A&pii-Test4-5-2

Front 1

what are flow volume curves and loops

Back 1

tests that record changes in volume and flow rate simultaneously

Front 2

inspiratory flow rate and lung volume increase rapidly from _____

Back 2

RV

Front 3

lung volume continues to increase with a decreased flow rate as what is approached

Back 3

TLC

Front 4

beginning when forced expiration increased expiratory flow rate and decreases lung volume

Back 4

TLC

Front 5

at TLC what occurs to flow rate and lung volume

Back 5

decrease in flow rate and a further decrease in lung volume

Front 6

effort dependence occurs when

Back 6

during the upslope of the forced expiration then continues just after the peak expiratory flow rfate and continuing into the expiratory air flow

Front 7

what causes effort dependence

Back 7

expiratory muscle contractions producing a positive IPP

Front 8

with effort dependence what happens to airflow

Back 8

it becomes INDEPENDENT of expiratory muscle effort b/c of increased IPP that causes dynamic compression in smaller airways w/o cartilagenous support down to RV

Front 9

obstructive disorders shift the expiratory curve how

Back 9

to the LEFT

Front 10

with obstructive disorders how does RV change

Back 10

it is HIGHER d/t air trapping

Front 11

with obstructive disorders how does TLC change

Back 11

it is greater d/t higher lung volume

Front 12

with obstructive disorders how does PEFR change

Back 12

it is LESS than normal

Front 13

with obstructive disorders how does expiratory flow change

Back 13

it is DECREASED (scooped out or concave appearance which is charac of obstructive disorders)

Front 14

restrictive disorders shift expiratory curve how

Back 14

to the RIGHT

Front 15

how is RV changed with restrictive disorders

Back 15

it is LESS d/t increased lung recoil

Front 16

how is TLC changed with restrictive disorders

Back 16

it is less than normal d/t lack of elasticity

Front 17

how is VC changed with restrictive disorders

Back 17

it is LESS than normal d/t lack of elasticity

Front 18

how if PEFR changed with restrictive disorders

Back 18

it is LESS than normal

Front 19

how is expiratory flow changed with restrictive disorders

Back 19

is is decreased b/c of decreased ability to inspire a large qty of air

Front 20

what is the procedure for flow volume loops

Back 20

1-subject forcibly exhales completely to RV followed by a max forced INHALATION to TLC then a forced exhalation back to RV
2-record breathing movements
3-inspiratory flow (region of loop below 0 line) & exp flow (region of loop above 0 line) are plotted against lung volume-the top is PEFR

Front 21

what part of the loop is the most informative

Back 21

configuration

Front 22

obstructive disorders show what kind of flow rate

Back 22

decreased

Front 23

obstructive disorders show what kind of configuration for expiratory flow on flow volume loops

Back 23

"scooped out"

Front 24

obstructive disorders show what kind of PEFR

Back 24

decreased

Front 25

restrictive disorders show what kind of lung volume

Back 25

decreased

Front 26

restrictive disorders show what kind of PEFR

Back 26

relatively normal

Front 27

restrictive disorders show what kind of flow volume loop

Back 27

"minature"

Front 28

with tracheal stenosis what is inspiratory flow loop like

Back 28

reduced then it plateaus and becomes constant slowing again as it approaches TLC

Front 29

with tracheal stenosis what is expiratory flow loop like

Back 29

is normal at 1st then it plateaus from a low PEFR prior to returning to RV at a lower than normal flow rate

Front 30

stenosis causes airway resistance when

Back 30

both inspiration and expiration

Front 31

what are PFT that do NOT use the FVC maneuver

Back 31

*max voluntary ventilation (MVV)

*closing volume and closing capacity

Front 32

what is maximal voluntary ventilation (MVV)

Back 32

largest volume of air that can ventilate the lungs in one minute by a voluntary effort

Front 33

what are the procedures for max voluntary ventilation

Back 33

*person sets own Tv and ventilation rate-volume must be above resting TV but less than VC

