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CPR 2 Pulm Section > Pulmonary Function Tests > Flashcards

Pulmonary Function Tests Flashcards

1
Q

What is tidal volume?

A

volume of air inspired and expired w/ each normal breath

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2
Q

What is forced vital capacity?

A

amount of air that can be forcefully expelled beginning with the lungs completely full and blowing maximally until the lungs are as empty as possible

(FEV1 is the amount of air expelled during the first second of this exhalation)

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3
Q

What is residual volume?

A

volume of air remaining in lungs after most forceful expiration

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4
Q

What is total lung capacity?

A

maximum volume to which lungs can be expanded with inspiration

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5
Q

What FEV1/FVC ratio is indicative of an obstructive pattern?

A

< 0.7

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6
Q

What is displayed on a Flow-Volume Curve?

A

expiratory flow

-can indicate obstructive or restrictive patterns

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7
Q

What is displayed on a Flow-Volume Loop?

A

expiratory and inspiratory flow

-can indicate obstructive or restrictive patterns; or obstructive lesions of the central airway

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8
Q

What test is used to measure gas exchange through the alveolar wall?

A

Diffusing Capacity of Lung for Carbon Monoxide

DLCO

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9
Q

What is bronchodilator therapy used for?

A

-used in obstructive lung disease to determine if the airway obstruction is reversible

(typically albuterol is used)

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10
Q

What is considered a positive response to bronchodilator therapy?

A

> 12% increase in FEV1 or FVC

AND an absolute volume increase of > 200mL

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11
Q

What does a positive bronchodilator therapy test indicate?

A

asthma

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12
Q

If the bronchodilator therapy test is negative, but you still suspect asthma, what test can you do next and what is the most common technique?

A

bronchoprovocation

-methacholine challenge is the most common

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13
Q

What is methacholine and what does it do?

A
  • synthetic analogue to acetylcholine

- stimulates muscarinic receptors on airway smooth muscle cells leading to bronchoconstriction

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14
Q

What defines a positive methacholine challenge?

A

> 20% reduction in FEV1 after administration of methacholine

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15
Q

What type of downward slop does a normal Flow-Volume Curve show?

A

linear

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16
Q

What type of downward slope does an obstruction show on a Flow-Volume Curve?

A

concave (scooping) pattern

17
Q

What type of downward slope does a restriction show on a Flow-Volume Curve?

A

peaked, steeple, or “witch’s hat” pattern

18
Q

For upper airway obstructions, how does an extrathoracic obstruction (ex: vocal cord paralysis, airway burn) appear on a Flow-Volume Loop?

A

exhalation will look normal

-inhalation will be flattened

19
Q

For upper airway obstructions, how does an intrathoracic obstruction (ex: airway trauma, foreign body) appear on a Flow-Volume Loop?

A

inhalation will look normal

-exhalation will be flattened

20
Q

For upper airway obstructions, how does a fixed obstruction (ex: tracheal stenosis, goiters, upper airway tumors) appear on a Flow-Volume Loop?

A

both exhalation and inhalation will be flattened

21
Q

What are some common causes of obstructive lung disease?

A
  • COPD (chronic bronchitis and emphysema)
  • asthma
  • bronciectasis
  • bronchiolitis
22
Q

What are some common causes of restrictive lung disease?

A
  • chest wall abnormalities (kyphosis, scoliosis, obesity)
  • pleural abnormalities (chronic pleural effusions)
  • drugs
  • interstitial lung disease
  • neuromuscular disease (ALS, Myasthenia Gravis)
23
Q

What are the characteristics of an obstructive lung disease on spirometry?

A
  • -FEV1 < 80% predicted
  • -FEV1/FVC ratio < 0.7
  • -Flow-Volume Curve w/ concave scooped pattern
24
Q

What happens to the Total Lung Capacity in an obstructive lung disease?

A

increases d/t air trapping

25
Q

What happens to the Residual Volume in an obstructive lung disease?

A

increases d/t air trapping

26
Q

In what obstructive lung disease would you expect to see a low DLCO?

A

emphysema d/t destruction of fxnl lung tissue

27
Q

What are the characteristics of a restrictive lung disease on spirometry?

A
  • -FVC < 80% predicted

- -Flow-Volume Curve w/ peaked steeple pattern

28
Q

What happens to the Total Lung Capacity in a restrictive lung disease?

A

decreases

29
Q

What happens to the Residual Volume in a restrictive lung disease?

A

decreases

30
Q

In what restrictive lung diseases would you expect to see a low DLCO?

A

-interstitial lung diseases d/t thickened alveolar wall causing a difficulty in gas exchange

(normal in chest wall abnormalities)

31
Q

What pattern would patients be said to have if they show signs of both restrictive and obstructive lung disease?

A

mixed pattern

32
Q

What are the characteristics of a mixed pattern Pulmonary Function Test?

A
  • FEV1/FVC ratio low

- TLC low ( <5th percentile of predicted)

CPR 2 Pulm Section (9 decks)

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