Pilbeam's Mechanical Ventilation: Physiological and
Clinical Applications 8th Edition by James M. Cairo.
,Chapter`01:`Basic`Terms`and`Concepts`of`Mechanical`Ventilation
Cairo:`Pilbeam’s`Mechanical`Ventilation:`Physiological`and`Clinical`Applications,`6th`Ed
ition
MULTIPLE`CHOICE
1. The`body’s`mechanism`for`conducting`air`in`and`out`of`the`lungs`is`known`as`which`of`the`f
ollowing?
a. External`respiration
b. Internal`respiration
c. Spontaneous`ventilation
d. Mechanical`ventilation
ANS:` C
The`conduction`of`air`in`and`out`of`the`body`is`known`as`ventilation.`Since`the`question`asks`fo
r`the`body’s`mechanism,`this`would`be`spontaneous`ventilation.`External`respiration`involves`t
he`exchange`of`oxygen`(O2)`and`carbon`dioxide`(CO2)`between`the`alveoli`and`the`pulmonary`
capillaries.`Internal`respiration`occurs`at`the`cellular`level`and`involves`movement`of`oxygen`fr
om`the`systemic`blood`into`the`cells.
REF:` ` pg.`2
2. Which`of`the`following`are`involved`in`external`respiration?
a. Red`blood`cells`and`body`cells
b. Scalenes`and`trapezius`muscles
c. Alveoli`and`pulmonary`capillaries
d. External`oblique`and`transverse`abdominal`muscles
ANS:` C
External`respiration`involves`the`exchange`of`oxygen`and`carbon`dioxide`(CO2)`between`the`alv
eoli`and`the`pulmonary`capillaries.`Internal`respiration`occurs`at`the`cellular`level`and`involves`
movement`of`oxygen`from`the`systemic`blood`into`the`cells.`Scalene`and`trapezius`muscles`are`
accessory`muscles`of`inspiration.`External`oblique`and`transverse`abdominal`muscles`are`acces
sory`muscles`of`expiration.
REF:` ` pg.`2
3. The`graph`that`shows`intrapleural`pressure`changes`during`normal`spontaneous`breathing`is`
depicted`by`which`of`the`following?
a.
, b.
c.
d.
ANS:` B
During`spontaneous`breathing,`the`intrapleural`pressure`drops`from`about` 5`cm`H2O`at`end-
`expiration`to`about` 10`cm`H2O`at`end-
inspiration.`The`graph`depicted`for`answer`B`shows`that`change`from` 5`cm`H2O`to` 10`cm`H2
O.
REF:` ` pg.`3
4. During`spontaneous`inspiration`alveolar`pressure`(PA)`is`about:` .
a. 1`cm`H2O
b.` ` +1`cm`H2O
c. 0`cm`H2O
d. 5`cm`H2O
ANS:` A
1`cm`H2O`is`the`lowest`alveolar`pressure`will`become`during`normal`spontaneous`ventilation.
`During`the`exhalation`of`a`normal`spontaneous`breath`the`alveolar`pressure`will`become`+1`cm
`H2O.
REF:` ` pg.`4
5. The`pressure`required`to`maintain`alveolar`inflation`is`known`as`which`of`the`following?
a. Transairway`pressure`(PTA)
b. Transthoracic`pressure`(PTT)
c. Transrespiratory`pressure`(PTR)
d. Transpulmonary`pressure`(PL)
ANS:` D
, The`definition`of`transpulmonary`pressure`(PL)`is`the`pressure`required`to`maintain`alveolar`infl
ation.`Transairway`pressure`(PTA)`is`the`pressure`gradient`required`to`produce`airflow`in`the`con
ducting`tubes.`Transrespiratory`pressure`(PTR)`is`the`pressure`to`inflate`the`lungs`and`airways`d
uring`positive-
pressure`ventilation.`Transthoracic`pressure`(PTT)`represents`the`pressure`required`to`expand`or`
contract`the`lungs`and`the`chest`wall`at`the`same`time.
REF:` ` pg.`4
6. Calculate`the`pressure`needed`to`overcome`airway`resistance`during`positive-
pressure`ventilation`when`the`proximal`airway`pressure`(PAw)`is`35`cm`H2O`and`the`alveolar`
pressure`(PA)`is`5`cm`H2O.
a. 7`cm`H2O
b. 30`cm`H2O
c. 40`cm`H2O
d. 175`cm`H2O
ANS:` B
The`transairway`pressure`(PTA)`is`used`to`calculate`the`pressure`required`to`overcome`airway`res
istance`during`mechanical`ventilation.`This`formula`is`PTA`=`Paw`-`PA.
REF:` ` pg.`4
7. The`term`used`to`describe`the`tendency`of`a`structure`to`return`to`its`original`form`after`being`s
tretched`or`acted`on`by`an`outside`force`is`which`of`the`following?
a. Elastance
b. Compliance
c. Viscous`resistance
d. Distending`pressure
ANS:` A
The`elastance`of`a`structure`is`the`tendency`of`that`structure`to`return`to`its`original`shape`after`b
eing`stretched.`The`more`elastance`a`structure`has,`the`more`difficult`it`is`to`stretch.`The`compli
ance`of`a`structure`is`the`ease`with`which`the`structure`distends`or`stretches.
Compliance`is`the`opposite`of`elastance.`Viscous`resistance`is`the`opposition`to`movement`offe
red`by`adjacent`structures`such`as`the`lungs`and`their`adjacent`organs.`Distending`pressure`is`pr
essure`required`to`maintain`inflation,`for`example,`alveolar`distending`pressure.
REF:` ` pg.`5
8. Calculate`the`pressure`required`to`achieve`a`tidal`volume`of`400`mL`for`an`intubated`patient`
with`a`respiratory`system`compliance`of`15`mL/cm`H2O.
a. 6`cm`H2O
b. 26.7`cm`H2O
c. 37.5`cm`H2O
d. 41.5`cm`H2O
ANS:` B
C`=` V/ P`then` P`=` V/ C
REF:` ` pg.`5