Neonatal and Pediatric Respir
h h h
atory Care 5th EditionWalsh
h h h h h
Test Bank A+
h h
, Chapter 1: Fetal Lung Development Test Bank
h h h h h h
MULTIPLEhCHOICE
1. Whichhofhthehfollowinghphaseshofhhumanhlunghdevelopmenthishcharacterizedhbyhthehf
ormationhofhahcapillaryhnetworkharoundhairwayhpassages?
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS:hD
Thehcanalicularhphasehfollowshthehpseudoglandularhphase,hlastinghfromhapproximatelyh17hweekshto
h26hweekshofhgestation.hThishphasehishsohnamedhbecausehofhthehappearancehofhvascularhchannels,horhc
apillaries,hwhichhbeginhtohgrowhbyhforminghahcapillaryhnetworkharoundhthehairhpassages.
Duringhthehpseudoglandularhstage,hwhichhbeginshathdayh52handhextendshtohweekh16hofhgestation,hth
ehairwayhsystemhsubdivideshextensivelyhandhthehconductinghairwayhsystemhdevelops,hendinghwithht
hehterminalhbronchioles.hThehsaccularhstagehofhdevelopment,hwhichhtakeshplacehfromhweeksh29htoh3
6hofhgestation,hishcharacterizedhbyhthehdevelopmenthofhsacshthathlaterhbecomehalveoli.
Duringhthehsaccularhphase,hahtremendoushincreasehinhthehpotentialhgas-
hexchanginghsurfacehareahoccurs.hThehdistinctionhbetweenhthehsaccularhstagehandhthehalveolarhsta
gehisharbitrary.hThehalveolarhstagehstretcheshfromh39hweekshofhgestationhtohterm.hThishstagehishrep
resentedhbyhthehestablishmenthofhalveoli.
REF:hpp.h3-5
2. Regardinghpostnatalhlunghgrowth,hbyhapproximatelyhwhathagehdohmosthofhthehalveolihthath
willhbehpresenthinhthehlungshforhlifehdevelop?
a. 6hmonths
,b. 1hyear
c. 1.5hyears
d. 2hyears
ANS:hC
Mosthofhthehpostnatalhformationhofhalveolihinhthehinfanthoccurshoverhthehfirsth1.5hyearshofhlife.hAth2hy
earshofhage,hthehnumberhofhalveolihvarieshsubstantiallyhamonghindividuals.hAfterh2hyearshofhage,hmal
eshhavehmorehalveolihthanhdohfemales.hAfterhalveolarhmultiplicationhends,hthehalveolihcontinuehtohin
creasehinhsizehuntilhthoracichgrowthhishcompleted.
REF:hp.h6
3. Thehrespiratoryhtherapisthishevaluatinghahnewbornhwithhmildhrespiratoryhdistresshduehtoht
rachealhstenosis.hDuringhwhichhperiodhofhlunghdevelopmenthdidhthishproblemhdevelop?
a. Embryonal
b. Saccular
c. Canalicular
d. Alveolar
ANS:hA
Thehinitialhstructureshofhthehpulmonaryhtreehdevelophduringhthehembryonalhstage.hErrorshinhdevelop
menthduringhthishtimehmayhresulthinhlaryngeal,htracheal,horhesophagealhatresiahorhstenosis.hPulmonar
yhhypoplasia,hanhincompletehdevelopmenthofhthehlungshcharacterizedhbyhanhabnormallyhlowhnumber
hand/orhsizehofhbronchopulmonaryhsegmentshand/orhalveoli,hcanhdevelophduringhthehpseudoglandula
rhphase.hIfhthehfetushishbornhduringhthehcanalicularhphaseh(i.e.,hprematurely),hseverehrespiratoryhdistre
sshcanhbehexpectedhbecausehthehinadequatelyhdevelopedhairways,halonghwithhinsufficienthandhimmat
urehsurfactanthproductionhbyhalveolarhtypehIIhcells,hgiveshrisehtohthehconstellationhofhproblemshknow
nhashinfanthrespiratoryhdistresshsyndrome.
, REF:h p.h6
4. Whichhofhthehfollowinghmechanismshish(are)hresponsiblehforhthehpossiblehassociationhb
etweenholigohydramnioshandhlunghhypoplasia?
I. Abnormalhcarbohydratehmetabolism
II. Mechanicalhrestrictionhofhthehchesthwall
III. Interferencehwithhfetalhbreathing
IV. Failurehtohproducehfetalhlunghliquid
a. IhandhIIIhonly
b. IIhandhIIIhonly
c. I,h II,handhIVhonly
d. II,hIII,handhIVhonly
ANS:hD
Oligohydramnios,hahreducedhquantityhofhamniotichfluidhpresenthforhanhextendedhperiodhofhtime,hwit
hhorhwithouthrenalhanomalies,hishassociatedhwithhlunghhypoplasia.hThehmechanismshbyhwhichhamni
otichfluidhvolumehinfluenceshlunghgrowthhremainhunclear.hPossiblehexplanationshforhreducedhquanti
tyhofhamniotichfluidhincludehmechanicalhrestrictionhofhthehchesthwall,hinterferencehwithhfetalhbreathi
ng,horhfailurehtohproducehfetalhlunghliquid.hThesehclinicalhandhexperimentalhobservationshpossiblyhp
ointhtohahcommonhdenominator,hlunghstretch,hashbeinghahmajorhgrowthhstimulant.
