Pulmonary Function Tests Flashcards by Lindsey Herrera

Increased lung volumes are associated with _____ diseases such as _____.

obstructive; asthma and emphysema

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Loss of muscle function can occur due to _____ or because of ______.

neuropathies; myopathies

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A reduced FEV1 = ?

obstructive disease

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In a flow volume loop, variable intra-thoracic obstruction will have a _________ curve.

compressed airway during expiration with a normal inspiratory loop

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Restriction can only be diagnosed by ______.

lung volumes

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How is gas transfer measured?

DLCO test

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What is IRV?

Inspiratory reserve volume; the volume of gas that can be inhaled above what would normally be inhaled during a tidal breath requiring maximum effort of the respiratory muscles

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Diseases that decrease blood in the lung (anemia, pulmonary vascular disease) will ____ CO transfer and result in a ______.

decrease; low diffusing capacity

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What causes variable extra-thoracic obstruction?

vocal cord paralysis
laryngeal edema
vocal cord dysfunction
upper airway tumor

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Examples of neurologic diseases which can reduce respiratory muscle strength (aside from trauma) include: 1) diseases of the motor-neuron endplate (such as myasthenia gravis, botulism, anti-cholinergic poisoning, tick paralysis), 2) diseases of the neuronal axon (Guillan-Barre, critical care neuropathy), or 3) diseases of the nerve root in the anterior horn of the spinal cord (such as ____).

polio, amyotrophic lateral sclerosis

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The amount of gas volume moved during a normal inspiration is the _____.

tidal volume (TV)

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What is Body Plethysmography?

a pulm function test where pt sits inside a pressurized box and very small changes in volume and pressure can be measured

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What is TV?

tidal volume; the amount of gas volume moved during a normal inspiration

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In a flow volume loop, the fixed obstruction curve will be ______.

flattened in both inspiration and expiration

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This is the maximum intra-thoracic pressure is measured when the patient attempts to inspire as forcefully as possible against an occluded airway (Mueller maneuver) while at residual volume.

Pi max

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In a flow volume loop, the airflow is decreased in obstruction with ______ of the expiratory flow loop, a hallmark sign of obstructive lung disease.

coving

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What is DLCO?

diffusion capacity of the lung using a small amount of CO

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What 2 tests assess lung muscle function?

Pi max 2. Pe max

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______ lung volumes are associated with obstructive diseases such as asthma and emphysema.

Increased

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What is Pi max?

The maximum intra-thoracic pressure is measured when the patient attempts to inspire as forcefully as possible against an occluded airway (Mueller maneuver) while at residual volume

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Pulmonary fibrosis, a restrictive disease, is characterized by stiff lungs and a _____ pressure-volume (P-V) curve.

flat

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This is the volume of gas in the lung even after maximal exhalation- cannot be measured with spirometry.

Residual volume (RV)

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What diseases or conditions can increase DLCO?

Polycythemia
early CHF
asthma
alveolar hemorrhage

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Muscle abnormalities can occur due to _____ (steroid myopathy), _______ (polymyositis, dermatomyositis), or ______ (Lambert-Eaton myasthenic syndrome), among others.

drugs
collagen vascular diseases
paraneoplastic syndromes

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Examples of neurologic diseases which can reduce respiratory muscle strength (aside from trauma) include: 1) diseases of the motor-neuron endplate (such as myasthenia gravis, botulism, anti-cholinergic poisoning, tick paralysis), 2) diseases of the neuronal axon (such as \_\_\_\_\_\_), or 3) diseases of the nerve root in the anterior horn of the spinal cord (polio, amyotrophic lateral sclerosis).

Guillan-Barre, critical care neuropathy

Examples of ______ which can reduce respiratory muscle strength (aside from trauma) include: 1) diseases of the motor-neuron endplate (myasthenia gravis, botulism, anti-cholinergic poisoning, tick paralysis), 2) diseases of the neuronal axon (Guillan-Barre, critical care neuropathy), or 3) diseases of the nerve root in the anterior horn of the spinal cord (polio, amyotrophic lateral sclerosis).

neurologic diseases

Decreased lung volumes are diagnostic of \_\_\_\_\_.

restrictive processes

In a flow volume loop, the airflow is decreased with coving of the expiratory flow loop, a hallmark sign of ______ lung disease.

obstructive

What is FRC?

Functional residual capacity; RV + ERV; amount of gas left in the lung after normal expiration; the point at which the respiratory system is in equilibrium

This is the volume of gas that can be inhaled above what would normally be inhaled during a tidal breath requiring maximum effort of the respiratory muscles.

Inspiratory reserve volume (IRV)

In a flow volume loop, _______ will have a compressed airway during expiration with a normal inspiratory loop curve.

variable intra-thoracic obstruction

What is the functional residual capacity?

when the lung and chest wall are at equilibrium

A ______ measures the compliance of the lung.

P-V curve

What is the sum of all the lung volumes called?

total lung capacity (TLC)

What causes a fixed obstruction?

circumferential lesions from tracheal stenosis, prior intubation, circumferential airway neoplasm

Muscle abnormalities can occur due to drugs (such as \_\_\_\_\_), collagen vascular diseases (\_\_\_\_\_\_), or paraneoplastic syndromes (\_\_\_\_\_\_\_), among others.

steroid myopathy polymyositis, dermatomyositis Lambert-Eaton myasthenic syndrome

This is TV + IRV; the amount of gas that can be inhaled via max effort.

inspiratory capacity (IC)

In a flow volume loop in the case of \_\_\_\_\_\_, the maximal airflow is reduced because the total volume of gas in the lung is reduced.

restrictive diseases

Diseases that decrease blood in the lung (\_\_\_\_, \_\_\_\_\_) will decrease CO transfer and result in a low diffusing capacity.

