative of normal lung function.
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Which of the following are types of pulmonary breath sounds?
Which of the following are types of pulmonary breath sounds?
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Pulmonary breath sounds can indicate different respiratory conditions.
Pulmonary breath sounds can indicate different respiratory conditions.
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Which of the following descriptions relates to wheezing breath sounds?
Which of the following descriptions relates to wheezing breath sounds?
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Pulmonary breath sounds are always abnormal.
Pulmonary breath sounds are always abnormal.
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Which of the following pulmonary breath sounds are considered abnormal?
Which of the following pulmonary breath sounds are considered abnormal?
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Which of the following respiratory sounds is characterized by a high-pitched wheezing?
Which of the following respiratory sounds is characterized by a high-pitched wheezing?
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What are the common types of abnormal breath sounds? (Select all that apply)
What are the common types of abnormal breath sounds? (Select all that apply)
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Which of the following are types of breath sounds associated with pulmonary conditions?
Which of the following are types of breath sounds associated with pulmonary conditions?
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Which type of pulmonary breath sound is typically associated with fluid in the lungs?
Which type of pulmonary breath sound is typically associated with fluid in the lungs?
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What type of breath sound is characterized by a high-pitched wheezing sound, often heard during expiration?
What type of breath sound is characterized by a high-pitched wheezing sound, often heard during expiration?
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Which of the following pulmonary breath sounds is typically described as high-pitched and musical?
Which of the following pulmonary breath sounds is typically described as high-pitched and musical?
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Which of the following lung sounds is typically associated with pneumonia?
Which of the following lung sounds is typically associated with pneumonia?
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What are the normal breath sounds heard during auscultation?
What are the normal breath sounds heard during auscultation?
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Which of the following types of abnormal lung sounds might indicate the presence of respiratory pathology?
Which of the following types of abnormal lung sounds might indicate the presence of respiratory pathology?
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Which of the following are common pulmonary breath sounds? (Select all that apply)
Which of the following are common pulmonary breath sounds? (Select all that apply)
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Study Notes
Pulmonary Breath Sounds
- Tracheal: Normal air movement through the trachea; loud, high pitched, equal inspiratory/expiratory phases (1:1), heard directly over the trachea.
- Bronchial: Air moving through large airways; high pitched, hollow, louder expiration than inspiration (1:2), heard in upper sternum and between scapulae.
- Bronchovesicular: Air movement in mid-sized airways; moderate pitch and intensity, equal inspiratory/expiratory phases (1:1), heard in peripheral lung fields.
- Vesicular: Air moving through small airways; soft, low pitched, longer inspiration than expiration (3:1), heard in peripheral lung fields.
- Crackles/Rales: Fluid or alveolar popping, representing wetness in the airways; continuous, heard during inspiration, associated with pneumonia, heart failure, pulmonary fibrosis.
- Wheezes/Rhonchi: Airflow obstruction, usually heard during exhalation (bronchoconstriction/secretions); continuous, high pitched musical sound (wheezes), or lower pitched snoring sound (rhonchi), heard in asthma, COPD, bronchitis.
- Stridor: Airflow obstruction at upper airway; continuous, high pitched, heard during inspiration/exhalation; associated with epiglottis, foreign body, laryngeal edema.
- Pleural Rub: Visceral and parietal pleura rubbing together; continuous, creaking or grating sound, heard during inspiration and exhalation, associated with pleuritis, pleural effusion.
Mediate Percussion
- Resonant: Loud/low pitched, heard over air-filled lungs.
- Hyper Resonant: Very low pitched, heard over tissue with decreased density (ex diseased lungs, emphysema).
- Tympanic: High pitched, heard over hollow organs.
- Dull: Low amplitude medium to high pitched, over solid organs.
- Flat: Very dull sound/high pitch, over very dense tissues/muscle.
Lung Diseases/Pathology
- Bronchitis: Airway disease, inflammation of bronchi, obstruction of airways, alveolar wall destruction, often associated with a barrel chest, faster shallow breathing, and increased vibration over mucosal areas.
- Emphysema: Abnormal, irreversible enlargement of airways distal to terminal bronchioles, decreased breath sounds, often associated with a barrel chest and pursed lips.
- Asthma: Chronic inflammation of airways, reversible obstruction to airflow, bronchospasm, often associated with wheezing exhalation greater than inhalation.
