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CVPR Pulmonary (Exam 3) > Pulmonary Function Tests > Flashcards

Pulmonary Function Tests Flashcards

1
Q

Increased lung volumes are associated with _____ diseases such as _____.

A

obstructive; asthma and emphysema

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2
Q

Loss of muscle function can occur due to _____ or because of ______.

A

neuropathies; myopathies

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3
Q

A reduced FEV1 = ?

A

obstructive disease

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3
Q

In a flow volume loop, variable intra-thoracic obstruction will have a _________ curve.

A

compressed airway during expiration with a normal inspiratory loop

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3
Q

Restriction can only be diagnosed by ______.

A

lung volumes

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4
Q

How is gas transfer measured?

A

DLCO test

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5
Q

What is IRV?

A

Inspiratory reserve volume; the volume of gas that can be inhaled above what would normally be inhaled during a tidal breath requiring maximum effort of the respiratory muscles

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6
Q

Diseases that decrease blood in the lung (anemia, pulmonary vascular disease) will ____ CO transfer and result in a ______.

A

decrease; low diffusing capacity

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7
Q

What causes variable extra-thoracic obstruction?

A
  • vocal cord paralysis
  • laryngeal edema
  • vocal cord dysfunction
  • upper airway tumor
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7
Q

Examples of neurologic diseases which can reduce respiratory muscle strength (aside from trauma) include: 1) diseases of the motor-neuron endplate (such as myasthenia gravis, botulism, anti-cholinergic poisoning, tick paralysis), 2) diseases of the neuronal axon (Guillan-Barre, critical care neuropathy), or 3) diseases of the nerve root in the anterior horn of the spinal cord (such as ____).

A

polio, amyotrophic lateral sclerosis

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8
Q

The amount of gas volume moved during a normal inspiration is the _____.

A

tidal volume (TV)

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8
Q

What is Body Plethysmography?

A

a pulm function test where pt sits inside a pressurized box and very small changes in volume and pressure can be measured

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9
Q

What is TV?

A

tidal volume; the amount of gas volume moved during a normal inspiration

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10
Q

In a flow volume loop, the fixed obstruction curve will be ______.

A

flattened in both inspiration and expiration

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11
Q

This is the maximum intra-thoracic pressure is measured when the patient attempts to inspire as forcefully as possible against an occluded airway (Mueller maneuver) while at residual volume.

A

Pi max

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12
Q

In a flow volume loop, the airflow is decreased in obstruction with ______ of the expiratory flow loop, a hallmark sign of obstructive lung disease.

A

coving

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12
Q

What is DLCO?

A

diffusion capacity of the lung using a small amount of CO

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13
Q

What 2 tests assess lung muscle function?

A
  1. Pi max 2. Pe max
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14
Q

______ lung volumes are associated with obstructive diseases such as asthma and emphysema.

A

Increased

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14
Q

What is Pi max?

A

The maximum intra-thoracic pressure is measured when the patient attempts to inspire as forcefully as possible against an occluded airway (Mueller maneuver) while at residual volume

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14
Q

Pulmonary fibrosis, a restrictive disease, is characterized by stiff lungs and a _____ pressure-volume (P-V) curve.

A

flat

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16
Q

This is the volume of gas in the lung even after maximal exhalation- cannot be measured with spirometry.

A

Residual volume (RV)

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17
Q

What diseases or conditions can increase DLCO?

A
  • Polycythemia
  • early CHF
  • asthma
  • alveolar hemorrhage
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17
Q

Muscle abnormalities can occur due to _____ (steroid myopathy), _______ (polymyositis, dermatomyositis), or ______ (Lambert-Eaton myasthenic syndrome), among others.

A
  • drugs
  • collagen vascular diseases
  • paraneoplastic syndromes
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17
Q

Examples of neurologic diseases which can reduce respiratory muscle strength (aside from trauma) include: 1) diseases of the motor-neuron endplate (such as myasthenia gravis, botulism, anti-cholinergic poisoning, tick paralysis), 2) diseases of the neuronal axon (such as ______), or 3) diseases of the nerve root in the anterior horn of the spinal cord (polio, amyotrophic lateral sclerosis).

