CM- pulm -1- Pulmonary Function tests
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| What are the 3 divisions of the respiratory system | airways
parenchyma
chest
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| What is diffusion in the lungs | air exchange across alveolar capillary membranes
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| What are PFTs used for | evaluate how lungs work
-how much air lung can hold
-how quickly air moves in and out
-how well lungs add o2 and remove co2
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| Why do we do PFTs | diagnose dyspnea/cough or shortness of breath to see if it is obstructive or restrictive problem
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| When would you order a PFT | evaluate s/sx of lung disease
assess progression of lung disease
monitor tx
evaluate preoperative patient
screen people at risk for pulm disease
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| What does spirometry measure | measures air movement can determine how much and how fast air can be inhaled and exhaled
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| What does diffusing capacity measure | ability of lung to transfer/exchange gases
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| what is residual lung volume | amount of air left in lung after maximal expiration
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| What is SVC | slow vital capacity- volume of air which can be inhaled or exhaled in a slow steady maneuver
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| what is FVC | forced vital capacity- amount of air that can be exhaled with force after deep inhalation
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| what is VC | vital capacity- the maximum volume of air exhaled during FVC or SVC
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| What is TLC | Total lung capacity- VC + residual volume is the total volume of air at full inhalation
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| What is ERV | expiratory reserve volume- maximum volume of additional air that can be exhaled after a normal exhalation
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| What is IC | inspiratory capacity- max volume of air that can be inspired from tidal volume and expiratory level
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| What is TV | Tidal Volume- air inhaled and exhaled at rest
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| What is FET | forced expiratory time- the time it takes patient to complete FVC maneuver (exhale all air after maximal inspiration)
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| What is FEV1 | forced expiratory volume in 1 second- volume of air forced out in 1 second
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| What is FEV1/FVC | ratio of FEV1 to FVC
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| on a peak flow volume loop what if PEFR and PIFR | Peak expiratory flow rate, and Peak inspiratory flow rate
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| What are FEF25, 50 and 75 on flow volume loop | flow rate at which 25, 50 and 75% of volume has been exhaled
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| What is DLCO | diffusing capacity of lung- measure ability of lungs to transfer carbon mononxide gives a measurment of how well the lungs are working with gas exchange
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| What are the following values for FVC test normal mild reduction moderate reduction sever reduction | normal FVC= 80-120%
mild= 70-79
moderate- 50-69
severe- below 50
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| What would be a normal FEV1 | 75-80%
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| What would be a normal fev1/FVC ratio | 70%
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| What would be a normal fef25-75 | greater than 50% would be normal
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| What are the standards for pulm function tests based on | age, height, and sex
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| Can you measure TLC with spirometry | NO because you can't measure RV
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| What would be a normal TLC | 80%
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| How can you measure RV | nitrogen washout, helium dilution, body plethysmography
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| IF you think patient may suffer from asthma but they don't have s/sx currently what can you administer to get a spirometry that would show if they have it or not | methacholine, bronchial provocation test
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| compared to normal flow volume loop what would an obstructive disease look like | width would be same but expiratory curve slope would be decreased and flattened
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| Compared to normal flow volume loop what would a restrictive disease look like | narrower loop less volume exchanged but slopes would be steeper
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| what is a characteristic of a restrictive airway disease | decreases lung volume, decreased TLC and FVC but normal or increased FEV1/FVC ratio
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| What is characteristic of an obstructive airway disease | outlow limitation TLC and Lung Volume normal but low FEV1 FEV1/FVC and FEF25-75
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| What type of airway disease is asthma | obstructive
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| what type of airway disease is COPD | obstructive
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| How do you generally differentiate between COPD and Asthma | get a DLCO COPD will have a diminished DLCO asthma will be normal
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| What type of airway disease is interstitial lung disease | restrictive
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| What type of airway disease is chest bellows diseases | restrictive
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| how do you distinguish between interstitial airway disease and bellows disesases | DLCO test- Interstial will have impaired gas exchange, Bellows lungs gas exchange is normal but can't get air in
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