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56 terms

Pulmonary Function Tests 2

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pulmonary function testing
Diagnostic procedure(s) that provde objective, quantifiable measures of lung function
carbon monoxide diffusing capacity
Marker of gas diffusion across the alveolar-capillary membrane
DLCO
This test is reduced in situations where impairment of gas transfer exists (abbreviation)
arterial blood gas; carbon monoxide diffusion capacity; gas dilution; body plethysmography
Procedures for evaluation of pulmonary function: 1)_____ 2)_____ 3)_____ 4)_____
spirometry
Measurement of the movement of air into and out of the lungs during various breathing maneuvers
spirometric graph
Curve resulting from maximum inhalation and exhalation preceded by normal breathing
tidal volume (VT)
Volume of air inhaled or exhaled during normal breathing
inspiratory reserve volume (IRV)
Amount of air inhaled over and above normal tidal volume after a normal tidal inspiration
expiratory reserve volume (ERV)
Amount of air that can still be expired by forceful expiration after the end of a normal tidal expiration
vital capacity (VC)
Volume of air that can be exhaled after a maximal inhalation
inspiratory capacity (IC)
Sum of inspiratory reserve volume and tidal volume
residual volume (RV)
Volume of air remaining in the lungs at the end of maximal exhalation
functional residual capacity (FRC)
Amount of air contained in the lungs at the end of normal expiration
total lung capacity (TLC)
Total lung volume
forced vital capacity (FVC)
The vital capacity (VC) performed at maximal efforts
forced expiratory volume (FEV)
Measured after maximal inhalation then exhalation
forced expiratory volume in 1 second (FEV1)
Amount of air moved over 1 second
flow volume loop
Term used to describe the graph resulting from plotting the forced vital capacity (FVC) against the forced expiratory volume in 1 second (FEV1)
VC (vital capacity)
IRV + VT + ERV = ?
IC (inspiratory capacity)
IRV + VT = ?
TLC (total lung capacity)
VC + RV = ?
FEV1; pulmonary disease; response to bronchodilators
Most important PFT; used to diagnose _____ and to predict _____
75-80%
The FEV1 should be at least _____ of FVC in normal pulmonary function
diagnostic purposes; monitoring purposes
Primarily, PFT's are performed for two reasons: 1) _____ and 2) _____
inability of patient to cooperate; technical problems; misinterpretation of results
Three reasons for a poor PFT study
assess effectiveness of therapeutic intervention(s); monitoring of patient(s) with known lung disease; monitoring of patient(s) receiving drugs known to cause pulmonary toxicity
Three reasons to monitor using PFT studies
evaluation of (patient/person) for insurance disability; lawsuits; epidemiologic surveys
Other reasons for performing PFT studies
mental status changes; patient does not understand directions; poor effort; advanced disease
Four reasons a patient may be unable to cooperate during a PFT study
leakage around mouthpiece; equipment inaccuracies
Two reasons for having technical problems during a PFT study
reduction in TLC (total lung capacity)
Hallmark of a restrictive disease
decrease in lung volumes without reduction of airflow; VC
A restrictive defect is characterized by an overall ____; a decrease in _____ may also be seen
TLC ≤80% of predicted value
Mild restrictive disease
TLC ≤65% of predicted value
Moderate restrictive disease
TLC ≤50% of predicted value
Severe restrictive disease
interstitial lung disease(s); infiltrative lung disease(s); chest wall disease(s); pleural disease(s)
General diseases associated with restrictive defect (4 of them)
collagen vascular disease; interstitial pneumonitis; hypersensitivity pneumonitis; pulmonary fibrosis; pulmonary edema
Interstitial lung disease associated with restrictive defect
kyphoscoliosis; ankylosing spondylitis; neuromuscular disease(s)
Chest wall diseases associated with restrictive defect
granulomatosis; tumor
Infiltrative lung diseases associated with restrictive defect
fibrothorax; pleural effusion; pneumothorax
Pleural diseases associated with restrictive defect
obesity; paralyzed diaphragm; ascites; pregnancy; flail chest
Other conditions associated with restrictive defect
reduction of airflow; conducting airways; decrease in diameter; loss of integrity
Obstructive defect is characterized by a(n) _____ through the _____ due to a(n) _____ or _____
FEV1
The most useful PFT in diagnosing obstructive defects
FEV1 to <70% of predicted value
Mild obstructive defect classification
FEV1 to <60% of predicted value
Moderate obstructive defect classification
FEV1 to <40% of predicted value
Severe obstructive defect classification
asthma; emphysema; chronic bronchitis; granuloma; tumor; mechanical obstruction of bronchi
Diseases associated with obstructive defect
bronchial smooth muscle contraction
Asthma is due to _____
airway collapse from loss of radial traction
Emphysema is due to _____
anatomic thickening of the bronchial walls
Chronic bronchitis is due to _____
4-4-4-0-4
Asthma: ↓FEV1 = ? ↓FEV1/FVC = ? ↑airway resistance = ? ↓DLCO = ? Response to bronchodilators = ? (use scale of 0 to 4 for response)
4-4-4-0-1
Chronic bronchitis: ↓FEV1 = ? ↓FEV1/FVC = ? ↑airway resistance = ? ↓DLCO = ? Response to bronchodilators = ? (use scale of 0 to 4 for response)
4-4-1-4-0
Emphysema: ↓FEV1 = ? ↓FEV1/FVC = ? ↑airway resistance = ? ↓DLCO = ? Response to bronchodilators = ? (use scale of 0 to 4 for response)
↓DLCO = 2
Differing PFT (and numeric value) in chronic bronchitis patient who smokes
response to bronchodilator(s) = 3
Differing test (and numeric value) in 20% of emphysemic patients
↓;↓;↓;↓;≥75%
Restrictive defects: FVC = ? RV = ? TLC = ? FEV1 = ? FEV1/VC% = ?
normal/↑; ↑; normal/↑; ↓; <75%
Obstructive defects: FVC = ? RV = ? TLC = ? FEV1 = ? FEV1/VC% = ?