Test Bank for Neonatal and Pediatric Respiratory
Care, 6th Edition
by Brian K. Walsh
,Chapter 1: Fetal Lung Developme
G G G G
nt Test Bank
G G
MULTIPLEGCHOICE
1. WhichGofGtheGfollowingGphasesGofGhumanGlungGdevelopmentGisGcharacterizedGbyGtheGforma
tionGofGaGcapillaryGnetworkGaroundGairwayGpassages?
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS:G D
TheGcanalicularGphaseGfollowsGtheGpseudoglandularGphase,GlastingGfromGapproximatelyG17G
weeksGtoG26GweeksGofGgestation.GThisGphaseGisGsoGnamedGbecauseGofGtheGappearanceGofGvasc
ularGchannels,GorGcapillaries,GwhichGbeginGtoGgrowGbyGformingGaGcapillaryGnetworkGaroundGt
heGairGpassages.GDuringGtheGpseudoglandularGstage,GwhichGbeginsGatGdayG52GandGextendsGto
GweekG16GofGgestation,GtheGairwayGsystemGsubdividesGextensivelyGandGtheGconductingGairwa
yGsystemGdevelops,GendingGwithGtheGterminalGbronchioles.GTheGsaccularGstageGofGdevelopme
nt,GwhichGtakesGplaceGfromGweeksG29GtoG36GofGgestation,GisGcharacterizedGbyGtheGdevelopme
ntGofGsacsGthatGlaterGbecomeGalveoli.GDuringGtheGsaccularGphase,GaGtremendousGincreaseGinGth
eGpotential
gas-
exchangingGsurfaceGareaGoccurs.GTheGdistinctionGbetweenGtheGsaccularGstageGandGtheGalv
eolarGstageGisGarbitrary.GTheGalveolarGstageGstretchesGfromG39GweeksGofGgestationGtoGter
m.GThisGstageGisGrepresentedGbyGtheGestablishmentGofGalveoli.
REF:G pp.GGG 3-5
2. RegardingGpostnatalGlungGgrowth,GbyGapproximatelyGwhatGageGdoGmostGofGtheGalveoliGthat
GwillGbeGpresentGinGtheGlungsGforGlifeGdevelop?
a. 6Gmonths
b. 1Gyear
c. 1.5Gyears
d. 2Gyears
ANS:G C
MostGofGtheGpostnatalGformationGofGalveoliGinGtheGinfantGoccursGoverGtheGfirstG1.5GyearsGofGl
ife.GAtG2GyearsGofGage,GtheGnumberGofGalveoliGvariesGsubstantiallyGamongGindividuals.GAfterG
2GyearsGofGage,GmalesGhaveGmoreGalveoliGthanGdoGfemales.GAfterGalveolarGmultiplicationGend
s,GtheGalveoliGcontinueGtoGincreaseGinGsizeGuntilGthoracicGgrowthGisGcompleted.
REF:Gp.G6
3. TheGrespiratoryGtherapistGisGevaluatingGaGnewbornGwithGmildGrespiratoryGdistressGdueGtoGtr
achealGstenosis.GDuringGwhichGperiodGofGlungGdevelopmentGdidGthisGproblemGdevelop?
a. Embryonal
b. Saccular
c. Canalicular
d. Alveolar
ANS:G A
, TheGinitialGstructuresGofGtheGpulmonaryGtreeGdevelopGduringGtheGembryonalGstage.GErrorsG
inGdevelopmentGduringGthisGtimeGmayGresultGinGlaryngeal,Gtracheal,GorGesophagealGatresiaG
orGstenosis.GPulmonaryGhypoplasia,GanGincompleteGdevelopmentGofGtheGlungsGcharacterized
GbyGanG abnormallyGlowGnumberGand/orGsizeGofGbronchopulmonaryGsegmentsGand/orGalveol
i,GcanGdevelopGduringGtheGpseudoglandularGphase.GIfGtheGfetusGisGbornGduringGtheGcanalicul
arGphaseG(i.e.,Gprematurely),GsevereGrespiratoryGdistressGcanGbeGexpectedGbecauseGtheGinade
quatelyGdevelopedGairways,GalongGwithGinsufficientGandGimmatureGsurfactantGproductionGb
yGalveolarGtypeGIIGcells,GgivesGriseGtoGtheGconstellationGofGproblemsGknownGasGinfantGrespira
toryGdistressGsyndrome.
