Chapter 17; Effects of Positive Pressure Ventilation on the Pulmonary System

Chapter 17; Effects of Positive Pressure Ventilation on the Pulmonary System

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. Biotrauma is caused directly by which of the following?

ANS:   B

High distending volumes result in overdistention of the alveoli, leading to the release of inflammatory mediators from the lungs, which can result in multiorgan failure. The release of these inflammatory mediators is called biotrauma.

DIF:    1                      REF:    pg. 328

2. Alveolar tissue and pulmonary capillary injury is caused by which of the following?

ANS:   C

Repeated opening and closing of lung units, also called recruitment/derecruitment, generates shear stress, which results in direct tissue injury at the alveolar and pulmonary capillary level. Barotrauma is lung injury caused by high pressure. Biotrauma refers to the release of inflammatory chemical mediators that cause multiorgan failure. Overdistention is the cause of biotrauma.

DIF:    1                      REF:    pg. 328

3. Shear stress injury and loss of surfactant from the resulting unstable lung units result in a loss of surfactant. This type of pulmonary trauma is known as _____________.

ANS:   A

Shear stress injury and loss of surfactant constitute atelectrauma. Lung injury caused by high levels of pressure and volume is referred to as barotrauma or volutrauma. The release of inflammatory mediators from the lungs that can lead to multiorgan failure is called biotrauma.

DIF:    1                      REF:    pg. 328

4. Ventilator-induced lung injury (VILI) is associated with which of the following?

ANS:   B

VILI is a lung injury that occurs at the level of the acinus. It is the microscopic level of injury that includes biotrauma, shear stress, and surfactant depletion (atelectrauma). The term ventilator-associated lung injury (VALI) generally is used to refer to lung injury identified as being a consequence of mechanical ventilation. The most common forms of VALI are ventilator-associated pneumonia (VAP), air trapping, patient-ventilator asynchrony, and extra-alveolar gas (barotrauma), such as pneumothorax and pneumomediastinum

DIF:    1                      REF:    pg. 328