Pulmonary Diagnostic Tests/Procedures - PPT Flashcards
which pulmonary tests are applicable for physical therapists
CXR
PFT
bronchoscopy
ABG
oximetry
bacteriological/cytological tests
what is a CXR used for
screening for abnormalities
provide a baseline
monitor progress of disease process/treatment
radiolucent items on a CXR
air = dark
radiopacity items on a CXR
bone = white
typical views of CXR
PA view
L to R view
explain positioning of PA CXR
patient standing with front of chest facing film
a left lateral view is helpful in
localizing position of an abnormality
systematic way to think through a CXR observation
1 - look for bones
–> clavicle, ribs, vertebrae
2 - position of organs
–> lungs/heart
3 - note diaphragm position
4 - trachea / any mediastinal shift
decubitus positioning of CXR? indication?
taken in a lying position
used for assessing fluid level in lungs or pleural effusion
explain lordotic positioning for a CXR? indication?
from lumbar spine facing upwards
used to assess apical / middle regions of the lung
screen for pulmonary TB
explain oblique positioning for a CXR? indication?
patient turned 45 degrees from the film
detect pleural thickening
evaluate carina
visualize heart/great vessels
explain an AP positioning for a CXR? indication?
taken from ant to post
– if patient cannot get out of bed
the hila is formed via
root of lungs
pulmonary blood vessels, bronchi, and group of lymph nodes travel through
what is a silhouette sign?
normal line of demarcation between two structures being partially/completely obliterated
fluffy infiltrates indicate
congestion in alveoli
what are CT scans typically used for in the lungs
diagnosis of tumors vs calcifications or nodules
high resolution CT scans detect
disease of lung parenchyma
lung disease in symptomatic patients with normal CXR
high resolution CT scans provide
accurate assessment of pattern, distribution, activity, and possible reversibility or disease
what is the gold standard for PE diagnosis
pulmonary arteriography
disadvantages of pulmonary arteriography
invasive
increased morbidity/mortality due to complications
time consuming
expensive
what has taken over for PE testing
CT scans
how is ventilation measured in the lungs
patient inhales xenon gas and holds breath
ventilation scans are made over lung
how is pulmonary blood flow measured in the lungs
radioactive iodine is introduced and perfusion scans are made over the lung
what indicates a PE from V/Q scans
perfusion defects with normal ventilation
a normal V/Q will show
greater ventilation and perfusion in the bases of the lungs
less V/Q match in apices
bronchography is used for ___? what is commonly detected with it?
evaluation / management of tracheobronchial tree abnormalities
atelectasis
what information do PFTs provide
integrity of airways
function of respiratory musculature
condition of lung tissue
body plethysmography determines
max amount of air in lungs after taking a maximal breath
amount of air in lungs after person maximally exhales
what value is considered normal from FEV1
> 70% of predicted value
how does total lung capacity relate to those with obstructive vs restrictive lung disease
OLD = > VC
RLD = < VC
Forced Vital Capacity definition
maximum volume of gas pt can exhale as quickly and forcefully as possible
forced expiratory volume in 1 second definition
volume of air exhaled during the first second of the FVC
what does FEV1 reflect
airflow in large airways
maximum voluntary ventilation is defined as
maximal amount of gas a patient can move in 1 minute
peak expiratory flow is defined as
maximum flow that occurs at any point in time during FVC
abnormal DLCO tests are attributed to
1- decreased quantity of hemoglobin per unit of blood volume
2 - increased thickness of alveolar-capillary membrane
3 - decreased functional surface area
flow-volume loop purpose
graphical representation of events during forced inspiration/expiration
how to determine obstructive disease reversibility
administer bronchodilator
- 12% change in pre and post = reversibility
what are ABGs used for
problems related to acid-base balance, ventilation and oxygenation
what does an ABG report
arterial pH
partial pressure of CO2
partial pressure of O2
oxygen saturation
bicarbonate concentration
base excess
PaCO2 related to hyperventilation
<40 mmHg
PaCO2 related to hypoventilation
PaCO2 > 40 mmHg
PaCO2 related to ventilatory failure
> 50 mmHg
normal pH range
7.35-7.45
normal range of PaCO2
35-45
normal range for HCO3-
22 to 26
normal range for pO2
> 80
describe volatile vs nonvolatile acids
volatile = turn to a gas, expelled via lungs
nonvolatile = remains liquid, expelled via kidney
value associated with acidemia
pH <7.4
what can lead to acidemia
low HCO3- (metabolic)
high PaCO2 (respiratory)
value associated with alkalemia
pH >7.4
what can lead to alkalemia
high HCO3- (metabolic alkalosis)
low PaCO2 (respiratory alkalosis)
what does base excess reflect
concentration of bicarbonate in body
what does oximetry measure
oxyhemoglobin saturation
what signifies hypoxemia
SpO2 of 90% or less
cytological tests identify
specific microorganisms that may cause disease
hematological test aid in
assessment of cardiopulmonary disease
what are typically included in hematological tests
ABGs
electrolyte analysis
blood cell counts
coagulation studies
what is used to evaluate blood’s tendency to clot
bleeding time
platelet count
partial thromboplastin time
prothrombin time
normal times associated with
- bleeding time
- PTT
- PT
- INR
bleed = up to 6 min
PTT = 32-70 seconds
PT = 12 to 15 seconds
INR = 2 to 3
