Gravity-assisted positions in postural drainage are specifically indicated for which patient group?
A. Patients with a defective clearance mechanism
B. All patients with any respiratory diagnosis referred to physiotherapy
C. Patients who are mechanically ventilated in an ICU setting
D. Patients who have failed a trial of high-frequency chest wall oscillation
A
Which techniques are most commonly used alongside postural drainage?
A. Intermittent positive pressure breathing (IPPB) and inspiratory muscle training
B. Active Cycle of Breathing Technique (ACBT) and manual techniques
C. Incentive spirometry and pursed-lip breathing
D. Continuous positive airway pressure (CPAP) and percussion alone
B
The right middle lobe consists of which bronchopulmonary segments?
A. Apical (1) and posterior (2)
B. Medial basal (7) and anterior basal (8)
C. Lateral (4) and medial (5)
D. Apical (6) and lateral basal (9)
C
Which of the following is a listed precaution for postural drainage?
A. Sputum production of more than 30ml per day
B. Patient preference for gravity-assisted drainage
C. Difficulty clearing secretions by other methods
D. Severe haemoptysis
D
How should a patient be positioned during postural drainage?
A. With the area to be drained uppermost, so gravity assists secretion movement toward the central airways
B. With the affected area dependent (lowest) to encourage pooling before clearance
C. In a neutral supine position regardless of the affected area to ensure patient safety
D. In a high Fowler’s position for all lung segments to reduce aspiration risk
A
The left lung’s lingula is represented by which bronchopulmonary segments, and where is it anatomically located?
A. Segments 3 and 4 of the left upper lobe, equivalent to the right upper lobe’s posterior and anterior segments
B. Segments 4 (superior) and 5 (inferior) of the left upper lobe, representing the lingula — the left lung’s equivalent of a middle lobe
C. Segments 6 and 7 of the left lower lobe, positioned apically within the lower lobe
D. Segments 8 and 9 of the left lower lobe, corresponding to anterior and lateral basal segments
B
Which patient characteristics most strongly indicate that postural drainage may be beneficial?
A. A patient with mild intermittent asthma and no daily sputum production
B. A patient with pleuritis producing less than 10ml of sputum per day
C. A patient producing more than 30ml of sputum per day who has difficulty clearing secretions by other methods
D. A patient with a chronic dry cough and normal mucociliary function on testing
C
Which segment is present in the right lower lobe but absent in the left lower lobe?
A. Apical (segment 6)
B. Posterior basal (segment 10)
C. Anterior basal (segment 8)
D. Medial basal (segment 7)
D
Postural drainage is typically avoided following meals. When might it be considered beneficial in relation to mealtimes?
A. Before meals in certain patients, as clearing secretions prior to eating may be helpful
B. Immediately after meals to aid digestion in patients with gastro-oesophageal reflux
C. One hour after meals once gastric emptying is well underway
D. Only during fasting periods; postural drainage should never be timed around meals
A
For specific pathologies such as a lung abscess, how should postural drainage positioning be approached?
A. A standardised head-down tilt at 15–20 degrees is used regardless of abscess location
B. Positioning for the exact bronchopulmonary segment involved should be attempted, with the area to be drained uppermost
C. The patient should be placed supine with the unaffected side uppermost to prevent spread of infection
D. Postural drainage is contraindicated for lung abscesses due to risk of systemic sepsis from mobilised secretions
B
Which of the following is NOT a listed precaution for postural drainage, and is in fact a potential indication?
A. Cardiac failure and severe hypertension
B. Cerebral oedema and raised intracranial pressure
C. Productive cough with sputum greater than 30ml per day and difficulty clearing by other methods
D. Gastro-oesophageal reflux and abdominal distension
C
How many bronchopulmonary segments does the right lower lobe contain?
A. Three: apical, anterior basal, and posterior basal
B. Four: apical, anterior basal, lateral basal, and posterior basal
C. Four: medial basal, anterior basal, lateral basal, and posterior basal
D. Five: apical (6), medial basal (7), anterior basal (8), lateral basal (9), and posterior basal (10)
D
Which condition is listed as a postural drainage precaution due to the risk of worsening vascular compromise?
