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The Nervous System & Respiratory Diseases > Pulmonary Function Tests and Treatment Options (L21) > Flashcards

Pulmonary Function Tests and Treatment Options (L21) Flashcards

1
Q

List the ways of testing lung function.

A
  • Spirometry
  • Peak flow meter
  • Pulse oximetry
  • Arterial blood gas analysis
  • Flow volume loops
  • Gas transfer (KCO) and transfer factor
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2
Q

What does Spirometry measure?

A

Lung volume, forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC).

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3
Q

What does a Peak flow meter measure?

A

Peak expiratory flow rate (PEFR).

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4
Q

What does Pulse oximetry measure?

A

Non invasive assessment of peripheral O2 saturation.

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5
Q

What does Arterial blood gas analysis measure?

A

pH, PaO2 and PaCO2.

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6
Q

What do Flow Volume loops measure?

A

Flow rates (expiration and inspiration and various lung volumes).

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7
Q

What does Gas transfer (KCO) and transfer factor measure?

A

Carbon monoxide uptake from a single inspiration.

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8
Q

Define Tidal volume.

State the average (ml).

A

Volume of gas inspired or expired during normal breath.

500 ml.

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9
Q

Define Inspiratory Reserve volume (IRV).

State the average (ml).

A

Volume of air that can be added to the TV during deepest possible inspiration.

3000 ml.

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10
Q

Define Expiratory Reserve volume (ERV).

State the average (ml).

A

The volume of air that can be moved out of lungs following the end of the maximum expiration.

1100 ml.

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11
Q

Define Residual volume (RV).

State the average (ml).

A

A maximum expiration does not completely empty the lungs. The RV is the volume of air left after maximal expiration.

1200 ml.

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12
Q

True or false? Residual volume (RV) can be measured directly.

A

False. Can not be measured directly. Measured indirectly through gas diffusion techniques involving inspiration of a known amount of harmless tracer gas.

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13
Q

Define Inspiratory Capacity (IC).

State the average (ml).

A

The maximum amount of air that can be inspired after a normal expiration (IRV + TV).

3500 ml.

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14
Q

Define Functional Residual Capacity (FRC).

State the average (ml).

A

The volume of air in the lungs at the end of a normal passive expiration.

2300 ml.

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15
Q

Define Total Lung Capacity (TLC).

State the average (ml).

A

Maximum amount of air that the lungs can hold (IRV+TV+ERV+RV).

5800 ml.

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16
Q

Define Vital Capacity (TLC)

State the average (ml).

A

The maximum amount of air that can be moved into and out of the lungs in a single breath (IRV+TV+ERV).

4600ml.

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17
Q

Using the lung equations/symbols, describe the lung volumes in obstructive lung diseases.

A
  • Patients with obstructive lung disease experience difficulty emptying lungs
  • TLC is normal
  • FRC and RV elevated due to air trapped in lungs
  • As RV increases VC decreases
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18
Q

Using the lung equations/symbols, describe the lung volumes in restrictive lung diseases.

A
  • The lungs are less compliant
  • TLC, IC and VC are down as lungs can not expand as normal
  • RV is normal
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19
Q

Define FEV1.

A

The forced expiratory volume in one second. It reflects airway narrowing and is relatively independent of effort.

20
Q

Define FVC.

A

The forced vital capacity.

21
Q

True or false? Normally FEV1 = 80%-90% of the FVC.

A

False. Normally FEV1 = 70%-80% of the FVC.

22
Q

True or false? FEV1 and FVC are used to differentiate between obstructive and restrictive patterns of disease.

A

True.

23
Q

In Obstructive lung disease what happens to FEV1 and FEVC.

How can this be used to determine whether the disease is restrictive or obstructive?

A
  • FEV1 is reduced
  • FEVC is reduced to a lesser extent
  • Therefore the ratio changes which means the disease is obstructive
24
Q

In Restrictive lung disease what happens to FEV1 and FEVC.

How can this be used to determine whether the disease is restrictive or obstructive?

A
  • FEV1 and FVC decrease to same extent

- Therefore the ratios remain the same which means the disease is restrictive

25
Q

Define Peak flow.

