Lung Volumes Flashcards
as we age ( ) goes up and ( ) goes down and ( ) doesn’t change
RV goes up
IRV goes down
tidal volume
Increased PaCO2 in asthma is a sign of
respiratory failure, possible intubation
Increased PaCO2 in COPD/bronchiectasis is a sign of
advanced disease
alveolar disorders of pus leads to
water
blood
pneumonia
CHF
hemoptysis
CHF presenting complaint
pink frothy sputum, bilateral coarse crackles (basal crepitations), CXR/ECHO
treat with beta blockers, ace inh, diuretics
Pneumonia presenting complaint
rust colored sputum, unilateral, CXR
treat with abx
Hemoptysis presenting comlpaint
fresh blood, typically unilateral, CXR, CT, bronchoscopy
what vessel supplies the lung itself?
bronchiole artery, generally source of hemoptysis….do a CT scan an bronchoscopy if CT neg
MCC of hemoptysis
- cancer
- bronchiectasis
- arteriovenous malformation
- TB in rest of world
MGMT of hemoptysis
- maintain airway
- localize source of bleed
- control hemorrhage
common interstitial diseases
- PE (CT angiogram)
- PHTN (echo, right heart cath)
- fibrosis (high res CT or biopsy)
how to treat interstitial diseases?
steroids
Pleural effusion presenting complaints
dull percussion, thoracentesis
hyoxemia may not improve w/supp O2
Pneumothorax presenting complaints
hyperresonant, CXR
Mesothelioma presenting complaints
dull percussion, CT/pleura biopsy
Malignant Mesothelioma
- only one exposure is needed for damage
- first causes fibrosis in lung, then tumor, then cancer
treatment of pts with chest wall problems
CPAP, then invasive if needed
problems with the following will cause breathing to stop
- brain (cerebellum)
- spine trauma/infection
- corticospinal fiber, alpha motor neuron (lou gehrigs)
- neuropathy (myelin sheath degradation)
- NMJ (botulism, myasthenia gravis)
- myopathy
hypoxemic vs
hypercapnic respiratory failure
PaO2<60 mm/Hg
PaCO2>45
normal partial pressure of O2 in alveoli
CO2
105 mm/Hg
40 mm/Hg
diffusion of ( ) is much faster than ( )
CO2, O2
normal tidal volume
500 cc
MCC of ARDS
sepsis (caused by pneumonia)
how to treat ARDS
decrease tidal volume, sedate to decrease O@ consumption, paralyze pt
obstructive lung disease occurs when…
FEV1/FVC
TLC
volume of air in lungs at full inspiration
functional residual capactiy
volume in lungs at resting expiration
RV
volume in lungs at full expiration
FVC
volume of air exhaled from full inspiration to max full expiration
FEV1/FVC ratio
- indicates what % of total FVC was expelled during 1st second of exhalation
- important for dx of obstructive and restrictive disease
in restrictive lung disease, TLC is ( ), VC is ( ) , FEV1 is ( ), and the ratio is ( )
decreased, decreased, decreased, normal
if FEV1/FVC ratio is normal, check…..
FVC, can indicate restrictive disease
if FEV1/FVC ratio is low, think….
obstruction, give bronchodilator and check for 200CC or 12% FEV1 improvement
inhalation diseases are seen in…
blood….
upper lobe
lower lobe
acute cough
subacute
chronic
less than 3 weeks
3-8 weeks
greater than 8 weeks
4 causes of chronic cough
- GERD
- hidden bronchial asthma
- postnasal drip
- eosinophilic bronchitis
apnea
cessation of breathing >20 sec
cessation of breathing <20 sec w/cyanosis or bradycardia
OSA
- narrowing or collapse of pharyngeal airway during sleep
- obesity is the biggest factor
OSA comorbidities
- HTN
- Afib
- heart failure
- stroke
- decreased insulin sensitivity
- depression
mgmt of OSA
- weight loss
- CPAP or BiPAP
- surigcal
MCC of congenital stridor
- laryngomalacia
- bilateral vocal cord paralysis
- subglottic stenosis
- tracheal compression
MCC of bacterial tracheitis
staph aureus
croup
acute laryngotracheobronchitis
“steeple sign”
MCC of epiglottitis
H influenza, loss of voice, no cough
“thumb sign”
Rendu-osler-weber syndome
AVM, telangectasia
Bilateral Vocal Cord Paralysis:
Inspiratory stridor associated with weak cry & respiratory distress
Laryngomalacia:
Inspiratory stridor that often positional.