REF:hpp.h6-7
5. WhathishthehpurposehofhthehsubstancehsecretedhbyhthehtypehIIhpneumocyte?
h h h
atory Care 5th EditionWalsh
h h h h h
Test Bank A+
h h
, Chapter 1: Fetal Lung Development Test Bank
h h h h h h
MULTIPLEhCHOICE
1. Whichhofhthehfollowinghphaseshofhhumanhlunghdevelopmenthishcharacterizedhbyhthehf
ormationhofhahcapillaryhnetworkharoundhairwayhpassages?
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS:hD
Thehcanalicularhphasehfollowshthehpseudoglandularhphase,hlastinghfromhapproximatelyh17hweekshto
h26hweekshofhgestation.hThishphasehishsohnamedhbecausehofhthehappearancehofhvascularhchannels,horhc
apillaries,hwhichhbeginhtohgrowhbyhforminghahcapillaryhnetworkharoundhthehairhpassages.
Duringhthehpseudoglandularhstage,hwhichhbeginshathdayh52handhextendshtohweekh16hofhgestation,hth
ehairwayhsystemhsubdivideshextensivelyhandhthehconductinghairwayhsystemhdevelops,hendinghwithht
hehterminalhbronchioles.hThehsaccularhstagehofhdevelopment,hwhichhtakeshplacehfromhweeksh29htoh3
6hofhgestation,hishcharacterizedhbyhthehdevelopmenthofhsacshthathlaterhbecomehalveoli.
Duringhthehsaccularhphase,hahtremendoushincreasehinhthehpotentialhgas-
hexchanginghsurfacehareahoccurs.hThehdistinctionhbetweenhthehsaccularhstagehandhthehalveolarhsta
gehisharbitrary.hThehalveolarhstagehstretcheshfromh39hweekshofhgestationhtohterm.hThishstagehishrep
resentedhbyhthehestablishmenthofhalveoli.
REF:hpp.h3-5
2. Regardinghpostnatalhlunghgrowth,hbyhapproximatelyhwhathagehdohmosthofhthehalveolihthath
willhbehpresenthinhthehlungshforhlifehdevelop?
a. 6hmonths
,b. 1hyear
c. 1.5hyears
d. 2hyears
ANS:hC
Mosthofhthehpostnatalhformationhofhalveolihinhthehinfanthoccurshoverhthehfirsth1.5hyearshofhlife.hAth2hy
earshofhage,hthehnumberhofhalveolihvarieshsubstantiallyhamonghindividuals.hAfterh2hyearshofhage,hmal
eshhavehmorehalveolihthanhdohfemales.hAfterhalveolarhmultiplicationhends,hthehalveolihcontinuehtohin
creasehinhsizehuntilhthoracichgrowthhishcompleted.
REF:hp.h6
3. Thehrespiratoryhtherapisthishevaluatinghahnewbornhwithhmildhrespiratoryhdistresshduehtoht
rachealhstenosis.hDuringhwhichhperiodhofhlunghdevelopmenthdidhthishproblemhdevelop?
a. Embryonal
b. Saccular
c. Canalicular
d. Alveolar
ANS:hA
Thehinitialhstructureshofhthehpulmonaryhtreehdevelophduringhthehembryonalhstage.hErrorshinhdevelop
menthduringhthishtimehmayhresulthinhlaryngeal,htracheal,horhesophagealhatresiahorhstenosis.hPulmonar
yhhypoplasia,hanhincompletehdevelopmenthofhthehlungshcharacterizedhbyhanhabnormallyhlowhnumber
hand/orhsizehofhbronchopulmonaryhsegmentshand/orhalveoli,hcanhdevelophduringhthehpseudoglandula
rhphase.hIfhthehfetushishbornhduringhthehcanalicularhphaseh(i.e.,hprematurely),hseverehrespiratoryhdistre
sshcanhbehexpectedhbecausehthehinadequatelyhdevelopedhairways,halonghwithhinsufficienthandhimmat
urehsurfactanthproductionhbyhalveolarhtypehIIhcells,hgiveshrisehtohthehconstellationhofhproblemshknow
nhashinfanthrespiratoryhdistresshsyndrome.
, REF:h p.h6
4. Whichhofhthehfollowinghmechanismshish(are)hresponsiblehforhthehpossiblehassociationhb
etweenholigohydramnioshandhlunghhypoplasia?
I. Abnormalhcarbohydratehmetabolism
II. Mechanicalhrestrictionhofhthehchesthwall
III. Interferencehwithhfetalhbreathing
IV. Failurehtohproducehfetalhlunghliquid
a. IhandhIIIhonly
b. IIhandhIIIhonly
c. I,h II,handhIVhonly
d. II,hIII,handhIVhonly
ANS:hD
Oligohydramnios,hahreducedhquantityhofhamniotichfluidhpresenthforhanhextendedhperiodhofhtime,hwit
hhorhwithouthrenalhanomalies,hishassociatedhwithhlunghhypoplasia.hThehmechanismshbyhwhichhamni
otichfluidhvolumehinfluenceshlunghgrowthhremainhunclear.hPossiblehexplanationshforhreducedhquanti
tyhofhamniotichfluidhincludehmechanicalhrestrictionhofhthehchesthwall,hinterferencehwithhfetalhbreathi
ng,horhfailurehtohproducehfetalhlunghliquid.hThesehclinicalhandhexperimentalhobservationshpossiblyhp
ointhtohahcommonhdenominator,hlunghstretch,hashbeinghahmajorhgrowthhstimulant.
REF:hpp.h6-7
5. WhathishthehpurposehofhthehsubstancehsecretedhbyhthehtypehIIhpneumocyte?
