Fouty: Pulmonary Function Tests Flashcards

1
Q

85% of patients who complain of dyspnea on exertion usually due to what 2 things

A

lung or heart disease

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2
Q

3 main diseases of the lungs

A

airways
interstitial
pulmonary vascular

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3
Q

the total work of breathing is a combination of what 2 things

A

restrictive work
elastic work

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4
Q

work that moves air in and out of lungs

A

resistance work

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5
Q

work that distends lungs and chest wall

A

elastic work

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6
Q

respiratory rate in a minute

A

frequency

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7
Q

tidal volume per breath

A

Vt

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8
Q

lung volume that is high has very little what

A

resistance

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9
Q

minimal work has a tidal volume of 400 and how many breaths per minute

A

12-18

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10
Q

purpose of PFTs (pulmonary function tests)

A

if pulmonary disease is present
type of disease
severity of disease

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11
Q

lung volumes
airflow
adequacy of pulmonary vasculature
respiratory muscle strength

A

variables measured by PFTs

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12
Q

normal breathing=

A

tidal volume

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13
Q

big breath in measurement

A

total lung capacity

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14
Q

blow all of the breath out

A

vital capacity

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15
Q

end up with some air in the lungs after expiration

A

residual volume

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16
Q

4 volumes that makes up total lung capacity

A

tidal volume
expiratory reserve volume
inspiratory reserve volume
residual volume

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17
Q

4 capacities

A

functional residual capacity
inspiratory capacity
vital capacity
total lung capacity

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18
Q

how to measure residual volume

A

FRC-ERV

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19
Q

how to measure TLC

A

VC + residual volume

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20
Q

breathing in and out normally, what point do you come back to

A

functional residual capacity (resting expiration)

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21
Q

what is activated if you want to go lower than functional residual capacity

A

muscles of expiration

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22
Q

what is activated if you want to go higher than functional residual capacity

A

muscles of inspiration

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23
Q

How Do You Determine Total Lung Capacity if You Can’t Measure Residual Volume?

A

functional residual capacity - expiratory reserve volume (then add that to vital capacity to get TLC)

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24
Q

a way to measure functional residual volume that has limitations of profusion of gas not being uniform

A

helium dilution

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25
Q

another way of measuring functional residual volume that uses boyle’s law

A

“body box”

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26
Q

lung volumes can be what 3 things

A

increased, decreased, normal

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27
Q

most important test to check lung volumes

A

total lung capacity (by body box)

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28
Q

2nd thing to look at to check lung volumes

A

functional residual volume

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29
Q

TLC or FRC > Upper limits of normal (ULN)
greater than 120% predicted per GOLD

A

lung volumes increased

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30
Q

TLC or FRC < Lower limits of normal (LLN)
Less than 80% predicted per GOLD

A

lung volumes decreased

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31
Q

a ______ TLC defines restrictive physiology

A

decreased

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32
Q

a way to measure airflow through the lungs

A

spirometry

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33
Q

Most people blow out ____% of what you are trying to at 1 second

A

80%

34
Q
A

normal spirometry

35
Q
A

normal spirometry

36
Q
A

airflow obstruction

37
Q

main thing to look at when checking airflow through the lungs

A

FEV1/FVC ratio

38
Q
A

increased airflow

39
Q

what to use to determine airflow obstruction

A

spirometry

40
Q

If the _______ is less than the lower limits of normal (LLN), the patient has airflow obstruction

A

FEV1/FVC

41
Q
A

normal flow-volume loop

42
Q

_____ decreases as lung volume gets smaller

A

flow rate

43
Q

no matter how hard you breathe out at this point, there is no increase in flow

A

effort-independent flow

44
Q

pressure in pleural space is normally ______ keeping airways open

A

negative

45
Q

expiratory flow loop has effort-dependent + _______ flow

A

effort-independent

46
Q

in many cases of airway obstruction, ______ stays the same

A

total lung capacity

47
Q

in emphysema, ______ frequently changes

A

TLC

48
Q

what to use when identifying upper airway obstruction

A

flow-volume loops

49
Q

inspiratory loop abnormal

A

variable extrathoracic obstruction

50
Q
A

expiration on L
inspiration on R

51
Q

expiratory loop abnormal

A

variable intrathoracic obstruction

52
Q
A

fixed obstruction

53
Q

kid w/ epiglottitis

A

variable extrathoracic obstruction

54
Q

key things to look at for airflow

A

FEV1/FVC ratio
flow-volume loop (upper airway obstruction)

55
Q

4 types of lung physiology

A

normal
obstructive
restrictive
mixed

56
Q

how to determine effectiveness of area of gas exchange

A

DLCO (diffusing capacity of the lung for CO)

57
Q

diffusing capacity of the lung for CO determined by what 3 things

A

surface area
diffusion gradient
presence of Hb

58
Q

____ is perfusion limited (pressure equilibrates immediately and no diffusion)

A

nitrous oxide

59
Q

diffusion limited; breathe in and hold for 10 seconds and any blood passing through will be exposed to ____

A

CO

60
Q

____ binds hemoglobin more adequately than O2

A

CO

61
Q

CO in plasma never completely equilibrates with the CO in alveolar space, so there is always a _____ for CO

A

diffusion gradient

62
Q
A

R: emphysema

63
Q

decreased surface area in emphysema decreases _____

A

DLCO

64
Q

dyspnea on exertion

A

emphysema

65
Q

interstitial lung disease can decrease ____ by thickening of membrane

A

DLCO

66
Q
A

L: normal
R: interstitial lung disease

67
Q
A

pulmonary fibrosis

68
Q

alveolar filling decreases _____

A

DLCO

69
Q
A

pulmonary embolism

70
Q

decreased pulmonary blood flow decreases _____

A

DLCO (less blood flow downstream less Hb available to bind to CO)

71
Q

pulmonary arterial HTN decreases pulmonary blood flow and therefore decreases what

A

DLCO

72
Q
A

pulmonary arterial HTN

73
Q

Marker of adequacy of gas-exchange

Determined by:
surface area
diffusion gradient
presence of hemoglobin

Normalize to alveolar volume
DLCO/VA

A

DLCO (diffusing capacity of CO)

74
Q

inspiratory maximum effort (for respiratory muscle strength)

A

PImax

75
Q

expiratory maximum effort (for respiratory muscle strength)

A

PEmax

76
Q

Exhale to Residual Volume put your hand tightly over your mouth, plug your nose, and inhale as hard as you can

A

Mueller maneuver (PImax)

77
Q

Inhale to TLC, put your hand tightly over your mouth, plug your nose, and exhale as hard as you can

A

Valsalva maneuver (PEmax)

78
Q

TLC/FRC and FEV1/FVC in normal range

A

normal physiology

79
Q

FEV1/FVC less than LLN

A

obstructive physiology

80
Q

TLC/FRC less than LLN

A

restrictive physiology

81
Q

TLC/FRC and FEV1/FVC less than LLN

A

mixed obstructive-restrictive disease