Pulmonary Function Test Review Flashcards by Christine Deihl

What is the formula for Oxygen Extraction?

(a-v)O2

Normal at rest is 5 vol%

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What does O2 extraction represent?

Pulling of O2 from circulation to support cellular production of energy for muscle constraction

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What will improve your O2 extraction? What makes it decline

endurance training; In a conditioned person the Max O2 delivery and VO2 rise because their cardiac output is higher; and vice versa; and with unconditioned everything lowers

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What happens to your diffusion of O2 during exercise?

It can almost triple

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What effect does increased CO have on perfusion, & pulmonary vascular pressure?

Increases both

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What is VO2? What is normal value

O2 consumption

Resting VO2= 3.5 ml/kg/min which is 1 Met

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What does exercise due to your VO2?

It increases directly with muscular work

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What does Max VO2 depend on?

Genetics, conditioning, disease

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What is a normal VO2 max predicted %

Greater than 84%

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O2 consumption can be predicted from ______ _______.

Work Rate

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What is VO2 peak defined as?

Where exercise is stopped below Maximal capacity for O2 due to another factor like dyspnea, pain, peripheral vascular disease

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What is a normal CO2 production?

200 ml/min or 2.8 ml/ml/min/kg

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Exhaled CO2 depends on?

Matching alveolar ventilation

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Where is the Respiratory Exchange Ratio measurement obtained, what location?

The mouth

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What is the formula for RER?

VCO2/VO2 or the ratio of CO2 molecules produced to O2 molecules consumed

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The RER ratio normally equals what?

The RQ quotient

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Where is the RQ quotient obtained?

At the tissue level

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What is a normal value for RER & RQ?

200/250 ml min= 0.8

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When might the RER & RQ values be different?

During short bursts of maximal exercise because tissue O2 consumption (RQ) and CO2 production exceed O2 uptake and CO2 elimination, this should happen in a short exercise burst like 100 yard dash

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When exercise intensity increases what happens to the RER or RQ values?

They will increase as exercise increase, onset of anaerobic exercise will cause a further increase as bicarb reacts with lactic acid generates more CO2

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Which measurement is not a direct measurement?
A. RER
B. RQ

B. RQ

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The act of pulling Oxygen from circulation to support cellular production of energy for muscle contraction is called?
A.  O2 diffusion
B.  O2 consumption
C.  O2 extraction
D.  Aerobic exercise

C. O2 extraction

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This measurement of O2 reflects work rate, it will increase directly with level of muscular work
A.  O2 delivery
B.  O2 diffusion
C.  O2 Extraction
D.  O2 Consumption

D. O2 consumption

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When exercise is stopped below max capacity for O2 transport due to symptoms?

VO2 Peak

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What is the normal level of VCO2?

200 ml/min or 2.8 ml/min/kg

When looking at your respiratory exchange ratio one level is an invasive measure & the other is not; Name the measurements for each? A The invasive measurement is ? B. The non invasive is?

A. Invasive measurement done at tissue level is RQ or respiratory quotient B. Non invasive is RER or (R) which is obtained at mouth

What is a normal value for R?

0.8 ml/min

What is the formula for the RER?

VCO2/VO2

Which generates less CO2 per ATP molecule, fat metabolism or Carbohydrate metabolism?

Fat metabolism

In a steady state the lung's O2 uptake equals the tissue's O2 consumption rate and same with CO2 production & consumption which means the R = RQ, when would they not be the same?

Short bursts of maximal exercise because tissue O2 consumption and CO2 production exceed the lung's uptake & elimination

T or F: Like RQ, R increases as exercise intensity increases, The onset of anaerobic metabolism increases R further

True

What is the critical level with RER where metabolic substrate changes to glucose?

1.0

During an exercise test in a lab a long distance conditioned runner has a PaCO2 of 40mmhg, R of 0.8, and MV of 6.5. After 5 minutes of running her values are VCO2 = 960 ml/min; VO2 1200 ml/min & Minute Ventilation of 33 L/min. What would happen to her CO2? A. Increase B. Decrease C. Stay normal

C. Stay Normal; the increase in MV matched increase in CO2 production and VO2, so her increase in MV was in proportion to her increased metabolic demands VCO2/VO2 =960/1200 = 0.8

``` Healthy individuals VE is usually less than? A. 70% B. 75% C. 50% D. 60% ```

A. 70%

During aerobic metabolism _______, ______, and ________ provide major source of ATP synthesis?

Carbs, Fats, & proteins

The major energy sources at maximal exercise is ______ metabolism?

Glucose metabolism

What does anaerobic metabolism generate and what happens to it?

Lactic acid is generated, produces more CO2 adding to amount already produced by aerobic metabolism, this stimulates an increase in ventilation

This evaluates respiratory response & depends on PaCO2 and dead space?

Minute Ventilation

``` During maximum exercise healthy people do not alter their ______. A. Minute Ventilation B. O2 diffusion C. MVV D. Tidal Volumes ```