* anemia * pulmonary vascular disease

Examples of neurologic diseases which can reduce respiratory muscle strength (aside from trauma) include: 1) ______ (myasthenia gravis, botulism, anti-cholinergic poisoning, tick paralysis), 2) ______ (Guillan-Barre, critical care neuropathy), or 3) _______ (polio, amyotrophic lateral sclerosis).

1. 1. diseases of the motor-neuron endplate 2. diseases of the neuronal axon 3. diseases of the nerve root in the anterior horn of the spinal cord

\_\_\_\_\_ graphs represent airflow (velocity in L/s) versus lung volume.

Flow volume loops

\_\_\_\_\_\_ lung volumes are diagnostic of restrictive processes.

Decreased

In a flow volume loop, a \_\_\_\_\_\_will have a flattened curve in both inspiration and expiration.

fixed obstruction

Emphysema, an obstructive disease resulting from a loss of elastic recoil, is characterized by a _____ P-V curve.

steep

What is Pe max?

a test of muscle function where the patient attempts to expire as forcefully as possible against an occluded airway (Valsalva maneuver) while at TLC

What diseases or conditions can decrease DLCO?

* emphysema * pulmonary vascular disease * interstitial lung disease * anemia

What is RV?

Residual volume; the volume of gas in the lung even after maximal exhalation- cannot be measured with spirometry

On a flow volume loop curve, ______ will show limited inspiration with normal expiratory flow.

variable extra-thoracic obstruction

On a flow volume loop curve, variable extra-thoracic obstruction will show \_\_\_\_\_.

limited inspiration with normal expiratory flow

This is inhaled to induce bronchospasm in asthmatics but not normal people.

methacholine

In a flow volume loop and ______ disease, the curve is shifted right to a lower TLC and the maximum airflow is decreased.

restrictive

In a flow volume loop and airflow obstruction, the maximal airflow is ______ due to increased resistance to flow.

reduced

What 3 things affect the DLCO test?

* SA * membrane thickness * hemoglobin

This is ERV + TV + IRV; the amount of gas that can be inhaled from the end of a maximum expiration to the maximum inflation .

vital capacity (VC)

Flow volume loops represent ____ vs \_\_\_\_.

airflow (velocity in L/s) versus lung volume

In a flow volume loop in obstructive lung disease, lung volumes are ______ and the curve is shifted to the \_\_\_\_.

increased; left

What is TLC?

Total lung capacity; sum of all volumes in the lung

What is IC?

Inspiratory capacity; TV + IRV; the amount of gas that can be inhaled via max effort

This is the volume of breath that can be further expelled after a normal tidal volume (active)..

Expiratory reserve volume (ERV)

Examples of neurologic diseases which can reduce respiratory muscle strength (aside from trauma) include: 1) diseases of the motor-neuron endplate (such as \_\_\_\_), 2) diseases of the neuronal axon (Guillan-Barre, critical care neuropathy), or 3) diseases of the nerve root in the anterior horn of the spinal cord (polio, amyotrophic lateral sclerosis).

* myasthenia gravis * botulism * anti-cholinergic poisoning * tick paralysis

In a flow volume loop in the case of restrictive diseases, the maximal airflow is _______ because the total volume of gas in the lung is reduced.

reduced

What causes variable intra-thoracic obstructions?

non-circumferential tracheal tumor (ball-valve effect)

Gas exchange is decreased if the surface membrane area is?

(A) is decreased (as in emphysema) or if the membrane (d) is thickened (as in some interstitial lung diseases).

A P-V curve measures the ______ of the lung.

compliance

What is a methacholine challenge?

a pt is given methacholine to inhale which induces bronchospasm in asthmatics but not normal people

This is measured while the patient attempts to expire as forcefully as possible against an occluded airway (Valsalva maneuver) while at TLC.

Pe max

The helium dilution test wont be accurate for diseases such as \_\_\_\_\_\_.

emphysema, asthma, or chronic bronchitis (air trapping)

In a flow volume loop in ______ lung disease, lung volumes are increased and the curve is shifted to the left.

obstructive

In a flow volume loop and restrictive disease, the curve is shifted ______ to a lower TLC and the maximum airflow is \_\_\_\_\_\_\_.

right; decreased

This is RV + ERV; amount of gas left in the lung after normal expiration; the point at which the respiratory system is in equilibrium.

Functional residual capacity (FRC)

What is ERV?

Expiratory reserve volume; the volume of breath that can be further expelled after a normal tidal volume (active)

In a flow volume loop and \_\_\_\_\_\_, the maximal airflow is reduced due to increased resistance to flow.

airflow obstruction

What is VC?

vital capacity; ERV + TV + IRV; the amount of gas that can be inhaled from the end of a maximum expiration to the maximum inflation

What is FEV1?

forced expiratory volume in the first second; normal = 80%

\_\_\_\_\_\_ can occur due to drugs (steroid myopathy), collagen vascular diseases (polymyositis, dermatomyositis), or paraneoplastic syndromes (Lambert-Eaton myasthenic syndrome), among others.

Muscle abnormalities