Pulm Dx and Therapeutic Skills - Exam 1 Flashcards
When percussing why would the lungs sound dull?
consolidation, pleural effusion, tumors or could be the liver
When percussing the lungs why would they sound hyperresonant?
air, emphysema, asthma or pneumothorax
Which PFTs measure against predicted values?
spirometry and plethysmography
What are the 5 indications of PFTs?
● Evaluate patients with respiratory symptoms or rib fracture
● Assess progression of previously diagnosed lung disease
● Monitor the efficacy of treatment
● Evaluate patients preoperatively
● Monitor for potentially toxic side effects of certain drugs
What are some limitations to PFTs?
patient must cooperate and be able to follow directions
kids usually 5 and older
______ is the volume of air inspired or expired with each normal breath at rest
tidal volume
______ is the maximum volume of air
that can be inspired over and above the tidal volume
inspiratory reserve volume
______ is the volume of air that can
be expired after the expiration of the tidal volume
expiratory reserve volume
______ is the volume of air that remains in the lungs after maximal exhalation
residual volume
Draw the PFT chart with volumes
What is this called? What is its function?
spirometry
Non-invasive assessment of maximum
inspiratory and expiratory volume as
well as maximal expiratory effort
- can be done pre and post bronchodilator
What are the pt directions for how to use a spirometry?
When is a spirometry indicated?
diagnostic and monitoring of lung and neuromuscular diseases that affect
breathing
prevention of post-surgical/traumatic pulmonary complications
When is spirometry contraindicated?
○ recent (<6wks) since abdominal, intracranial, or eye surgery or a
pneumothorax
○ thoracic, abdominal and cerebral aneurysms
○ unstable angina or a recent MI
○ acute severe asthma, acute respiratory distress, active TB
_______ the greatest volume of air that can be expelled from the lungs after
taking the deepest possible breath
vital capacity
______ the maximal speed at which air can be exhaled with force
peak expiratory flow rate
What is the gold standard for PFT? What does it measure? When is it indicated?
Plethysmography
Measures the total volume of air held in the lungs
Indicated if decreased FVC on
spirometry
What is this?
Plethysmography
air tight chamber with various transducers that measure pressures in the airway and within the box
What is the difference between obstructive and restrictive lung disease?
Obstructive - difficulty exhaling air from the lungs
○ Restrictive - difficulty expanding the lungs during inhalation
**What is the cutoff that determines responsiveness to bronchodilators for adults? for kids?
What does the green graph indicate? red? blue?
green: normal PFT
blue: restrictive
red: obstructive
How much air is in the reserve volume? How much air does the normal lung hold?
reserve: 2 liters
normal: 6 liters
**Draw the flowchart that is used to interpret PFTs
What is maximal respiratory pressures? When is it assessed?
When is it indicated?
part of plethysmography, forced expiration (with cheeks
bulging) through a blocked mouthpiece
after a full inhalation that measures respiratory muscle strength
unexplained decrease in
VC or suspected respiratory muscle weakness
____ is the most sensitive PFT. What does it assess?
Diffusing capacity (DLco)
assesses the transfer of oxygen and carbon dioxide