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Adv DX Test 2.2
WilliamWall Adv DX chapt 8 and 9 Test 2
| Question | Answer |
|---|---|
| what are lung volumes | distinc measurements that do not overlap each other |
| what are lung capacities | measurements containing two or more lung volumes |
| what volumes and capacities cannot be measured directly | RV, FRC and TLC |
| how do we measure RV, FRC and TLC | indirectly using helium dilution, nitrogen washout, body plethysmograph or radiologic estimation |
| TLC | total lung capacity, sum of VC and RV, based on age size and gender, increased w/obstructive and decreased with restrictive |
| VC | vital capacity, max exhaled volume after a deep breath (if forced it is called FVC, reflects pt ability to take a deep breath, cough and clear secretions |
| what is the most important part of the FVC | coaching, bad coaching is bad results |
| the 3 phases of the FRC are | 1(max inspiratory effort, 2)initial expiratory blast, 3)forceful emptying of the lungs |
| why do we not continue coaching and yelling during the forceful emptying portion of the FRC | may lead to airtrapping in obstructive pts |
| can a VC be to high? | no, the higher the better, just to low |
| how does obstructive disease cause a decrease in FVC | by causing a slow rise in the RV |
| IC | inspiratory capacity, measured with spirometer |
| FRC | functional residual capacity, (RV+ERV is FRC) resting volume in lungs following exhalation of VT |
| what volume represents the the force of the expanding chest wall and the contractile rebound of the lung tissue(elastic equilibrium) | FRC |
| what kinds of diseases cause a <FRC | pneumothorax, restrictive diseases, age, obesity (shrinks lung) |
| what kinds of diseases cause an >FRC | emphysema, any disease that causes a loss of lung tissue, obstruction |
| IRV | inspiratory reserve volume, measured with routine spirometer |
| VT | tidal volume, exhaled or inhaled in each breath, can be reduced in both restrictive or obstr (quiet breathing) |
| a decrease in VT with no change in RR will result in what | hypoventilation and >CO2 |
| What is the normal RR for a pt with restrictive disease | increased, because VT's are shallow, RR must be increased proportional to loss of VT |
| SVC | slow vital capacity, test performed by having pt blow everything out slowly after max inspiration, allows for less airtrapping |
| what is the most important measurement for a preop pt | VC, significant reduction in VC indicates pt is at high risk for resp failure after surgery (<20 mL/kg) |
| ERV | expiratory reserve volume, (FRC-RV is ERV) max exhaled following passive exhalation, < obesity, poor performance and restrictive (limited clinical use) |
| RV | residual volume, amount left in lung after pt exhales all that is physically possible, < in restrictive and >in obstructive as airtrapping occurs |
| RV/TLC, what percent of TLC is normally RV | 25% |
| RV/VC, what percent of VC is normally RV | 33%, >33% COPD is present |
| What is the significance of a reduced RV/VC | none, there are no clinical states that reduce RV/VC only increase as with COPD (will be in normal range with restrictive disease state) |
| VE | RRxVT, best index of ventilation when used in conjunction with ABG. Should be up with exercise, fever, pain, hypoxia and acidosis (regardless of acidosis cause) |
| What does the expiratory side of the FVC curve provide | contractile state of the airways, FEV1, FEV3, FEF25-75, PEF (peak flow) |
| FEVt | forced expiratory volume timed in liters (t is commonly expressed in .5, 1, 2, 3 seconds) norm is relative to his FVC |
| FEV1 | max forced exhalation during 1st second, best indicator of obstructive disease, reflects the flow in larger airways, best express as a % of FVC (FEV1/FVC is FEV1%), norm is 75% of VC, <in acute or chronic COPD, norm in restrictive |
| FEV3 | looks at the 3 second point on the curve. |
