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Clinical skills Yr2 > Data interpretation: Spirometry > Flashcards

Data interpretation: Spirometry Flashcards

1
Q

What is the difference between lung volume and lung capacity?

A

Lung volume: Volume of air in the lungs at various phases of resp cycle

Lung capacity: How much air can be inhaled after a maximum exhalation

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2
Q

Which 4 lung volumes add together to form the Total Lung Capacity (TLC), in spirometry?

A

Tidal Volume (TV)

Expiratory Reserve Volume (ERV)

Inspiratory Reserve Volume (IRV)

Residual Volume (RV)

TV+IRV+ERV+RV = TLC

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3
Q

Define Total Lung Capacity (TLC), in spirometry?

A
  1. Maximum volume of air the lungs can accommodate
  2. Sum of all volume compartments
  3. Volume of air in lungs after maximum inspiration
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4
Q

What type of lung diseases increase Total Lung Capacity (TLC), and what is the mechanism?

A

Obstructive lung diseases

Premature airway closure increases the volume of air retained in the lungs at the end of expiration (air trapping)

Trapped air already in lung with maximum inhaled air causes pulmonary hyperinflation, which causes increased TLC

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5
Q

Give 4 examples of lung conditions that cause an increased TLC, in spirometry?

A

COPD
Emphysema
Chronic bronchitis
Bronchiectasis

Increased TLC usually due to hyperinflation caused by obstructive lung diseases

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6
Q

What type of lung conditions decrease Total Lung Capacity, and what is the mechanism?

A

Restrictive lung diseases

Loss of elastic recoil and fibrosis makes lungs stiffen and unable to expand

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7
Q

Give 5 examples of lung conditions that cause decreased TLC, in spirometry?

A

CTD-ILDs eg. Sarcoidosis
ILDs eg. IPF
TB
Pleural effusion
Pneumothorax

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8
Q

What is kyphoscoliosis, and how does it effect the TLC value in spirometry?

A

Kyphoscoliosis: Abnormal curvature of the spine in the sagittal and coronal planes and can include a rotation of the spinal axis

Causes chest wall defects which produce restrictive lung function: Decreased TLC

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9
Q

Give 6 examples of conditions that cause chest wall defects, which decreases TLC in spirometry?

A

Ankylosing spondylitis
Kyphoscoliosis
Trauma
Neuromuscular conditions
Scleroderma
Morbid obesity

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10
Q

What is Tidal Volume (TV or VT) in spirometry?

A

Volume of air inspired and expired with each breath, in quiet breathing

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11
Q

What is Residual Volume (RV) in spirometry?

A

Volume of air remaining in lungs after maximum exhalation (beyond TV and ERV)

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12
Q

What is Inspiratory Reserve Volume (IRV) in spirometry?

A

The extra volume of air that can be inspired with maximal effort after reaching the end of a normal, quiet inspiration (beyond tidal volume)

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13
Q

What is Expiratory Reserve Volume (ERV) in spirometry?

A

The extra volume of air that can be exhaled forcibly after reaching the end of a normal, quiet exhalation (beyond tidal volume)

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14
Q

What is Vital Capacity (VC) in spirometry?

A

Maximum volume of air a person can expel from the lungs (TV + ERV) after a maximum inhalation (TV + IRV)

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15
Q

Which 3 spirometry values added together form the VC?

A

TV+IRV+ERV = VC

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16
Q

What is Inspiratory Capacity (IC) in spirometry?

A

The maximum volume of air that can be inspired after reaching the end of a normal, quiet expiration

TV+IRV = IC

17
Q

What is Functional Residual Capacity (FRC) in spirometry?

A

Maximum volume of air in the lung at the end of a normal, quiet tidal exhalation

ERV+RV = FRC

18
Q

When identifying the spirometry pattern, what are the 3 values you should analyse?

A

Patient predicted Forced Vital Capacity (FVC)

Patient predicted Forced Expiratory Volume 1 (FEV1)

Patient FEV1:FVC ratio

19
Q

What is Forced Vital Capacity (FVC) in spirometry?

A

The maximum amount of air you can forcibly exhale from your lungs after fully inhaling

20
Q

What is the normal range for FVC in spirometry?

A

80-120%

21
Q

What are the 3 types of spirometry patterns that can be identified from FVC, FEV1 and FEV1:FVC ratios in spirometry?

A

Normal pattern

Restrictive pattern

Obstructive pattern

22
Q

What is the Forced Expiratory Volume 1 (FEV1) in spirometry?

A

Volume if air that has been exhaled at the end of the first second of forced expiration

23
Q

How is the FEV1:FVC ratio calculated in spirometry, and what is the normal range?

A

Actual FEV1 divided by actual FVC, multiply by 100

Normal FEV1:FVC ratio: 80-120%

24
Q

How is the patient predicted FEV1 value calculated in spirometry, and what is the normal range?

A

Actual FEV1 divided by reference FEV1

Normal predicted FEV1: 80-120%

25
Q

How is the patient predicted FVC value calculated in spirometry, and what is the normal range?

A

Actual FVC divided by reference FVC

Normal predicted FVC: 80-120%

26
Q

Describe the FEV1, FVC and FEV1:FVC ratio in obstructive spirometry patterns?

A

Reduced FEV1

Normal FVC

Reduced FEV1:FVC ratio

27
Q

Describe the FEV1, FVC and FEV1:FVC ratio in restrictive spirometry patterns?

A

Reduced FEV1

Reduced FVC

Normal FEV1:FVC ratio

28
Q

If a patient has an obstructive spirometry pattern, what test should they do next and why?

A

Spirometry with bronchodilator reversibility test

Confirms if patient has asthma or COPD

29
Q

How is the spirometry with bronchodilator reversibility test completed?

A
  1. Patient does first spirometry readings
  2. Patient takes 4 puffs (each is 100 micrograms) of salbutamol inhaler
  3. Patient waits 20 minutes then completes post-bronchodilator spirometry
30
Q

How many spirometry tests should a patient do, and which results are used to identify the spirometry pattern?

A

Take 3 spirometry readings (8 is the absolute maximum in one sitting)

Use best readings for interpretation

31
Q

If a patient has asthma or COPD, what will the results of their BDR test and spirometry be?

A

Asthma: Actual post-bronchodilator FEV1 is 12 or more % greater than actual baseline FEV1

COPD: Actual post-bronchodilator FEV1 is less than 12% greater than actual baseline FEV1 (no significant improvement)

32
Q

If a patient has an obstructive spirometry pattern, which 2 scoring tools should be used to assess severity?

A

NICE 2010 severity score

GOLD severity score

33
Q

Before a patient has a spirometry test, what 4 things should you ask if they have done?

A

Have you smoked within the last 24 hours?

Have you drank alcohol today?

Have you had caffeine/drank tea or coffee within the last 4 hours?

Have you eaten a large meal within the last few hours?

Have you done vigorous exercise within the last few hours?

34
Q

Before a patient has a spirometry test, what should they be wearing?

A

Loose clothing

35
Q

What should you ask a patient to bring to their spirometry appointment?

A

Existing inhalers

Medications for breathing

36
Q

Give 5 contraindications to having spirometry?

A

Active infection

Current/recent pneumothorax

Recent surgery

Communication problems in understanding directions

Conditions/patient unwellness that has serious consequences with aggravation by forced expiration

37
Q

In spirometry, how should you instruct the patient to blow into the mouthpiece?

A
  1. Ask patient to sit upright in chair with legs uncrossed and feet flat on floor
  2. Ask patient to breathe normally

Clinical skills Yr2 (9 decks)

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