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RTH 217 > Pulmonary Gas Distribution > Flashcards

Pulmonary Gas Distribution Flashcards

1
Q

What does a single breath N2 elimination test (SB N2) measure?

A
  • evenness of distribution of inspired gases

- closing volume/closing capacity

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2
Q

What does phase I of closing volume/closing capacity represent?

A

deadspace (100% O2, no N2)

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3
Q

What does phase II of closing volume/closing capacity represent?

A

combination of deadspace and alveolar gases (N2 gases begin to increase)

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4
Q

What does phase III of closing volume/closing capacity represent?

A

alveolar gas

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5
Q

How is the evenness of gas distribution in phase III shown on the closing volume/closing capacity?

A
  • mid-portion of the test is flat

- poor distribution slants up more

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6
Q

What is phase IV of the closing volume/closing capacity?

A
  • shows a sudden rise in the N2%
  • called the closing volume (airway closure)
  • airway closure of dependent regions
  • reason compression of lower airways
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7
Q

What is the closing capacity?

A

the adding of the closing volume to the RV

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8
Q

What other tests measure the distribution of gases?

A

ventilation scans

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9
Q

How is the closing volume affected with obstructive disease?

A
  • closing volume is elevated

- slow of phase III is increased

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10
Q

What does DLCO stand for?

A

carbon monoxide diffusion capacity

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11
Q

What does DLCO measure?

A
  • all the factors that affect the diffusion of a gas across the A-C membrane
  • measured in ml/min/mmHg
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12
Q

What is normal DLCO?

A

25 mL/min/mmHg

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13
Q

What factors affect DLCO?

A
  • Hb, Hct
  • body position
  • breath holding time
  • lung volume
  • smoking
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14
Q

What does an increase in eosinophils cause?

A

increase in inflammation

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15
Q

What does decreased DLCO occur in?

A
  • pulmonary fibrosis
  • sarcoidosis
  • ARDS
  • edema
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16
Q

What does increased DLCO occur in?

A
  • exercise
  • asthma
  • obesity
  • polycythemia
  • intralveolar hemorrhage, L to R intracardiac shunts
17
Q

In corrected alveolar volume, a pure reduction in DLCO can represent ___

A

small lungs

18
Q

Why should you compare decreased DLCO to alveolar volume?

A

to evaluate alveolar-capillary membrane abnormalities

19
Q

What are the first three patient performance standards (ATS)?

A
  • all patients should be carefully instructed on the procedure
  • the therapist should demonstrate the procedure to the patient
  • a minimum of three (3) acceptable procedures should be recorded
20
Q

What are the last four patient performance standards (ATS)?

A
  • no false starts
  • test should not differ by more than 5%
  • “best test” should be determined and recorded
  • “best test” = highest FVC and FEV1
21
Q

What are the measurement principles?

A
  • specificity
  • sensitivity
  • validity
  • reliability
22
Q

What does specificity mean?

A

how we known it is valid. ratio of true negative results to the patient’s results

23
Q

What does sensitivity mean?

A

ratio of true positive results to the patient’s results

24
Q

What are the steps of infection control?

A
  • standard precautions
  • clean mouthpiece, tubing
  • low resistance bacteria filter
  • handwashing
  • do not have to routinely clean interior
25
Q

What causes obstruction?

A
  • bronchoconstriction
  • excessive secretions
  • mucosal swelling
  • tumors
  • bronchiole collapse
26
Q

How are obstructions characterized?

A
  • increased Raw

- decreased flow

27
Q

What obstructive diseases lead to decreased flows?

A
  • cystic fibrosis
  • bronchitis
  • asthma
  • bronchiectasis
  • emphysema
28
Q

How are restrictions characterized?

A
  • decreased compliance

- decreased thoracic compliance

29
Q

What is compliance?

A

change in volume per change in pressure

30
Q

With restrictive diseases, there is a ___ relationship between volume and compliance

A

direct (decreased volume = decreased compliance)

31
Q

What restrictive diseases cause decreased volumes?

A
  • inflammatory diseases
  • cardiac disease
  • neurological/neuromuscular diseases
  • pleural disease
  • thoracic deformities
  • post-surgical patients
  • fibrotic diseases

RTH 217 (6 decks)

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