A

A measure of the air expired from the large upper airways (trachea-bronchi).

26
Q

True or false? The FEF25-75 is the first parameter that will decline in many respiratory diseases.

A

True.

27
Q

Define Peak Expiratory Flow rate.

Units?

A

The highest air flow achieved at the mouth during a forced expiration (measure of how fast you can blow air out of your lungs).

Litres/min.

28
Q

The Peak Flow meter is usually used to monitor diseases such as asthma to see if there is a worsening of disease.

Describe the prognosis of:
> 80% expected?

> 50% expected

A
  • Condition is OK
  • Some, medication needed, monitor
  • Immediate medical care
29
Q

Pulse oximetry allows a non-invasive assessment of peripheral O2 saturation of ___1___.

It provides a useful tool for monitoring those who are acutely ill or are in danger of deteriorating.

The pulse oximeter consists of a ___2___ attached to the patients ___3___ or ear lobe which is linked to a computer.

The unit displays the percentage of ___1___ saturated with oxygen together with an audible signal.

A
  1. Haemoglobin
  2. Probe
  3. Finger
30
Q

On most pulse oximeters the alarm is set at __%.

A SaO2 < __% is abnormal and action is required.

A

90.

31
Q

Describe Arterial Blood Gas Analysis.

A

Heparinised blood is drawn anaerobically from a peripheral artery (radial, brachial, femoral, or dorsalis pedis) and pH PaO2 and PaCO2 are measured using an automatic analyser.

32
Q

State the normal pH range of blood.

pH < 7.35 =

pH > 7.45 =

A
  • 7.35-7.45
  • Acidosis
  • Alkalosis
33
Q

What is the potential cause of acidosis.

A

Any respiratory failure.

34
Q

List the potential causes of alkalosis.

A
  • Hyperventilation
  • Stroke
  • Meningitis
  • Anxiety
  • Altitude,
  • Fever
  • Pregnancy
35
Q

What is the normal PaO2 range? (units)

A

10.5 – 13.5 kPa (38 -105 mm Hg).

36
Q

List the causes of Hypoxia.

A
  • Ventilation/perfusion mismatch
  • Hypoventilation
  • Abnormal diffusion
  • Right to left cardiac shunt (opening between atria and ventricles, right heart pressure is higher than left heart pressure)
37
Q

Define Respiratory failure in terms of PaO2.

A

PaO2 < 8 kPa.

38
Q

What is the normal PaCO2 range? (units)

A

4.5 – 6.5 kPa (35-50 mm Hg).

39
Q

A PaCO2 < 4.5 kPa (35 mmHg) indicates what?

A

Hyperventilation.

40
Q

A PaCO2 > 6.5 kPa (50 mm Hg) indicates what?

A

Hypoventilation.

41
Q

Type __ respiratory Failure is defined as PaO2 < 8kPa and PaCO2 < 6.5 kPa.

A

1.

42
Q

Type __ respiratory failure is defined as PaO2 < 8 kPa and PaCO2 > 6.5 kPa.

A

2.

43
Q

What does the Diffusing Capacity for carbon monoxide (DLco) measure?

A

The ability of gas to transfer from alveoli to RBCs across the alveolar epithelium and the capillary endothelium.

44
Q

How is DLco measured?

A

By measuring the partial pressure of carbon monoxide (CO) after a patient inspires a small amount of CO, holds his breath, and exhales.

45
Q

List factors that reduce DLco.

Give examples.

A
  • Conditions that primarily affect the pulmonary vasculature (pulmonary embolism).
  • Hindrance in the alveolar wall (fibrosis, alveolitis).
  • Decrease in total lung area (emphysema).
  • Haemoglobin decrease in blood.
46
Q

Fibre-optic ___1___ is performed under local anaesthetic via the nose or ___2___. Fibre-optic ___1___ is used to view the lungs. Biopsies and bronchoalveolar lavage may also be carried out with the bronchoscope.

A
  1. Bronchoscopy

2. Mouth

47
Q

How is Bronchoalveolar lavage performed?

A

By instilling and aspirating a known volume of warmed buffered 0.9% saline into the airway.

The Nervous System & Respiratory Diseases (15 decks)

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