class two: pulmonary exam Flashcards
inspritaroy reserve volume
the amount of air that can be forcible inhaled after the inspiration of a normal tidal volume
expirapry reserve volume
how much air hat you can get out of your lungs after your normal tidal volume
what is reserve volume
the air the is left over in the lungs after expirtoary reserve volume is exhaled
always present in the lungs
what is tidal volume
500 ml
air inhaled during normal breathing
what is happening with COPD
the is chronic obstructive disorder
people do not have a issue getting air into the lungs but they have a hard time getting air out
this mean reserve volume increases
what is ispertaity capcity equal to
IRV + TV
what is vital capcity
the maximum amount of air a person can exhale after inhaling as much as possible
IRV + TV + ERV
what is total lung capacity
IRV + TV + ERV + RV
the max amount of air that can fill the lungs
what is functional res. cap.
RV + ERV
this increased with COPD because of the increase in RV
AIR IN THE LUNGS FOLLOWING TV
is asthma restrictive of obstructive
obstructive
the bronchioles get inflamed (muscus) and makes it hard to exhale
what happens to lungs volumes with restrictive diseases
everything decreases
forced expiratory volume remains normal
which lung volumes increases with obstructive lung diseases
TV, FRC, RV, TLC
what are some example of restrictive lug diseases
lung fibrosis, PNA, ankylosing spondylosis, hemothorax
what are some examples of obstructive lung disease
CBABE
COPD
bronchitis
asthmas
brochiestiesis
emphysema
what is pulmomary fibrosis
this is scaring of the lungs
occurs in older age from unknown eviromental cuases
for COPD what does the FEV1/FVC ratio have to be
<70%
FEV1 > 80% COPD
mild
FEV1 > 50% COPD
moderate
FEV1 > 30% COPD
severe
FEV1 <30% COPD
very severe
what are vesicular breath sounds
soft with low pitch
heard over most of the lung area
inspriation is longer the expiration
what is the location of vesicular breath sounds
over most of the lungs
what are broncho-vesicular lung sounds
intensity - intermediate
pitch - intermediate
inspiratory and expiration the same length
what is the location of bronch vesciular breath sounds
between the first and secound rib anteriorly and between the shoulder blades
what are brochial breath sounds
loud and high
expiratory is longer the inspiratory
where are brochial breath sound heard
over the manubrium
what are tracheal breath sounds
very loud and high
both inspiration and expiration are equal
where are tracheal breath sounds heard
over the tracheal
what is rhonchi
continuous low pitch rattling sound
often resemble snoring (the rhino snores)
what kind of pt is rhonchi heard in
COPD, brochiectasis, PNA, chronic bronchitis, or CF
what is bronchiectasis
a chronic lung disease that causes the airways of the lungs to permanently widen, leading to a buildup of mucus and making the lungs more susceptible to infection
what os wheeze lung sound
a high pitched sound often heard with expiration
if severe can be heard with inspiration as well
what is wheeze lung sound caused by
airway obstruction ( COPD, asthma, or aspiration of a foreign body)
what are crackles lung sounds
brief discontinuous popping sounds that are high pitched
can be heard in both phases
what are pleural rub lungs sounds
Auscultation in the lower lateral chest areas it occurs with each
inspiration and expiration.
It can be an indication of pleural inflammation.
what is brochophony
increased vocital resonence with greater clarity and loudness of spoken words
99
what is Egophony:
A form of bronchophony in which the spoken long “E”
sounds changes to a long, nasal sounding “A”.
E > A
what is Whispered pectoriloquy:
An increased loudness of whispering.
Recognition of whispered words “1, 2, 3”.
when looking at voice sound what is indicated when they are off
indication of secreation and cosolidation in the lungs
clear sounds are abnormal
what is Atelectasis
a condition that occurs when part or all of a lung collapses, resulting in reduced or absent gas exchange.
what is Pneumothorax
occurs when air accumulates in the space between the lung and chest wall.
This air can put pressure on the lung, causing it to collapse.
A pneumothorax can affect the entire lung or just a part of it
what is the normal average for our blood pH
7.35-7.45
PaCO2 should be around what
35-45
HcO3 should be around what
22 -26
PaCO2 what is considered acidic
> 45
HCO3 what is considered acidic
<22
what is respiratory acidosis
pH decreased
PaCO2 increase
HCO3 normal
what is respiratory alkalosis
pH increase
PaCO2 decrease
HCO3 normal
PaCO2 or HCO3 respirotry
PaCO2
what is metabolic acidosis
pH decrease
PaCO2 normal
HCO3 decrease
what is metabolic alkylosis
pH increase
PaCO2 normal
HCO3 increase
ROME
respiratory - CO2 does the opposite to pH
metabolic - HCO3 does the equal (same) as pH
Is IRV OR ERV higher
IRV is greater because of reserve volume taking up some space in terms of expiatory reserve volume
WHAT IS FEV1
forced expiratory volume on one sec
the volume of air exhaled in one sec under force after max inhalation
what is FVC
the total volume of air that can be forcefully exhaled during a max experiatory effort
what is a gentle vs more vigorous approach to get rid of patient mucus
gentle: puffing, PLB
vigorous: postural drainage and percussion
