Pulmonary Function Tests Flashcards
Increased lung volumes are associated with _____ diseases such as _____.
obstructive; asthma and emphysema
Loss of muscle function can occur due to _____ or because of ______.
neuropathies; myopathies
A reduced FEV1 = ?
obstructive disease
In a flow volume loop, variable intra-thoracic obstruction will have a _________ curve.
compressed airway during expiration with a normal inspiratory loop
Restriction can only be diagnosed by ______.
lung volumes
How is gas transfer measured?
DLCO test
What is IRV?
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
Diseases that decrease blood in the lung (anemia, pulmonary vascular disease) will ____ CO transfer and result in a ______.
decrease; low diffusing capacity
What causes variable extra-thoracic obstruction?
- vocal cord paralysis
- laryngeal edema
- vocal cord dysfunction
- upper airway tumor
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 ____).
polio, amyotrophic lateral sclerosis
The amount of gas volume moved during a normal inspiration is the _____.
tidal volume (TV)
What is Body Plethysmography?
a pulm function test where pt sits inside a pressurized box and very small changes in volume and pressure can be measured
What is TV?
tidal volume; the amount of gas volume moved during a normal inspiration
In a flow volume loop, the fixed obstruction curve will be ______.
flattened in both inspiration and expiration
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.
Pi max
In a flow volume loop, the airflow is decreased in obstruction with ______ of the expiratory flow loop, a hallmark sign of obstructive lung disease.
coving
What is DLCO?
diffusion capacity of the lung using a small amount of CO
What 2 tests assess lung muscle function?
- Pi max 2. Pe max
______ lung volumes are associated with obstructive diseases such as asthma and emphysema.
Increased
What is Pi max?
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
Pulmonary fibrosis, a restrictive disease, is characterized by stiff lungs and a _____ pressure-volume (P-V) curve.
flat
This is the volume of gas in the lung even after maximal exhalation- cannot be measured with spirometry.
Residual volume (RV)
What diseases or conditions can increase DLCO?
- Polycythemia
- early CHF
- asthma
- alveolar hemorrhage
Muscle abnormalities can occur due to _____ (steroid myopathy), _______ (polymyositis, dermatomyositis), or ______ (Lambert-Eaton myasthenic syndrome), among others.
- drugs
- collagen vascular diseases
- paraneoplastic syndromes
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).
Guillan-Barre, critical care neuropathy
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).
neurologic diseases
Decreased lung volumes are diagnostic of _____.
restrictive processes
In a flow volume loop, the airflow is decreased with coving of the expiratory flow loop, a hallmark sign of ______ lung disease.
obstructive
What is FRC?
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
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.
Inspiratory reserve volume (IRV)
In a flow volume loop, _______ will have a compressed airway during expiration with a normal inspiratory loop curve.
variable intra-thoracic obstruction
What is the functional residual capacity?
when the lung and chest wall are at equilibrium
A ______ measures the compliance of the lung.
P-V curve
What is the sum of all the lung volumes called?
total lung capacity (TLC)
What causes a fixed obstruction?
circumferential lesions from tracheal stenosis, prior intubation, circumferential airway neoplasm
Muscle abnormalities can occur due to drugs (such as _____), collagen vascular diseases (______), or paraneoplastic syndromes (_______), among others.
steroid myopathy polymyositis, dermatomyositis Lambert-Eaton myasthenic syndrome
This is TV + IRV; the amount of gas that can be inhaled via max effort.
inspiratory capacity (IC)
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.
restrictive diseases
Diseases that decrease blood in the lung (____, _____) will decrease CO transfer and result in a low diffusing capacity.
- anemia
- pulmonary vascular disease
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).
- diseases of the motor-neuron endplate
- diseases of the neuronal axon
- diseases of the nerve root in the anterior horn of the spinal cord
_____ graphs represent airflow (velocity in L/s) versus lung volume.
Flow volume loops
______ lung volumes are diagnostic of restrictive processes.
Decreased
In a flow volume loop, a ______will have a flattened curve in both inspiration and expiration.
fixed obstruction
Emphysema, an obstructive disease resulting from a loss of elastic recoil, is characterized by a _____ P-V curve.
steep
What is Pe max?
a test of muscle function where the patient attempts to expire as forcefully as possible against an occluded airway (Valsalva maneuver) while at TLC
What diseases or conditions can decrease DLCO?
- emphysema
- pulmonary vascular disease
- interstitial lung disease
- anemia
What is RV?
Residual volume; the volume of gas in the lung even after maximal exhalation- cannot be measured with spirometry
On a flow volume loop curve, ______ will show limited inspiration with normal expiratory flow.
variable extra-thoracic obstruction
On a flow volume loop curve, variable extra-thoracic obstruction will show _____.
limited inspiration with normal expiratory flow
This is inhaled to induce bronchospasm in asthmatics but not normal people.
methacholine
In a flow volume loop and ______ disease, the curve is shifted right to a lower TLC and the maximum airflow is decreased.
restrictive
In a flow volume loop and airflow obstruction, the maximal airflow is ______ due to increased resistance to flow.
reduced
What 3 things affect the DLCO test?
- SA
- membrane thickness
- hemoglobin
This is ERV + TV + IRV; the amount of gas that can be inhaled from the end of a maximum expiration to the maximum inflation .
vital capacity (VC)
Flow volume loops represent ____ vs ____.
airflow (velocity in L/s) versus lung volume
In a flow volume loop in obstructive lung disease, lung volumes are ______ and the curve is shifted to the ____.
increased; left
What is TLC?
Total lung capacity; sum of all volumes in the lung
What is IC?
Inspiratory capacity; TV + IRV; the amount of gas that can be inhaled via max effort
This is the volume of breath that can be further expelled after a normal tidal volume (active)..
Expiratory reserve volume (ERV)
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).
- myasthenia gravis
- botulism
- anti-cholinergic poisoning
- tick paralysis
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.
reduced
What causes variable intra-thoracic obstructions?
non-circumferential tracheal tumor (ball-valve effect)
Gas exchange is decreased if the surface membrane area is?
(A) is decreased (as in emphysema) or if the membrane (d) is thickened (as in some interstitial lung diseases).
A P-V curve measures the ______ of the lung.
compliance
What is a methacholine challenge?
a pt is given methacholine to inhale which induces bronchospasm in asthmatics but not normal people
This is measured while the patient attempts to expire as forcefully as possible against an occluded airway (Valsalva maneuver) while at TLC.
Pe max
The helium dilution test wont be accurate for diseases such as ______.
emphysema, asthma, or chronic bronchitis (air trapping)
In a flow volume loop in ______ lung disease, lung volumes are increased and the curve is shifted to the left.
obstructive
In a flow volume loop and restrictive disease, the curve is shifted ______ to a lower TLC and the maximum airflow is _______.
right; decreased
This is RV + ERV; amount of gas left in the lung after normal expiration; the point at which the respiratory system is in equilibrium.
Functional residual capacity (FRC)
What is ERV?
Expiratory reserve volume; the volume of breath that can be further expelled after a normal tidal volume (active)
In a flow volume loop and ______, the maximal airflow is reduced due to increased resistance to flow.
airflow obstruction
What is VC?
vital capacity; ERV + TV + IRV; the amount of gas that can be inhaled from the end of a maximum expiration to the maximum inflation
What is FEV1?
forced expiratory volume in the first second; normal = 80%
______ can occur due to drugs (steroid myopathy), collagen vascular diseases (polymyositis, dermatomyositis), or paraneoplastic syndromes (Lambert-Eaton myasthenic syndrome), among others.
Muscle abnormalities
