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IER Chapter 4
Pulmonary PT (IER Chapter 4)
| Question | Answer |
|---|---|
| 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
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