A

Guillan-Barre, critical care neuropathy

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18
Q

Examples of ______ which can reduce respiratory muscle strength (aside from trauma) include: 1) diseases of the motor-neuron endplate (myasthenia gravis, botulism, anti-cholinergic poisoning, tick paralysis), 2) diseases of the neuronal axon (Guillan-Barre, critical care neuropathy), or 3) diseases of the nerve root in the anterior horn of the spinal cord (polio, amyotrophic lateral sclerosis).

A

neurologic diseases

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19
Q

Decreased lung volumes are diagnostic of _____.

A

restrictive processes

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20
Q

In a flow volume loop, the airflow is decreased with coving of the expiratory flow loop, a hallmark sign of ______ lung disease.

A

obstructive

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22
Q

What is FRC?

A

Functional residual capacity; RV + ERV; amount of gas left in the lung after normal expiration; the point at which the respiratory system is in equilibrium

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24
Q

This is the volume of gas that can be inhaled above what would normally be inhaled during a tidal breath requiring maximum effort of the respiratory muscles.

A

Inspiratory reserve volume (IRV)

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25
Q

In a flow volume loop, _______ will have a compressed airway during expiration with a normal inspiratory loop curve.

A

variable intra-thoracic obstruction

26
Q

What is the functional residual capacity?

A

when the lung and chest wall are at equilibrium

26
Q

A ______ measures the compliance of the lung.

A

P-V curve

27
Q

What is the sum of all the lung volumes called?

A

total lung capacity (TLC)

28
Q

What causes a fixed obstruction?

A

circumferential lesions from tracheal stenosis, prior intubation, circumferential airway neoplasm

29
Q

Muscle abnormalities can occur due to drugs (such as _____), collagen vascular diseases (______), or paraneoplastic syndromes (_______), among others.

A

steroid myopathy polymyositis, dermatomyositis Lambert-Eaton myasthenic syndrome

30
Q

This is TV + IRV; the amount of gas that can be inhaled via max effort.

A

inspiratory capacity (IC)

30
Q

In a flow volume loop in the case of ______, the maximal airflow is reduced because the total volume of gas in the lung is reduced.

A

restrictive diseases

31
Q

Diseases that decrease blood in the lung (____, _____) will decrease CO transfer and result in a low diffusing capacity.

A
  • anemia
  • pulmonary vascular disease
31
Q

Examples of neurologic diseases which can reduce respiratory muscle strength (aside from trauma) include: 1) ______ (myasthenia gravis, botulism, anti-cholinergic poisoning, tick paralysis), 2) ______ (Guillan-Barre, critical care neuropathy), or 3) _______ (polio, amyotrophic lateral sclerosis).

A
    1. diseases of the motor-neuron endplate
  2. diseases of the neuronal axon
  3. diseases of the nerve root in the anterior horn of the spinal cord
32
Q

_____ graphs represent airflow (velocity in L/s) versus lung volume.

A

Flow volume loops

33
Q

______ lung volumes are diagnostic of restrictive processes.

A

Decreased

35
Q

In a flow volume loop, a ______will have a flattened curve in both inspiration and expiration.

A

fixed obstruction

36
Q

Emphysema, an obstructive disease resulting from a loss of elastic recoil, is characterized by a _____ P-V curve.

A

steep

37
Q

What is Pe max?

A

a test of muscle function where the patient attempts to expire as forcefully as possible against an occluded airway (Valsalva maneuver) while at TLC

38
Q

What diseases or conditions can decrease DLCO?

A
  • emphysema
  • pulmonary vascular disease
  • interstitial lung disease
  • anemia
39
Q

What is RV?

A

Residual volume; the volume of gas in the lung even after maximal exhalation- cannot be measured with spirometry

41
Q

On a flow volume loop curve, ______ will show limited inspiration with normal expiratory flow.

