Pulmonary Assessments Flashcards
- dyspnea at work, with exercise, stress, tying shoes, stairs
episodic
dyspnea that seems to be all the time, COVID 19 recovery, multiple chronic disease
Chronic
dyspnea that is cardiac related, trauma, spontaneous pneumo, PE, anaphylaxis, virus, pneumonia
acute
what are some limitations to pulse oximetry?
- accuracy tends to decrease at low saturations
- perfusion, vascularity and motion artifact
- carbon monoxide backpressure causes false high values
- skin pigment and dark nail polish can skew readings
- ambient light
- intravascular dyes (methylene blue) false low spO2
Indications for spirometry
- assess lung health/ mechanics of breathing
- effect and monitoring of disease
- evaluate bronchodilator responsiveness
- preoperative risk evaluations
Linear F/V curves are consistent with?
Normal airflow mechanics
curvilinear F/V curves are consistent with?
abnormal airflow (obstructive)
volume/time curves that plateau are?
generally normal
volume/time curves that do not plateau are consistent with?
Obstructive disease
what does a normal spriometry graphic look like?
- sharp peak flow
- linear flow pattern
- no hesitation, coughs, glottic closure or flow interruptions
- 6 second expiration minimum (adults)
- inspiratory flow should be rounded and the volume should match closely
Three main factors affecting diffusion?
Area (A)
- greater area, increased rate of transfer
- alveolar and capillary walls
Thickness (T)
- increased thickness, decreased transfer
Driving pressure (change in PO2)
- difference in alveolar gas tension and deoxygenated venous blood from the pulmonary artery
- causes of decreased surface area?
- emphysema
- lung resection
- bronchial obstruction
- multiple pulmonary emboli
- anemia
- cause of increased wall thickness?
- asbestosis (exposure)
- idopathic pulmonary fibrosis
- congestive heart failure
- sarcoidosis
- collagen vascualr disease
- drug toxicity
- hypersensitivy pneumonitis
*
- assess airway responsiveness- pulmonary funtion
- provactative dose that results in a 20% fall in FEV1
Airway Hyper-responsiveness
- an increased sensitivity and exaggerated response to non-allergic stimuli
- AHR is associated with asthma
- AHR is also seen in other diseases associated with airway inflmmation and obstruction
Methacholine challenge testing
fractional exhaled nitric oxide
- biomarker
- tool to identify eosinophilic asthma phenotype
- tool to evaluate non-specific respiratory symptoms
- tool to evaluate steroid responsive airway inflammation
- FENO > 50 ppb is elevated
FENO
