Week 3 - Respiratory Flashcards
Spirometry Values for Restrictive Disorders
FEV - decreased
FVC - decreased
TLC - decreased
Ratio - normal
Spirometry Values for obstructive disorders
FEV - decreased
FVC - normal/decreased
TLC - greater than 120%
Ratio - Decreased
Forced vital capacity (FVC)
Volume of air in teh lungs that can be exhaled (normal is 80-120%)
Forced expiratory volume (FEV)
Amount of air that can be forcefully expired from the lungs in the first second of expiration. Normal level is 80%.
FEV1/FVC Ratio
Determines whether a disease is obstructive, restrictive or normal
Diffusing capacity
The ability for gas exchange in the alveoli. This can be decreased with conditions like emphysema where there is decreased function of alveoli.
Residual volume
Amount of air left in the lungs after forceful exhalation.
Total lung capacity
Residual volume x FVC
Steps to analyze Pulmonary Function tests
- Determine pattern of the condition (obstructive or restrictive)
- Ratio less than 70% –> obstructive
- Ratio greater than 70% –> restrictive. - Determine the severity by looking at FEV1 % predictive
- mild - greater than 70%
- moderate - 60-70%
- moderately severe - 50-60%
- severe - 35-50%
- very sever - less than 35% - Determine whether there is a bronchodilator response
PFT measurements for obstructive disease
FEV - decreased
FVC - decreased/normal
Ratio - less than 70%
TLC - greater than 120%
PFT measurements for restrictive disease
FEV - decreased
FVC - decreased
Ratio - Normal or > 70%
TLC - < 80%
Obstructive pulmonary diseases include:
- asthma
- ephysema
- chronic bronchitis-
Restrictive pulmonary diseases include:
Includes intrinsic and extrinsic lung disorders
Symptoms of obstructive disorders
- reduction in airflow
- SOB with exhalation
- difficulty with expiration
- air trapping in lungs
Types of obstructive disorders
- asthma
- emphysema
- chronic bronchitis
Symptoms of restrictive disorders
- reduction in lung volume
- difficulty on inspiration
- stiffness in lung compliance or chest wall structural abnormality
- pulmonary fibrosis
Types of Intrinsic restrictive disorders
- Interstitial Lung Disease
- Pulmonary fibrosis
- Pneumonia
- Pneumoconioses
- ARDS
- Sarcoidosis
Types of extrinsic restrictive lung disorders
- scoliosis
- obesity
- pleural effusion
- malignant tumors
- rib fractures
Types of extrinsic restrictive lung disorders
- scoliosis
- obesity
- pleural effusion
- malignant tumors
- rib fractures
Drugs associated with medication induced ILD
- methotrexate
- nitrofurantoin
- amiodarone
COPD Gold Staging Guidelines
Gold 1- Mild, FEV1 <, = 80% predicted
Gold 2 - Moderate FEV1 < 80% predicted
Gold 3 - Severe FEV1 < 50% predicted
Gold 4 - Very severe FEV1 < 30% predicted
What is the number one case of chronic bronchitis?
Smoking
Alpha-antitrypsen 1 deficiency
Genetic disorder which prevents the body from turning off the immune response resulting in damage to lungs.
Leads to COPD.
Chronic bronchitis
Disease characterized by inflammation, mucous secretion, chronic productive cough for at least three months in the last 2 years.
Pathophysiology of Chronic bronchitis
- exposure to irritant
- bronchial smooth muscle contraction
- release of inflammatory mediators
- mucus secretion and inflammation
Pathophysiological changes caused by chronic bronchitis
- excess mucus production
- hypertrophy of bronchial smooth muscle
- hypertrophy/hyperplasia of bronchial mucus producing cells
- airflow obstruction
- decreased alveolar ventilation
Extrinsic Asthma
Exposure to allergen produces chronic reaction that increased production of IgE cells and you get a hyperactive immune response which includes construction of smooth muscle, increased mucus secretion, vasodilation producing edema and more antibodies at the area of exposure.
Intrinsic Asthma
Caused by non-allergen stimulus like infection, GERD, obesity, medications (NSAIDS). Has no IgE elevation and usually occurs in adults over 40.
Symptoms of asthma
- chest tightness
- wheezing
- dyspnea
- prolonged expiration
- non-productive cough
- symptomatic morning and night
- tachycardia
-tachypnea
Interstitial Lung Disease
Restrictive lung disorder in which there is damage to the lungs or parenchymal tissue, can cause progressive scarring and fibrosis.
