Pilbeam’s Mechanical Ventilation: Physiological and Clinical Applications, 6th Edition

Chapter 01: Basic Terms and Concepts of Mechanical Ventilation
vj vj vj vj vj vj vj vj


Cairo: Pilbeam’s Mechanical Ventilation: Physiological and Clinical Applications, 6th
vj vj vj vj vj vj vj vj vj

Edition vjvj




MULTIPLEvjCHOICE

1. Thevjbody’svjmechanismvjforvjconductingvjairvjinvjandvjoutvjofvjthevjlungsvjisvjknownvjasvjwhichvjofvjt
hevjfollowing?
a. Externalvjrespiration
b. Internalvjrespiration
c. Spontaneousvjventilation
d. Mechanicalvjventilation
ANS:v j C
Thevjconductionvjofvjairvjinvjandvjoutvjofvjthevjbodyvjisvjknownvjasvjventilation.vjSincevjthevjquestionvjas
ksvjforvjthevjbody’svjmechanism,vjthisvjwouldvjbevjspontaneousvjventilation.vjExternalvjrespirationvjin
volvesvjthevjexchangevjofvjoxygenvj(O2)vjandvjcarbonvjdioxidevj(CO2)vjbetweenvjthevjalveolivjandvjthevj
pulmonaryvjcapillaries.vjInternalvjrespirationvjoccursvjatvjthevjcellularvjlevelvjandvjinvolvesvjmovemen
tvjofvjoxygenvjfromvjthevjsystemicvjbloodvjintovjthevjcells.

REF:v j v j pg.vj2

,2. Whichvjofvjthevjfollowingvjarevjinvolvedvjinvjexternalvjrespiration?
a. Redvjbloodvjcellsvjandvjbodyvjcells
b. Scalenesvjandvjtrapeziusvjmuscles
c. Alveolivjandvjpulmonaryvjcapillaries
d. Externalvjobliquevjandvjtransversevjabdominalvjmuscles

ANS:v j C
Externalvjrespirationvjinvolvesvjthevjexchangevjofvjoxygenvjandvjcarbonvjdioxidevj(CO2)vjbetweenvjthevj
alveolivjandvjthevjpulmonaryvjcapillaries.vjInternalvjrespirationvjoccursvjatvjthevjcellularvjlevelvjandvjin
volvesvjmovementvjofvjoxygenvjfromvjthevjsystemicvjbloodvjintovjthevjcells.vjScalenevjandvjtrapeziusvj
musclesvjarevjaccessoryvjmusclesvjofvjinspiration.vjExternalvjobliquevjandvjtransversevjabdominalvjmu
sclesvjarevjaccessoryvjmusclesvjofvjexpiration.

REF:v j v j pg.vj2

3. Thevjgraphvjthatvjshowsvjintrapleuralvjpressurevjchangesvjduringvjnormalvjspontaneousvjbreathingvji
svjdepictedvjbyvjwhichvjofvjthevjfollowing?
a.

, b.




c.




d.




ANS:v j B
Duringvjspontaneousvjbreathing,vjthevjintrapleuralvjpressurevjdropsvjfromvjaboutvj 5vjcmvjH2Ovjatvjend-
vjexpirationvjtovjaboutvj 10vjcmvjH2Ovjatvjend-


inspiration.vjThevjgraphvjdepictedvjforvjanswervjBvjshowsvjthatvjchangevjfromvj 5vjcmvjH2Ovjtovj 10vjcm
vjH2O.




REF:v j v j pg.vj3

4. Duringvjspontaneousvjinspirationvjalveolarvjpressurevj(PA)vjisvjabout:vj .
a. 1vj cmvj H2O
b.v j v j +1vjcmvjH2O
c. 0vjcmvjH2O
d. 5vjcmvjH2O
ANS:v j A
1vjcmvjH2Ovjisvjthevjlowestvjalveolarvjpressurevjwillvjbecomevjduringvjnormalvjspontaneousvjventilati
on.vjDuringvjthevjexhalationvjofvjavjnormalvjspontaneousvjbreathvjthevjalveolarvjpressurevjwillvjbecomevj
1vjcmvjH2O.