REF:GGGp.G6
4. WhichGofGtheGfollowingGmechanismsGisG(are)GresponsibleGforGtheGpossibleGassociationGbetw
eenGoligohydramniosGandGlungGhypoplasia?
I. AbnormalGcarbohydrateGmetabolism
II. MechanicalGrestrictionGofGtheGchestGwall
III. InterferenceGwithGfetalGbreathing
IV. FailureGtoGproduceGfetalGlungGliquid
a. IGandGIIIGonly
b. IIGandGIIIGonly
c. I,GII,GandGIVGonly
d. II,GIII,GandGIVGonly
ANS:G D
Oligohydramnios,GaGreducedGquantityGofGamnioticGfluidGpresentGforGanGextendedGperiodGofGtim
e,
withGorGwithoutGrenalGanomTaE lieSsT
,GiB
sGA
asNsoKcS
iaE
teLdLwEitR
hG.luCnO
gGM
hypoplasia.GTheGmechanismsGbyG
GwhichGamnioticGfluidGvolumeGinfluencesGlungGgrowthGremainGunclear.GPossibleGexplanations
Gfor
reducedGquantityGofGamnioticGfluidGincludeGmechanicalGrestrictionGofGtheGchestGwall,Ginterf
erenceGwithGfetalGbreathing,GorGfailureGtoGproduceGfetalGlungGliquid.GTheseGclinicalGandGex
perimentalGobservationsGpossiblyGpointGtoGaGcommonGdenominator,GlungGstretch,GasGbeing
GaGmajorGgrowthGstimulant.
REF:Gpp.G6-7
5. WhatGisGtheGpurposeGofGtheGsubstanceGsecretedGbyGtheGtypeGIIGpneumocyte?
a. ToGincreaseGtheGgasGexchangeGsurfaceGarea
b. ToGreduceGsurfaceGtension
c. ToGmaintainGlungGelasticity
d. ToGpreserveGtheGvolumeGofGtheGamnioticGfluid
ANS:G B
TheGprimaryGroleGofGmammalianGsurfactantGisGtoGlowerGtheGsurfaceGtensionGwithinGtheGalveo
lus,GspecificallyGatGtheGair–
liquidGinterface.GThisGallowsGtheGdelicateGstructureGofGtheGalveolusGtoGexpandGwhenGfilledGwi
thGair.GWithoutGsurfactant,GtheGalveolusGremainsGcollapsedGbecauseGofGtheGhighGsurfaceGtensi
onGofGtheGmoistGalveolarGsurface.GSurfactantGisGcomposedGpredominantlyGofGanGintricateGble
ndGofGphospholipids,GneutralGlipids,GandGproteins.
REF:Gp.G8
, 6. WhichGofGtheGfollowingGtestsGofGtheGamnioticGfluidGhaveGbeenGshownGtoGbeGsensitiveGindica
torsGofGlungGmaturity?
a. LevelsGofGprednisone
b. LevelsGofGepidermalGgrowthGfactor
c. LevelsGofGprostaglandins
d. LevelsGofGphosphatidylglycerolGandGphosphatidylcholine
ANS:G D
OfGclinicalGrelevanceGduringGlateGgestation,GanalysisGofGamnioticGfluidGforGtheGconcentratio
nGofGphosphatidylglycerolGandGphosphatidylcholineGhasGbeenGshownGtoGbeGaGsensitiveGindic
atorGofGtheGstateGofGfetalGlungGmaturity.
REF:Gp.G8
7.GApproximatelyGhowGmuchGfetalGlungGfluidGisGsecretedGdaily?
a.GAboutG150GtoG200Gml
b.GAboutG250GtoG300Gml
c.GAboutG350GtoG400Gml
d.GAboutG450GtoG500Gml
ANS:GB
FetalGlungsGareGsecretoryGorgansGthatGmakeGbreathing-
likeGmovementsGbutGserveGnoGrespiratoryGfunctionGbeforeGbirth.GTheyGsecreteG
aboutG250GtoG300GmlGofGliquidGperGday.
G8.GTheGlungGbudGemergesGfromGwhichGofGtheGfollowingGstructures?
a.GTheGpharynx
b.GTheGforegut
c.GTheGmesenchyme
d.GTheGtubularGepithelium
ANS:GA
TheGembryonalGphaseGincludesGprimitiveGlungGdevelopmentGandGisGgenerallyGregardedGtoGencompassGtheGfirstG2
GmonthsGofGgestation.G
TheGlungGbeginsGtoGemergeGasGaGbudGfromGtheGpharynxG26GdaysGafterGconception.