| FEV.5 and FEV1 | used along with FEV200-1200 to assess the flow rates and disorders of the large airways, will be < with airway obstruction |
| FEV% | FEVT/FVC reduced with obstructive disorders |
| FEV1% | 75-85% <65% is is airway obstruction |
| FEV3% | 95% |
| FEF25-75% | sensitivity test expressed in L/sec (measures flow or speed of exhalation), middle 50% of the exhalation (not 50% point but total 50%) and reflects patency of airways, best early indicator of obstructive disease |
| PEF | max flow rate during PFT maneuver, steepest part of FVC, can be measured with spirogram or hand-held device at home or ER. Often used by asthmatics to measure severity of asthma obstruction |
| PEF measurements | <100 L/min is sever obstruction, 100-200 L/min is mod to severe obstruction, >200 is mild |
| Once treatment has been started in an asthma pt, what test can be given to help determine response to TX | PEF |
| spirometer | positive displacement-volume, used to measure volumes and flow rates |
| water-seal spirometer | measures volume and time |
| what is the best indicator of a restrictive disease? | Vital Capacity |
| how do we measure obstructive diseases | flow rates, FEV1, FEF200-1200, FEF25-75, PERF and FVC |
| what is the best indicator of obstructive disease | FEV1 |
| what is the best indicator of large airway obstruction | FEF200-1200 |
| what is the best indicator of a small airway obstruction | FEF 25-75 |
| what is the best indicator of airtrapping | FVC that is smaller than SVC |
| what is a PFT | determines the functional status of the lungs |
| what can PFT's be used for | presence of pulm disease, esp which pts will be harmed by smoking, evaluating pts before surgery, eval effectiveness of therapy, documenting progression of pulm disease, effects of exercise on lung function, measures degree of airway hyper-responsiveness |
| what is bronchoprovocation testing | PFT that measures degree of airway hyper-responsiveness |
| contraindications of PFT's | recent ab, thoracic or eye surgery, hemodynamic instability, symptoms indication acute sever illness, recent hypoptysis, pneumothorax, recent hx of ab thoracic or cerebral aneurysm |
| what tis the most important factor influencing lung size and predicted values | height |
| at what age does a persons lung size begin to shrink | 20yrs |
| what is the primary instrument used in PFT's | spirometer |
| what does a spirometer measure | the lung volume compartments that exchange gas with the atmosphere |
| spirograph | attaches to spirometer to graphically record PFT's |
| spirogram | the graphic tracing of the PFT |
| body plethysmograph | for total lung capacity and airway resistance studies |
| what are the 2 main categories of PFT abnormalities | obstructive and restrictive defects |
| how do obstructive disease present on PFT's | if expiratory flow is below normal |
| how do restrictive diseases present on PFT's | if lung volume is reduced |
| Upper airway obstruction will show up where on PFT | reduced flow rate in initial 25% of FEC (small airways in late portion) |
| what portion of the flow/volume curve is effort Dependant | the first 1/3 |
| what portion of the flow/volume curve is effort independent | the later 2/3 |
| a restrictive disease is present when PFT | lung volumes are reduced to less than 80% of predicted levels in spirogram or body plethsymograph |
| what are the two most common causes of restrictive disease | atelectasis and obesity (also seen in chest wall dysfunction, neuro diaphragm disf, absent lung tissue and interstitial lung disease) |
| what are two examples of combined obstructive/restrictive disease | sarcoidosis (<volumes limit airflow) and emphysema (>volumes restricts inspiratory airflow) |
| sarcoidosis | unknown cause characterized by deposition of cicronodules called noncaseating granulomas throughout the body and lungs |