REF:v j v j pg.vj4

5. Thevjpressurevjrequiredvjtovjmaintainvjalveolarvjinflationvjisvjknownvjasvjwhichvjofvjthevjfollowing?
a. Transairwayvjpressurevj(PTA)
b. Transthoracicvjpressurevj(PTT)
c. Transrespiratoryvjpressurevj(PTR)
d. Transpulmonaryvjpressurevj(PL)
ANS:v j D

, Thevjdefinitionvjofvjtranspulmonaryvjpressurevj(PL)vjisvjthevjpressurevjrequiredvjtovjmaintainvjalveolarvj
inflation.vjTransairwayvjpressurevj(PTA)vjisvjthevjpressurevjgradientvjrequiredvjtovjproducevjairflowvjinvjth
evjconductingvjtubes.vjTransrespiratoryvjpressurevj(PTR)vjisvjthevjpressurevjtovjinflatevjthevjlungsvjandvja
irwaysvjduringvjpositive-
pressurevjventilation.vjTransthoracicvjpressurevj(PTT)vjrepresentsvjthevjpressurevjrequiredvjtovjexpandv
jorvjcontractvjthevjlungsvjandvjthevjchestvjwallvjatvjthevjsamevjtime.




REF:v j v j pg.vj4

6. Calculatevjthevjpressurevjneededvjtovjovercomevjairwayvjresistancevjduringvjpositive-
pressurevjventilationvjwhenvjthevjproximalvjairwayvjpressurevj(PAw)vjisvj35vjcmvjH2Ovjandvjthevjalveol
arvjpressurevj(PA)vjisvj5vjcmvjH2O.
a. 7vjcmvjH2O
b. 30vjcmvjH2O
c. 40vjcmvjH2O
d. 175vjcmvjH2O
ANS:v j B
Thevjtransairwayvjpressurevj(PTA)vjisvjusedvjtovjcalculatevjthevjpressurevjrequiredvjtovjovercomevjairwayvj
resistancevjduringvjmechanicalvjventilation.vjThisvjformulavjisvjPTAvj=vjPawvj-vjPA.

REF:v j v j pg.vj4

7. Thevjtermvjusedvjtovjdescribevjthevjtendencyvjofvjavjstructurevjtovjreturnvjtovjitsvjoriginalvjformvjaftervjbei
ngvjstretchedvjorvjactedvjonvjbyvjanvjoutsidevjforcevjisvjwhichvjofvjthevjfollowing?
a. Elastance
b. Compliance
c. Viscousvjresistance
d. Distendingvjpressure
ANS:v j A
Thevjelastancevjofvjavjstructurevjisvjthevjtendencyvjofvjthatvjstructurevjtovjreturnvjtovjitsvjoriginalvjshapevjaft
ervjbeingvjstretched.vjThevjmorevjelastancevjavjstructurevjhas,vjthevjmorevjdifficultvjitvjisvjtovjstretch.vjThe
vjcompliancevjofvjavjstructurevjisvjthevjeasevjwithvjwhichvjthevjstructurevjdistendsvjorvjstretches.

Compliancevjisvjthevjoppositevjofvjelastance.vjViscousvjresistancevjisvjthevjoppositionvjtovjmovementvj
offeredvjbyvjadjacentvjstructuresvjsuchvjasvjthevjlungsvjandvjtheirvjadjacentvjorgans.vjDistendingvjpressu
revjisvjpressurevjrequiredvjtovjmaintainvjinflation,vjforvjexample,vjalveolarvjdistendingvjpressure.

REF:v j v j pg.vj5

8. Calculatevjthevjpressurevjrequiredvjtovjachievevjavjtidalvjvolumevjofvj400vjmLvjforvjanvjintubatedvjpatie
ntvjwithvjavjrespiratoryvjsystemvjcompliancevjofvj15vjmL/cmvjH2O.
a. 6vjcmvjH2O
b. 26.7vjcmvjH2O
c. 37.5vjcmvjH2O
d. 41.5vjcmvjH2O
ANS:v j B
Cvj =vj V/ Pvjthenv j Pvj=v j V/ C

REF:v j v j pg.vj5