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Diagnostic Unit 1-2
spc
| Question | Answer |
|---|---|
| Direct spirometry | measures the exact volumes that a patient can breathe in and out of lungs |
| Indirect spirometry | determines volumes that cannot be measured directly, RV, FRC, TLC.. These volumes cannot be exhaled by the patient. |
| A lung volume is a single? | volume |
| A lung capacity is a? | combination of one or more volumes |
| Primary lung volumes? | VT, IRV, ERV, RV |
| Lung capacities? | IC, VC, TLC, FRC |
| Volume of air that can be inhaled and then exhaled with each normal breath? | VT |
| Amount of air that can be forcibly inhaled past a normal VT breath? | IRV |
| Amount of air that can be forcibly exhaled past a normal VT breath? | ERV |
| Amount of air that remains in lungs after a forced exhalation? | RV |
| Maximum amount of air that can be inhaled after a normal expiration, VT+IRV= | IC |
| Amount of air that can be exhaled after a maximal inspiration, VT+ERV+IRV= | VC |
| Amount of air in the lungs after a maximum inspiration, RV+VT+IRV+ERV= | TLC |
| Amount of air in the lungs after a normal expiration, ERV+RV= | FRC |
| Dont do spirometry when? | acute situations |
| SVC > FVC? | obstructive disease, emphysema |
| Indirect spirometry methods? | gas dilution(open or closed), body plethysmography |
| SVC and FVC accuracy is? | effort dependent |
| Indirect spirometry accuracy is? | not effort dependent |
| Gas dilution uses what principle? | boyles law |
| By having a known gas concentration at the start and end of a gas dilution test, we can calculate? | the unknown volume |
| If air is trapped in the lungs(emphysema) gas dilution techniques will? | not work, can only measure volumes in communication with the conduction airways |
| Any accuracy differences between the open or closed circuit gas dilution methods? | no difference, nitrogen is more common due to helium requiring a correction factor for tissue helium |
| Open circuit? | nitrogen washout, measures the percentage on nitrogen in the alveolar gas after a patient breathes 100% O2 for 7 mins |
| What is the clinical significance of a patient who takes a long time to wash out? | air trapping disease, such as emphysema |
| The test continues until nitrogen concentration falls to 1%, in a healthy patient this should take? | 3-4 minutes |
| Closed circuit? | Pt breathes in He mixed w/ air = 10-15%He concentration, use an absorber to remove exhaled CO2 so pt doesn't rebreathe it, small amount of O2 used so pt doesn't become hypoxic. Measures amount of He going in & out to determine volume |
| Helium dilution method sources of error? | long procedure, leaks, slow lung units, non communicating lung units cause an underestimation of FRC |
| Some patients may take longer to reach equilibration with the HE mixture, this may indicate? | emphysema or another obstructive disease |
| Body plethysmography? | measures FRC, most accurate because it can measure trapped air. |
| The body box measures all the gas in the patients chest, so if higher FRC measured than with a gas dilution technique this indicates? | the patient has some degree of airway obstruction |
| What is PVM? | Primary volume measuring spirometers: measure the volume of air moving out of the pt's lungs then / it by the time requ to move this volume to determine flow |
| What is PFM? | Primary flow measuring spirometers: measure the amount of flow moving out of the pt's lungs then x it by the amount of time to move this flow to determine volume |
| Your pt's FEF 25% 75% is below predicted, what does this indicate? | early stages of obstructive or restrictive disease |
| FEF 25%-75%? | medium to small airways, later in expiratory maneuver, normal is 4-5 l/sec,<80% pt on way to developing airway disease |
| FEF 200-1200? | larger airways, earlier in expiratory maneuver, norma is 6-8 /sec. decreased with obstruction |
| Your pt's FEF 200-1200 is below predicted, what does this indicate? | larger airways may be obstructed |
| What is the most negative pressure generated with inspiratory effort called? | MIP/NIF |
| MIP/NIF is used for? | strength test of the diaphragm, intercostals, and inspiratory accessory muscles. |
| What is a normal MIP? | <-60 (-61,-62,-63, etc...) |
| If pt has an abnormal MIP what does this indicate? | weakened inspiratory muscles, neuromuscular disease, chest/spine abnormalities |
| What is the greatest positive pressure that can be generated with expiration called? | MEP, done after TLC when pt has taken their largest breathe in |
| MEP is used for? | strength test for abdominal muscles and accessory expiratory muscles. if decreased pt may not be able to cough |
| Normal MEP? | 80-100 |
| A pre and post bronchodilator study is used to asses? | if an obstructive airway disease is reversible, with an increase in FEV1 of >12% it is considered a positive result |
| Pre and post studies are indicated when? | there is evidence of reactive airways, unexplained cough, to see if pt will benefit from bronchodilater therapy |
| Normal % predicted TLC | 80-120, < restricted, > obstructed |
| Normal % predicted FRC | 35-135, < restricted, > obstructed |
| FEV1/FVC < 80% = | obstructed |
| FVC < 80% predicted = | restricted |
| Your subject's spirometry results shows a VC, FRC, RV, and TLC less than predicted. This indicates... | restrictive |
| An RV/TLC percentage of 55% indicates ? | air trapping |
| American Thoracic Society (ATS) standards require all lung volumes be reported at? | BTPS |
| A patient has an increased TLC, RV, and has a reduced peak flow. What does this suggest? | obstruction |
| Reduced peak flow= | obstruction |
| Reduced volume= | restriction |
| Spirometer calibration? | A 3 liter super syringe is normally used, Different flow rates are used, a rotary pump or rotometer may be used, is required by ATS guidelines, done daily |
| What study is indicated for subjects who have normal spirometry but periodic wheezing or SOB? | bronchoprovocation |
| Bronchoprovocation? | causes an acute temporary obstruction via inhalation or methacholine or histamine, determines if pt has hyper reactive airways, decrease in FEV1 of >20%= positive result |
| What type of study is indicated when the patient has a history of wheezing, is a known asthmatic, has a cough of unknown etiology, or to see if bronchodilater therapy will benefit pt? | pre and post bronchodilater study, an increase in FEV1 > 12% indicates positive response, used to determine if obstructive disease is reversibe |
| Peak flow monitoring is used too? | assess asthma severity and determine response to bronchodiltor |
| All PFM's use? | a pneumotach to measure flow |
| Severe obesity will? | seem restricted, reduce VC |
| Short & Fat Loops indicate | obstruction |
| Tall & skinny loops indicate | restriction |
| Scoop in the loop of expiratory side? | obstruction, early is larger airways, later in smaller airways |
| Range for an acceptable FVC? | 3 attempts within 5% or 200ml, do not exceed 8 attempts |
| Back extrapolation? | done by the computer, used to correct for a pt's late start, cannot exceed 5% or 150ml |
| Where can spirometry be performed? | Pt room, bedside, physician's office, PFT lab, outpatient clinic, hospital |
Created by:
juialynn92
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