Respiratory Mechanisms III

Question 1

asthma

Answer 1

(obstructive)

airflow obstruction and bronchospasm

Question 2

bronchitis

Answer 2

(obstructive)

inflammation of mucus membranes of bronchi (UPPER AIRWAYS)

Question 3

Cystic Fibrosis

Answer 3

(obstructive)
mutation in CFTR
thick mucus in lungs and digestive tract

Question 4

COPD

Answer 4

(obstructive)
chronic bronchitis and emphysema
narrowing of airways and SOB

Question 5

Pulmonary fibrosis

Answer 5

(restrictive)

scarring of alveoli and interstitial tissues, causes stiffening of lungs

Question 6

Sarcoidosis

Answer 6

(restrictive)

causes granulomas, stiffening

Question 7

Silicosis, asbestosis

Answer 7

(restrictive)

self explanatory based on name

Question 8

Wegener’s Granulomatosis

Answer 8

(Restrictive) pulmonary nodules in lungs (“coin lesions”)

Question 9

FEV1.0 diagnostic importance

Answer 9

bigger FEV1, lower resistance

abnormally low FEV1= obstructive pulmonary disease

Question 10

are max expiratory flow rates effort dependent

Answer 10

no

Question 11

normalization of FEV1

Answer 11

FEV1/FVC

80= restrictive

Question 12

fibrosis

Answer 12

look at DLCO and TLC

Question 13

emphysema

Answer 13

look at TLC

Question 14

asthma

Answer 14

look at metacholine challenge tests

Question 15

obstructive increases

Answer 15

FRC, RV, TLC,

Question 16

obstructive decreases

Answer 16

FVC, FEV1, FEV1/FVC, FEF25-75, PEF, Slope of PEF

Question 17

restrictive increases

Answer 17

slope of PEF curve, FEV1/FVC

Question 18

restrictive decreases

Answer 18

FRC, RV, TLC, FVC, FEV1, FEF25-75, PEF

Question 19

slope of PEF curve

Answer 19

smaller and shifted to left for both obstructive and restrictive

Question 20

Flow

Answer 20

dV/dt in the flow-volume loop (aka its slope)

Question 21

tidal breathing

Answer 21

central small loop (pts 1-3)

Question 22

TLC point

Answer 22

point 4 during deep inspiration

Question 23

FRC point

Answer 23

point 3 (end of tidal volume)

Question 24

RV point

Answer 24

point 6 (lowest point on volume time graph)

Question 25

emphysema on flow graph

Answer 25

shifts to left (larger volume), and is smaller loop

Question 26

restrictive disease on flow graph

Answer 26

shifts to right (small vol) and is smaller loop

Question 27

asthma on flow graph

Answer 27

no effect on volume, just decreases flow

Question 28

PEF slope for obstructive

Answer 28

decreased due to low, prolonged expiration due to high compliance, dynamic collapse

Question 29

PEF slope for restrictive

Answer 29

increased due to stiffer lungs causing small volume inhaled and expired quickly; increased elastic recoil of lung

Question 30

FEV graph O vs R/

Answer 30

O: concavity of graph, low slope R: witch hat slope

Question 31

gestalt approach

Answer 31

compare graph of flow volume of normal patient to what your patient is, predicts pathology

Question 32

variable intrathoracic lesion

Answer 32

obstruction inside thoracic cage, will be affected by expiration>>>inspiration tumor of trachea

Question 33

variable extrathoracic lesion

Answer 33

outside of thoracic cage, affects inspiration>>expiration vocal cord lesion

Question 34

fixed intra/extrathoracic lesion

Answer 34

not affected by forced breathing, affects both equally scarring or foreign body

Question 35

Methacholine challenge test

Answer 35

positive if decreases FEV1 by more than 20% AND/OR PC20 <8 mg/mL

Question 36

PC20

Answer 36

the concentration of methacholine it takes to decrease the patients FEV by 20%

Question 37

DLCO

Answer 37

diffusing capacity of the lung how efficient the diffusion process of O2 from alveolar air to Hb DLCO= Area/Thickness

Question 38

Conductance

Answer 38

Flux/driving force tells how good DLCO is

Question 39

DLCO emphysema

Answer 39

decreased due to destruction of alevola | = decreased area

Question 40

restrictive DLCO

Answer 40

decreased due to increased thickening