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IER Chapter 4

Pulmonary PT (IER Chapter 4)

Tidal Volume (TV) Volume of gas inhaled/exhaled during normal resting breath
Inspiratory Reserve Volume (IRV) Inhalation beyond normal tidal inhalation
Expiratory Reserve Volume (ERV) Exhalation beyond normal tidal exhalation
Residual Volume (RV) Remaining gas in the lungs after expiratory reserve volume has been exhaled.
Inspiratory Capacity (IRV+TV); Amount of air that can be inhaled from REEP
Vital Capacity (IRV+TV+ERV); Amount of air under volitional control; measured as forced expiratory vital capacity (FVC)
Functional Residual Capacity (ERV+RV); Amount of air that resides in the lungs after normal resting tidal exhalation
Total Lung Capacity (IRV+TV+ERV+RV); Total amount of air that is contained within the thorax during a max inspiratory effort.
FEV1 Amount of air exhaled during the first second of FVC. Normal ratio is >70%
Fraction of oxygen in inspired air (FiO2) Based on a total of 1.0. Room air is approx 21% oxygen & written as 0.21. Supplemental O2 increases the %.
PaO2 Partial pressure of oxygen at room air is 95-100mmHg. Hypoxemia is <90. PaO2 decreases with age. Supplemental O2 prescribed when PaO2 is <55mmHg
Normal pH 7.35-7.45
Normal PaCO2 35-45mmHg. Hypercapnea is >45mmHg. Increased PaCO2 causes decreased pH.
Normal HCO3 22-28 mEq/mL. Increase in HCO3 causes increased pH.
Smoking in pack years Number of packs per day x number of years smoked
Auscultation: Vesicular Normal breath sound, soft rustling heard throughout
Auscultation: Bronchial More hollow, echoing sound normally found only over the right superior anterior thorax corresponding to an area over the right main stem bronchus.
Auscultation: Crackels a.k.a: Rales. A crackling sound heard during inspiration. May indicate: atelectasis, fibrosis, pulmonary edema
Auscultation: Wheezes A musical pitched sound during expiration caused by airway obstruction such as asthma, COPD, aspiration
Egophony A nasal sound heard during auscultation. "E" sounds like "A"
Bronchophony Characterized by an intense, clear sound during auscultation even at the bases.
Whispered Pectoriloquy Occurs when whispered sounds are heard clearly during auscultation.
Normal White Blood Cell Count (WBC) 4,000 - 11,000
Normal Hemoglobin (Hgb) 12-16
Normal Hematocrit (Hct) 35-48%
Changes due to Restrictive conditions (page 176 Fig.4-2) Decreased: IRV & ERV as compared to normal; therefore decreased IC, FRC, VC & TLC. TV & RV remain equal to normal
Changes due to Obstructive conditions (page 176 Fig.4-2) Decreased ERV & therefore VC. IRV remains equal, while RV, FRC & TLC are increased
Classes of respiratory impairment: Class 1 0% impairment. Dyspnea consistent with activity. FEV1 >85%
Classes of respiratory impairment: Class 2 20-30% impairment. Dyspnea does not occur at rest. Pt can keep pace with peers on level ground but not hills or stairs. FEV1 70-85%
Classes of respiratory impairment: Class 3 40-50% impairment. Dyspnea with normal ADLs & cannot keep pace with peers. FEV1 50-70%. O2 saturation usually 88% or greater (88% = 58 mmHg).
Classes of respiratory impairment: Class 4 60-90% impairment. Dyspnea at rest or during stair climbing, amb 100yds. FEV1 < 55%. O2 saturation <88%
Bronchiectasis Abnormal dilation of bronchi & excessive sputum production
Respiratory Distress Syndrome (RDS) Alveolar collapse in a premature infant resulting from lung immaturity & inadequate level of surfactant
Bronchopulmonary Dysplasia Hyperinflation from mechanical vent, high flow, infection or RDS cause obstruction.
Chronic Obstructive Diseases COPD, asthma, cystic fibrosis, bronchiectasis, respiratory distress syndrome, bronchopulmonary dysplasia
Chronic Restrictive Diseases Changes in lung parenchyme & pleura, changes in chest wall, neuromuscular changes
Causes of restrictive lunch disease due to changes in lunch parenchyme or pleura Idiopathic pulmonary fibrosis, asbestosis, radiation
Causes of restrictive lung disease due to changes in chest wall Restricted motion of thorax, ankylosing spondylitis, arthristis, scoliosis, pectus excavatum, arthrogryposis, thoracis burns or scleroderma.
Causes of restrictive lung disease due to neuromuscular changes Decreased muscular strength results in the inability to expand the rib cage. As seen in such conditions as: MS, muscular dystrophy, parkinson's, SCI or CVA
Pulmonary Edema Excessive seepage of fluid from the pulmonary vascular system into the interstitial space; may cause alveolar edema.
Atelectasis Collapsed or airless alveoli caused by hypoventilation
Endotracheal Suctioning Approx 120 mmHg of suction lasting 10-15 seconds.
Karvonen's Formula [(Max HR - resting HR) x 40-85%] + resting HR
Created by: carsonwolf