M2-C9-L08 --> Pulmonary Function Testing

Front 1

SPIROMETRY

- Assesses what 4 things?

- which one is the likely #1 reason for performing a Spirometry?

Back 1

(REDS)

- Response to Inhaled Aerosolized MES

- Exercise Tolerance

- Degree of Lung Dysfunction
(with patients who smoke)

- Severity of Lung Disease
(Obstructive & Restrictive)
(likely #1 reason for doing spirometry)

Front 2

SPIROMETRY

- Evaluates what 3 things?

Back 2

(POD)

- Preoperative Risks
- Occupational Risks
- Disability

Front 3

SPIROMETRY

- measures the Patients Ability to do what? x2

- Lung Disease can affect which of the above abilities?

Back 3

- Take a deep breath IN and blow OUT
(volume)

- how FAST a patient can blow OUT

- either one or Both

Front 4

SPIROMETRY

- what are the 3 most important values that are obtained from Spirometry?

Back 4

- FVC
(Forced Vital Capacity)

- FEV 1.0
(Forced Expiratory Volume 1 second)

- PEFR
(Peak Expiratory Flow Rate)

Front 5

SPIROMETRY

- Forced Vital Capacity (FVC) is what?

- what is the usual normal value range?

Back 5

- taking the Deepest Breath Possible and Blowing out until Lung is Empty

- 3 to 5 liters

Front 6

SPIROMETRY

- Forced Expiratory Volume (FEV 1.0) is what?

- what is the usual normal value range?

Back 6

- How much Volume is Exhaled during First second of FVC maneuver

- 70% of FVC or higher

Front 7

SPIROMETRY

- Peak Expiratory Flow Rate (PEFR) is what?

- what is the usual normal value range?

Back 7

- Fastest a patient can Blow out

- 300 to 600 L/min

Front 8

SPIROMETRY

- Normal FEV 1.0 / FVC ratio is?

Back 8

0.7 or greater

(or 70% or greater)

Front 9

COPD

- define COPD

- COPD affects what airways?

- COPD is due to what mechanism?

- COPD mechanism above is a result of what?

- is COPD reversible?

Back 9

- Fiberotic Narrowing of Small Airways due to inflammation as a result of irritants (e.g. - smoke)

- Small airways

- Inflammation

- Irritants (smoke)

- Partially reversible
(for Fibrotic narrowing)

Front 10

COPD

- what spirometry measurement is changed and how?

- what physiology is inhibited?

- what spirometry pattern is noted?

Back 10

- FEV 1.0 is decreased

- Cannot create Sufficient Expiratory Flow

- Obstructive spirometry pattern

Front 11

COPD

- COPD patients have what type of pathological conditions associated? x2

Back 11

- Bronchitis

- Emphysema

Front 12

COPD

- what normal lung function is lost? x2

- how do the lungs appear on X-ray?

- all of the above are usually due to what?

Back 12

- loss of elasticity in lungs
- loss of lung recoil

- hyperinflated lungs on x-ray

- cigarettes

Front 13

COPD

- what are the clinical signs of COPD? x3

Back 13

(PID)

- Prominent Anterior Chest

- Increased Antero-Posterior Chest Diameter

- Dorsal Kyphosis

Front 14

COPD

- Barrelling and Wide Chest is due to what etiology?

Back 14

- loss of elasticity

(thus)

- Lungs don't oppose chest wall and walls go out

Front 15

COPD

T/F : the COPD clinical signs of barrel chest and widening of chest wall is due to lung hyperinflation

Back 15

- False

- due to loss of elasticity, thus loss of chest wall opposition by the lungs

Front 16

what disease does this show?

Back 16

Front 17

- what condition seen in the first 3?
- what is going on next 2?
- what is going on for last picture?

Back 17

Emphysema
(loss of recoil due to loss of elasticity)

Complete loss of elasticity / recoil

"Popping" of elasticity
(its a goner)

Front 18

ASTHMA

- general definiton

- spirometry changes? x2

- spirometry pattern?

- Reversible?

