week 7 Flashcards
Whats the purpose of pulmonary function tests?
to look for the presence of lung disease and diagnosis
To grade the severity of a respiratory disorder and show the progress or response to medical treatment
to monitor disease progression over time
to assess risk
to differentiate between different pathologies
to elevate the response to treatment such as bronchodilators/steroids
What is the most common PFT?
spirometry
What does spirometry show?
abnormalities in lung function, but is not disease specific
What is static lung volume?
how much air the lungs can hold
What is dynamic lung volumes?
the flow of air through the airways
how fast that volume of air can be moved
What are some contraindications for spirometry?
pneumothorax
haemoptysis of unknow origin
aneurysm
recent myocardial infarction or unstable angina
CVS instability
Cerebral instability
recent surgery
recent chest infection
if the patient is too unwell to perform forced expiration
What is the spirometry procedure?
sit upright, wearing comfortable loose fitting clothes
after a relaxed breath out, take a maximal breath in
seal your lips around the mouthpiece and blow out as fast and completely as possible
What does an acceptable spirogram demonstrate?
quick and forceful exhalation
no coughing
smooth lines on graph
minimum exhalation time of 6 seconds with no change in volume in last second
Define total lung capacity
the amount of gas the lungs contain after a maximal inspiratory effort when a person breathes in fully
What is the tidal volume?
volume of air normally inhaled or exhaled with each breath during resting, quiet breathing
What is the expiratory reserve volume?
Volume of air that can be exhaled with a maximal effort after a normal resisting expiratory breath
What is residual volume?
volume of air remaining in the lung after a maximal-effort expiration
What inspiratory reserve volume?
The extra volume of air that can be inhaled with maximal effort after a normal resting inspiratory breath
What is the equation for inspiratory capacity?
IC = TV + IRV
What is inspiratory capacity?
volume of air that can be inhaled with a maximal effort from a resting end expiratory level
What is the equation for functional residual capacity?
FRC = RV + ERV
What is functional residual capacity?
volume of gas remaining in the lungs at the end of a normal tidal exhalation
What is the equation of vital capacity?
VC = IRV + TV + ERV
What is vital capacity?
volume from maximal inspiration to maximal expiration
Name some factors influencing airway resistance?
types of airflow
lung volume
elastic recoil
bronchial smooth muscle tone
airway obstructions
What is forced vital capacity?
the volume expired forcefully (following a maximal inspiration), until residual volume is reached
What is forced expiratory volume in one second?
The volume of air a subject can exhale in the first second of a maximal breath out, following a maximal inspiration. This should be approximately 3/4 of the FVC
What does the FEV1/FVC ratio look at?
the amount expelled within the first second compared with the overall volume acheived
When is FVC considered normal?
the result is considered normal if the score is 80% or more
Name some causes of reduced FVC
decreased expansion
decreased inspiration muscle strength
obesity
decreased expiration muscle strength
increased airway resistance
Name some characteristics of obstructive diseases
limitation of airflow due to partial or complete obstruction
Give some examples of obstructive pathologies
emphysema
chronic bronchitis
bronchiectasis
asthma
What is the TLC, FVC, FEV1?
TLC = normal
FVC = normal or decreased if manoeuvre causes airway collapse
FEV1 = decreased
What are the characteristics of restrictive diseases?
reduced expansion of lung parenchyma accompanied by decreased total lung capacity
Give some examples of restrictive pathologies
interstitial lung disease
idiopathic pulmonary fibrosis
pneumoconiosis
sarcoidosis
chest wall neuromuscular disease
What is the TLC, FVC and FEV1 of restrictive pathologies?
TLC = decreased
FVC = reduced
FEV1 = normal or reduced
What population group does shortness of breath on exertion effect?
heart failure patients
COPD patients
Interstitial lung disease
What is heart failure?
the pumping ability of the heart has reduced and cant keep up with the workload
blood and oxygen may not be circulated around the body as efficiently
What can chronic and progressive heart failure be managed by?
medications and lifestyle adapatations
How does the heart try to make up for heart failure?
enlarging
developing more muscle mass
pumping faster
How does the body try to compensate for heart failure?
blood vessels narrow
The body diverts blood away from less important tissues and organs
Name some heart failure symptoms
shortness of breath
persistent coughing or wheezing
build up of excess fluid in body tissues
tiredness and fatigue
lack of appetite/nausea
confusion and impaired thinking
increased HR/palpitations
Why do COPD patients become breathless?
COPD is an obstructive condition, bronchioles become inflamed
Muscle spasm within the airways, narrowing the area for air to flow
excessive mucus production - lining the airways
emphysema - break down of the elasticity in the alveoli
What type of disease is interstitial lung disease?
restrictive condition
What does interstitial lung diseases include?
includes various condition including idiopathic pulmonary fibrosis, sarcoidosis
What does interstitial lung disease involve?
fibrosing, scarring and thickening of the lung tissue
Why do you exercise?
increase exercise tolerance
improves muscle strength
reduces breathlessness and fatigue
benefits on quality of life
other general benefits
What is the exclusion criteria for pulmonary rehab?
unstable angina
unstable diabetes
acute LVF
uncontrolled BP
uncontrolled arrhythmias
history of MI or cardiac surgery in 6 weeks leading up to start of PR
mobility limited by musculoskeletal or neurological condition
cognitive problems
compliance issues (motivation)
aortic aneurysm
What does exercise in pulmonary rehabilitation involve?
warm up
aerobic programme
strength training programme
cool down
Name some health related quality of life tools
chronic respiratory disease questionnaire
COPD assessment tool
Hospital anxiety and depression scale
