pft testing Flashcards
what are 3 types of measurements?
- lung volumes
- flow rates
- gas diffusion
what are the 4 lung volumes?
- IRV
- VT
- ERV
- RV
what are the 4 lung capacities?
- IC
- FRC
- VC
- TLC
1 lung capacities = how many lung volumes?
2 or more
what are the directly measured lung volumes?
- IC -VC
- IRV -VT
- ERV
What are the indirect measured lung volumes?
- RV
- FRC
- TLC
how do we measure indirect volumes?
the vital capacity (VC) maneuver or slow vital capacity (SVC) maneuver
how do we instruct a patient to do a VC or SVC?
take a maximal inspiration followed by a maximal exhalation without force.
SVC will provide important volumes used to determine what type of disease?
restrictive
In restrictive disease what will be decreased?
volumes
what lung volumes would you look at to determine if a patient has a restrictive disease?
TLC, SVC, FVC
what is a patients normal tidal volume?
500-700 mL
maximum volume of air inspired following normal inspiration? its not clinically significant
IRV
ERV is exhale maximally what is the normal range for ERV
1.20 L
ERV is what % of VC?
20 to 25%
with all directly measured volumes you want to take the largest measurements within what % of each other?
5%
how would you instruct a patient to preform the IC?
normal exhalation, inhale maximally
what is the normal range for IC?
3.6 L
how is VC measured?
- on inspiration- exhale maximally, inhale deeply as possible
- on expiration-inhale maximally, exhale maximally
what is the normal range for VC?
4.80 L
you can measure VT, IRV, ERV, IC and VC buy one spirometry maneuver?
VC maneuver
FVC measures flows or volumes?
flows
Patient is instructed to take a maximal inspiration followed by a maximal expiration as forcefully as possible is what type of maneuver?
FVC
FVC will provide important flow rates used to measure what type of disease?
obstructive disease
when doing the FVC how long should the pt exhale?
> or = 6 seconds
if FVC < SVC this would indicate what?
obstruction
extrapolated volume in FVC should < what %?
5% or .150 L
what maneuver measures FEV1, PEFR, FEF 200-1200, FEF 25-75%
FVC
what is the typical value for peak expiratory flow rates?
10 L/sec or 600 L/min
on a flow volume graph where would you find PEFR?
the highest point on expiration
average flow during the first 1000 mL after 200 mL expired is known as ?
forced expiratory flow (FEF) 200-1200
typical value for FEF 200-1200 ?
8L/sec or 480L/min
decreased values of FEF 200-1200 are associated with what kind of obstruction?
large airway
average flow rate during the mid portion of the FVC is known as what?
FEF 25-75
this is associated with small airway obstruction and decreased in the early stages of obstructive disease?
FEF25-75
what is the best indicator of obstructive disease?
forced expiratory volumes FEV1
volume of gas expired over a given time interval of 0.5, 1.0, 2.0, 3.0 ?
FEV1
largest FEV1 is not always largest what?
FVC
FEV1 is reported as a volume but it is actually what?
flow
FEV1/FVC ratio is decrease what type of disease?
obstructive
<70% fev1/fvc ratio is ?
obstructive disease
> 70% fev1/fvc ratio is ?
normal to restrictive disease
look at FVC if it is smaller its classified as
restrictive
what is the purpose of pulmonary function testing?
identification quantification epidemiological post-op risk pulmonary disability therapeutic effectiveness
detect diseases as obstructive or restrictive is known as what?
identification
the severity of pulmonary impairment as mild, moderate, severe or very severe. Helps determine the progression or reversibility of the disease.
quantification
pulmonary abnormalities caused by disease or environmental factors, occupational settings, smokers, or other high risk groups.
epidemiological
identify patients who may have an increased risk after surgery. risk can sometimes be reduced by preoperative respiratory care and sometimes enough to rule out surgery.
post-op risk
PFT help confirm claims for insurance policies for financial compensation in diseases such as occupational diseases and pneumoconiosis of coal workers.
pulmonary disability
may aid clinicians form PFT in selecting a specific therapeutic regimen such as bronchodilator, airway clearance, rehabilitation exercise.
therapeutic effectiveness
give me 3 types of equipment that measures volume displacement?
water sealed spirometers
bellows
dry rolling seal
give me 5 measuring devices that can measure flow?
turbinometers sonic devices peak flow meters thermistors pneumotachometers
in peak flow meters repeatability is more important then what?
accuracy
volume calibration spirometer are done by using a large volume syringe normally how many liters?
3.0 liters
what are the principles of pulmonary function?
capacity accuracy error precision linearity output
the range or limits of how much it can measure is known as what?
capacity
how well it measures a known reference value is know as what?
accuracy
difference between reference values and measured values is known as what?
error
synonymous with reliability of measurements and opposite of variability is know as what?
precision
refers to the accuracy of instrument over its entire range of measurement or its capacity is known as what?
linearity
includes the specific measurements made or computed by the instrument is known as what?
output
measures the volume and flow rates of the FVC?
flow volume loop
patient preforms a FEV from what capacity? and then is quickly followed by FIV from what?
TLC
RV
on the flow volume loop where is expiratory flows located?
above baseline
on the flow volume loop where is inspiratory flows located ?
below the baseline
how will a flow volume loop look if a patient has a restrictive disease?
skinny and tall loop
how will a flow volume loop look is a patient has an obstructive disease?
scooped out
what kind of obstruction can cause a equal decrease in both expiratory and inspiratory flow rates?
fixed airway obstruction
what kind of obstruction can cause a exhalation restriction but have a normal inspiratory capacity?
intrathoracic airway obstruction
what kind of obstruction can cause inspiration to be restrictive but expiration to be normal?
extrathoracic airway obstruction
what is used to measure the reversibility of an obstructive pattern?
post bronchodilator
a increase of what % of a post bronchodilator is considered significant for reversibility?
12 to 15 %
all bronchodilators should be held __ hours prior to testing?
8 hours
what does bronchial provocation mean?
testing for asthma
methacholine challenge, histamine challenge , cold air challenge, exercise challenge is also know as what?
bronchial provocation
bronchial provocation is positive for airway reactivity when what % decrease in FEV1 occurs?
20%
the patient is told to breathe in and out as fast as possible until told to stop is known as what kind of test?
MVV- maximum voluntary ventilation
how long is a MVV preformed?
12-15 seconds
the largest volume and rate that can be breathed per minute by voluntary effort is what kind of test?
MVV
____ can be done to evaluate pulmonary disability
MVV
this mimics exercise and can tell if a Pt is having any type of arrhythmias?
MVV
meausres the muscular mechanics of breathing?
MVV
a decreased in MVV is _____ disease and increase in airway resistance (RAW)
obstructive disease
MVV can be muscle weakness, decreased compliance or poor pt ______
effort
predicted normal values are primarily based on what?
age, height, sex
classification of interpretation 80 to 120 is considered to be
normal
classification of interpretation of 60 to 79 is considered to be
mild
classification of interpretation of 40 to 59 is considered to be
moderate
classification of interpretation of anything less than 40% is considered to be
severe disorder
if the FEV1 is less then 79% a ______ should be given to check or reversibility?
bronchodilator
when looking at the FEV1 we are looking for what kind of disease?
obstruction
when we are looking at the FVC we are looking to see if it is a ______ disease?
restrictive
indirect volumes measures what?
TLC
RV
FRC
Draw the box
and know that junk!!!
