Small groups Flashcards
What decreases the thoracic gas volume (TGV)?
TGV = point when inward lung recoil is exactly balanced by outward chest wall recoil
anything that makes lung stiffer (ILF, loss of surfactant) w/o changing chest wall compliance = ↓ TGV
What Increases the thoracic gas volume (TGV)?
TGV = point when inward lung recoil is exactly balanced by outward chest wall recoil
anything that increases lung compliance (emphysema) will ↑ TGV
TGV and ____ are essentially the same thing but measured differently
- what variables determine them?
FRC
they should be the same in normal people - no effort required
They are based off of:
lung compliance and chest wall compliance
Diffusing capacity is determined by what variables?
- alveolar surface area
- thickness of alveolar-cap membrane
- presence of passing hb to which CO binds
Diffusing capacity: diff btwn amt of CO inhaled and exhaled in 10 seconds
What does increased TGV indicate about respiratory sys?
- Either lung compliance curve ↑ed
- Compliance curve of the chest wall has ↑ed
(less pressure is required to effect given change in vol - ie: ephysema - permanent, asthma - acute)
List some general obstructive lung diseases
- asthma
- chronic bronchitis
- emphysema
- bronchiectasis
- bronchiolitis
Purulent vs nonpurulent sputum production
purulent: bronchiectasis (buckets of smelly)
Non purulent: chronic bronchitis
What might lead to ILD?
abestoes
coal mining
birds
What would DLCO be in restrictive diseases?
Decreased in ILD
normal in others
On an expiratory flow volume loop, what direction is obstructive and restrictive shifted?
obstructive to Left
Restrictive to Right (RR)
If PFTs are normal, but DLCO is low, what is on your differential?
Pulmonary vascular disease
- chronic pulmonary emboli
- primary pulmonary htn
- scleroderma
- collagen vascular disease
- congenital heart disease
- anorectic drug induced pulm HTN
- HIV infxn
- Severe anemia
A reduction in passing hemoglobin can occur if either severe anemia is present or if the blood vessels perfusing alveoli have been blocked or destroyed
What can fen fen give you?
Pulmonary HTN
In a person with bronchiectasis, PFTs would likely reveal what?
airflow obstruction and hyperinflation
(in x ray: tram tracking) bad bc airways shouldn’t be that easy to see (bronchiectasis) - Airway shouldn’t be bigger than the vessels next to it
If pt has emphysema due to a-1-antitrypsin deficiency, what treatment would you give them?
std care for COPD: oxygen therapy
recombinant enzyme infusion if pt is homozygous
Prolastin (help slow down decline, but not cure)
Lung transplant
If an infant survives respiratory distress syndrome (RDS), what impaired lung development can result?
bronchopulmonary dysplasia: persistent need for O2 therapy
- pulmonary infiltrates
- grow out of it, or restrictive w/ gas xchange abnormalities
- kids can and do die of BPD!
