Pulmonary Function Test Flashcards
What is ischemia?
when demand for O2 is more than supply of O2
What can frequently occur during exercise and manifest as angina?
ischemia
How much of horizontal or down sloping of the ST segment is indicative of ischemia?
1.0 mm
How much of up sloping of the ST segment is positive for ischemia?
1.5 mm
What is lung compliance?
ability of lungs to stretch and expand
What is elastic recoil of the lungs?
ability of lungs to recoil inwards from lung collagen, elastin, and smooth muscle fibers
What type of lung disease has low compliance and high recoil?
restrictive lung disease
what type of lung disease has a high compliance and low recoil?
obstructive lung disease
what type of lung disease will have changes in the rib cage and chest wall?
obstructive
what type of lung disease has a decreased lung volume?
restrictive lung disease
what type of lung disease has an increased lung volume but a reduction in air flow?
obstructive lung disease
what type of lung disease causes the diaphragm to flatten?
obstructive lung disease
What are the 5 types of causes of restrictive lung disease?
pleural, alveolar, interstitial, neuromuscular, and thoracic cage
what is the overall pathophysiology of a restrictive lung disease?
decreased working lung space impairing gas exchange
what are the 3 clinical manifestations of restrictive lung disease?
increased RR, decreased SpO2, and increased work of breathing
what are the 4 signs and symptoms of restrictive lung disease?
tachypnea, hypoxemia, decreased breath sounds, and decreased chest wall expansion
what causes pulmonary fibrosis?
immune disorders, occupational exposure, genetic abnormality, or a complication of lung injury
what type of breathing can pulmonary fibrosis lead to?
shallow and rapid due to loss of compliance, hypoxemia, and/or DOE
what type of restrictive lung disease involves an inflammatory to fibrotic process in the lungs?
pulmonary fibrosis
What are the 7 implications for rehab for the restrictive lung disease?
thoracic mobs, respiratory muscle stretching, breathing exercises and inspiratory muscle training, interval training, relaxation techniques, pulmonary rehab, titration of O2
what type of lung disease has a reduction in FVC?
restrictive
what type of lung disease has a normal or decreased FEV1?
restrictive
What type of lung disease has a normal FEV1/FVC ratio?
restrictive
what type of lung disease has a reduced TLC?
restrictive
what type of lung disease has a smaller flow volume loop?
restrictive
what is the primary cause of obstructive lung disease?
smoking which causes inflammation
what type of obstructive lung disease has an irreversible dilation of 1 or more bronchi and a cough with sputum?
bronchiectasis
what type of obstructive lung disease is inherited?
cystic fibrosis
what are the 2 types of chronic obstructive pulmonary disease?
emphysema and chronic bronchitis
What type of COPD is permanent, abnormal enlargement of the alveoli and destruction of bronchioles?
emphysema
when hyperinflation occurs, what happens to the inspiratory muscles and diaphragm?
shortening of inspiratory muscles and flattening of the diaphragm
what is the most common complaint with emphysema?
DOE
what are types of treatment used for emphysema?
smoking cessation, bronchodilators, O2, pulmonary rehab, volume reduction surgery, lung transplant
What type of COPD has a persistent cough that produces sputum for more than 3 months for at least 2 consecutive years and is usually caused by smoking?
chronic bronchitis
what is considered end stage chronic bronchitis?
bronchiectasis with permanent dilation of bronchi with purulent secretions and recurrent infections
what are treatment options for chronic bronchitis?
smoking cessation, antibiotics for infection, bronchodilators, inhaled corticosteroids, expectorants, mucolytics, O2, airway clearance, and pulmonary rehab
what type of obstructive lung disease has reversible airway obstruction related to inflammation?
asthma
what can asthmatic episodes be triggered by?
air pollutants, pollen, respiratory infections, exertion, cold air, and medications
does asthma have a reproductive or non-reproductive cough?
non-reproductive
What are treatment options for asthma?
inhaled steroids prior to inflammation, mainly bronchodilators after inflammation
what should be emphasized with exercise and asthma
warm-up
what is thought to happen to induce an asthmatic attack during exercise?
due to loss of water and heat from lower respiratory system
What is the sequence of events that occurs due to decreased elastic recoil with obstructive lung disease?
decreased recoil leads to hyperinflation then V/Q mismatch then hypoxemia and hypercapnia
what is the most common symptom of obstructive lung disease?
dyspnea
Clubbing is present in what type of lung disease?
obstructive
what type of lung disease has an increases TLC, IRC, and RV?
obstructive
what lung disease will have a reduction in FEV1 and FEV1/FVC ratio?
obstructive
what lung disease has a prolonged exhalation phase?
obstructive
what lung disease will have diminished breath sounds?
obstructive
what lung disease will you hear wheezes and crackles?
obstructive
What are treatment techniques used for obstructive lung disease?
thoracic mobs and stretching, postural re-ed, rescue breathing ed, O2 target between 88-92% for some patients, pulmonary rehab, and mucus clearance techniques
why don’t you want to give a patient with obstructive lung disease too much O2?
they can become hypercapnic (too much CO2 in the blood)
What test reveals the strength of the diaphragm and other inspiratory muscles?
maximal inspiratory pressure
what should the MIP be in patients 18-65 yrs?
lower than -90 cmH2O in men and -70 cmH2O in women
what should the MIP be in patients older than 65 yrs?
less than -65 cmH2O in men and -45 cmH2O in women
what test indicates the strength of the abdominal and other expiratory muscles?
maximal expiratory pressure
what should MEP be in men?
higher than 140 cmH2O
what should the MEP be in women?
higher than 90 cmH2O
What MEP predicts a weak cough and difficulty clearing secretions?
less than 60 cm H2O
what is used to acquire a spirogram?
spirometer
in normal lungs, how much of air in the lungs should be expelled in the first second?
80%
What is the forced vital capacity (FVC)?
when the patient exhales as long and forcefully as they can after a deep inhale
what stage of COPD has an FEV1 of >80%?
stage 1 (mild)
what stage of COPD has an FEV1 is between 50-80%?
stage 2 (moderate)
what stage of COPD has an FEV1 between 30-50%?
stage 3 (severe)
what stage of COPD has an FEV1 of <30%?
stage 4 (very severe)