Floreani PFT Flashcards by michelle granstrom

What are the contraindications for performing a PFT?

A patient who is uncooperative.

A patient who is not healthy enough to perform the test.

How well did you know this?

Not at all

Perfectly

Why is a PFT important for pre-operative evaluation?

It helps you determine if the patient has sufficient pulmonary status to undergo their operation.
It helps you determine if you are about to take a lung tumor if the patient will still be able to function afterwards.

How well did you know this?

Not at all

Perfectly

What are some of the uses of the pulmonary function test?

Help diagnose & exclude diseases
Assess the severity of the disease
Monitor the course of the disease
Monitor response to therapy
Occupational & disability evaluations
pre-operative evaluation

How well did you know this?

Not at all

Perfectly

When you measure the volume of air/time in a PFT…what values does this offer?

Inspiratory air flow
Expiratory air flow
FVC
FEV1

How well did you know this?

Not at all

Perfectly

When you measure the volumes of air in the lungs…w/ a PFT…what values does this offer?

Lung Volumes

How well did you know this?

Not at all

Perfectly

When you measure pressure in a PFT…what values does this offer?

Muscle Strength
Compliance
Lung Mechanics

How well did you know this?

Not at all

Perfectly

When you measure gas conc’n & transfer in a PFT…what values does this offer?

diffusion capacity

How well did you know this?

Not at all

Perfectly

What does diffusion capacity basically tell you?

whether you can get gas across the alveolar membrane…

How well did you know this?

Not at all

Perfectly

What is another name for a body plethysmograph? What values does it give you?

Body Box

Lung volumes etc.

How well did you know this?

Not at all

Perfectly

deltaV/Pel indicates what?

static compliance

How well did you know this?

Not at all

Perfectly

delta Pel/V indicates what?

Elastance

How well did you know this?

Not at all

Perfectly

delta F/Pel indicates what?

Resistance–important info for obstructive lung disease

How well did you know this?

Not at all

Perfectly

delta Pel/F indicates what?

Conductance

How well did you know this?

Not at all

Perfectly

What values does a spirometer help you get?

Inspiratory & expiratory air flows

How well did you know this?

Not at all

Perfectly

What does it mean when you say that an asthmatic is hyper-responsive?

Their airways are twitchy.
They are abnormally sensitive to nonspecific stimuli (smoke, cold air etc)
they’re not allergic to these things, but they are sensitive.

How well did you know this?

Not at all

Perfectly

What happens in a methacholine challenge test?

Methacholine is a nonspecific cholinergic agonist. It causes smooth muscle constriction in the airways. it doesn’t present a huge problem for normal people. It is a problem for asthmatics.

How well did you know this?

Not at all

Perfectly

Exercise tests are an example of ______ tests for asthmatics. What happens with this test?

challenge test type
Bring up the heart rate of the patient. Compare the spirometry at different points.
**exercise can be a trigger for asthmatic symptoms.

How well did you know this?

Not at all

Perfectly

Is exercise-induced asthma a real thing?

NO! It is a trigger for asthma. Sometimes the only discernible one…

How well did you know this?

Not at all

Perfectly

What are 5 provocation or challenge tests for asthmatics?

Methacholine
Exercise
Cold Air
Histamine
Adenosine 5 monophosphate.

How well did you know this?

Not at all

Perfectly

What are some examples of cardiopulmonary exercise tests?

Treadmill Test
Stationary Bicycle
6 minute walk test

How well did you know this?

Not at all

Perfectly

What are some factors that can affect the normal reference ranges for PFTs?

Age
Sex
Height
Weight 
Race
Altitude & other physical factors

How well did you know this?

Not at all

Perfectly

How do age & sex affect the normal PFT range?

As you age, the PF decreases

Males have a higher PF

How well did you know this?

Not at all

Perfectly

After age _____ adults usu lose ____ of forced vital capacity.

25-30 years of age

20 cc

How well did you know this?

Not at all

Perfectly

The primary signal in spirometers is either ____ or ____.

Volume or flow

How well did you know this?

Not at all

Perfectly

Restrictive Abnormalities relate to _____ mechanics. They relate to changes in what factors?

Static mechanics Compliance **volumes, pressures

Obstructive Abnormalities relate to _____ mechanics. They relate to changes in what factors?

Dynamic Mechanics Flow Rates **volume/ time & airflow

Vascular Abnormalities relate to: | They relate to changes in what factors?

defects in gas exchange. changes in arterial blood gas **diffusion capacity

What is the main type of spirometer that is used?

Flow sensing type. Pneumotachometers

If you determine vital capacity thru spirometry thru a slow expiration maneuver what is it called?

SVC Slow Vital Capacity

If you determine vital capacity thru spirometry thru a rapid expiration maneuver what is it called?

FVC forced vital capacity

In a normal individual...their FEV1 will be ___% of their ____.