A

variable extra-thoracic obstruction

43
Q

On a flow volume loop curve, variable extra-thoracic obstruction will show _____.

A

limited inspiration with normal expiratory flow

44
Q

This is inhaled to induce bronchospasm in asthmatics but not normal people.

A

methacholine

46
Q

In a flow volume loop and ______ disease, the curve is shifted right to a lower TLC and the maximum airflow is decreased.

A

restrictive

46
Q

In a flow volume loop and airflow obstruction, the maximal airflow is ______ due to increased resistance to flow.

A

reduced

47
Q

What 3 things affect the DLCO test?

A
  • SA
  • membrane thickness
  • hemoglobin
49
Q

This is ERV + TV + IRV; the amount of gas that can be inhaled from the end of a maximum expiration to the maximum inflation .

A

vital capacity (VC)

51
Q

Flow volume loops represent ____ vs ____.

A

airflow (velocity in L/s) versus lung volume

52
Q

In a flow volume loop in obstructive lung disease, lung volumes are ______ and the curve is shifted to the ____.

A

increased; left

53
Q

What is TLC?

A

Total lung capacity; sum of all volumes in the lung

55
Q

What is IC?

A

Inspiratory capacity; TV + IRV; the amount of gas that can be inhaled via max effort

56
Q

This is the volume of breath that can be further expelled after a normal tidal volume (active)..

A

Expiratory reserve volume (ERV)

57
Q

Examples of neurologic diseases which can reduce respiratory muscle strength (aside from trauma) include: 1) diseases of the motor-neuron endplate (such as ____), 2) diseases of the neuronal axon (Guillan-Barre, critical care neuropathy), or 3) diseases of the nerve root in the anterior horn of the spinal cord (polio, amyotrophic lateral sclerosis).

A
  • myasthenia gravis
  • botulism
  • anti-cholinergic poisoning
  • tick paralysis
59
Q

In a flow volume loop in the case of restrictive diseases, the maximal airflow is _______ because the total volume of gas in the lung is reduced.

A

reduced

61
Q

What causes variable intra-thoracic obstructions?

A

non-circumferential tracheal tumor (ball-valve effect)

62
Q

Gas exchange is decreased if the surface membrane area is?

A

(A) is decreased (as in emphysema) or if the membrane (d) is thickened (as in some interstitial lung diseases).

63
Q

A P-V curve measures the ______ of the lung.

A

compliance

64
Q

What is a methacholine challenge?

A

a pt is given methacholine to inhale which induces bronchospasm in asthmatics but not normal people

65
Q

This is measured while the patient attempts to expire as forcefully as possible against an occluded airway (Valsalva maneuver) while at TLC.

A

Pe max

67
Q

The helium dilution test wont be accurate for diseases such as ______.

A

emphysema, asthma, or chronic bronchitis (air trapping)

68
Q

In a flow volume loop in ______ lung disease, lung volumes are increased and the curve is shifted to the left.

A

obstructive

69
Q

In a flow volume loop and restrictive disease, the curve is shifted ______ to a lower TLC and the maximum airflow is _______.

A

right; decreased

70
Q

This is RV + ERV; amount of gas left in the lung after normal expiration; the point at which the respiratory system is in equilibrium.

A

Functional residual capacity (FRC)

71
Q

What is ERV?

A

Expiratory reserve volume; the volume of breath that can be further expelled after a normal tidal volume (active)

72
Q

In a flow volume loop and ______, the maximal airflow is reduced due to increased resistance to flow.

A

airflow obstruction

73
Q

What is VC?

A

vital capacity; ERV + TV + IRV; the amount of gas that can be inhaled from the end of a maximum expiration to the maximum inflation

74
Q

What is FEV1?

A

forced expiratory volume in the first second; normal = 80%

75
Q

______ can occur due to drugs (steroid myopathy), collagen vascular diseases (polymyositis, dermatomyositis), or paraneoplastic syndromes (Lambert-Eaton myasthenic syndrome), among others.

A

Muscle abnormalities

CVPR Pulmonary (Exam 3) (42 decks)

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