*person breathes rapidly and deeply for 10,12 or 15 sec-results are extrapolated to one min

*results are compared to standard values

Front 34

what is the average for healthy young adult for max voluntary ventilation

Back 34

170 L/min

Front 35

what is the utility of the max voluntary ventilation test

Back 35

*measures endurance of inspiratory and expiratory muscles

*reflects lung-thorax compliance

*reflects air way resistance

Front 36

when are reductions in max voluntary ventilation considered significant

Back 36

only very large reductions are considered significant b/c values can vary as much as 30% from predicted

Front 37

what is the best PFT to measure pulmonary endurance

Back 37

max voluntary ventilation

Front 38

what would max voluntary ventilation be with an obstructive disorder

Back 38

significantly reduced with moderate to severe dz

Front 39

what would max voluntary ventilation be with a restictive disorder

Back 39

usually NO change from normal

Front 40

what is the procedure for closing volume and closing capacity

Back 40

1-person forcibly EXHALES to RV
2-followed by a max INHALATION to TLC while breathing 100% o2
3-followed by a forced EXHALATION
(during this exhalation N2 content of exhaled gas monitored)

Front 41

what results are recorded for closing volume and closing capacity

Back 41

results recorded during phases of exhalation

-N2% of exhaled air plotted against lung volumes

Front 42

phase 1 of closing volume and closing capacity contains what % N2 and O2
why?

Back 42

*0% N2

*100% o2

-contains dead space air

Front 43

phase II of closing volume & closing capacity contains what % N2 and O2
why?

Back 43

mixture N2 and O2

-b/c sample contains a mixture of dead space air and alveolar air

Front 44

phase III of closing volume and closing capacity what is the content of N2 like and why

Back 44

*alveolar plateau

-N2 increasing in sample b/c sample contains more alveolar air from upper and lower regions of the lungs

Front 45

phase IV of closing volume and closing capacity what is the content of N2

Back 45

marked increase in N2

Front 46

N2 of phase IV comes from what alveoli

Back 46

APICAL

Front 47

which alveoli open later and close sooner and have a smaller size so their N2 content is lower and their o2 content is higher

Back 47

BASAL

Front 48

which alevoli expand later in inhalation

Back 48

BASAL

Front 49

which alveoli have a higher N2 content and are initially more expanded

Back 49

APICAL

Front 50

what is closing volume

Back 50

the volume of air exhaled between closure of dependent (basilar) airways and the beginning of RV

Front 51

what is closing capacity

Back 51

closing volume + RV

Front 52

what occurs with closing capacity and obstructive dz

Back 52

it increases

Front 53

what occurs with closing capacity and age

Back 53

it increases

Front 54

what are the methods for determining FRC

Back 54

*hilium dilution method

*nitrogen washout method

Front 55

what is FRC useful for

Back 55

determining between obstructive and restrictive disorders

Front 56

what does an increased FRC indicate

Back 56

an obstructive dz largely d/t an increased RV

Front 57

what does a decreased FRC indicate

Back 57

a restrictive dz d/t a decreased RV

Front 58

for interpretation of PFT what do you look at 1st

Back 58

lung volumes (FRC, TLC and RV)

Front 59

if lung volumes are above normal (>120% of the predicted value) what should be condsided as dx

Back 59

obstructed airways secondary to hyperinflation

Front 60

of lung volumes are below normal (<80% of predicted value) what should be considered as dx

Back 60

restriction secondary to lung or chest wall stiffness

Front 61

when interpreting PFT what do you look at 2nd

Back 61

spirometry (FVC, FEV1, FEV1/FVC and FEF 25%-75%)

Front 62

if FEV1. FEV1/FVC and FEF 25-75% are reduced this is confirmation of what

Back 62

obstructive disorder

Front 63

if FEV1, FEV/FVC and FEF 25-75% are NORMAL and lung volume is reduced (<80% of predicted) this confirms SUSPICION of what

Back 63

pure restriction