80% of their VC

A decrease in what 3 values is a hallmark of an obstructive disease? What 2 diseases would fit this?

FEV1 FVC Flow rate Emphysema & Asthma

What is FEF25-75%?

midflow rate termed in L/sec | **varies person to person, but helpful to look at a person's progress?

What is maximal voluntary ventilation? What does it indicate?

sustained maximal ventilation for 15 seconds | indicates muscle fatigue & endurance

When you are making FEV1 & FVC measurements...how long must your exhalation take?

6-8 seconds

What are the 2 types of body boxes?

Constant Volume, Variable Pressure Type | Flow or Variable Volume Type

What do body boxes measure?

Measurements of volumes in the lungs. Thoracic Gas Volume Changes in airway resistance & conductance

What are 2 things that body boxes measure?

utilize pneumotachometers | utilize mouth pressure transducers

What lung volume value do you especially need to think about w/ patients on mechanical ventilation?

Functional Residual Capacity

___ ______ in people with asthma or other lung conditions increase what 2 values?

air trapping | Increases functional residual capacity & residual volume

What does diffusion capacity (DLCO) measure?

the transfer of gas across the alveolocapillary membranes | integrity of the alveoli, capillary bed, & the membranes

What are some conditions that impair DLCO?

Emphysema Cystic Lung Disease Fibrotic Lung Disease Pulmonary Vascular Disease

What does emphysema reduce DLCO?

b/c it distorts the bronchoalveolar structures & compromises the supporting structures in the interstitium & alveoli...

T/F Emphysema decreases DLCO & RV.

False. It decreases DLCO. It increases RV & FRC b/c of air trapping.

The DLCO measurement is not ____, but is ____.

DLCO measurement is not specific, but it is sensitive.

How do you take the DLCO?

Gas Mixture of 0.3% CO & 21% oxygen, some nitrogen & some helium, neon or methane... **uses single breath hold maneuver

``` What does obstruction do to: FVC FEV1 FEF25-75 MVV FRC RV TLC ```

``` FVC: stays the same or decreases FEV1: decreases FEF25-75: decreases MVV: decreases FRC: increases RV: increases TLC: increases ```

``` What does restriction do to: FVC FEV1 FEF25-75 MVV FRC RV TLC ```

``` FVC: decreases FEV1: stays the same or decreases FEF25-75: stays the same or decreases MVV: stays the same or decreases FRC: decreases RV: decreases TLC: decreases ```

What causes a volume & flow decrease?

Mild Obstructive Lung Disease

What causes normal inspiration & changed expiration?

Variable Intrathoracic Upper Airway Obstruction

What causes limited inspiration, but normal expiration?

Variable Extrathoracic Upper Airway Obstruction | **dynamic truncation of the inspiratory limb

What causes limited inspiration & expiration?

Fixed Intrathoracic or Extrathoracic Upper Airway Obstruction

What causes a decreased volume of inspiration?

Restriction, such as pulmonary fibrosis

What are 3 things that can cause a variable extra thoracic upper airway obstruction?

tracheomalacia: a trachea that collapses upon inspiration laryngomalacia: a larynx that collapses upon inspiration vocal cord dysfunction: it adducts(closes) when it should abduct.

A variable intrathoracic obstruction is a dynamic truncation of _______. What are 5 things that can cause this?

``` the expiratory limb tracheal lesions intrathoracic tracheomalacia Tracheal Stenosis Lymphadenopathy Bronchogenic cysts ```

What are some things that can cause a fixed airway obstruction? What does this limit?

This limits the inspiratory & expiratory limbs. Extraluminal Obstructive Lesions: bulky mediastinal adenopathy, invasive thymoma, large thyroid cancers Bronchial Mainstem Lesions: usu cancers

What is considered a significant pulmonary function change w/ the addition of bronchodilators?

12%

What are 3 hallmarks of asthma?

inflammation hyper-responsiveness airway obstruction

What happens to FEV1 & FEV1/FVC with asthmatics?

FEV1 decreases FVC decreases FEV1/FVC ratio decreases

What does idiopathic pulmonary fibrosis cause?

a restriction of volume | there is no known treatment

In restrictive lung disease, which values are decreased? What treatment is NOT appropriate?

Total Lung Capacity decreases Inspiratory Capacity decreases Diffusion Capacity decreases Bronchodilators are NOT helpful with this...

What are some things that can cause hypoxemia or problems with diffusion?

Pulmonary Edema Diffuse Pneumonitis Fibrosis Emphysema

Pulmonary HTN is a type of _______.

pulmonary vascular disease

What are some conditions that can cause reduced diffusion capacity?

Emphysema Cystic Lung Disease Fibrotic Lung Disease Pulmonary Vascular Disease

What is an example of interstitial lung disease?

Pulmonary Fibrosis

What are some things that cardiopulmonary stress testing captures?

VO2, VCO2, Vd/Vt, End tidal CO2