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59 Cards in this Set

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Define Perfusion;
Blood flow through pulmonary vessels.
Define Diffusion;
Movement of oxygen & carbondioxide across alveolar-capillary membrane.
Define Ventilation;
Air exchange between alveolar spaces & the atmoshere.
What do pulmonary function tests determine?
The presence, nature & extent of pulmonary dysfunction caused by obstruction, restriction or both.
Is COPD obstructive or restrictive?
Obstructive
(can be restrictive too)
Is obesity obstructive or restrictive?
Restrictive
Indications for pulmonary function test?
Early detection of pulmonary dz.
D/Dx of dyspnea.
Presurg assessment.
Monitor progress of pumonary dz.
Workers comp claims
What information do airflow rates provide?
Severity of obstruction
What does a spirometer measure?
Lung capacity, volume & flow rate.
What is a Incentive Spirometer?
It measures inspiratory volume & is used p surgery or for pts w/COPD or asthma (people who need to exercise their lungs) it will help them return to normal breathing rythms.
Define dyspnea;
Air hunger resulting in labored or difficult breathing, sometimes accompanied by pain. It is normal when due to vigorous work or athletic activity.
What blood test should be ran for most pulmonary pts?
WBC-tells if there is an infection or inflammation.
A pulmonary pt's WBC w/25,000 mature & immature segmented neutrophil count would lead you to think of what Dx?
What other tests would you order?
Bacterial Pneumonia
Chest X-ray
Blood or Sputum cultures
What dz is "currant jelly sputum" a classic sign of?
Klebsiella (gram positive or negative)
An increase in polymorphonuclar (PMN's) leukocytes & mononuclear (monocytes)is a characteristic of?
& what other test would you order?
Mycoplasma pneumonia
Sputum Culture (the nastier the better)
The culture would tell what will kill the dz.
What test should be ordered for a pt with COPD?
ECG-to check heart function & R/O heart dz.
Chest x-ray-look for lung changes.
Spirometery & PFT
Pulse ox
ABG
What do you look for in the Chest X-ray of a pt with COPD?
Hyperinflated lungs
Flattened Diaphram
Cor pulmonale
Define cor pulmonale;
Hypertrophy or failure of the right ventricle resulting from disorders of the lungs, pulmonary vessels, or chest wall. Living for an extended period at a high altitude also may cause this condition.
What tests should be ordered for a pt w/acute bronchitis?
Chest X-ray-if O2 sat is <92
ABG
Gram Stain
Sputum Culture
Why would a Chest x-ray be ordered for a pt w/acute bronchitis?
To R/O other Dzs
or complictaions if bronchitis is severe or prolonged.
Why would a ABG be ordered for a pt w/acute bronchitis?
ABG should be monitored if a serious underlying chronic respiratory dz is present.
Why would a gram stain & sputum culture be ordered for a pt w/acute bronchitis?
To determine the cuasative organism, if symptoms are severe or prolonged.
What is usual contaminate of a gram stain of a pt w/bacterial pneumonia.
What is the best technique to prevent this?
Normal flora from the orotharynx.
Early AM sputum deep in the lungs.
Define Tidal Volume;
Vt
Amount of a person breathes in & out during quiet, normal breathing.
Define Inspiratory reserve volume;
IPV
Additional amount a person could inhale.
Define Expiratory reserve volume;
ERV
Additional amount a person could exhale.
Define Residual Volume;
RV
After a person blows out all the air he or she can, the air that is still left in the lungs.
Define Total Lung Capacity;
TLC
Total amount of air the lungs can contain.
Define Vital Capacity;
VC
Total amount of air the person can breathe in & out.
Define Functional Residual Capacity;
FRX
Total amount of air left in the lungs at the end of a normal exhalation.
What are the 6 parts a pulmonary function test can be divided into?
Air flow, Maximum, Voluntary Ventilation, lung volumes, diffusion of carbon monoxide, flow volume loop & arterial blood gases.
What part of the pulmonary function test is the key to detecting obstruction?
Air flow

FEV1/FVC less than 75% defines obstruction
What is FEV1 & FVC?
What defines obstruction?
FEV1-forced expiratory volume in 1 second.
FVC-forced vital capacity
Ratio of FEV1/FVC less than 75% defines obstruction.
What does maximum voluntary ventilation determine?
The pts ability to breath in & out as hard & as fast as possible for l0 seconds.
What should the Maxium Voluntary Ventilation results be?
40 X the FEV1
What does the Maxium Voluntary Ventilation reflect?
Effort & correlates in general w/overall pulmonary function.
What tests are preformed to establish lung volumes?
Helium dilution technique
Body plethysmography
What is the KEY lung volume?
Total lung capacity (TLC)
TLC > 120% of predicted valule=hyperinflation
What implies airtrapping?
Increased RV (residual volume)

Increased RV/TLC ratio
What does diffusion capacity test?
The ability of inhaled carbon monoxide to diffuse into the pulmonary circulation.
What does hypoxia refer to?
Reduced oxygen pressure in the aveolus.
What does hypoxemia refer to?
Low arterial PaO2
What is the normal range for pH?
7.35-7.45
A pH below the normal range is?
Acidemic pH <7.35
A Ph above the normal range is?
Alkalemic pH >7.45
What is the normal range for PaCO2?
35-45
If the PaCO2 is below normal range it is?
Alkalotic
What alters the PaCO2?
A respiratory disturbance.
What alters the HCO3?
A metabolic disturbance.
If the PaCO2 is above normal it is?
Acidic >45
What is the normal range for HCO3 (bicarb)?
22-26
If the HCO3 (bicarb) serum level is below normal it is?
Acidic <22
If the HCO3 (bicarb) serum level is above normal it is?
Alkolotic >26
What is normal for PO2?
>80 Normal PO2
What does a PO2 below normal signify?
Hypoxemia
What is the range for mild hypoxemia?
70-80 Mild Hypoxemia
What is the range for moderate hypoxemia?
60-70 Moderate Hypoxemia
What is the range for severe hypoxemia?
<60 Severe Hypoxemia
What is PO2?
Partial pressure of oxygen in the blood.