- Bronchiectasis: Abnormal permanent dilation of bronchi/bronchioles, chronic inflammation/infection, destruction of elastic and muscular, often associated with more air in lungs and hyper resonant sounds.
- Cystic Fibrosis: Thick, excessive secretions and poor ciliary function, obstruction of small bronchi, affects bronchial hygiene, often associated with a barrel chest, faster shallow breaths, and increased vibration over mucosal areas.
- Bronchopulmonary Dysplasia (BPD): Underdeveloped lungs, inflammation and scarring of the lungs, often in children, often associated with mechanical ventilation.
- Pulmonary Fibrosis: Restrictive, inflammation of alveolar wall, scarring, stiffness, and decreased compliance, often associated with diminished breath sounds.
- Pneumonia: Restrictive, inflammation of the lung, crackles and low-pitched wheezing, bronchial breath sounds over area of consolidation.
- Acute Respiratory Distress Syndrome (ARDS): Restrictive, sudden respiratory failure, diffuse crackles, wet breath sounds, decreased breath sounds.
- Lung Carcinoma: Restrictive, malignant lung tumor, diminished breath sounds, crackles/wheezing.
- Pleural Effusion: Restrictive, fluid in the pleural space, decreased breath sounds, pleural rub.
- Atelectasis: Restrictive, partial or total collapse of alveoli/lung segments, diminished or absent breath sounds.
- Pneumothorax: Restrictive, presence of air in the pleural cavity, Hemothorax is blood in pleural cavity, often associated with absent or diminished breath sounds.
- Tuberculosis: Infection of the lungs, often associated with crackles and bronchial breath sounds.
COVID-19
- Hypoxemic disease, can progress to ARDS, scarring in the lungs, fever, chills, shortness of breath, cough, fatigue, body/muscle aches, headaches, loss of taste/smell.
Diagnostic Testing
- Pulmonary Function Tests (PFTs): Used to diagnose and monitor respiratory symptoms and disease. Measures volume and flow of air. Includes FEV1, FEV1/FVC, RV, TLC, and other tests that show obstruction or restriction.
Additional
- ABGs: Could be an early sign of interstitial lung disease (ILD). Important values are pH (7.35-7.45), PCO2 (35-45), PO2 (80-100), HCO3 (22-28), Hgb (12-16).
- Oxygenation Status: Normal PO2 values are 80-100. Mild/Moderate/Severe Hypoxemia means PO2 is around 60-80, 40-60, and under 40 mmHg respectively.
- Imaging: includes radiographs (x-rays), and CT scans.
- Pulmonary Angiogram: Catheter with dye injected into the heart to see how dye moves through lungs arteries to diagnose blockages.
- Bronchoscopy: visualizes bronchial tree using scope for diagnostic and therapeutic purposes.
- Radionuclide V/Q Scans: Ventilation and perfusion scan should match; poor ventilation or perfusion suggests airway obstruction or PE (pulmonary embolism).
- Lung Volumes/Capacities: Includes tidal volume, inspiratory reserve volume, expiratory reserve volume, residual volume, inspiratory capacity, functional residual capacity, and vital capacity.
- Surgical Interventions: Includes Wedge Resection, Bullectomies, Lobectomies, and Pneumonectomies.
- Lung Transplant: Advanced stage pulmonary disease, absolute and relative criteria.
- Positive Pressure Ventilation: includes Constant Pressure, Positive End Expiratory Pressure (PEEP), Continuous Positive Airway Pressure (CPAP).
- Negative Pressure Ventilation: Iron lung, vacuum pump created negative pressure chamber.
- Ventilator Alarms: High pressure, Low pressure, Apnea.
- Oxygen Therapy: Indications include, Hypoxemia, Increased work of breathing, and Increased myocardial work.
- Cough Maneuvers: Aimed at removing secretions from the lungs using forceful exhalation.
- Active Cycles of Breathing (ACB): Series of 3 steps to facilitate breathing control through inspiratory, thoracic, and expiratory exercises.
- Autogenic Drainage (AD): Use of controlled breathing to mobilize secretions to remove mucus from lungs using varying degrees of expiratory airflow.
- Paced Breathing: Facilitates diaphragmatic breathing, paired with breathing and activity, with specific instructions for inspiration and expiration.
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Description
Test your knowledge on the various types of pulmonary breath sounds. This quiz covers tracheal, bronchial, bronchovesicular, vesicular sounds, and abnormal sounds like crackles and wheezes. Perfect for medical students and healthcare professionals!
