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Pulmonology > Diagnostic and Therapeutic Skills > Flashcards

Diagnostic and Therapeutic Skills Flashcards

1
Q
  • When atmospheric pressure is equal to alveolar pressure, what stage of respiration are you in?
  • When pleural pressure is less than atmospheric?
  • When atmospheric pressure is less than pleural?
A
  • Rest
  • Inhalation
  • Expiration
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2
Q
  • Is resting expiration an active or passive process?

- What does resting expiration depend on?

A
  • Passive

- The elastic properties of the lungs

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3
Q
  • Which sympathetic nervous system receptors control bronchiolar dilation?
  • Which Parasympathetic neurotransmitter is responsible for bronchiolar constriction?
A
  • Beta 2

- Acetylcholine

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4
Q
  • Where is the major resistance to air flow found?
  • A decrease in lung volume also results in ____?
  • What is the major determining factor of air flow and resistance?
A
  • The upper airways
  • An increase in resistance
  • The radius of the bronchiols
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5
Q

-What happens when the elasticity of lung tissue is lost?

A

-The airway can no longer remain open

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6
Q
  • The compliance of the lungs is determined by elastic forces, what are these elastic forces?
  • What prevents the build up of suface tension and collapse of the alveoli?
  • How does surfactant reduce surface tension and the alveolar-air interface?
A
  • Lung tissue and surface tension
  • Surfactant
  • It interferes with hydrogen bonding between water molecules
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7
Q

-Define minute ventilation:

A

-Total amount of air moved into and out of respiratory system per minute

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8
Q

-Define Respiratory rate/frequency:

A

-Number of breaths taken per minute

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9
Q
  • Define Anatomic dead space:

- How is this different from a physiological dead space?

A
  • Part of respiratory system where gas exchange does not take place
  • A physiological dead space may also include alveoli where gas exchange is supposed to occur, but doesn’t
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10
Q

-Define alveolar ventilation:

A

-How much air per minute enters the parts of the respiratory system in which gas exchange takes place

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11
Q
  • What volume of air is contained in the anatomical dead space?
  • What about in the physiological?
A
  • ~ 150 ml

- It varies depending on the ventilation-perfusion ratio

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12
Q
  • What does the tidal volume test measure?
  • What is inspiratory reserve volume?
  • What is expiratory reserve volume?
  • What is residual volume?
A
  • The volume of air moved in and out of the lungs during normal inspiration and normal expiration
  • The volume of air that can be taken in in addition to normal inspiration
  • The volume of air that remains in the lungs after termination of normal expiration
  • The volume of air that cannot be expired even after maximal expiration
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13
Q
  • What is inspiratory capacity?
  • What is vital capacity?
  • Which disease process causes the reserve volume to become gradually larger?
A
  • The maximum amount of air that can be inspired following a normal expiration
  • The maximum amount of air that can be expired following a maximal inspiration
  • COPD
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14
Q
  • What is the functional residual capacity?

- What is total lung capacity?

A
  • The amount of air remaining in the lungs following a normal expiration
  • The amount of air in the lungs at the end of a maximal inspiration
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15
Q

-What is the of PFT’s?

A

-Diagnosis of disease, quantify severity of disease, follow disease activity/progression, determine therapeutic respinse, preoperative assessment

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16
Q
  • How are PFT’s measured?
  • What is considered a normal PFT?
  • What is elevated?
  • What is low?
  • What must you adjust for that you wouldn’t think is necessary for these types of tests?
A
  • In liters, or liter/minute, and a relative value is given based on predicted values
  • 80-120% of the predicted value
  • > 120%
  • <80%
  • Race
17
Q
  • What is spirometry?

- How is it performed?

A
  • The time dependent determination of lung volumes

- The patient maximally exhales from full inspiration to full expiration

18
Q
  • What is forced vital capacity (FVC)?
  • What is forced expiratory volume 1 (FEV1)?
  • What three criteria must be met in order for the -FVC maneuver to be acceptable?
A
  • The volume of air that can be forcefully exhaled over a given period of time.
  • The volume of air that can be forcefully exhaled in one second
  • Exhalation must las for at least 6 seconds, spirogram must show a plateau, the linear flow volume loop must be smooth
19
Q
  • What is the FEF 25-75%?

- Why is this measurement useful?

A
  • The slope of the line on the spirometry curve that connects the points of 25% and 75% of total volume exhaled
  • It reflects flows at “mid” lung volumes and is believed to be effort independent
20
Q

-The FEV1/FVC ratio differentiates between what types of pulmonary disease?

A

-Obstructive (70%)

21
Q

-What does peak flow testing?

A

-Measures airflow through the bronchi and helps determine the level of obstruction in the airways?

22
Q
  • What is oximetry?

- What are some limitations?

A
  • It measures Oxygen saturation in the blood. Light of two wavelengths is passed through the patient and detected on the other side. The change in absorbance at each of the wavelengths is measured
  • Not a complete measurement of respiratory sufficiency, not a substitute for blood gases, low readings can be from poor perfusion, carbon monoxide, cyanide
23
Q
  • What is capnography?

- When is it used?

A
  • Monitoring the concentration or partial pressure of CO2 in the respiratory gases
  • During anesthesia and intensive care, but also to evaluate the position of an ET tube
24
Q
  • What is a sputum culture used for?
  • How can you obtain a sputum culture?
  • What can you also expect to find when taking a sputum culture?
A
  • To detect and identify bacteria or fungi in the lungs or breathing passages
  • Expectorated, induced, taken through ET tube with a specimen brush
  • Cells from the respiratory system
25
Q

-What are the major limitations of a CT scan?

A

-Not great detail on soft structures, high amount of radiation

26
Q
  • What is pulmonary angiography?

- What is CT pulmonary angiography?

A
  • Pulmonary vessels are injected with contrast dye and x-rayed to detect arteriovenous malformations
  • Same, but only involves venous contrast
27
Q
  • What does a VQ scan allow you to visualize?
  • What is a VQ scan most commonly used for?
  • CT is easier and faster, so when would you use VQ scanning?
A
  • Visualization of the relationship between ventilation of the lungs and perfusion. Ventilation part of the the test looks at the ability for air to reach all parts of the lung. Perfusion part evaluates how well blood circulates within the lungs (breath radioisotope)
  • To detect a PE
  • In patients with renal disease because the contrast dye may cause further damage
28
Q
  • What is bronchoscopy?

- What can is be used to detect?

A
  • Technique of visualizing the inside of the airway, can be rigid or flexible
  • Foreign bodies, tumors, bleeding, inflammation. Specimens can also be taken

Pulmonology (2 decks)

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