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31 Cards in this Set
- Front
- Back
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Quiz question:
If the flow volume loop is longer, what does this indicate ? |
obstructive pattern
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draw and label the 3 patterns of forced expiration
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(see picture 1.)
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fev ratio in a restrictive pattern is 90%. Is this good or bad? Why ?
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this is bad. Although the fev/fvc ratio is almost normal, the actual volume being blown out is less
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with a restrictive pattern, how is the exhalation time, long or short ?
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short
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approximately, what is normal fev ?
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4 L
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approximately, what is normal fvc ?
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5 L
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what would fev be, approximately, in a patient with a restrictive process ?
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2.8 L
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what would fev the, approximately, in a patient with an obstructive process ?
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1.3 L. This is low. fev/fvc would be less (approximately 40%) in these cases
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what is normal forced expiratory time, approximately ?
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6 seconds
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evaluate the following pft results:
pre bronchodilator:fev1 1.52 L, fvc 2.42 L fet 11.2 sec post bronchodilator:fev1 2.05 L, fvc 2.72 L fet 10.7 sec what kind of disease is this? Why ? |
this is a restrictive process. Why? Because it response to bronchodilators. Obstructive (COPD) does not respond to bronchodilators
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what type of pfts are we concerned about ?
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spirometry
this includes forced vital capacity (fvc), forced expiratory volume in 1 second (fev1) and the ratio of these two (fev1/fvc ratio.) |
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How do you make a patient give you a forced vital capacity ?
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ask them to breathe in deeply, and from there, blow out as fast as they can.
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Evaluate the following pft results:
fev1 1.64 L, fvc 1.85 L, fet 9.2 seconds which pattern is this, normal, obstructive, or restrictive ? |
restrictive
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evaluate the following pft results:
fev1 2.15 L, fvc 2.63 liters, fet 8.13 seconds which pattern is this, normal, obstructive, or restrictive ? |
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when evaluating pft's, what automatically rules out obstructive ?
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fev1/fvc that is almost normal (80%.)
remember: if you have a normal fev1/fvc ratio and other stuff is abnormal, you have an abnormal process (like, for example, restrictive process.) |
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In which diseases would pulmonary function tests be confusing ?
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nonpulmonary diseases, like congestive heart failure
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if the fev1/fvc ratio is low, what does this automatically indicate ?
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obstructive defect
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what happens with air and severe obstructive process ?
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there is air trapping and pseudo restriction
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what is the primary goal of interpreting pfts ?
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recognize the pattern, do not make the diagnosis
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divider ?
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function of the disease and failing lung
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name the 4 types of obstructive processes
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airway obstruction
COPD asthma localized airway obstruction |
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draw and label the 3 mechanisms of airway obstruction
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see picture 2
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name the 2 diseases that are included in COPD
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emphysema
chronic bronchitis |
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what are the characteristics of type a COPD ?
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"pink puffer"
increasing dyspnea over years no cough barrel chest absence of cyanosis quiet breath sounds normal jv pressures no edema PO2 only slightly depressed (pink) PCO2 normal |
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what are the characteristics of type b COPD ?
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"blue bloater"
increasing dyspnea over years frequent cough with sputum no change in chesr volume cyanosis rales or ronchi may have elevated jvd or edema PO2 low PCO2 elevated |
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draw the alveoli and the progression of emphysema
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see picture 3
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name 8 restrictive diseases
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pulmonary fibrosis
sarcoidosis pneumonitis pneumothorax plueral perfusion scoliosis ankylosing spondylosis neuromuscular disorders |
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what breathing pattern will asthma patients display on the ventilator ?
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they buck a lot.
also, they start coughing post extubation |
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what can cause stimulation with reactive airway disease ?
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aspirin
nsaids instrumentation of the airway |
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how does laparoscopic abdominal surgery affect ventilation?
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pneumoperitoneum causes changes in structural compliance
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do crnas so subclavian lines ?
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only if you can do a chest tube.
If you can't fix the complication, don't do the procedure. |
