Assessment notes from introduction lecture

Question 1

What are the 4 main parts of the ear?

Answer 1

• ear drum, ear canal, middle ear, and eustachian tube

Question 2

What is the function of the eustachian tube?

Answer 2

The Eustachian tube equalizes pressure between the ear canal and the middle ear and provides drainage of mucous from the middle ear.4

Question 3

Describe the Onset and symptoms of AOM, OME, Chronic suppurative OM, Otitis externa, TMJ

Answer 3

Question 4

What is the sinus ostium and what is the issue when it gets blocked?

Answer 4

When the sinus ostium becomes blocked a sinusitis can occur.6 Therefore, conditions associated with the nasal cavity and paranasal sinuses are more accurately called rhinosinusitis.

Question 5

Describe the onset, symptoms and when it occurs for :
1. Cold
2. Allergic Rhinitis
3. Vasomotor rhinitis
4. influenza
5. bacterial sinusitis

Answer 5

Question 6

Describe the onset and symptoms of:
1. GABS pharyngitis
2. Viral Pharyngitis
3. Mono
4. Herpangina
5. Postnasal drip

Answer 6

Question 7

What needs to be included in the assessment of the lungs?

Answer 7

consider laboratory assessment of lung function, cough, difficulty breathing, painful breathing as well symptoms that are related to the lungs but may not be specifically coming from the lungs.

Question 8

What is the purpose of plumonary function tests?

Answer 8

Pulmonary function tests (PFTs) are used to evaluate how effectively gas exchange is occurring between the lungs and the blood. They are also used more specifically to determine reversibility of lung disease, lung hyperreactivity, obstruction within the lungs and restriction of the lungs.

Question 9

What are the usual mechanisms by which PF is assessed?

Answer 9

Spirometry and body plethysmography are the usual mechanisms by which pulmonary function is assessed. PFTs need to be completed three times to ensure they have a similar result.

Question 10

Define all of the following:
1. Tidal volume
2. Expiratory reserve volume
3. Residual volume
4. Inspiratory capacity
5. Functional residual capacity
6. Vital capacity
7. Total lung capacity

Answer 10

Question 11

Describe the difference in flow-volume loops for obstructive, restrictive and normal situations!

Answer 11

Question 12

Define:
1. Forced vital capacity
2. Forced expiratory volume in 1 second
3. FEV1/FVC
4. Peak expiratory flow

Answer 12

1. FVC - The maximal amount of air that can be exhaled after a maximal inspiration and forced expiration.
2. FEV1 - The volume of air exhaled during the first second of the FVC maneuver. It conveys information on obstruction because it is measured over a known time interval. The more obstructed, the smaller FEV1. The FEV1 depends on the volume of air within the lung and the effort during exhalation. It can be affected by a decrease in TLC or by a lack of effort.
3. FEV1/FVC - A ratio that is not dependant on the size of the patient or the TLC. It is a more specific measure of airway obstruction with or without restriction than FEV1. In normal patients greater than 20 years, the FEV1/FVC is approximately ≥80%, but will decrease naturally with age. In obstructive diseases the FEV1 and FVC may both be decreased but the FEV1 is usually more decreased. In restrictive lung diseases, the FEV1 and FVC are usually similar so the ratio of the two appears normal.
4. Is the maximum flow obtained during the FVC. This measurement is used often in the outpatient management of COPD and asthma as it is inexpensive and can be evaluated with the use of peak flow meters.

Question 13

1. What does a reduction in FEV1/FVC ration (<0.7) indicate?
2. What does a reduced FEV1 post broncodilator of <12 indicate?

Answer 13

1. A reduction in FEV1/FVC ratio (<0.7) indicates airway obstruction.
2. A reduced FEV1 post bronchodilator of <12% indicates irreversible airway obstruction

Question 14

Which method is the the easiest way to determine some lung volumes?
How long does it take to complete?
What information does it not provide?

Answer 14

1. Spirometry
2. Takes 20 to 30 mins
3. It can not provide info regarding RV, FRC, and TLC

Question 15

What is body plethsmography?

Answer 15

This is where a patient is placed in a clear box that looks like a small telephone booth
It’s the most complete technique for measuring lung volume. It measures all the lung volumes, including air that is trapped in the lungs.
Essentially, the box is sealed, and the difference between the pressure in the box and the patient’s lungs volumes determine the lung parameters.

Question 16

HOw is a PFT ordered and interpreted?

Answer 16

Question 17

What does the FEV1/FVC ratio tell you?
What is FVC?

Answer 17

• FEV1/FVC - allows you to determine the degree of lung disease and obstruction
• When you have a FEV1/FVC ratio, the FVC allows you to determine what type of lung disease your patient has. Obstructive, restrictive or a combination of both.

Question 18

What type of lung disease dose a patient have in the following situation
1. FEV1/FVC - Normal
FVC normal

2. FEV1/FVC ratio - Normal, FVC - decreased
3. FEV1/FVC - Decreased, FVC - normal
4. FEV1/FVC decreased, FVC decreased

Answer 18

Question 19

Describe the difference in FEV1% predicted in:
1. Mild
2. Moderate
3. Moderately severe
4. Severe and very severe disease

Answer 19

Question 20

How do they assess for reversibility?

Answer 20

This is where they will do two PFTs.
One performed before a dose of bronchodilator is provided, and then another test after the bronchodilator is given.
If there is a change of ≥12%, there is reversibility present.

Question 21

What is the purpose of coughing?

Answer 21

It clears the upper respiratory tract and increases oxygenation post-cough breathing (particularly in asthmatics).

Question 22

What is acute vs. chronic cough defined?

Answer 22

1. Acute - <3 weeks
2. Chronic >3 weeks

Question 23

Describe the difference in onset and symptoms of:
1. Bacterial pneumonia
2. Acute bronchitis
3. COPD
4. Asthma
5. Post nasal drip (AKA upper airway cough syndrome)
6. GERD

Answer 23