Back 18

- inflammatory response to a trigger

- FEV 1.0 decrease
- PEFR decrease

- Obstructive Spirometry pattern

- Typically REVERSIBLE

Front 19

ASTHMA

- what is the #1 MC trigger for asthma?

- what is the #2 MC trigger?

- what is the #1 trigger for asthma in URBAN America?

- list another trigger that can be antigenic to asthma..

Back 19

- cat saliva
(not the dander)

- cockroach poopy

- cockroach poopy

- House mites poopy

Front 20

ASTHMA

- how come dogs aren't as antigenic to asthma as cats?

Back 20

- not so much antigenic protein in saliva as cats

Front 21

ASTHMA

- what is "obstructing" the airways?

Back 21

- Mucous plugs

Front 22

ASTHMA

- what anatomical structure is usually inflamed?

- give 3 pathologies associated with the above anatomical structure.

Back 22

- Inflamed Bronchus

(MMR)
- Mucous plug
- Muscle Layer contraction
- Reduced airway opening

Front 23

ASTHMA

- Pathology of Status Asthmaticus x3

Back 23

(status ast-HMA-ticus or HAM)

- Hyperinflation (regional or diffuse)

- Mucous plugs in airways
(tenacious & viscid)

- Atelectasis foci

Front 24

OBSTRUCTIVE DISEASE REVIEW

- list 2 obstructive diseases

Back 24

- COPD

- Asthma

Front 25

OBSTRUCTIVE DISEASE REVIEW

- which one hyperinflates the lungs?

- which one is mainly caused by cigarettes?

Back 25

- both

- COPD

Front 26

OBSTRUCTIVE DISEASE REVIEW

- which one partially reversible?

- what is partially reversible for above disease?

Back 26

- COPD

- fibrotic narrowing of small airways

Front 27

OBSTRUCTIVE DISEASE REVIEW

- which one decreases FVC?

- which one decreases FEV1?

- which one decreases PEFR?

Back 27

- neither

- both

- Asthma

Front 28

OBSTRUCTIVE DISEASE REVIEW

- Obstructive Disease decrease what as opposed to Restrictive Diseases?

- Restrictive Diseases decrease what as opposed to Obstructive Diseases

- how does the patients manifest the above decreased states? x2

Back 28

- Flow is decreased
(can't BLOW out as much)

- Volume is decreased
(can't TAKE in enough volume)

Front 29

PNEUMONIA

- changes what spirometry value(s)?

- spirometry pattern seen?

- how is pulmonary inflammation type different from the COPD or Asthma?

Back 29

- FVC decrease (volume decrease)

- Restrictive pattern

- Bacterial inflammation

Front 30

PNEUMONIA

- what respiratory symptom is commonly seen?

- why do patients do this?

Back 30

- panting

- b/c it is the least amount of work

Front 31

PNEUMONIA

- is this an Obstructive or Restrictive disease?

Back 31

(CAP = OOR)

- Restrictive

Front 32

RESTRICTIVE DISEASES

- Restrictive diseases usually have decreased what as opposed to Obstructive diseases?

Back 32

- Restrictive Dz = decreased Volume
(can't TAKE IN enough volume)

- Obstructive Dz = decreased Flow
(can't BLOW out as much)

Front 33

SPIROMETRY PERFORMANCE

- what is very important to have when obtaining a quality spirometry result?

Back 33

- Good COACHING

(or a well-trained therapist)

Front 34

SPIROMETRY PERFORMANCE

- the respiratory coach needs to make sure the patient breathes out for how long in order to get a good measurement?

Back 34

- 6 seconds

Front 35

- what does this graph represent?
- what may have caused the increase in volume?
- how much volume increase are you wanting?

Back 35

- graphical representation of an Asthmatic patient blowing out at Pre-Tx and Post-Tx (20 min later)

- Bronchodilator Tx

- 12%

Front 36

- what does this represent?
- what is the peak called?
- what is X?

