Respiratory Assessment Flashcards
What is the purpose of resting spirometry?
To measure volume and speed of air, and identify breathing difficulties at rest
What is the significance of the comparison between male and female lung sizes?
Males generally have larger lungs than females, which can affect predicted values.
What does the term “dynamic ventilation” refer to in respiratory assessment?
It refers to the measurement of flows and volumes during breathing, indicating how well the lungs are working
What do the terms PEFR and MEFR refer to, and why are they important?
They stand for Peak Expiratory Flow Rate and Maximum Expiratory Flow Rate respectively, which are measures of how quickly air can be exhaled. They are important in assessing the expiratory ability.
What do FEF25, FEF50, and FEF75 measure, and what does their evaluation tell us?
These measure the Forced Expiratory Flow at 25%, 50%, and 75% of the forced vital capacity. They assess small airway resistance
Explain the concept of “effort independent” in the context of small airway resistance.
This concept suggests that past a certain point, the speed of air coming out cannot be significantly increased no matter how hard the person tries. This is due to the multiple branches and resistance in the airway structure
What two measurements are central to the resting forced vital capacity test?
FVC (Forced Vital Capacity) and FEV1 (Forced Expiratory Volume in one second)
What is the FEV1/FVC ratio, and what does it indicate?
It is a measure of expiratory ability and overall resistance to expiration. It is expressed as a percentage
What is a healthy FEV1/FVC ratio?
A healthy individual should be able to exhale 70% or more of their air in one second
How should a participant perform the maximal exhalation in an FVC test?
They should exhale as forcefully as possible and for as long as possible
What are the end-of-test criteria for a spirometry test?
The test ends when the participant can no longer exhale or when there is a plateau in exhaled flow (less than 0.025 L/s)
Why is it necessary to perform the FVC test multiple times?
The test should be repeated at least 3 times to ensure the results are consistent and accurate. The two best performances should be within 150 mL
What does it mean when a measured spirometry value exceeds or is within 10% of the predicted value?
This is considered a normal result
What is the purpose of an exercise spirometry test?
To investigate breathing difficulties during or following exercise
Describe the exercise test protocol for exercise spirometery
A single stage exercise test of 6-8 minutes at 80-90% of HR max, followed by post-exercise FVC tests at 5, 10, 15, and 20 minutes.
What is the Eucapnic Voluntary Hyperventilation Test designed to assess?
It is used to assess breathing difficulties, especially in athletes, by mimicking an exercise challenge.
What is the protocol for the hyperventilation in the Eucapnic test?
6 minutes of hyperventilation using air + 5% CO2, with tidal volume fixed at 85% of TLC or FEV1 and a breathing rate of 30 bpm, followed by post-exercise FVC tests
What level of drop in FEV1 indicates Exercise-Induced Bronchoconstriction (EIB)?
A drop of ≥10% from the pre-exercise value.
What are some of the factors that can induce EIB?
Exercise, heavy breathing, cold dry air, and “bad air”.
What level of reduction in FEV1 suggests Exercise Induced Asthma (EIA)?
A reduction of ≥15% or more
In which athletic populations is EIA/EIB more common?
Athletes in winter sports and aquatic sports
What is COPD, and what does it refer to?
Chronic Obstructive Pulmonary Disease. It refers to a group of lung diseases that obstruct airflow
What is the term “Pink Puffer” associated with, and what are its main characteristics?
Emphysema, which involves stiffening and damage to the alveoli over time
What is a common cause of emphysema?
smoking and vaping
What is the term “Blue Bloater” associated with, and what are its main characteristics?
Chronic Bronchitis, which involves chronic inflammation of the lungs.
Describe the pathophysiology of COPD in terms of lung tissue.
COPD involves breakdown and loss of lung tissue/structure, narrowing and compression of small airways, and airway obstruction (mucus)
What is a key functional result of the pathophysiology of COPD?
Elevated resistance to airflow, particularly during exhalation.
Explain “air trapping” or “hyperinflation” in the context of COPD.
People with COPD tend to have bigger lungs and have a hard time getting air out. This leads to air being trapped in the lungs
What does a flattened flow-volume loop generally indicate?
Increased resistance in the airway
What does a flow-volume loop that is squashed at the bottom typically indicate?
An obstruction that is limiting flow.
What is tidal volume (TV)?
volume of inspired and expired air per breath
what is the inspiratory reserve volume (IRV)
maximum inspiration at the end of normal tidal inspiration
What is the expiratory reserve volume (ERV)
maximum expiration at the end of tidal expiration?
What is total lung capacity?
the volume in the lungs after maximum inspiration
What is residual lung volume (RLV)
the volume in teh lungs afer maximum expiration
What is forced vital capacity (FVC)?
The maximum volume expired after maximum inspiration
What is the Inspiratory Capacity (IC)?
Maximum volume inspired followiing tidal expiration
What is the functional residual capacity (FRC)?
Volume in lungs after tidal expiration
Lung volumes
