Pulmonary Diagnostic Tests/Procedures - Book Flashcards
what principal objects are shown in a radiograph
air fat water tissue bone
why is lateral view radiograph better for observing pathology
in PA view, upper and middle lobes override portion of the lower lobes
what specific areas of the lungs can be seen in lordotic view radiograph
right middle lobe
left lingular segments
what imaging method is best for ruling out a pulmonary embolism?
CT scan
what is NOW considered the gold standard for PE diagnosis
angiography with CT scan
explain the purpose of CT scans alone when treating pulmonary pathologies
ability to detect diseases of lung parenchyma
95% sensitivity
almost 100% specificity
what pathologies can a high resolution CT (HRCT) scan detect
emphysema
sarcoidosis
idiopathic interstitial pneumonia
– idiopathic pulmonary fibrosis
bronchiectasis
in a CT scan, what is “ground glass opacity”
- what can this indicate?
opacity that is focal or diffuse but does not obscure any underlying anatomical structures
can indicate early interstitial lung disease
in a CT scan, what is “honeycombing”
- what can it indicate?
multilayered cystic air spaces with well-defined walls
can indicate collapsed secondary pulmonary lobules
on a HRCT hoe is emphysema characterized
reduction of respiratory bronchioles
destruction of alveoli
what are MRIs most often used for in pulmonary populations
evaluation of chest wall processes
- involvement of bone, muscle, fat of pleura
explain the shift in bronchoscopy’s application
fiberoptic bronchoscopy has become more practical than contrast broncography
PFTs specifically give information about the
integrity of airways
function of respiratory musculature
condition of lung tissues
the tests that make up a pulmonary function test inspect the
measure of lung volumes/capacities
gas flow rates
gas diffusion
gas distribution
spirograms measure
basic lung volumes and capacities
what does body plethysmography determine
how much air is in your lungs after a deep breath
how much air is left after you exhale as much as possible
what does FEV1 reflect
airflow in large airways
how is FVC described in obstructive vs restrictive lung disease
reduced in both
FEV1 value associated with little/no obstruction
> 2 L
FEV1 value associated with mild to moderate obstruction
between 1-2 L
FEV1 value associated with severe obstruction
<1 L
what predicted FEV1 value indicates restrictive vs obstructive lung pathology
> 80% = Restrictive
<70% = obstructive
why is CO measured in diffusion tests
it has a high affinity for hemoglobin
what is PEFR? what does it represent?
peak expiratory flow rate
- on a flow volume loop, the max amount of air expired
the inspiratory portion of the flow-volume loop is more sensitive to
airway obstruction
the expiratory portion of the flow-volume loop is more sensitive to
peripheral airway obstruction
what amount of difference should be found to be considered abnormal on a PFT
a 20% difference between observed and predicted volume loops
explain difference between SaO2 and SpO2
SaO2 = direct measure of oxygen through ABG
SpO2 = indirect calculated measure of oxygen saturation through pulse oximetry
PaCO2 values reflect
adequacy of alveolar ventilation
what PaO2 value is considered mildly hypoxemic
60 to 80 mmHg
what PaO2 value is considered moderately hypoxemic
40 to 60 mmHg
what PaO2 value is considered severely hypoxemic
<40 mmHg
how to measure arterial oxygenation in patients who receive supplemental oxygen
fraction of inspired oxygen (FiO2)
– will be multiplied by 500 to approximate arterial oxygen tension
