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Cardiorespiratory 2 > Lung Function Tests > Flashcards

Lung Function Tests Flashcards

1
Q

what is the function of the respiratory system

A
  • The flow of air in and out of the respiratory system

- Devilry of air to the alveoli where gas exchange takes place

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2
Q

what does spirometry measure

A

Assess lung function tests

Measure both expired and inspired air

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3
Q

what are the basic 3 related measurements of spirometry

A

volume
time
flow

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4
Q

what are the positives of spirometry

A

objective
non-invasive
sensitive to disease

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5
Q

how should the patient be positioned in spirometry

A
  • sit upright
  • feet flat on the floor with legs uncrossed
  • no use of abdominal muscles for leg position
  • loosen tight fitting clothing, if clothing is too tight this can give restrictive pictures on spirometry
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6
Q

what is the technique that should be used in spirometry

A
  • deep breath taken in why still using the mouthpeice
  • followed by a further quick full inspiration
  • deep breath can be taken in then the mouth is placed tightly around the mouthpiece before a full expiration is performed
  • patient asked to completely empty their lungs then take a quick full inspiration followed by a full expiration
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7
Q

what is the quality of spirometry

A
  • have to have an explosive start
  • manoeuvre was performed with a maximal inspiration and expiration
  • no glottis closure or cessation of airflow occurred
  • no coughs
  • manoeuvre should meet the end of test criteria (exhaling for 6s with 50ml being exhaled in the last 2s)
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8
Q

define tidal volume

A

this is the volume of air you move into and out of the lungs during rest subconsciously,

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9
Q

define inspiratory capacity

A

maximum volume of air inout and out of the lungs in a single respiratory cycle

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10
Q

define forced vital capacity

A

volume of air that you breath out as hard and fast as possible after the deepest possible breath

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11
Q

define inspiratory reserve volume

A

volume of air you can draw into your lungs

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12
Q

define expiratory reserve volume

A

volume of air you can expel from your lungs

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13
Q

define residual volume

A

volume of air that remains in the lungs even after maximal exhalation

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14
Q

how do you work out forced vital capacity

A

inspiratory reserve capacity + tidal volume + expiratory reserve volume

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15
Q

what is the PEF

A

maximal airflow you can achieve during the expiration phase

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16
Q

what are the main determinants in determining the FVC

A
  • Age
  • Height
  • Sex
  • Race
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17
Q

the taller you are the…

A

greater the lung function

18
Q

as you age…

A

your lung function declines

19
Q

what happens to the PEF in asthma

A
  • it is decreased
20
Q

why is it important to repeat lung function tests

A
  • lung function might be fine one day and change the next day
21
Q

asthmatics have xxx lungs

A

hyper inflated lungs

22
Q

what happens to the volume flow graph in obstructive lung disease

A
  • hyperinfalted lungs so there is.a greater residual volume then someone with no obstructive comprise therefore the graph shifts to the left
23
Q

what happens to the volume flow graph in restrictive lung disease

A

– loss of lung capacity, the residual volume is significantly less than with someone with no respiratory comprise, the volume that they are able to generate in forced vital capacity is also less, thus the loop shifts to the right

24
Q

what is a normal FEV1/FVC ratio

A
  • FEVI/FVC is a ratio of Forced Expiratory Volume in 1 sec & Forced Vital Capacity
  • Values above 70-80% = normal. Age/gender/height adjusted
  • Airflow limitation (e.g. Asthma) : ↓FEV1/FVC
25
Q

describe the difference between FEV1/FVC in asthmatic and COPD

A
  • Although FEV1 is reduced FV is still the similar to someone with no respiratory compromise
  • COPD is different as they usually have obstructive airflow that is persistent
26
Q

what is the limitations of spirometry

A
  • Values above 70-80% = normal. Age/gender/height adjusted
  • Airflow limitation (e.g. Asthma) : ↓FEV1/FVC
  • Incorrect in some populations = Asian communities
  • Misdiagnosis risk? Age-related decline in lung function not because they have obstructive lung disease
  • therefore the solution is the 95th percentile for a population - these limits lower normality
27
Q

what does DLCO/TLCO measure

A
  • Measures how efficient lungs are at exchanging gases

- Ability of lungs to transfer gas from inhaled air to red blood cells

28
Q

how does the DLCO work

A
  • Diffusing capacity of the lungs for CO (DLCO) – used at 0.3%
  • Haemoglobin has a higher affinity for carbon monoxide then oxygen
29
Q

what is the technique for DLCO

A
  • Single breath hold technique
  • Unforced maneous empties the lungs, take a rapid inhalation of CO/helium to total lung capacity, breath hold for 10 seconds and then unforced exhalation for less than 4 seconds
  • The sample is exhaled breath
30
Q

what does DLCO stand for

A

diffusing capacity of the lungs for carbon monoxide

31
Q

what are the two important parameters that determine the DLCO

A
  • Lung surface area available for gas exchange

- Rate of capillary blood CO uptake

32
Q

how do you work out the DLCO

A

Lung surface area available for gas exchange (Va) X rate of capillary blood CO uptake (Kco)

33
Q

Why in restrictive lung disease does the DLCO decrease

A
  • ILD: ↓DLCO primarily due to ↓Kco (NB ILD: Fibrosis of Interstitium)
34
Q

what is DLCO useful for

A
  • Useful for early stage ILD detection before substantial reduction in lung volumes
35
Q

what are the limitations of the DLCO

A

Falsely reduced in individuals who fail to inspire to TLC (technique) and Significant variation

36
Q

describe what exercise tests test assess

A
  • Assess how much exercise a patient is able to manage
  • Assess benefit of extra oxygen to help with daily activities
  • Assess pre-operative fitness
  • Part of a rehabilitation programme
37
Q

name some exercise tests

A

6 minute walk
shuttle walk
cardiopulmonary exercise

38
Q

describe how the 6 minute walk works

A
  • Walk up and down a flat route for 6 minute
  • Asses breathless pre and post test
  • Blood oxygen saturation levels recordered
39
Q

describe how the shuttle test works

A
  • Assess distance and speed without taking rest (bleep test)
40
Q

describe how the cardio-pulmonary exercise test works

A
  • Assess pre-operative fitness/undiagnosed shortenss of breath/poor exercise tolerance cycle ergometer/treadmill
  • Increase resistance

Measures

  • Oxygen consumtion
  • ECG
  • SpO2
41
Q

how do you work out

  • vital capacity
  • end respiratory volume
  • total lung capacity
  • inspiratory capacity
  • functional residual volume
  • expiratory reserve volume
A
  • vital capacity = is calculated by adding the inspiratory reserve volume, the tidal volume and the expiratory reserve volume (IRV + VT + ERV)
  • end respiratory volume = measured, total lung capacity (TLC)
  • total lung capacity = is calculated by adding the inspiratory reserve volume, the tidal volume, the expiratory reserve volume and the residual volume (IRV + VT + ERV + RV)
  • inspiratory capacity = is calculated by adding the tidal volume and the inspiratory reserve volume (VT + IRV)
  • functional residual volume = FRC) is calculated by adding the expiratory reserve volume and the residual volume (ERV + RV)
  • expiratory reserve volume = (ERV) is a measured value and cannot be calculated
42
Q

what is the FEV1/FVC in obstructive and restrictive

A
  • raises in restrictive - The lungs could be normal
    The ratio may be unaffected whilst both the FEV1 and the FVC have decreased, as occurs in restrictive lung disease
  • decreases or remains the same in obstructive
    This indicates obstructive lung disease
    The value FEV1 decreases and therefore the ratio decreases

Cardiorespiratory 2 (43 decks)

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