A. Aortic and cerebral aneurysms
B. Bronchiectasis with daily sputum production exceeding 30ml
C. Neuromuscular disease with an impaired cough reflex
D. Post-thoracotomy with an intact and healing surgical wound
A
How many bronchopulmonary segments does the left upper lobe contain, and how does this compare to the right upper lobe?
A. Three each — the two upper lobes are anatomically identical in segmental number
B. The left upper lobe has five segments (apical, posterior, anterior, superior lingula, inferior lingula), compared to three in the right upper lobe
C. The left upper lobe has four segments, one fewer than the right upper lobe’s five
D. Both upper lobes have four segments — two apical and two anterior variants each
B
A patient with neuromuscular weakness requires postural drainage. Why is this listed as a precaution?
A. Neuromuscular weakness causes excessive sputum production, making gravity-assisted drainage counterproductive
B. These patients are unable to perform ACBT in gravity-assisted positions due to respiratory muscle fatigue
C. Compromised respiratory and bulbar muscle strength may impair the patient’s ability to protect their airway and safely tolerate positional changes
D. Postural drainage in neuromuscular patients always causes significant oxygen desaturation due to V/Q mismatch in lateral positions
C
Which statement correctly describes how the left lung’s segmental anatomy differs from the right lung overall?
A. The left lung has a separate middle lobe anatomically identical to the right middle lobe, with its own bronchus
B. The left lung has 11 bronchopulmonary segments, one more than the right lung due to the lingula
C. The left lung mirrors the right lung exactly with 10 segments distributed identically across three lobes
D. The left lung has no segment 7 in the lower lobe, and the lingula (segments 4–5) is part of the upper lobe rather than forming a separate middle lobe
D
How long should a patient receive drainage in each postural drainage position?
A. 5 minutes per position, with up to three positions per session
B. 20 minutes per position to ensure adequate secretion mobilisation
C. 15 minutes per position, adjusted based on secretion volume
D. 10 minutes in each position
D
Which patient should raise the most concern regarding head-down postural drainage positions?
A. A patient with bronchiectasis producing 50ml of sputum per day with an intact cough
B. A patient with known raised intracranial pressure following a head injury
C. A patient with moderate COPD who is non-compliant with their inhaler regimen
D. A patient with mild gastrointestinal discomfort two hours after a light meal
B
The right upper lobe contains three bronchopulmonary segments. Which option correctly names all three?
A. Apical (1), lateral (4), and medial (5)
B. Apical (1), superior (4), and inferior (5)
C. Apical (1), posterior (2), and anterior (3)
D. Anterior (3), lateral basal (9), and posterior basal (10)
C
In a patient with a known aortic aneurysm, postural drainage is listed as a precaution. What is the most clinically relevant reason?
A. Aortic aneurysms cause increased sputum production, making gravity-assisted positions unnecessary
B. Positional changes in these patients cause bronchospasm through autonomic instability
C. Head-down positions reduce coronary perfusion pressure, triggering arrhythmias specifically in aneurysm patients
D. Positional changes and Valsalva-like effort during airway clearance manoeuvres may increase intravascular pressure, posing a risk of aneurysm rupture
D
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Gross Anatomy of the Thorax20
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Lungs and Bronchial Tree20
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Respiration13
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Respiratory System Development23
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Heart Development22
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Adult Heart and Cardiovascular System30
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Haemodynamics12
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Control of Breathing20
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Oxygen Therapy52
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COPD33
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Obstructive and Restrictive Conditions12
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ABGs43
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General Surgical Patient33
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Prehabilitation8
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Cardiac and Thoracic Surgical Patient11
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Therapeutic Positioning45
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Asthma15
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Dyspnoea35
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CF and Bronchiectasis25
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Airway Clearance Techniques38
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TILEO6
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Normative Values10
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Abnormal Breath Sounds8
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ACBT14
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Lung Function Assessment12
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Breathing Assessment11
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Postural Drainage20