| what is the easiest way to distinguish between obstructive and restrictive diseases on a PFT | obstructive causes reduced expiratory flows, restrictive causes reduced lung volumes |
| 3 ways to measure TLC | body plethysmograph (body box), open-circuit nitrogen washout, or closed-circuit helium dilution |
| why is body box more accurate | it measures communicating and non-communicating/poor communicating spaces (volumes) |
| what are non communicating or poor communicating lung volumes | airtrapping (COPD, Asthma) or pneumothorax |
| (open-circuit) nitrogen washout | air in lungs is 79% nitrogen just like atmosphere, pt breaths 100% O2 for approx 7 mins, nitrogen is measured during exhalation for volume measurements |
| (closed-circuit) helium dilution | pt breaths helium for 7 minutes, when equilibrium is reached, helium is measured and lung volumes are calculated |
| why is helium used as a measuring gas | helium is an inert gas so not significantly absorbed |
| what PFT equipment uses an open-circuit system | nitrogen washout |
| what PFT equipment uses a closed-circuit system | helium dilution |
| what is the most accurate determination of gas volumes in the chest | plethsmograph/body box |
| MVV | max vol vent, pt breaths as rapid/full as possible for 12-15 sec, total exhaled obtained, test is repeated 4 or 5 times and multiplied to get a max vol for 1 minute (15x4 is 60), status of resp muscles, compl and resist, used prior to surg, NOT USED MUCH |
| Flow volume loops (FLOOP) | flow and volume on a graph paper, V is horizontal, F is vertical, Inspiration is below horizontal, expiratory is above |
| how are FLOOPs used to show if response to medications | two flow volume curves superimposed on each other, one before bronchodilator and one after |
| FLOOPs are best used to look for patterns in what diseases | restrictive (<volume), large airway obstruction (<flow, norm volume), severe COPD (hockey stick or boot) |
| PFT's before and after bronchodilator | 2 of 3 must improve, FVC >10%, FEV1 15%, or FEV25-75 20-30%, best in asthmatics, misleading in COPD |
| DLCO | diffusion capacity of the lungs, <with emphysema and pulm fibrosis |
| RAW | normal w/out ETT tube .5-3.0 cmH2O/L/sec, as airways narrow, pressure of resistance increases |
| compliance | volume change per unit of pressure change, measured with balloon catheter |
| Dynamic compliance | measured when gas is flowing |
| static compliance | measured with no flow of gas |
| Total CL | lung tissue compliance + chest wall compliance, <CL as lungs become stiff, the more non-compliant the more stiff, |
| what is a flat top of the curve represent on a floop | stiff lungs-<CL, (less volume, more pressure) |
| what does a round top of the curve represent on the floop | emphysema, <elastance (more volume and less press) |
| RQ | respiratory quotient, norm is .8-.85, ratio of CO2 produced to O2 consumed. Fatty diet RQ is .7 and RQ is 1 for carbs, best used during weaning to adjust pt diet and <WOB |
| Bronchoprovocation | pt inhales histamine or methacholine, cold air and exercise, used to test pt for hyperactive airways |
| methacholine challenge | parasympathomimetic used to induce bronchospasm |
| most useful PFT tests as seen in table 8-1 | 1-VC, 2-FEV1 and FEV1%, 3-TLC, FRC, RV, RR, VE, FEV3, FEV25-75, DLCO, RAW and CL |
| Do PFT's measure the ability of the lungs to exchange resp gases | no, DLCO does and it is done in a closed circuit helium test with carbon monoxide |
| which of the following is least use PFT-A)documenting disease progression B) eval probability of getting a pulm disease C) exercise eval D) weaning from mech ventilation | B |
| The tracing obtained from a PFT is called | spirogram |
| which is the most important factor in predicting PFT measurement age, weight, height, gender | height |
| PFT's are effort dependent T/F | True |
| What piece of equip is used to measure TLC and RAW | body plethysmography |
| which of the following are consistent with obstructive disease? > exp flows, <exp flows, <vol and flows, or >volumes and flows | <exp flow |
