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Diag Pro Unit 1

SPC Diagnostic Procedures Unit 1 Exam 1

What is spirometry? Measures the volume and flow a patient is capable of producing.
What are the 4 Primary Volume Measuring (PVM) Spirometers? 1. Water Sealed 2. Dry Sealed 3. Bellows 4. Turbine/Wright
What is significant of Water Sealed Spirometers? "GOLD STANDARD" Rugged, dependable, and too large to move
What is significant of Dry Sealed Spirometers? More Portable and easier to maintain but resistance by dry seal is a source for measurement error
What is significant of Bellow Spirometers? Large bellows expanded horizontally and are accurate but crack and tear
What is significant of Turbine/Wright Spirometers? Only PVM that allows air to pass through device Best for bedside, small and easy
What are the 3 Primary Flow Measuring (PFM) Spirometers? 1. Differential Pressure Pneumotach 2. Thermal 3. Ultrasonic
What is significant of Differential Spirometers? Very accurate and widely used but not used with heliox
What is significant of Thermal Spirometers? Used difference in temperature caused by air flows to measure flows
What is significant of Ultrasonic Spirometers? Used ultrasonic crystals to measure flow
How often should spirometers be calibrated? Daily
ATS (American Thoracic Society states calibration can be off by what? 3% or 50ml
What is an alternative to using a super syringe for calibration? Rotometer or rotary pump
What is ATPS? Air in the spirometer is at ambient temperature, pressure saturated (ATPS) which is cooler than the air in the body and takes less volume in the spirometer.
What is BTPS? Air in the human body is at body temperature pressure saturated (BTPS) and takes up more volume in the spirometer.
Should results be reported in ATPS or BTPS The conversion is performed by the spirometer but it's important to understand that all spirometer results must be reported at BTPS.
Indications for Spirometry? 1. Detects Presence or absence of lung disease 2. Quantifies extent of known disease 3. Measures effects of occupational and environmental exposures 4. Evaluate effects of therapy 5. Assess risk for surgery 6. Evaluate degree of disability
Predicted values are based on what characteristics? 1. Height 2. Age 3. Weight 4. Gender 5. Race
What is VC? Amount of gas exhaled after a maximal inspiration All the way in, All the way out
5 important facts about VC? 1. Vary as much as 20% between efforts 2. Vary with body position and time of day 3. Increase to age 20 then decreases 4. Taller patient larger VC 5. VC can differ with race
What is FVC? Forced Vital Capacity- Air blown out fast as possible
What is SVC? Slow Vital Capacity- Air blown slowly
Significant of FVC vs. SVC? Will be equal in individuals without lung disease
How many times must patient complete test to insure accuracy? x3
What does the Black, Red, and Blue graph means on a volume time curve? Black- Normal Lung Red- Restricted Lung Blue- Obstructed Lung
What type of diseases are restrictive? All cancers and the "osis" diseases (except Cystic fibrosis)
What time of diseases are obstructive? CBABE Cystic Fibrosis--Bronchitis--Asthma--Bronchiectasis--Emphysema
If the actual FVC is less than 80% of the predicted FVC then the patient has? Restricted Lung Disease
How do you know if there is an obstructed lung disease? Divide actual FEV1 by the actual FVC. FEV1/FVC is less than 80% they are obstructed
If all numbers are above 80% then what? Normal Spirometry
FVC actual/FVC predicted = 80-100% Normal
FVC actual/FVC predicted = 60-80% Mild
FVC actual/FVC predicted = 40-60% Moderate
FVC actual/FVC predicted = <40% Severe
What is Pseudo restrictions? When a patient is so obstructed the appear restricted.
3 ways to tell if there is pseudo restriction? 1. Patient is more obstructed (severe) than restricted (mild) 2. Air trapping like emphysema of hyperinflation 3. Patient history indicated obstructive but no restrictive such as asthma
What is FEV1? Volume exhaled during 1st second of a FVC.
What significant of FEV1? Expressed as a percentage of VC and is the standard index for assessing & quantifying airflow limitation, obstruction, and bronchoconstriction.
What is back Extrapolation? Performed by the computer to correct for a patients late start on a Volume Time Curve Loop
Extrapolation may not exceed more than what of the FVC? 5% or 150ml
What is FEF 200-1200? Flow that occurs between 200-1200ml of patients expiration.
The 1st 200ml of expiration is considered what? Deadspace
What is FEF 25%-75%? Measures expiratory flow in the MIDDLE of the FVC and shows flow from medium and small airways.
FEF 25%-75% may decrease in early stages of what? obstructive lung disease as well as restrictive lung disease.
Both FEF 25%-75% & FEF 200-1200 are dependent on what? Patient effort
How to use a Peak Flow Meter? Take a deep breath, Blow out hard and fast, record the reading on the meter
What is MVV (Maximum Volume Ventilation)? Largest volume of air that can be breathed in and out in one minute. Patient must cooperate
RR for 1 min MVV test should be what? 70-120 breaths
Formula for percentage of change in FEV1 after a bronchodilator is given? (Post FEV1-Pre FEV1)/Pre FEV1
If there is a 12% or > increase post bronchodilator that indicated what? Positive response
What is Bronchoprovocation? Bronchoprovocation studies are used to determine if a patient has hyper reactive airways and is usually ordered for patients who have normal spirometry results with a history of wheezing or shortness of breath.
A Reduction of greater than 20% in FEV1 with Bronchoprovocation means what? A positive test
What is inhaled with a Bronchoprovocation Study? Methacholine or Histamine
What is Elastic Recoil Pressure? Patient must swallow esophageal ballon which will measure changes in pressure via transducer outside the body. Reflect changes in pleural pressure
What is Impulse Oscillometry? Non-invasive and fast way to detect airflow obstructions in who can not perform spirometry. Uses sound waves to measure FEV1, Peak, and resistance.
Advantages of Plethysmography? For patients who have air spaces within the lung who do not communicate with the bronchial tree.
Created by: Langhout1418