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Pre test physiology of one lung ventilation

Total questions: 10

Worksheet time: 10mins

Name
Class
Date
1.

Which of the following can increase pulmonary vascular resistance?

a)

Septicemia

b)

Systemic hypoxia

c)

Positive end-expiratory pressure (PEEP)

d)

All of the above

2.

Which of the following statements is TRUE regarding changes seen when a patient is positioned in the lateral decubitus position?

a)

Blood flow to the nondependent lung is significantly greater than it is to the dependent lung.

b)

The distribution of blood flow is turned by 180 degrees compared with the supine position.

c)

An awake, spontaneously breathing patient will demonstrate poor ventilation–perfusion matching in the dependent lung.

d)

Ventilation in the dependent lung is greater than in the nondependent lung.

e)

The nondependent hemidiaphragm is displaced higher into the chest.

3.

A patient undergoing a right thoracotomy with one-lung ventilation is given vecuronium bromide and is placed in the left lateral

decubitus position. The following statements are true EXCEPT:

a)

Thirty-five percent of the cardiac output participates in gas exchange in the left lung.

b)

Hypoxic pulmonary vasoconstriction reduces blood flow to the nondependent hypoxic lung by 50%.

c)

The patient's functional residual capacity (FRC) is reduced by receiving vecuronium bromide.

d)

One-lung ventilation causes a right-to-left shunt through the nonventilated lung.

4.

All of the following antagonize hypoxic pulmonary vasoconstriction EXCEPT:

a)

Pulmonary hypertension secondary to pulmonary embolism

b)

Epinephrine

c)

Mitral stenosis

d)

Infection

e)

Propofol

5.

Which of the following sympathomimetic drugs are β2 -selective and typically produce minimal cardiac effect from β1 -stimulation?

a)

Albuterol

b)

Terbutaline

c)

Metaproterenol

d)

Epinephrine

6.

The right lung, in the upright position

a)

is the smaller of the two

b)

has a single fissure

c)

has three lobes

d)

receives 45% of total lung blood flow

e)

is less frequently involved in aspiration

compared to the left

7.

During awake, closed chest ventilation in the

lateral decubitus position

a)

the lung relationships are the same as in

the semirecumbent position, i.e., the

apex is in zone 1 and the bases are in zone 3

b)

ventilation is highest at the apex

c)

perfusion is greater in the nondependent lung

d)

compliance is unequal in the two lungs

e)

the nondependent lung receives most of

the tidal ventilation

8.

In surgical cases requiring lung isolation

a)

Measurement of tracheal width from a posteroanterior chest radiograph is of no

use in selecting the size of a double-lumen tube (DLT)

b)

More frequent use of left-sided DLT is based on the anatomy of

tracheobronchial tree

c)

Uniform ventilation to all lobes is most likely achieved by a right-sided DLT

because it has a ventilation slot in the bronchial tube

d)

Fiber–optic confirmation of correct DLT placement is not required if you have

good clinical confirmation

9.

Which of the following statements is false regarding ventilation/perfusion

relationship in a lateral decubitus position during spontaneous ventilation ?

a)

The ventilation /perfusion matching is preserved

b)

Contraction of dependent hemidiaphragm is more efficient

c)

Dependent lung is on a more favorable part of the compliance curve

d)

The lower lung receives less ventilation and more perfusion than the upper lung

10.

Which of the following statements is not true regarding lower lung syndrome?

a)

It is caused by excessive fluid administration in a lateral decubitus position

b)

It increases intrapulmonary shunting

c)

It is gravity-dependent transudation of fluid in to the dependent lung

d)

It is due to volutrauma caused during

one-lung ventilation