lecture 34 spirometry

Question 1

What is the definition of recoil?

Answer 1

the ability to return to resting volume once stretched

Question 2

what does lung recoil mean?

Answer 2

inward force produced by the elastic properties of the alveoli; acts to collapse the lung

Question 3

what does chest wall recoil mean?

Answer 3

(PCWR) outward force produced by the chest wall

Question 4

what is PIP?

Answer 4

intrapleural pressure
this is the pressure within the pleural cavity

• this is between the visceral layer connected to lung and chest wall parietal layer

The opposing recoil forces of the chest wall and the lung create a negative subatmospheric PIP

Question 5

what condition has air in the pleural space?

Answer 5

pneumothorax..

can be caused by punctured chest wall or lung. the pressure is moving towards 0 and the lung collapses as it wants to

Question 6

What occurs in a a closed pneumothorax?

Answer 6

air enters the pleural space from a punctured lung

Question 7

what occurs in an open pneumothorax?

Answer 7

air enters into pleural space from chest wall

Question 8

what occurs in a tension pnemothorax?

Answer 8

it causes a shift in the mediastinum and compromises hemodynamic stability.. great vessels are kinked
-can be spontaneous or traumatic

Question 9

a patient does a pulmonary test with emphysema what are his results?

Answer 9

decreased FEV1/FVC

emphysema is an obstructive lung disease, their lungs are more compliant, more air in lung than normal
increased TLC
increased FRC
increased RV

Question 10

what test measures lung volumes?

Answer 10

spirometry

Question 11

what is tidal volume? (TV)

Answer 11

the volume of air inhaled or exhaled with each normal breath

Question 12

what is Inspiratory Reserve Volume? (IRV)

Answer 12

the volume of air that can be inhaled at the end of a normal tidal inspiration

Question 13

What is Expiratory Reserve Volume ( ERV)?

Answer 13

the volume of air within the lungs that can be exhaled after the end of a tidal exhalation

Question 14

what is Residual Volume (RV)?

Answer 14

the air remaining in the lungs after a maximal expiration ( this volume of gas cannot be expelled, and cannot be measured by spirometry because it doesn’t come out)

Question 15

What is functional residual capacity? (FRC)

Answer 15

the total volume of air remaining in the lungs at the end of a tidal exhalation, spirometer doesn’t work

ERV+RV

Question 16

what is total lung capacity (TLC)?

Answer 16

the volume of air in the lungs at the end of maximal inspiration

this is measured by adding IRV TV ERV RV

spirometry will not work

Question 17

What is vital capacity? (VC)

Answer 17

the volume of air exhaled from maximal inspiration to maximal exhalation; maximum expiration.

when done with force this volume is termed forced vital capacity (FVC) ( tells you about lung status function)

this is the sum of IRV TV and ERV

Question 18

what is forced expiratory volume in 1 second?

Answer 18

the forced volume of air exhaled in the first second of FVC test (FEV1)

Question 19

What is IC?

Answer 19

inspiratory capacity it is IRV+TV which means inspiratory reserve volume + tidal volume

LOOK AT 12

Question 20

what are obstructive long disease?

Answer 20

expiratory flow rate is significantly decreased resulting n decreased FEV1/FVC ratio
both FEV and FVC is decreased
emphysema/is compliant lung recoil is lost its hard to breath out
asthma is also one, narrow airways

Question 21

what is restrictive disorder?

Answer 21

Lung inflation is decreased, inspiration is screwed. decreased FEV1 and FVC.

the FEV1/FVC ratio is normal or increased…

force vital capacity is less

pulmonary fibrosis/less compliant
infant respiratory distressed
or fractures rib

Question 22

on a spirometer test/graph what occurs at time 0? how does the spirometer work?

Answer 22

it is the total lung capacity

then once inspired completely, the FVC test is expire forcefully until you can’t anymore… that time is measured. then the volume of air expired is also measured. look at pic! the fvc was marked with an X slide 15

low ratio of FEV1/ FVC means obstructive
high ratio= restrictive

Question 23

what is FEF 25-75?

Answer 23

Forced expiratory flow (FEF).
represents the expiratory flow over the middle half of the FVC ( between 25-75)

sometimes FEV1/FVC cannot see early airflow obstruction but FEF can see it

Question 24

FEV1/FVC ratio in restrictive disease can remain what?

Answer 24

normal because of proportional decrease

history and presentation is important
see pic slide 17

Question 25

FEV1/FVC ratio in obstructive disease lung disease

Answer 25

FEV1 is smaller compared to FVC, so ratio is decreased

see pic
slide 18

Question 26

In obstructive disease total lung capacity is ______

Answer 26

increased

Question 27

in restrictive disease total lung capacity is___

Answer 27

decreased

Question 28

in obstructive disease residual volume is______

Answer 28

increased

Question 29

in restrictive disease residual volume is______

Answer 29

decreased

Question 30

in obstructive disease functional residual capacity is ?

Answer 30

FRC

increased

Question 31

in restrictive disease functional residual capacity is ?

Answer 31

decreased

Question 32

what is the ratio of FEV1/FVC for obstructive disease?

Answer 32

<0.8

Question 33

what is the ratio of FEV1/FVC for restrictive disease?

Answer 33

> 0.8

Question 34

what is a genetic risk factor for emphysema?

Answer 34

Alpha 1 antitrypsin

Question 35

what are signs of air trapping? what disease has this?

Answer 35

prolonged expiratory phase, barrel chest, flat diaphragm

emphysema

remember this is disentegration of the lung’s elastic framework and destruction of alveolar walls

Question 36

what test can measure residual volume (RV)?

Answer 36

helium dilution technique, can only measure for people without obstructive disease

Question 37

what test can measure residual volume with an obstructive disease?

Answer 37

plethysmograph

Boyles law is used to estimate the lung volume