| an obstruction in the upper airway will affect which portion of the spirometric tracing | the initial |
| which is true regarding restrictive disease-<volumes on PFT, can be caused by obesity, exp flow are usually normal | all |
| what PFT is useful in determining the need for mech ventilation | FVC |
| Air (low density) | Black (radiolucent), passes threw body and allows for more penetration |
| Water | Water densities result in less exposure and therefore whitish-gray shadows on film |
| Bone (high density) | includes ribs, clavicles,scapulae, and vertebrae. White, calcium (radiopaque) allows for less penetration |
| Fat | Shades of gray |
| Heart, diaphragm, & major vessels | considered to have the density of water. Do not change in density but may change in size, shape, & position. |
| Lung consolidation | Increase in density because of pneumonias, tumor, or collapse, that area will absorb more x-ray and appear as a white patch on the film. |
| Cavities and Blebs | Decrease lung density absorb fewer x-ray and result in darker areas on film |
| Distance from film | Important to conceder, the closer the the patient is to the source, the greater the magnification and distortion of objects seen. |
| Indications for X-Ray | Assist DX of lung pathology, determine appropriate TX, evaluating effective TX, track progress of lung disease, determine position of tubes and lines |
| Posterioanterior PA view | into the Posterior threw to the Anterior |
| Lateral | Side view (generally left) provides cardiac magnification and a sharper view of LLL. looks behind the heart |
| Lateral decubitus view (effusion down-Pneumo up) | Pt laying on the right or left side to see whether free fluid (plural effusion or blood) is present in the chest. Can help w pneumothorax (air rises and fluid drops) |
| Apical lordotic view | Projection is made at a 45 degree tube angulation. Sometimes required for closer look at the RML or apices's of the lung. |
| Oblique views | helpful in delineating a pulm or mediastinal lesion from structures that override it on the PA & lateral views. pt at 45 degree angle, plate is anterior |
| Pneumothorax | The only time you do an expiatory film. |
| AP | Film cassette placed behind pt back, chest x-ray passes from front (anterior) to back (posterior). Used for bedside x-ray's. |
| Post procedural x-ray evaluation | ETT (radiopaque strip 2 in Above Carina), central (R or L subclavian or jugular vein, rest in sup vena cavae & R Atrium), swanz (check position on a daily basis in the pulm artery), picc, NG (stomach, small bowel), chest tube (tip of tube posterior |
| Procedures requiring AP film | Thoracentesis, Pericardiocentesis, Bronch |
| CT scan | Computed enhancement of x-ray shadows to give clearer look @ internal anatomy. |
| CT scan & Lung Tumors | Superior to conventional x-ray can detect nodules 2-3mm. CT helps place biopsy needle to prevent pneumo. |
| CT scan & interstitial lung disease | Can show considerable changes even when x-ray reads normal. Used selectively because of high cost. |
| CT scan & AIDS | Early detection of pneumonias that occur as a result of AIDS |
| CT scan & Occupational lung | Helpful in identifying changes in the pleura & lung parenchyma. |
| CT scan & Pneumonia | Restricted use because of cost but they can detect pneumonia sooner. |
| CT scan & Bronchiectasis | Has replaced invasive use of bronchogram. CT scan can detect early |
| CT scan & COPD | Emphysema shown clear and detailed. Dx consistently in the high 90% |
| MRI | Used in the evaluation of the hilar. Can better see hilar lymph node enlargement from enlarged hilar blood vessels than is CT. Also, better at seeing chest wall invasion by lung cancer specifically Pancoast tumor or superior sulcus tumor. |
| Lung scanning (V/Q scan) | obtained by measuring gamma radiation emitted from chest after injected into bloodstream or inhaled. Useful to evaluate possible P.E. Results often inconclusive and are only suggestive,(rare use) |
