Pulmonary Function Test Flashcards

1
Q

Pulmonary Function Tests

Description

A

A group of tests which help evaluate the mechanical function of the lungs

Patient results are compared to predicated values to determine if the patient falls within normal range, or has a restrictive or obstructive lung disease based on the PFTs

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2
Q

PFT: Clinical Utility

(4)

A
  • Determine if patient’s presents with a respiratory condition
    1. Obstructive (resistance to getting air OUT)
    2. Restrictive (resistance to getting air IN)
    3. Combination of both
  • Determine the severity of respiratory condition
  • Determine response to bronchodilator treatment (does respond = asthma)
  • Outcome measure (pre-post test) to determine disease progression, effectiveness of treatment & medications
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3
Q

Categories of PFTs

(5)

A
  1. Volume
  2. Capacity
  3. Flow
  4. Diffusion studies
  5. Respiratory mm strength
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4
Q

Static Lung Volumes

(4)

Volume

A
  1. Tidal Volume (TV)
  2. Inspiratory Reserve Volume (IRV)
  3. Expiratory Reserve Volume (ERV)
  4. Residual Volume (RV)
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5
Q

Tidal Volume (TV)

Definition

Volume

A

The volume of air inhaled or exhaled during a single breath in a resting state (normal quiet breathing)

In & out during a QUIET breath

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6
Q

Inspiratory Reserve Volume (IRV)

Defintion

Volume

A

The maximum amount of air that can be inhaled following a normal inspiration

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7
Q

Expiratory Reserve Volume (ERV)

Definition

Volume

A

The maximum amount of air that can be exhaled following a normal exhalation

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8
Q

Residual Volume (RV)

Definition

Volume

A

The volume of air remaining in the lungs at the end of maximum expiration (cannot exhale it)

Nitrogen has helps keep our lungs inflated - residual volume
** Always going to have air remaining in lungs b/c it prevents the lungs from collapsing

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9
Q

Volume: DDx

(4)

Volume

A

Tidal Volume
- DEC TV = restrictive disease, lung cancer, atelectasis, msk impairment (all fall under restrictive diseases)

Residual Volume
- INC RV = obstructive disease
- DEC RV = restrictive disease, lung cancer, atelectasis, msk impairment

Inspiratory Reserve Volume:
INC IRV = obstructive
DEC IRV = restrictive

Expiratory Reserve Volume:
DEC ERV = pleural effusion, pneumothorax, ascities (S/S of RT HF - edema in the belly)
Restrictive diseases relating to the pleura

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10
Q

What is the main characteristic of obstructive disease in terms of volume??

A

Every component increases EXCEPT tidial volume

INC TLC, RV, IRV, ERV

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11
Q

Capacity:

Descrip & List

A

Lung capacities = 2+ lung volumes together

  1. Total Lung Capacity (TLC)
  2. Vital Capacity (VC)
  3. Inspiratory Capacity (IC)
  4. Functional Residual Capacity (FRC)

Volume = single entity // Capacity = 2+ vol

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12
Q

Total Lung Capacity (TLC)

Description

Capacity

A

The volume of gas in the lungs at the end of maximum inspiration

TLC = TV + IRV + ERV + RV

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13
Q

Vital Capacity

Definition

Capacity

A

The maximum amount of gas that can be expired from the lungs following a maximum inspiration

VC = TV + IRV + ERV

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14
Q

Inspiratory Capacity (IC)

Definition

Capacity

A

The maximum amount of gas that can be inspired from the resting expiratory level

IC = VT + IRV

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15
Q

Functional Residual Capacity (FRC)

Definition

Capacity

A

The amount of gas remaining in the lungs at the resting expiratory level

FRC = ERV + RV

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16
Q

Capacity: DDx

(2)

A

INC capacity = obstructive
DEC capacity = resistrictive

17
Q

Flow

Definiton + Types (2)

Flow

A

Rate - how long does it take to move that air

  1. Forced Vital Capacity (FVC)
  2. Forced Expiratory Volume (FEV)
18
Q

Forced Vital Capacity

Definition

Flow

A

The total lung volume of air that can be expired after a maximal inhalation

Independent of time

Will still have RV

19
Q

Forced Expiratory Volume (FEV)

Definition

Flow

A

The maximum volume of air that can be expired from maximal inhalation in “x” seconds

Dependent of time

20
Q

FEV1/FVC%

Defintion

Flow

A

The percent of FVC that can be expired in 1 second

< 70% = obstructive disease Diagnostic
- Lots of resistance to get that air out

21
Q

Flow: DDx

(2)

Flow

A

Condition > FVC > FEV1 > FEV1/FVC%

Obstructive > Normal or low > Low > Low
Restrictive > Low > Normal or Low > Normal or high (does not take a lot of time to force air out)

22
Q

GOLD Classification for COPD

(4)

A

Gold Classification > FEV1/FVC(%) > FEV1 % Predicted

  1. Mild > < 70% > FEV1 > 80% predicted
  2. Moderate > < 70% > FEV1 50%-80% of predicted
  3. Severe > < 70% > FEV1 30-50% of predicted
  4. Very Severe > < 70% > FEV1 < 30% of predicted OR
  5. FEV1 < 50% predicted + chronic respiratory failure (long-term O2 supplementation)
23
Q

Diffusion Studies

Definition & Types + Descripts

A

Diffusion Capacity of Carbon Monoxide (DLCO)
- Test that measure the functioning gas exchange from the lungs (alveoli) to the blood (pulmonary capillary bed)
- Helps diagnosis different pathologies

LOW DLCO: could be a problem with pulmonary or circulatory system
- Ex. Emphysema, fibrous, anemia

HIGH DLCO: Problem with circulatory system, NOT pulmonary (rule out)
- Ex. polycythemia (opposite of anemia) - makes your blood thick/vicous > takes up the CO2 immediately - difficult to pump - hard on the heart

24
Q

Respiration MM Strength Tests

2 Types

A

Maximal Inspiratory Pressure (MIP)
- Patient attempts a maximal inspiratory effort through a blocked mouthpiece
- A patient’s MIP reflects the strength of the patient’s inspiratory mms

Maximal Expiratory Pressure (MEP)
- Patient attempts a maximal forced expiratory effort through a blocked mouthpiece, after a full inhalation
- A patient’s MEP reflects the strength of the patient’s expiratory mm

25
Q

Respiration MM Strength Tests: Indications

(3)

A
  1. When respiratory weakness is suspected
    NM condition, dyspnea, ineffective cough
  2. When prescribing an inspiratory muscle trainer (IMT)
    = Max pressure - set parameters accordingly
  3. Outcome measure for respiratory mm strength
    Can see if they have gotten stronger OR if disease has progressed

Regular expiration is PASSIVE
Cough = forced expiration