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Cardiopulmonary > Pulmonary Diagnostic Procedures > Flashcards

Pulmonary Diagnostic Procedures Flashcards

1
Q

What are 4 common diagnostic pulmonary procedures?

A
  1. Chest imaging
  2. Bronchoscopy
  3. Blood gas analysis
  4. Ventilation/Perfusion (V/Q) scan
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2
Q

Which procedure is considered the predominant diagnostic test to determine anatomic abnormalities and pathological processes within the chest?

A

Chest Radiographs - Always performed first!

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3
Q

What structures should you be able to visualize on radiograph?

A

Bones, soft tissue, hemidiaphragms, mediastinum, trachea, heart
Pulmonary specific: Hilum, lung fields, lesions, silhouette sign

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4
Q

A pulmonary radiograph shows a partially or completely obliterated line of demarcation

A

Silhouette sign

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5
Q

What technique is primarily used for diagnosis of tumors vs calcifications or nodules?

A

Computed tomography (CT) – Also known as digital chest radiography

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6
Q

Disadvantages of CT Scan

A

Risk of transporting patient out of ICU
Significant increase in radiation
Risk of intravenous contract

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7
Q

Technique used for tissue biopsy, secretion sampling/removal, and bronchial lavage for tissue identification

A

Bronchoscopy

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8
Q

What is the purpose of bronchoscopy?

A

Allows direct access & visualization of previously inaccessible areas inside the tracheobronchial tree

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9
Q

What information is gained in an Arterial Blood Gas (ABG) analysis?

A

pH, Oxygen, Carbon Dioxide, & Bicarbonate

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10
Q

Normal = 7.35-7.45

A

pH

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11
Q

pH < 7.35

A

Acidosis

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12
Q

pH > 7.45

A

Alkalosis

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13
Q

Normal = 80-100 mmHg
Abnormal < 80 mmHg

A

PaO2 - Partial pressure of oxygen in blood (bound to hemoglobin)

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14
Q

Normal = >90-95%

A

SpO2 - Peripheral O2 saturation

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15
Q

Mild Hypoxemia Level

A

60-80 mmHg

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16
Q

Moderate Hypoxemia Level

A

40-60 mmHg

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17
Q

Severe Hypoxemia Level

A

< 40 mmHg

18
Q

Normal = 35-45 mmHg

A

PaCO2 - Partial pressure of CO2 in blood (reflecting alveolar ventilation)

19
Q

PaCO2 < 35 mmHg

A

Hyperventilation

20
Q

PaCO2 > 45 mmHg

A

Hypoventilation

21
Q

For every ___ mmHg increase in PaCO2 the pH should fall ___ units

A

10 mmHg, 0.07 units

Increase CO2 drives pH DOWN (more acidic)

22
Q

Normal = 22-26 mEq/L

A

Bicarbonate HCO3 – Determines acid balance vs imbalance

23
Q

Low HCO3

A

Metabolic Acidosis
Eliminating bicarbonate will decrease pH - Acidosis

24
Q

High PaCO2 (hypercapnia - hypoventilation)

A

Respiratory Acidosis

25
Q

High HCO3

A

Metabolic Alkalosis
Retaining bicarbonate will increase pH - Alkalosis

26
Q

Low PaCO2 (hypocapnia - hyperventilation)

A

Respiratory Alkalosis

27
Q

Respiratory Acidosis

A

INCREASE in PaCO2 + DECREASE in pH
Inverse
Compensation: RETAIN bicarbonate to increase pH

28
Q

Respiratory Alkalosis

A

DECREASE in PaCO2 + INCREASE in pH
Inverse
Compensation: EXCRETE bicarbonate to decrease pH

29
Q

Metabolic Acidosis

A

DECREASE in HCO3 = LOW pH
Both decrease
Compensation: Hyperventilation (decreasing CO2) to increase pH

30
Q

Metabolic Alkalosis

A

INCREASE in HCO3 = HIGH pH
Both increase
Compensation: Hypoventilation (increasing CO2) to decrease pH

31
Q

Inverse relationship exists between which two variables?

A

pH & CO2

32
Q

If inverse relationship remains between pH & CO2…

A

Respiratory

33
Q

If inverse relationship does NOT remain between pH & CO2…

A

Metabolic

34
Q

Process of reading ABG values

A
  1. Assess pH (acidosis vs alkalosis)
  2. Classify pH vs CO2 relationship (R vs M)… look at HCO3 as needed for metabolic
  3. Determine adequacy of alveolar ventilation (PaCO2)
35
Q

Alveolar Ventilation at <30 mmHg

A

Hyperventilation to increase PaCO2

36
Q

Alveolar Ventilation at 30-50 mmHg

A

Adequate as is

37
Q

Alveolar Ventilation at >50 mmHg

A

Ventilatory failure (too much PaCO2)

38
Q

Technique that uses inhaled and injected radioactive material to measure ventilation and perfusion within the lungs. Perfusion involves radioactive albumin and ventilation involves inhalation of radioactive gas

A

Ventilation/Perfusion Scan (V/Q Scan)

39
Q

Decreased uptake of radioisotope during perfusion scan

A

Problem with blood flow!

40
Q

Decreased uptake of radioisotope during ventilation scan

A

Reduced breathing & ventilation! Potential airway obstruction

Cardiopulmonary (8 decks)

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