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Respiratory > Lung testing > Flashcards

Lung testing Flashcards

1
Q

if you increase resistance what disease could occur

A

obstructive

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2
Q

if you decrease compliance what disease could occur

A

restrictive

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3
Q

describe for a peak flow meter is and what is a normal value

A

rapid exhaled puff from a full inspiration, measures peak expiratory flow rate (PEFR) -
500-600l/min

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4
Q

why is a peak flow meter good for an obstructive disease

A

reproducible

expiration

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5
Q

what does a nebuliser do and what are the two types

A

convert solution of drug into fine spray
Brown- preventer e.g. corticosteroids -anti-inflammatory
Blue-reliever - bronchodilator e.g. salbutamol

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6
Q

vitalograph how does it work

A 
sustained fced expiration from a full inspiration 
measure 
FVC 
FEV1- first second 
normal range of ratio is 75-85%
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7
Q

If FEV1/FVC<0.75 what disease is this indicative of

A

obstructive

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8
Q

compliance

A

expandability of the lungs

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9
Q

resistance

A

ease at which gas flows

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10
Q

In an obstructive disease such as asthma what would you see with the FVC,FEV1 and the ratio

A

FVC would stay more or less the same - takes longer but more effort to get out , same capacity of the lungs
FEV1 would decrease
FEV1/FVC ratio would decrease

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11
Q

In a restrictive disease such as pulmonary fibrosis what would you see with the FVC,FEV1 and the ratio

A

FVC would decrease as lungs cannot expand normally ( can’t create negative pressure )
FEV1 would also decrease
FEV1/FVC would either stay the same or increase

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12
Q

what do lung functions vary with

A

height, age , gender

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13
Q

Tidal volume ( Vt )

A

normal inspiration and expiration

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14
Q

IRV- inspiratory reserve volume

A

amount of extra air inhaled above tidal volume

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15
Q

ERV- expiratory reserve volume

A

extra air exhaled - force

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16
Q

RV - residual volume

A

air that remains in the lungs after fully exhale

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17
Q

TLC - total lung capacity

A

volume of air the lungs - max in

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18
Q

VC - vital capacity

A

max air that is expelled after inhalation

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19
Q

FVC - ( not forced vital capacity like In spirometry) functional residual capacity

A

vol of air in lungs after passive exhalation

capacities are sum of 2 or more volumes

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20
Q

how does fibrosis appear on X-ray

A

widely distributed throughout the lung fields - course or fine appearance

21
Q

Inspiration is limited more by what type of disease

A

restrictive

22
Q

does hyperinflation limit IRV

A

yes

also raises FRC and RV

23
Q

In COPD what is destroyed

A

alveolar destruction and elastin broken down

24
Q

what can you use to measure function residual capacity/residual volume

A

helium dilution and body plethysmography ( deep breath in and out measure Interhtoraic pressure)

25
Q

why and when is a wheeze normally heard

A

lower airway obstruction, normally on expiration

at level of bronchioles increasing resistance - inflammation of or smooth muscle spasms , inside the thoracic cavity
Greater effort only increase Pip compressing small intrrathoracic airways further limiting air flow o expiration
on inspiration there Is a negative Pip so bronchioles increase in diameter

high pitched whistle like sound - deep and low pitched rumbling - hear breaths better than stridor

26
Q

why and when is a stridor normally heard

A

upper airway obstruction heard on inspiration at level of larynx/trachea - tumours, croup or foreign body
outside thoracic cavity
on inspiration more negative pressure in thorax further narrows the obstructed part of the airway - on expiration the positive pressure increases the diameter

continuous high pitched crowing sound

27
Q

crackles what are they

A

alveolar rales
fine and short and high pitched - caused by air passing through fluid puss or mucus - bases of lung lobes on inspiration
course crackles - low pitch and moist - bronchitis
Fien - fibrosis - hair rubbing on ear

28
Q

pleural rub

A

movement of inflamed pleural surfaces against one another during chest wall movement
harsh grating like creaking
TB and pneumonia
lower anterior lung during both in and out

29
Q

in an obstructive disease both RV and TLC increasing by about 20% what happens with a restrictive disease

A

both decrease by about 20%

30
Q

in diffusion capacity DLCO/TLCO used CO to measure perfusion what does a decreased DLCO mean

A

obstructive ,pulmonary vascular os anemic disease

31
Q

what does an increased diffusion capacity for for carbon monoxide indicate( extend to which oxygen passes from the air sacs into the blood)

A

pulmonary haemorrhage or left right shunt

32
Q

what 3 things do flow volume loops allow movements of

A

upper airway obstruction - stridor or unexplained dyspnoea
variable extra thoracic obstruction ( above sternal notch) - vocal paralysis
Variable intrathoracic obstruction ( below sternal notch) chronic inflammatory disorders

33
Q

what is a bronchodilator response

A

degree to which FEV1 improves with inhaled bronchodilator indication of reversible airflow obstruction
significant. if FEV1 increases by 12%

34
Q

FEV1

and is reduced in what

A

(forced expiratory volume in 1 second) = max. volume of air exhaled in 1 second. Reduced w/ obstruction and restriction

35
Q

FVC

A

FVC (forced vital capacity) = total volume exhaled after full inhalation. Reduced w/ restriction.

36
Q

what test is good for asthma control and a test for obstructive disease

A

peak flow meter

37
Q

how are restrictive and obstructive diseases impacted respectively

A

obstructive increases resistance

restrictive decreases compliance

38
Q

how to determine the difference between asthma and COPD

A

Test for reversibility, give bronchodilator (salbutamol) obstruction reversed in asthma but not COPD

39
Q

normal tidal volume

A

500ml

40
Q

normal inspriaotry reserve volume

A

2.5L

41
Q

normal expiratory reserve volume

A

1.5L

42
Q

normal residual volume

A

1.5L

43
Q

total lung capacity

A

6L

44
Q

when does surfactant production markedly increase

A

after 34 weeks

45
Q

what hormones stimulate surfactant production

A

Cortisol (most important by far)
Thyroxine
Prolactin

46
Q

if a premature baby is born under 32 weeks do you give them corticosteroids

A

yes to combat affects of surfactant

47
Q

in addition to surfactant what also helps to keep airways open in normal respiration

A

cartilage

48
Q

Pulmonary shunt: ventilation is cut off in the lung so blood gets no oxygen so V/Q ration = 0
Dead space = blood supply to alveoli are cut off so V/Q ration is high

true or false

A

true

Respiratory (22 decks)

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