Pulmonary function test

Question 1

what is pulmonary function test also known as

Answer 1

spirometry, lung function test

Question 2

what is the pulmonary function test

Answer 2

the measurement of breathing, you may carry out the test or a technician may perform the test- have to interpret results

Question 3

what does spirometry tell us

Answer 3

shows abnormalities in lung function, static lung volume- how much air the lungs can hold, dynamic lung volume- the flow of air through the airways, how fast that volume of air can be move
no specific normal volume- predicted with age, weight height, nationality

Question 4

what abnormalities does spirometry look for

Answer 4

movement of air- airflow- impedances- reduction in speed, volume of air in

Question 5

indications for use- diagnostic

Answer 5

evaluate symptoms, signs, or previous abnormal results, measure effects of disease on pulmonary function, screen at risk groups- e.g. smokers, assess proprioceptive risk

Question 6

indications for use- monitoring

Answer 6

assess therapeutic intervention on lung function (over time or after therapy), monitor adverse reactions to drugs, assess potential environmental or occupational exposures

Question 7

indications for use- disability

Answer 7

assess impairment or disability from lung disease, assess risks as part of insurance evaluation, assess prognosis, does not impact quality of life, perceived level of disability/ breathlessness, ADL’s

Question 8

indications for use- research

Answer 8

clinical research, epidemiologic surveys

Question 9

contraindications

Answer 9

pneumothorax, haemoptysis, aneurysm- could be thoracic/abdominal/ cerebral in nature, recent myocardial infarction or unstable angina, CVS instability, cerebral instability, recent surgery (chest, abdomen, and eyes), recent chest infection- may hinder results

Question 10

what might some of the contraindications be a problem

Answer 10

changes in pressure in thorax, in abdomen, in intracranial area- don’t want to rupture

Question 11

factors influencing airway resistance

Answer 11

type of airflow, lung volume- linked to age, gender, etc., elastic recoil, bronchial smooth muscle tone- constrictions, airway obstruction

Question 12

what is measure- forced vital capacity

Answer 12

the volume expired forcefully (following a maximal inspiration), until residual volume is reached
80% of predc.= normal

Question 13

what is measure- FEV1

Answer 13

forced expiratory volume in one second- the volume of air a subject can exhale in the first second of a maximal breath out, following a maximal inspiration
80% of predic.

Question 14

what is measure-FEV1:FVC

Answer 14

looks at the amount expelled within the first second compared with the overall volume achieved
the ratio should be 75% or higher to be normal

Question 15

pec flow

Answer 15

maximum rate of expiratory flow, highlights issue- may be referred on for more accurate results

Question 16

the spirometry procedure

Answer 16

sit upright, wearing comfortable loose- fitting clothes, after a relaxed breath out, take a maximal breath in, seal your lip around the mouthpiece and blow out as fast and completely as possible

Question 17

an acceptable spirogram demonstrates

Answer 17

quick and forceful exhalation, no coughing, smooth lines on graph, minimum exhalation time of 6 seconds with no change in volume in last second
in practice 3 acceptable spirograms are used which show reproductively and no variations in effort

Question 18

classifications of spirometry results

Answer 18

normal- volume and flow normal, restrictive- a restriction in lung volume or obstructive- obstruction to flow
restrictive disease- stop patient taking maximal inhalation
obstructive disease- COPD, asthma, emphysema, bronchitis

Question 19

FEV1 results

Answer 19

obstructive- mild=80%, moderate= 50-80%, severer= 30-50%, very severe >30%
restrictive- <80%, combined- <80%

Question 20

FVC results

Answer 20

obstructive >80%, FVC predicted <80%,

Question 21

FEV1/ VC, FEV1/FVC

Answer 21

Obstructive- FE1/VC/FVC <70%

restrictive- FEV1/VC/FVC >70%

Question 22

volume time plot-

Answer 22

the volume of gas exhaled is plotted over time- want it to minimum 6 secs for good tet, the slop of the curve at ant point is equal to flow

Question 23

volume time plot- obstructive

Answer 23

the slope or gradient of the curve is much less steep as air struggles to get out quickly because the airways are obstructed. FEV1 will be reduced but the total volume may be less affected

Question 24

volume time plot-restrictive

Answer 24

the slope or gradient of the curve is very similar to normal as there is no obstruction to flow in the airways but the overall volume is less so the FEV1 and FVC are both reduced