Test Bank for Neonatal and Pediatric
Respiratory Care, 6th Edition
by Brian K. Walsh
Chapter 1: Fetal Lung Development Test
Bank
MULTIPLE
CHOICE
• Which of the following phases of human lung development is characterized by
the formation of a capillary network around airway passages?
• Pseudoglandular
• Saccular
• Alveolar
• Canalicular
ANS: D
The canalicular phase follows the pseudoglandular phase, lasting from approximately 17
weeks to 26 weeks of gestation. This phase is so named because of the appearance of
vascular channels, or capillaries, which begin to grow by forming a capillary network around
the air passages. During the pseudoglandular stage, which begins at day 52 and extends to
week 16 of gestation, the airway system subdivides extensively and the conducting airway
system develops, ending with the terminal bronchioles. The saccular stage of development,
which takes place from weeks 29 to 36 of gestation, is characterized by the development of
sacs that later become alveoli. During the saccular phase, a tremendous increase in the
potential
gas-exchanging surface area occurs. The distinction between the saccular stage and the
alveolar stage is arbitrary. The alveolar stage stretches from 39 weeks of gestation to term.
This stage is represented by the establishment of alveoli.
REF: pp. 3-5
• Regarding postnatal lung growth, by approximately what age do most of the
alveoli that will be present in the lungs for life develop?
• 6 months
• 1 year
• 1.5 years
• 2 years
ANS: C
Most of the postnatal formation of alveoli in the infant occurs over the first 1.5 years of life.
At 2 years of age, the number of alveoli varies substantially among individuals. After 2
years of age, males have more alveoli than do females. After alveolar multiplication ends,
the alveoli continue to increase in size until thoracic growth is completed.
REF: p. 6
• The respiratory therapist is evaluating a newborn with mild respiratory distress
due to tracheal stenosis. During which period of lung development did this problem develop?
• Embryonal
, • Saccular
• Canalicular
• Alveolar
ANS: A
The initial structures of the pulmonary tree develop during the embryonal stage. Errors in
development during this time may result in laryngeal, tracheal, or esophageal atresia or
stenosis. Pulmonary hypoplasia, an incomplete development of the lungs characterized by
an abnormally low number and/or size of bronchopulmonary segments and/or alveoli, can
develop during the pseudoglandular phase. If the fetus is born during the canalicular phase
(i.e., prematurely), severe respiratory distress can be expected because the inadequately
developed airways, along with insufficient and immature surfactant production by alveolar
type II cells, gives rise to the constellation of problems known as infant respiratory distress
syndrome.
REF: p. 6
• Which of the following mechanisms is (are) responsible for the possible
association between oligohydramnios and lung hypoplasia?
• Abnormal carbohydrate metabolism
• Mechanical restriction of the chest wall
• Interference with fetal breathing
• Failure to produce fetal lung liquid
• I and III only
• II and III only
• I, II, and IV only
• II, III, and IV only
ANS: D
Oligohydramnios, a reduced quantity of amniotic fluid present for an extended period of time,
with or without renal anomTaElieSsT, iBs AasNsoKcSiaEteLdLwEitRh .luCnOg
Mhypoplasia. The mechanisms by which amniotic fluid volume influences lung growth
remain unclear. Possible explanations for
reduced quantity of amniotic fluid include mechanical restriction of the chest wall,
interference with fetal breathing, or failure to produce fetal lung liquid. These clinical and
experimental observations possibly point to a common denominator, lung stretch, as being a
major growth stimulant.
REF: pp. 6-7
• What is the purpose of the substance secreted by the type II pneumocyte?
• To increase the gas exchange surface area
• To reduce surface tension
• To maintain lung elasticity
• To preserve the volume of the amniotic fluid
ANS: B
The primary role of mammalian surfactant is to lower the surface tension within the alveolus,
specifically at the air–liquid interface. This allows the delicate structure of the alveolus to
expand when filled with air. Without surfactant, the alveolus remains collapsed because of the
high surface tension of the moist alveolar surface. Surfactant is composed predominantly of
an intricate blend of phospholipids, neutral lipids, and proteins.
, REF: p. 8
• Which of the following tests of the amniotic fluid have been shown to be
sensitive indicators of lung maturity?
• Levels of prednisone
• Levels of epidermal growth factor
• Levels of prostaglandins
• Levels of phosphatidylglycerol and phosphatidylcholine
ANS: D
Of clinical relevance during late gestation, analysis of amniotic fluid for the concentration
of phosphatidylglycerol and phosphatidylcholine has been shown to be a sensitive indicator
of the state of fetal lung maturity.
REF: p. 8
7. Approximately how much fetal lung fluid is secreted daily?
a. About 150 to 200 ml
b. About 250 to 300 ml
c. About 350 to 400 ml
d. About 450 to 500 ml
ANS: B
Fetal lungs are secretory organs that make breathing-like movements but serve no respiratory function
before birth. They secrete
about 250 to 300 ml of liquid per day.
8. The lung bud emerges from which of the following structures?
a. The pharynx
b. The foregut
c. The mesenchyme
d. The tubular epithelium
ANS: A
The embryonal phase includes primitive lung development and is generally regarded to encompass the
first 2 months of gestation.
The lung begins to emerge as a bud from the pharynx 26 days after conception.
7. Approximately how much fetal
lung fluid is secreted daily?
a. About 150 to 200 ml
b. About 250 to 300 ml
, c. About 350 to 400 ml
d. About 450 to 500 ml
ANS: B
Fetal lungs are secretory organs
that make breathing-like
movements but serve no
respiratory function before birth.
They secrete
about 250 to 300 ml of liquid per
day.
8. The lung bud emerges from
which of the following structures?
a. The pharynx
b. The foregut
c. The mesenchyme
d. The tubular epithelium
ANS: A
The embryonal phase includes
