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CardioPulm - Lungs > Objective Measures of Pulmonary Function > Flashcards

Objective Measures of Pulmonary Function Flashcards

1
Q

What is a PFT

A

Pulmonary Function Test

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2
Q

RR nl for adult and neonate

A

Adult- 10-20

Neonate 30-40

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3
Q

Pulse oximeter optimal level

A

> 95

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4
Q

Pulse ox, when should you change your intervention

A

<90

remember the steep drop off bc of the dissociation curve

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5
Q

Pulse ox, when should you stop activity

A

<85

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6
Q

Can you do chest percussion to someone with a pneumothorax

A

NO, it is a contraindication - it might make the pneumothorax bigger

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7
Q

Two ways to treat a pneumothorax

A

Chest tube if it is big
or
DBE

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8
Q

When might you see a pneumothorax and who is at high risk

A
  • May be seen post surgically
  • May result from a stab wound or MVA
  • Can occur spontaneously

At high risk:
Very tall, thin people
People with connective tissue disease like Marfan’s
People with dz that leads to blebs and bullae like CF

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9
Q

What are V-Q scans

A

It is how we decide if we have equal ventilation and perfusion in equal measure

Tests reveal how alveolar ventilation and pulmonary perfusion are matched

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10
Q

How are V-Q scans done

A

The subject inhales xenon gas and then holds his/her breath while photoscintigrams – ventilation scans – are taken

To measure perfusion in lungs, the subject receives an IV injection of radioactive iodine and photoscintigrams – perfusion scans – are taken

Then you put the two test together

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11
Q

What is the symbol for perfusion

A

Q

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12
Q

What are V-Q scans diagnostic for

A

Can be diagnostic for Blood Clots or SHUNTING

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13
Q

What other test might be done if you have a V-Q mismatching

A

D-Dimer

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14
Q

How is D-dimer produced

A

D-Dimer is produced when fibrin degrades

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15
Q

How is a D-Dimer test scored

A

A negative score virtually rules out thromboembolism

A positive score indicates the possibility of DVT or PE

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16
Q

A PFT provides information on, and can help determine (4 points)

A
  • Provide information regarding the integrity of the airways
  • Help to determine if a patient has obstructive or restrictive lung disease
  • Used by insurance companies to determine whether someone qualifies for pulmonary rehab
  • Provide an objective measure for improvement or decline
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17
Q

How is a PFT done and what is used to do a PFT

A

A simple spirometer is used to obtain lung capacities

A graphic tracing called a spirogram is used to interpret test results

For testing, the patient sits upright with a clip
over the nose

The patient breathes in the spirometer through a tight-fitting mouthpiece

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18
Q

What is a tracing

A

A graphic tracing called a spirogram is used to interpret test results of the PFT

19
Q

What are the 8 things that a spirogram measures

A

TLC - Total lung capacity

VC - Vital capacity

RV - Residual volume

IC - Inspiratory Capacity

FRC - Functional reserve capacity

IRV - Inspiratory reserve volume

TV - Tidal volume

ERV - Expiratory reserve volume

20
Q

What is TLC

A

total lung capacity - everything together

21
Q

What is VC

A

Vital capacity is the IRV + TV + ERV

22
Q

What is RV

A

Residual volume - amount of air that doesn’t leave lungs

you do not want lungs to be empty

23
Q

What is IC

A

Inspiratory Capacity is your TV plus your IRV

24
Q

What is FRC

A

It is the RV+the ERV

25
Q

What is TV

A

Tidal Volume - breathing in and out

26
Q

What is ERV

A

Expiratory reserve volume - it is how much you can exhale past the tidal volume

27
Q

What happens to the RV of someone who has an air trapping disease

A

Their RV gets very big

28
Q

How are the results of spirogram measures reported

A

in percentages - this helps take into account age and size

29
Q

How does the performance that someone gives on a PFT tell you if the person has normal function

A

Performance is compared to a huge data base of
age and size matched controls

If accurate it will reveal what % of normal function a person has

30
Q

Can someone have a VC above 100%

A

Yes, it just means the person went above the norm.

ex: olympic swimmer is likely to be above 100%

31
Q

A PFT tracing gives you a …

A

visual picture of airflow and volume

32
Q

What would a PFT look like for person with an obstruction

A

If a person has and obstructive disease it is going to take them longer to breath out so you will get a concavity

33
Q

What would a PFT look like for person with a restrictive disease

A

Looks like a normal shape but everything is smaller

34
Q

What is normal IC between

A

3000 and 4000ml

35
Q

What does FVC stand for and what is it

A

Forced vital capacity (FVC) is the amount of air that can be forcefully exhaled as quickly as possible

36
Q

What would cause the FVC to change

A

Obstructive disease

37
Q

FEV1, what is it and what are the normal and abnormal values

A

Volume of air that can be forcefully expired in the first second of a FVC

An FEV1 > 2.0 liters is normal

An FEV1 < 1.0 liter is considered indicative of
severe obstruction

38
Q

Can you measure RV using a spirometer

A

NO

39
Q

How do you measure RV

A

Either the subject is measured using an air-tight booth and pressure changes are recorded as the subject breathes
or
The subject inhales a small amount of an inert gas like helium and residual volume is calculated based on how much is expired

40
Q

Would someone with COPD have a RV greater than 100% or less than 100%

A

Greater bc air is trapped

41
Q

FEV1/FVC, how is it different than other readings, what is it measuring and what is the nl

A

FEV1/FVC is different than the other readings

Most values are converted to percentages,
after comparison to matched norms

FEV1/FVC is already reported as a percentage
so we look at the raw number (80% is ≈ nl)

How much you can get out in one second verses how much you can get out completely

42
Q

FEV1/FVC, how is it different than other readings, what is it measuring and what is the nl

A

FEV1/FVC is different than the other readings

Most values are converted to percentages,
after comparison to matched norms

FEV1/FVC is already reported as a percentage
so we look at the raw number (80% is ≈ nl)

How much you can get out in one second verses how much you can get out completely

43
Q

Is FEV1/FEC more useful with restrictive or obstructive disease and why

A

Obstructive Disease!

obstructive disease everything is smaller so you might get the same ratio out but everything is reduced

44
Q

What FEV1/FVC percentage is our value to justify services

A

60% or less is the value often used as criteria to justify services

CardioPulm - Lungs (7 decks)

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