Pulmonary Examination Flashcards
Tidal volume (TV)
500 mL
Air inspired during normal, relaxed breathing
Inspiratory reserve volume (IRV)
3100 mL
Additional air that can be forcibly inhaled after the inspiration of a normal tidal volume
*inspired OVER and ABOVE tidal volume
Expiratory reserve volume (ERV)
1200 mL
Additional air that can be forcibly exhaled after the expiration of a normal tidal volume
*Expired OVER tidal volume
Residual volume (RV)
1200 mL
Volume of air remaining in the lungs after the expiratory reserve volume is exhaled
Always present in the lungs
Total lung capacity (TLC)
6000 mL
Max amount of air that can fill the lungs
TLC = IRV + TV + ERV + RV
Vital capacity (VC)
4800 mL
Total amount of air that can be expired after fully inhaling
VC = IRV + TV + ERV = ~80% TLC
Value varies according to age and body size
Inspiratory capacity (IC)
3600 mL
Max amount of air that can be inspired
IC = TV + IRV
Functional residual capacity (FRC)
2400 mL
Amount of air remaining in lungs after a normal expiration
FRC = ERV + RV
Obstructive lung disease and lung volume changes
RV, FRC, TLC increases
All other values decrease
*TV increases or stays normal
Restrictive lung disease and lung volume changes
All values decrease
*FEV1 stays the same
Chronic obstructive pulmonary diseases (COPD)
CBABE
Cystic fibrosis
Bronchitis (chronic)
Asthma
Bronchiectasis
Emphysemaa
COPD cant get air OUT
Restrictive lung diseases
Sarcoidosis
Lung fibrosis
Ankylosing spondylitis
Obesity
Burns
Pneumonia
Pneumothorax
Hemothorax
Pulmonary effusion
GOLD classification - mild COPD
FEV1/FVC <70%
> /= 80% FEV1
With or w/o production of cough and sputum production
GOLD classification - moderate COPD
FEV1/FVC = <70%
50-80% FEV1
SOB w/ exertion
With or w/o production of cough and sputum production
GOLD classification - severe COPD
FEV1/FVC < 70%
30-50% FEV1
Greater SOB w/ exercise
Decreased exercise capacity
Fatigue and repeated disease exacerbation
GOLD classification - very severe COPD
FEV1/FVC <70%
<30% FEV1 or <50% FEV1 + chronic respiratory failure
Respiratory failure
Signs of right heart failure/corpulmonale
(corpulmonale/pulmonary heart disease - when the right ventricle of the heart enlarges and fails due to high blood pressure in the lungs)
FEV1
Forced expiratory volume in 1 sec
Volume of air exhaled in the 1st second under force after a max inhalation
FVC
Forced vital capacity
Total volume of air that can be exhaled during a max forced expiration effort
Vesicular breath sounds
Normal
Inspiratory longer than expiratory
Soft and low
Over most of the lungs
Broncho-vesicular breath sounds
Normal
Inspiratory and expiratory duration equal
Intermediate intensity and pitch
Bronchial breath sounds
Normal
Expiratory longer than inspiratory
Loud and high
Over manubrium
Tracheal breath sounds
Normal
Inspiratory and expiratory equal duration
Very loud, very high
Over trachea
Rhonchi breath sounds
Abnormal
Continuous, low pitched, rattling
Resemble snoring
Caused by air passing through airway obstructed by inflammatory secretions or bronchial spasms
COPD, bronchiectasis, pneumonia, chronic bronchitis, cystic fibrosis
Wheeze breath sound
Abnormal
High pitched, heard in expiration, like whistling
Caused by airway obstruction (asthma, COPD, aspiration of foreign body)
When severe, can be heard in inspiration
Think of a kazoo