| PET scan | Positron emission tomography, Used to Dx and stage cancers. Compound is injected into a vein, malignant cells show >metabolic rates |
| Pulmonary Angiography | evaluate thromboembolic disease- only used if V/Q scan results are uncertain definitive dx, contrast into pulm artery, pulm emboli is proof of filling defect |
| X-ray interpretation | (A) airways, (B) bones, (C) cardiac, (D) diaphragm, (E) extras. |
| (A) airways | Tracheal mid line, carina,main stem bronchi, air bronchogram(occur with alveolar filling) |
| (B) bones | Clavicles equal, ribs, scapulae, spine |
| ( C) Cardiac | Cardio-thoracic ratio 1/3 on PA ½ on AP, cardiac borders, aortic arch and vessels, cardio phrinic angle. |
| Silhouette sign | Infiltrates in the lung will blur the edges of the heart or the diaphragm where the infiltrate touches them. This helps to locate w better precision where the infiltrates located. |
| Air bronchogram | Patent airway w/ deep lung consolidation, norm bronchi are unseen (all air), bronchograms are seen if surrounded by consolidation, often seen w/pneumonia and pulm edema |
| Compressive Atelectasis | Seen in pt w/ pleural effusion, pneumo, hemo, & any space-occupying lesion. |
| Obstructive Atelectasis | Blockage of airway, absence of ventilation. Tumor, aspirated foreign body, fibrosis, mucus plug, mechanical obstruction, & scaring. Trachea and heart shifts toward. |
| X-ray & Atelectasis | Shift of the fissure toward, movement of hilar toward, overall loss of volume, hemidiaphragm elevation. |
| X-ray & Pneumothorax | Hyperlucency on the affected side, shift of the mediastinal away from the air-filled pleural space. Trachea shift away. <blood flow, <good lungs ability to oxygenate. |
| X-ray and Hyperinflation | COPD, can be red as normal if mild, mod-severe large lung volumes, depressed diaphragm, small narrow heart, enlarged intercostal spaces. |
| X-ray Interstitial lung disease | Alveolar pattern may lead to air bronchograms as a result of alveolar spaces becoming infiltrated/denser, air filled airway is clear and dark, the contrast between the two appear as ground glass. |
| X-ray & CHF | 1redistribution of pulm vasculature to the UL(norm in LL)2Cardiomegaly 3Kerley's B lines(1-2cm)usually right base, (pleural lymphatic vessels filled w/fluid)4Misc. >interstitial markings, plural effusion in R hemithorax,enlarged pulm art segments |
| If vertebrae are easily seen in x-ray | film is over exposed (underexposed-cant see behind heart) |
| properly exposed xray | thoracic vertebrae are just visualized through the heart shadow |
| depth of inspiration is adequate in PA film when | 10 posterior ribs are seen in film |
| primary purpose of xrays is what | identify abnormalities |
| why are PA views most often used | less chance of pt rotation, heart size less magnified, pt must stand |
| xrays are normally taken on inspiration, what is the exception | suspected pneumothorax |
| problems associated with AP (portable xrays) | poor radiographic exposure, pt not centered, artifact shadows, heart magnified |
| xray to identify Pneumothorax | lateral decubitus on expiration |
| ETT tube on an xray | 3-5cm above Corina |
| what can be assessed on an xray | CVP line position, chest tube position and effectiveness, NT placement |
| MRI is better than CT for evaluating what? | Hilar areas for lymph node and vascular enlargement |
| Pneumonias can cause what on lung scan | <perfusion and <ventilation |
| xrays are produced by what | electromagnetic waves |
| >density causes what to an xray | < penetration |
| radiographic density | water, air, bone, fat |
| radiopaque | white |
| radiolucent | black |
| as the distance from the source (machine) and the pt decreases, what happens to the magnification? | magnification increases |
| what is standard distance for an xray | 6ft |
