General Pulmo Flashcards
Volume of gas contained in the lungs after a maximal inspiration
Total lung capacity
Volume of gas remaining in the lungs at the end of maximal expiration
Residual volume
Volume of gas that is exhaled from the lungs in going from TLC to REsidual volume
Vital capacity
Volume of gas exhaled during the first 1st second of expiration , normal value is 80-100%
FEV1
Forced expiratory volume
Total volume exhaled
FORCED VITAL CAPACITY FVC
Now the recommended screening procedure for lung cancer in at risk individuals
Multidetector CT scan or MDCT
Choice in evaluating pulmonary embolism
CT PULMONARY ANGIOGRAPHY
3D image of the thorax obtained by MDCT with reconstruction of the airways down to the 6th to 7th generation
Virtual bronchoscopy
Current use: evaluation of patient with impaired lung function for lung resection to estimate level of post operative lung function
Scintigraphic imaging or nuclear medicine techniques
Used for evaluation of solitary pulmonary nodules
AIDS in staging lung cancer (mediastinal lymph node involvement)
PET SCAN
Allows diagnosis of idiopathic pulmonary fibrosis without histologic confirmation
MDCT
Use for detection of pulmonary embolism demonstrated by filling defect or abrupt termination ir cut off of the vessel
Pulmonary angiography
Diagnostic and therapeutic for pleural effusion
Thoracentesis
Useful in the retrieval of foreign object and the suctioning of a massive hemorrhage
Bronchoscopy
What is the most likely abnormality associated with a pulmonary function test showing elevated TLC and Residual volume but decreased forced vital capacity and forced expiratory volume in 1s with no response to bronchodilator?
Airflow obstruction due to decreased elastic recoil
(Ex. Severe emphysema)
Hallmark increased TLC
What is the most likely abnormality associated with a pulmonary function test showing decreased TLC, Residual volume, forced vital capacity and functional residual capacity. In short lung recoil is increased in all volumes.
Ventilator restriction due to increased elastic recoil
Ex idiopathic pulmonary fibrosis
What is the most likely abnormality associated with a pulmonary function test showing decreased functional residual capacity And normal TLC AND RV due to normal elastic volume however outward recoil is blunted by the weight of the chest wall and space occupied by the intraabdominal fat.
Ventilator restriction due to chest wall abnormality
-most common patter
Ex Moderate Obesity
What is the most likely abnormality associated with a pulmonary function test showing:
Only one with normal FRC / functional residual capacity and DLCO,
decreased FVC and FEV1 and
Increased TLC and residual volume
Ventilator restriction due to reduced muscle strength
Ex myasthenia gravis
What is the most likely abnormality associated with a pulmonary function test showing:
normal TLC
decreased FVC
Increased FRC, RESIdual volume due to exaggerated airway closure at low lung volumes
Airways obstruction due to decreased airway diameter
Ex acute asthma
Almost always preferred to directly visualize the tracheobronchial tree
Flexible fiberoptic bronchoscopy
Sample material from more distal pulmonary parenchyma including ALVEOLAR SPACES
Bronchoalveolar lavage
Another procedure involves use of a hollow-bore needle passedthrough the bronchoscope for sampling of tissue adjacent to the trachea or a large bronchus
TRANSBRONCHIAL NEEDLE ASPIRATION
requires general anesthesia and is only performed in the operatingroom.
A common diagnostic indication for medical thoracoscopy is theevaluation of a pleural effusion or biopsy of presumed parietal pleuralcarcinomatosis. It can also be used to place a chest tube under visualguidance, or perform chemical or talc pleurodesis, a therapeutic intervention to prevent a recurrent pleural effusion (usually malignant) orrecurrent pneumothorax
video-assisted thoracoscopic surgery (VATS)
Almost always preferred to directly visualize the tracheobronchial tree
Flexible fiberoptic bronchoscopy
Sample material from more distal pulmonary parenchyma including ALVEOLAR SPACES
Bronchoalveolar lavage
Another procedure involves use of a hollow-bore needle passedthrough the bronchoscope for sampling of tissue adjacent to the trachea or a large bronchus
TRANSBRONCHIAL NEEDLE ASPIRATION
is the operative technique for the diagnosis and management Of pleural as well as parenchymal lung disease.
video-assisted thoracoscopic surgery (VATS)
It provides the largestamount of material, and it can be used to biopsy and/or excise lesionsthat are too deep or too close to vital structures for removal by VATS.
THORACOTOMY
Also known a s the chamberlain procedure. Sampling of the left paratracheal , aortopulmonary lymph nodes
PARASTERNAL MEDIASTINOTOMY
Which condition commonly occurs in women described as tickle or sensitivity in the
throat and is typically “dry” or at most productive of scanty amount of mucoid sputum?
Cough hypersensitivity syndrome