Back 36

- graphical representation of expiration

- FVC
(about 5 L)

- X is the FEV 1.0
(about 3.5 L)

Front 37

Back 37

Front 38

Back 38

asthma

Front 39

Back 39

Emphysema (COPD)

Front 40

Back 40

Fixed Obstruction

(Fixed right thar' in middle)

Front 41

Back 41

mixed pattern

Front 42

Back 42

Normal pattern

Front 43

Back 43

Obstruction pattern

(note the "bowed out" area)

Front 44

Back 44

Restriction

(to da "R"ight is da "R"estriction)

Front 45

Back 45

Restriction pattern

Back 46

Variable Extrathoracic Obstruction

("Extra" because most of it in the Expiratory region)

Front 47

Back 47

Variable Extrathoracic Obstruction

("Extra" because most of it in the Expiratory region)

Front 48

Back 48

Variable Intrathoracic Obstruction

(Intra b/c in Inspiration region mostly)

Front 49

Back 49

Front 50

Back 50

Front 51

MISCELLANEOUS

- Spirometry prediction numbers are baed on what 2 things?

Back 51

- Age

- Height

Front 52

MISCELLANEOUS

- what med treatment might help differentiate between Asthma & COPD?

- how can you use above drugs to differentiate asthma and COPD?

Back 52

- Bronchodilators

- upon Post-med expiration, Asthmatics will show 12% increase

- COPD'ers will not have this increase

Front 53

MISCELLANEOUS

- Blowing out (expiratory flow) is decreased in what lung disease type?

Back 53

- Obstructive

(Out Blowing = OBstructive)

Front 54

MISCELLANEOUS

- Decrease in inspiratory volumes is due to what lung Dz type?

Back 54

- Restrictive

Front 55

MISCELLANEOUS

- which lung dz type shows panting?

Back 55

- Restrictive

Front 56

MISCELLANEOUS

- Decrease in FVC seen in what Dz?

- Decrease in FEV1 seen in what Dz?

- Decrease in PEFR seen in what dz?

Back 56

- Pneumonia (restrictive)

- COPD (obstructive)
- Asthma (obstructive)

- Asthma (obstructive)

Front 57

MISCELLANEOUS

- what causes the "obstruction" in Obstructive Lung Dz? x2

Back 57

- Mucous plugs in airways
(Asthma - Inflammatory trigger)

- Fibrotic narrowing of small airways (COPD - inflammatory irritant)

Front 58

MISCELLANEOUS

- which spirometry value has a normal range of about 300 to 600 Liters / min?

Back 58

- PEFR

(Peak Expiratory Flow Rate)

Front 59

MISCELLANEOUS

- what lung dz type has patients feeling fatigued and "don't have wind"

Back 59

- Obstructive Lung Dz

Front 60

MISCELLANEOUS

- cigarettes mostly affect which spirometry value?

Back 60

- FEV 1.0

Front 61

MISCELLANEOUS

- in COPD, what is the "obstruction"

- in Asthma, what is the "obstruction"

- in Pneumonia, what is the "restriction"

Back 61

- Fibrotic narrowing of small airways

- Mucous plugs that are tenacious & viscous

- Volume of air capacity
(can not inspire as much)

Front 62

MISCELLANEOUS

- which lung type dz has a "scooped out" or "bowed out" feature in the spirometry loop graph

Back 62

- Obstructive

Front 63

MISCELLANEOUS

- normal values are what % of predicted?

- predicted is based on what? x2

Back 63

70%

- Age
- Height

Front 64

MISCELLANEOUS

T/F : can Chihuahuas remove the effects of Asthma from adult patients.

Back 64

Fuck NO! Dat shit is False biaaatch!!!

Front 65

MISCELLANEOUS
(something i found on Wiki)

- in Obstructive Dz, the FEV1/FVC ratio changes how?

- in Restrictive Dz, the FEV1/FVC ratio changes how?

Back 65

- reduced ratio
(b/c FEV1 primarily affected)

- approximately normal
(b/c both values decrease)

Front 66

MISCELLANEOUS

- which lung disease type affects primarily airways?

- which lung disease type affects primarily lungs?

Back 66

- Obstructive Lung Dz

- Restrictive Lung Dz
(the lung volume is affected)

Front 67

MISCELLANEOUS

- in COPD, the chest wall goes out because why?

Back 67

- the chest is NOT opposed by the Lungs anymore