| when should an xray be taken | after intubation, assess progression of pneumonia, check effectiveness of CPT (not with CPR) |
| can an xray appear normal in the presence of significant pulm disease? | yes |
| tension pneumothorax xray | >radiolucency on affected side, mediastinal shift away, >resonance to percussion on affected side, BS absent on affected side |
| atelectasis xray | >radiopacity, hemidiaphragm elevated, hilar shift toward |
| CHF xray | > Cardio-thoracic ratio |
| consolidation due to pneumonia xray | lobar radiopaque pattern of infiltrates |
| hyperinflation xray | large lung volumes, widened intercostal space bilaterally, small narrow heart |
| small pleural effusion xray | blunted constrophrenic angle, meniscus sign, partially obscured and elevated hemidiaphragm (lateral decubitus to visualize fluid) |
| large pleural effusion xray | complete white out on infected side, complete obscure of diaphragm |
| obscure heart border | silhouette sign is absent, then consolidation is anterior lung segments, if silhouette is present (sharp lung borders) then consolidation is posterior |
| diaphragm border is obscure | anterior consolidation (not obscure then consolidation is posterior) |
| Left heart failure | (lungs back up) No 1 external dyspnea, orthopnea, possible nocturnal dyspnea, cheyne stokes, pale cool skin, dysrrhythmias, fatigue, restlessness, irritability, short attention span |
| Right heart failure | (body backs up) edema, JVD, cyanosis, dyspnea, dysrrhythmias, hepatomegaly, sometimes ascites |
| CHF Xray | fluid in dependent portions-enlarged vessels in upper lobes, heart >1/2 of cage, kerley B usually in right base, >interstitial marks, pleural effusion on right, >pulm artery segments |
| evaluating chest film | vertebral bodies easily seen, spineous process centered between clavicles and behind trach, ribs 10 |
| over exposed xray | lungs to black and vert to easy to see |
| under exposed xray | vert not seen through cardiac shadow and lungs to white |
| clinical predisposition for pneumo | trauma, broken rib, Thoracentesis, CVP line, pulm art cath, PPV, blebs, improper placement of ET, oral or NT tube |
| costrophrenic angle | the point where diaphragm meets the chest wall (blunted with pleural effusion) |
| meniscus sign | water moving up the chest wall, instead of diaphragm looking like upside down bowl, edges of look like bowl is right side up, water creeping up the side of a glass |
| late insp crackles | atelectasis, pneumonia, edema, pulm edema, fibrosis |
| early insp crackles | bronchitis, emphysema, asthma |
| insp & exp crackles | bronchitis and resp infect |
| wheeze | asthma, CHF, bronchitis |
| stridor | croup, epiglotitis, post extubation |
| <PaO2 | age, Pb, PIO2 |
| consolidation xray | minimal volume loss, usually lobar distribution, homogeneous density late in process, air bronchograms if airway leading to consolidation is open |
| physical findings of consolidation | dull (<resonance) percussion, bronchophony (99 sounds clear), bronchial BS, crackles, whispered pectriloquay (sounds clear), egophony (E sounds like A), tachypnea, fever |
| clinical SS of hyperinflation | barrel chest (increased AP diameter), >resonance to percussion, <BS, limited diaphragm movement, wheezing when tired, prolonged expiration, >RR, use of accessory muscles, tripodding, pursed lipped breathing |
| hyperinflation | most common cause is COPD, large lung volumes, >anterior space on lateral film, flat diaphragm, narrow elongated heart, enlarged intercostal space |
| free fluid in the intrapleural space | pleural effusion, transudate, exudate, blood (hemothorax), fatty (chylthorax), puss (empyema or pyothorax) |
| transudate | pleural effusion with clear fluid, low in protein, seen in CHF and atelectasis |
| exudate | pleural effusion w/protein, bacteria, pneumonia, pulm emboli, malignancy, virus, TB, fungal |
| how much fluid must be present to be seen on an x-ray | 100ml |