C. MVV

``` The MVV is a indicator of ______. A. Lung perfusion B. Lung diffusion C. Minute ventilation D. Muscle Strength ```

D. MVV is a indicator of muscle strength

T or F: The slope of VO2 increase is about the same for all people unaffected by training, age, or gender?

True

VO2 can be predicted by _____ ______.

Work rate

T or F: Once the first half of your tolerable work load has been met (45% of Max VO2) SV will rise steeply

False; once the first half has been met the only way the heart can increase its output further is to increase rate of contraction

During heavy exercise 80% of CO is diverted to where?

Skeletal muscle

T or F: HR max can improve with improved fitness

False; It is age related and does not change with fitness

``` During HR max the conditioned athlete has a greater ______ and also a much higher cardiac output at HR max? A. SV B. FOC C. DLCO D. MV ```

A. Stroke volume is higher and therefore cardiac output is higher for the conditioned athlete at HR Max

At HR max for the unconditioned person their maximum O2 delivery, Cardiac output, and VO2 are? A. Increased B. Decreased C. Not affected

B. Decreased

``` Early in exercise what produces most of the increase in minute ventilation? A. Respiratory Rate B. Tidal Volume C. It does not increase D. Chemoreceptors ```

B. Tidal Volume

``` Once 60-70% of Min Vol is reached _____ is responsible for further increases in minute ventilation A. Respiratory Rate B. Vt C. chemoreceptors D. Baroreceptors ```

A. Respiratory Rate

``` An abrupt increase in ventilation at the onset of exercise appears to be in response to: A. Chemical changes in the body B. Humoral changes in the body C. Chemoreceptor reflex D. Anticipated future metabolic demand ```

D. Anticipated future metabolic demand

During exercise the Vd/Vt _____ as exercise progresses. A. Doesn't change B. Increases C. Decreases

C. Dead space to tidal volume ratio decreases from normal values due to larger Vt and blood flow diversion to underperfused lung zones

The point at which the VCO2 slope becomes steeper than VO2 slope is?

Anaerobic threshold

T or F: Unhealthy individuals in a disease state will use less than 70% of ventilator capacity

False, only healthy use 70%

T or F: Healthy individuals will alter their MVV during exercise to make their efforts more productive?

False, they will not alter their MVV

What is the formula for breathing reserve?

MVV-VE max or VE/MVV %

What is a normal value for Breathing reserve?

T or F: Vd/Vt includes both anatomical and physiologic dead space

True

A plateau happens when your Vt is 55% of _______.

Vital Capacity

What is a normal RR in exercise for healthy individual?

40-50 bpm

In a patient with COPD what would happen to their end exp lung volume & their IC? A. Both would decrease B. Both would increase C. EELV will increase & IC will decrease D. EELV will decrease & IC will increase

C. End Exp Lung volume will increase and the IC will decrease

The portion of each breath not in contact with perfused alveoli is _______.

Vd/Vt

What is a normal value for healthy person at rest & at max exertion?

Normal < 0.35 at rest | Max exertion < 0.25

What is the formula for ratio of Vd/Vt?

PaCO2 - PeCO2/ PaCO2

What type of information does PetCO2 and P(a-ET)CO2 provide?

Estimates PaCO2

What is a normal resting value for the difference of (a-ET)CO2? & at max exertion? and with diseased lungs?

Resting = 2-3 mmHg Max exertion = -4 mmHg Diseased = > 10 mmHg

What is a normal value of P(A-a)O2? at max exercise?

Normal = 10 mmHg | Max exercise = 20-30

Define lactate Threshold?

The point where VCO2 & VE do not rise in proportion to VO2, once met VCO2 increases faster than VO2; can be found by the V-Slope method VCO2 vs VO2 plot

What is the normal value of Lactate Threshold?

50-60%

What is HR Max?

The max HR achieved prior to exhaustion; Calculated with 220 - age

T or F: HR will increase linearly with decreased workload

False; it increases linearly with increased workload

What 2 things can cause early onset of anaerobic threshold?

Deconditioning or cardiovascular problem

What are the reserve values for HR & BR

``` HR = 15 BR = 11 ```

A commonly accepted non invasive method for determining AT is?

V-Slope Method

Soon after AT is met ____ begins to increase soon; Then after isocapnic buffering occurs _____ increases and metabolic acidosis drives MV further

Ve/VO2 | Ve/VCO2

T or F: CaO2 will not increase significantly from rest to max exercise

True

Increased O2 delivery in healthy person relies entirely on _______.

Cardiac Output

What is the relationship between HR and CO? A. Inverse B. Linear C. Direct

B. Linear

What is the formula for VO2?

SV X HR X C(a-v)O2 = VO2 Norm = 3.5 ml/kg/min or 1 met or can use: CO X C(a-v)O2

This is a marker for the improved blood flow distribution and is a measure of heart's efficiency in terms of O2 delivered or consumed?

O2 pulse

What is the formula for O2 Pulse?

O2 Pulse= VO2/HR

How can VO2 max be raised?

Increasing heart's muscle mass, SV, and CO

What is the purpose of the timed walk test?

Evaluates functional performance