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507-Pathophys > Pulmonary > Flashcards

Pulmonary Flashcards

(39 cards)

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1
Q

Forced Vital Capacity (FVC) definition

A

The total volume of air in the lungs that can be exhaled

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2
Q

FVC normal measure

A

80-120%

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3
Q

How to measure FVC

A

Patient inhales as deep as possible then exhales as long and as forcefully as possible

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4
Q

Forced Expiratory Volume in 1 second (FEV1) definition

A

amount of air forcefully exhaled from the lungs in the first second

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5
Q

FEV1 normal measure

A

80-120%

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6
Q

FEV1 maneuver

A

The patient inhales and forcefully exhales as fast as possible

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7
Q

FEV1/FVC ratio definition

A

determines if the pattern is obstructive, restrictive or normal

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8
Q

What is residual volume (RV)

A

the amount of air that remains in the lungs after a forceful exhalation

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9
Q

How to calculate total lung capacity (TLC)

A

RV+FVC

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10
Q

What are the 3 steps in analyzing pulmonary funtion tests

A

1: Determine the pattern
2. Determine te severity
3: bronchodialator response

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11
Q

How does one determine the pattern (obstructive/normal/restrictive)

A

Looking at FEV1/FVC ratio

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12
Q

FEV1/FVC ratio in obstructive patterns

A

Ratio will be less than 70% or less than the lower limit of normal

FEV1 also falls to a greater degree than FVC (WTF)

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13
Q

FEV1/FVC ratio in restrictive patterns

A

Ratio may be greater than 70% so you must look at TLC

Predicted TLC will be less than 80%

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14
Q

How to determine the severity of issue

A

Grading is based on FEV1 %

mild >70%
Moderate 60-70%
Moderately severe 50-60%
Severe 35-50%
Very severe 35%
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15
Q

What percentage shows that a bronchodilator has had a significant response

A

FEV1 or FEV increases by 12% or 200+mL from the pre values

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16
Q

How are obstructive disorders characterized

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A

by an obstruction to the airflow during EXPIRATION

17
Q

What can cause obstructive disorders

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A

mucus plugs
loss of surface area
reduced elastic recoil ability

18
Q

With this disorder, both the FVC and FEV1 will decrease

19
Q

This type of lung disorder results in SOB on exhalation and causes air trapping

20
Q

Why do restrictive lung disorders occur

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A

decrease in lung compliance not related to recoil (limited air is allowed in)

21
Q

How are restrictive disorders characterized

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A

by a reduction in total lung volume making taking in air difficult due to stiffness in the lung compliance or chest wall abnormality

22
Q

Examples of obstructive disorders

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A

COPD
Emphazema
asthma

23
Q

Examples of restrictive lung disorders

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A

interstitial lung disease
scoliosis
neuromuscular causes
significant obesity

24
Q

Which two lung conditions contribute to COPD

Study These Flashcards
A

chronic bronchitis and emphysema

25
Is characterized by an airflow limitation that is not fully reversable
COPD
26
Risk factors for COPD
smoking of any type airborn irritants Anything effecting lung growth during gestation Alpha-antitrypsen gene
27
Describe what happens in the lungs of a patient with COPD
Patients have difficulty fully expiring air from lungs due to airway obstruction caused by mucus, edema, loss of elastic recoil causing airway to collapse. Air trapping causes the chest to hyper-expand leading to increased WOB. Patients develop hypoventilation and hypercapnia. Bronchoconstriction may occur due to ongoing inflammation which may be partially reversible with bronchodilators. Chronic inflammation can lead to systemic effects like weight loss, muscle weakness and increased infection risk.
28
What will the COPD patient look like upon clinical exam
- Hyperresonance due to air trapping - PFT will show a FEV1/FVC ratio of less than 70 with a decreased FEV1 % - Bronchodialator challenge fail - ABGs will show hypoxemia with activity or rest - ABGs wil show hypercapnia due to air trapping and encreased WOB - Chest xray will demonstrate a flattened diaphragm, distended lung fields and increased thoracic diameter
29
The Global Initiative for Obstructive Lung Disease (GOLD) criteria for COPD is used for
classifying severity of COPD for those diagnosed with spirometry lung function (should not be used in patients less than 18 yoa or those during acute exac.)
30
GOLD stage ratios based on FEV1 % predicted
Stage 1-mild: >80-100% Stage 2- mod: 50-80 stage 3- severe: 30-50% stage 4- Very severe: 30-50
31
What is chronic bronchitis
characterized by bronchial inflammation, hypersecretion of mucus and chronic productive cough over 3 consecutive months for at least 2 successive years
32
What causes chronic bronchitis
- long term exposure of environmental irritants - Repeated acute bronchitis inflections - factors affecting gestational or childhood lung development (premi, RSV)
33
Chronic bronchitis results in
- Too much mucus accumulation - jypertrophy of bronchial smooth muscles - Hypertrophy and hyperplasia of mucus producing cells - airflow obstruction and decreased alveolar ventilation LUNG DAMAGE IS IRREVERSIBLE
34
Most common presenting symptoms of chronic bronchitis
- Productive purulent cough - copious sputum production - dyspnea - wheezing - rhonchi - cyanosis of skin and mucus mems - peripheral edema
35
long-term exposure to an airborne irritants promote:
- Smooth muscle hypertrophy that leads to bronchoconstriction - Hypertrophy and hyperplasia of goblet cells that lead to the hypersecretion of mucus - Epithelial cell metaplasia that creates non-ciliated squamous cells - Migration of more white blood cells (WBC) to the site which leads to inflammation and fibrosis in the bronchial wall - Thickening and rigidity of bronchial basement membrane which leads to narrowing of bronchial passageways
36
Anatomical changes with chronic bronchitis
- Enlarged submucosal glands - Mucous accumulation - Inflammation of epithelium - hyperinflation of alveoli - mucus plugs
37
chronic bronchitis gas exchange
CO2 trapping causing a decrease in oxygen exchange leading to a ventilation/perfusion (V/Q) mismatch Decreased perfusion of the pulm caps with oxygen results in chronic hypoxia and cyanosis (BLUE BLOATER) Left to right shunting
38
Labs in chronic bronchitis
-Elevated hematocrit and secondary polycythemia vera (leads to pulmonary hypertention due to volume causing cardiac hypertrophy and r)hf=benous distention and peripheral edema)
39
chronic bronchitis /emphaysmea table
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507-Pathophys (4 decks)

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