| Pneumothorax clinical SS (w/o tension) | reduced chest wall movement on affected side, <BS on affected side, >resonance to percussion on affected side, tachycardia, tachypnea, absent whispered pectriloquay, absent tactile fremitus, trach shift away |
| pleural effusion SS | dependent on amount, pain on inspiration, dull at sight, coughing, SOB, significant amount may be dull percussion, egophony, <BS on effected side, tachypnea |
| interstitial lung disease xray | fibrotic infiltrates in LL, TB and silicosis in upper lobes, air bronchograms |
| clinical SS of interstitial lung disease | rapid shallow breathing, <CL, crackles on Insp(usually LL), severe has hypoxemia and cyanosis, final DX via biopsy bronchoscopy |
| Clinical SS of CHF | crackles at bases, >RR, orthopnea, JVD, >HR(may be irreg), S3, loud S2, hepatomegaly, pulses alterans, peripheral edema, noturia (nite pee) |
| Spirometers (positive displacement-volume) | measure volumes and flow rates |
| Pneumotachometers | spirometer that measures flow, used continuously it can measure VE |
| Spirometers that measure volume and time are | dry-rolling and water-sealed |
| Spirometers that measure flow are | pneumotachometers |
| Calibration of body box is verified with a | rotometer or pneumotach |
| Volume calibration and leak tests of FLOOP | super syringe |
| Flow calibration of a FLOOP is done with | a rotometer |
| Timing devices (kymograph X-Y recorders) are checked with | stop watch |
| Plethysmograph is calibrated with | rotometer for flows and barometer for pressures |
| SVC is an important measure of what | restrictive disease |
| Decreased volumes indicate what | restrictive disease |
| VC is the BEST INDICATOR OF WHAT | RESTRICTIVE LUNG DISEASE |
| FVC provides what to measure obstructive disease | flow rates |
| What is the BEST INDICATOR OF OBSTRUCTIVE DISEASE | FEV1 |
| Minimum acceptable FEV1% is | 75% |
| Decreased FEV1/FVC | OBSTRUCTIVE DISEASE |
| Normal FEV1/FVC | not obstructive, but still may be restrictive |
| FEV200-1200 | <with LARGE AIRWAY OBSTRUCTION |
| FEV25-75 | <WITH EARLY STAGES OF OBSTRUCTIVE DISEASE (ASSOCIATED WITH SMALL AIRWAYS) |
| PEFR | SOME USED TO EVAL ASTHMATICS PRE AND POST BRONCHODILATOR |
| IS FVC A FLOW OR VOLUME | VOLUME AND SHOULD BE EQUAL TO SVC |
| FVC NOT COMPLETED IN 3 SECONDS | OBSTRUCTION |
| FVC SMALLER THAN SVC | OBSTRUCTIVE (AIRTRAPPING) |
| MVV MEASURES | MUSCULAR MECHANICS OF BREATHING, |
| <MVV | OBSTRUCTIVE DISEASE, >RAW, MUSCLE WEAKNESS, <CL AND POOR PT EFFORT |
| POST BRONCHODILATOR TEST MUST BE HOW HIGH TO BE SIGNIFICAN | 15% |
| NITROGEN (N2) WASHOUT TIME | >7MINUTES IS POOR DISTRIBUTION |
| BEST TEST FOR PARTIAL VOCAL CORD PARALYSIS (LARGE AIRWAY OBSTRUCTION) | FLOOP |
| DISTRIBUTION OF GASSES ARE EVALUATED WITH | NITROGEN WASHOUT TEST (7MIN) AND HELUIM DILUTION |
| DLCO | CARBON MONOXIDE DIFFUSION CAPACITY |
| DLCO MEASURES | FACTORS THAT AFFECT THE DIFFUSION OF GAS ACROSS THE A-C MEMBRANE |
| HOW LONG DOES A DLCO TEST LAST | 1 BREATH |
| WHAT DISEASES HAVE A <DLCO | FIBROSIS, SARCOIDOSIS, ARDS, EDEMA, EMPHYSEMA |
| WHAT IS THE ONLY OBSTRUCTIVE DISEASE THAT HAS A DECREASED DLCO | EMPHYSEMA |
| POSITIVE BRONCHIAL PROVOCATION | 20%DECREASE IN FEV1 |
| PFT NORMS AND PREDICTED ACTUAL/PREDICTED IS OBSERVED | 80-100% OF PREDICTED NORMAL, 60-70% OF PREDICTED MILD, 40-59% OF PREDICTED MODERATE, <40% OF PREDICTED SEVERE DISORDER |
| RESTRICTIVE PFT | <VOLUMES, VC OR FVC |
| OBSTRUCTIVE PFT | <FLOWS OR FEV1 |
| OBSTRUCTIVE AND RESTRICTIVE BOTH | <FLOWS AND <VOLUMES |
| ALWAYS USE THE “BEST TEST” | HIGHEST FVC + FEV1 |
| OBSTRUCTIVE DISEASES W/ DECREASED FLOW (CBABE) | CF, BRONCHITIS, ASTHMA, BRONCHIECTASIS, EMPHYSEMA |
| RESTRICTIVE DISEASES W/DECREASED VOLUMES | PICT-PNNF, PLEURAL DIS, INFLAMMATORY DIS, CARDIAC DIS, THORACIC DIS, POST OP, NEUROLOGICAL NEUROMUSCULAR, FIBROTIC DIS |
Created by:
williamwallace
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