Fouty: Pulmonary Function Tests Flashcards

1
Q

85% of patients who complain of dyspnea on exertion usually due to what 2 things

A

lung or heart disease

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2
Q

3 main diseases of the lungs

A

airways
interstitial
pulmonary vascular

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3
Q

the total work of breathing is a combination of what 2 things

A

restrictive work
elastic work

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4
Q

work that moves air in and out of lungs

A

resistance work

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5
Q

work that distends lungs and chest wall

A

elastic work

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6
Q

respiratory rate in a minute

A

frequency

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7
Q

tidal volume per breath

A

Vt

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8
Q

lung volume that is high has very little what

A

resistance

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9
Q

minimal work has a tidal volume of 400 and how many breaths per minute

A

12-18

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10
Q

purpose of PFTs (pulmonary function tests)

A

if pulmonary disease is present
type of disease
severity of disease

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11
Q

lung volumes
airflow
adequacy of pulmonary vasculature
respiratory muscle strength

A

variables measured by PFTs

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12
Q

normal breathing=

A

tidal volume

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13
Q

big breath in measurement

A

total lung capacity

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14
Q

blow all of the breath out

A

vital capacity

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15
Q

end up with some air in the lungs after expiration

A

residual volume

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16
Q

4 volumes that makes up total lung capacity

A

tidal volume
expiratory reserve volume
inspiratory reserve volume
residual volume

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17
Q

4 capacities

A

functional residual capacity
inspiratory capacity
vital capacity
total lung capacity

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18
Q

how to measure residual volume

A

FRC-ERV

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19
Q

how to measure TLC

A

VC + residual volume

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20
Q

breathing in and out normally, what point do you come back to

A

functional residual capacity (resting expiration)

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21
Q

what is activated if you want to go lower than functional residual capacity

A

muscles of expiration

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22
Q

what is activated if you want to go higher than functional residual capacity

A

muscles of inspiration

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23
Q

How Do You Determine Total Lung Capacity if You Can’t Measure Residual Volume?

A

functional residual capacity - expiratory reserve volume (then add that to vital capacity to get TLC)

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24
Q

a way to measure functional residual volume that has limitations of profusion of gas not being uniform

A

helium dilution

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25
another way of measuring functional residual volume that uses boyle's law
"body box"
26
lung volumes can be what 3 things
increased, decreased, normal
27
most important test to check lung volumes
total lung capacity (by body box)
28
2nd thing to look at to check lung volumes
functional residual volume
29
TLC or FRC > Upper limits of normal (ULN) greater than 120% predicted per GOLD
lung volumes increased
30
TLC or FRC < Lower limits of normal (LLN) Less than 80% predicted per GOLD
lung volumes decreased
31
a ______ TLC defines restrictive physiology
decreased
32
a way to measure airflow through the lungs
spirometry
33
Most people blow out ____% of what you are trying to at 1 second
80%
34
normal spirometry
35
normal spirometry
36
airflow obstruction
37
main thing to look at when checking airflow through the lungs
FEV1/FVC ratio
38
increased airflow
39
what to use to determine airflow obstruction
spirometry
40
If the _______ is less than the lower limits of normal (LLN), the patient has airflow obstruction
FEV1/FVC
41
normal flow-volume loop
42
_____ decreases as lung volume gets smaller
flow rate
43
no matter how hard you breathe out at this point, there is no increase in flow
effort-independent flow
44
pressure in pleural space is normally ______ keeping airways open
negative
45
expiratory flow loop has effort-dependent + _______ flow
effort-independent
46
in many cases of airway obstruction, ______ stays the same
total lung capacity
47
in emphysema, ______ frequently changes
TLC
48
what to use when identifying upper airway obstruction
flow-volume loops
49
inspiratory loop abnormal
variable extrathoracic obstruction
50
expiration on L inspiration on R
51
expiratory loop abnormal
variable intrathoracic obstruction
52
fixed obstruction
53
kid w/ epiglottitis
variable extrathoracic obstruction
54
key things to look at for airflow
FEV1/FVC ratio flow-volume loop (upper airway obstruction)
55
4 types of lung physiology
normal obstructive restrictive mixed
56
how to determine effectiveness of area of gas exchange
DLCO (diffusing capacity of the lung for CO)
57
diffusing capacity of the lung for CO determined by what 3 things
surface area diffusion gradient presence of Hb
58
____ is perfusion limited (pressure equilibrates immediately and no diffusion)
nitrous oxide
59
diffusion limited; breathe in and hold for 10 seconds and any blood passing through will be exposed to ____
CO
60
____ binds hemoglobin more adequately than O2
CO
61
CO in plasma never completely equilibrates with the CO in alveolar space, so there is always a _____ for CO
diffusion gradient
62
R: emphysema
63
decreased surface area in emphysema decreases _____
DLCO
64
dyspnea on exertion
emphysema
65
interstitial lung disease can decrease ____ by thickening of membrane
DLCO
66
L: normal R: interstitial lung disease
67
pulmonary fibrosis
68
alveolar filling decreases _____
DLCO
69
pulmonary embolism
70
decreased pulmonary blood flow decreases _____
DLCO (less blood flow downstream less Hb available to bind to CO)
71
pulmonary arterial HTN decreases pulmonary blood flow and therefore decreases what
DLCO
72
pulmonary arterial HTN
73
Marker of adequacy of gas-exchange Determined by: surface area diffusion gradient presence of hemoglobin Normalize to alveolar volume DLCO/VA
DLCO (diffusing capacity of CO)
74
inspiratory maximum effort (for respiratory muscle strength)
PImax
75
expiratory maximum effort (for respiratory muscle strength)
PEmax
76
Exhale to Residual Volume put your hand tightly over your mouth, plug your nose, and inhale as hard as you can
Mueller maneuver (PImax)
77
Inhale to TLC, put your hand tightly over your mouth, plug your nose, and exhale as hard as you can
Valsalva maneuver (PEmax)
78
TLC/FRC and FEV1/FVC in normal range
normal physiology
79
FEV1/FVC less than LLN
obstructive physiology
80
TLC/FRC less than LLN
restrictive physiology
81
TLC/FRC and FEV1/FVC less than LLN
mixed obstructive-restrictive disease