45: Spirometry

Question 1

Pneumothorax:

Tension or Simple

Answer 1

Air or gas in pleural cavity

Tension: shift of mediastinum and compromise hemodynamic stability

Causes: Spontaneous or Traumatic

Question 2

Tidal Volume (TV)

Answer 2

volume of air inhaled or exhaled with each normal breath

Question 3

Inspiratory Reserve Volume (IRV)

Answer 3

volume of air that can be inhaled at the end of normal tidal inspiration

Question 4

Expiratory Reserve Volume (ERV)

Answer 4

volume of air within the lungs that can be exhaled after the end of tidal exhalation

Question 5

Residual Volume (RV)

Answer 5

air remaining in lungs after max. expiration (can’t be expelled or measured)

Question 6

Functional Residual Capacity (FRC)

Answer 6

total volume of air remaining in the lungs at the end of tidal exhalation

Question 7

Total Lung Capacity (TLC)

Answer 7

volume of air in the lungs at the end of max. inspiration

Question 8

Vital Capacity (VC)

Answer 8

volume of air exhaled from max. inspiration to max. exhalation, max expiration.

when done with force, volume termed forced vital capacity (FVC)

Question 9

Forced Expiratory Volume in 1 second (FEV1)

Answer 9

volume of air exhaled in the first second of FVC test

Question 10

Obstructive Disease

Answer 10

airway occlusion, wall thickening, loss of mechanical tethering

Ex: emphysema

Question 11

Restrictive Disease

Answer 11

Intrinsic: lung tissue
Extrinsic: chest wall, pleura or neuromuscular

Ex: Pulmonary Fibrosis

Question 12

FEV1/FVC ratio

Answer 12

4.5L/5.5L * 100 = 80%

Question 13

FEF 25-75%

Answer 13

has greatest sensitivity for detection of early airflow obstruction

represents expiratory flow rate over middle half of FVC

Question 14

Spirometry: Restrictive Lung Disease

Answer 14

both FEV1 & FVC reduced

ratio remains normal (0.8) or increases

Question 15

Spirometry: Obstructive Lung Disease

Answer 15

FEV1 reduced

ratio decreases less than 0.8

Question 16

Flow Volume Loop: Restrictive

Answer 16

Steep expiratory limb

Significant reduction in both FEV1 & FVC

Question 17

Flow Volume Loop: Obstructive

Answer 17

Scooped out appearance

Reduced FEV1

Minimal change to FVC

Question 18

Flow Volume Loop Curve

Answer 18

effort dependent until PEF achieved

flow after PEP limited due to compressed airways ( effort independent)

Question 19

Dynamic compression of airways

Answer 19

increases resistance to airflow

effect magnified in lungs w/ low elastic recoil (high compliance)

Question 20

cannot be measured with spirometry

Answer 20

RV, FRC, & TLC

Question 21

Helium Dilution Technique

Answer 21

healthy individuals

measures residual volume

V2 = V1 x ((C1-C2)/C2))

Question 22

Plethysmograph

Answer 22

body box

measures changes in pressure and volume in inspiration and expiration

Boyle’s Law used to estimate lung volume