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40 Cards in this Set
- Front
- Back
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PFT's are an assessment to determine...
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Vol. of gas moved in/out of the lung
How fast (flow rates) gases can be moved Stiffness of lung and chest wall Diffusion of gas across A-C membrane How well lungs respond to therapy |
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Results of PFT's are used to assist with diagnosis of...
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Normal Lung function
Obstructive Lung Disease Restrictive Lung Disease Both |
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PFT results are dependent on...
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The patient
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Indications for PFT
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Screening for the presence of pulm. disease
Eval. the pt before surgery Eval effectiveness to therapy Document progression of polm disease over time Studying effects of exercise on lung function Measuring the degree of airway hyperresponsiveness |
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PFT Contraindictions
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Hemoptysis
Pneumothorax Hemodynamic instability (recent MI, PE) Symptoms of acute severe illness: -angina -nausea and vomitting -High fever -sever dyspnea Recent eye surgery (cataract) Recent Hx of untreated aneurysm: -thoracic -abdominal -cerebral Recent abdominal or thoracic surgery |
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PFT Hazards and Complications
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Pneumothorax
Increased Intracranial Pressure Syncope, light-headedness, dizzness Chest Pain Paroxysmal coughing Nosocomial infection Oxygen desaturation (O2 therapy interruption) Bronchospasm |
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All PFT's are recorded in
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Ambient Temp and Pressure
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All PFT's are reported in
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Body Temp and Pressure
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How is ATPS converted to BTPS?
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Using Charles Law
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Normal predcted values are based on...
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Height (most important)
Weight Gender Age |
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Nomogram
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A collection of normal predcted PFT values based on gender, height, and age in chart form
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Spirometer
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A device designed to measure the Vital Capacity and its subdivisions
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Spirogram
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graphical representation of lung volumes and capacities
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Vol. vs Time graph
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graphical representation of lung volumes and capacties and flow rate
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Flow-Volume loop
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graphical representation of lung volumes and capacities and flow rates
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Direct Volumes Measurement Spirometers
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Water seal spirometers
Bellows Spirometer Dry Rolling Seal Spirometer |
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Indirect Volume Measurement Spirometers
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Heated wire Pneumotachometer
Turbine Pneumotachometer (Wright Spirometer) Pressure - Differential Pneumotachometer (CO2SMO) |
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Spirometry (Measured Directly)
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Vt
Insp. Reserve Vol Exp. Reserve Vol. Insp. Capacity Vital Capacity |
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Spirometry (Not Measured Directly)
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Resdual Volume
Functional Residual Capacity Total Lung Capacty *any volume or capacity that includes RV |
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Obstructive Disease effects...
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Flow Rate
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Restrictive Disease effects...
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Vol. and Capacities
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Obstructive Disease alters a flow vol. loop in what way?
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will cause the loop to bow in
COPD and asthma pts |
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FEV1
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Forced Exp. Volume at 1 sec
Determined from the FVC curve 75% is the norm Measures max vol of air exhaled during the first sec of exhalation Best indicator of obstructive airways disease if decreased from normal Reflects flow characteristics of larger airways emptying |
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FEV3
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Forced Exp. Vol at 3 sec
Determined from the FVC curve Measures max vol of air exhaled during the first three sec of exhalation Reflects flow characteristics of the smaller airways emptying Less reproducible and senstive then FEV1 95% is normal |
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FEV1%
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The ratio of the FEV1 to the FVC
FEV1% = FEV1/FVC Normal is 75% Decrease in FEV1% is an important indicator of obstructive lung disease |
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FEF 25-75%
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Forced Exp Flow 25-75%
Mifexp. phase of the FVC Reflects flow from medium and small airways Expressed in Liters/sec Sensitive to early indicators of obstructive dysfunction |
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FEF 200-1200
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Forced Exp. Flow
The avg exp flow rate of the first 200 mL of the FVC Reflects flow from large airways Expressed in Liters/Sec |
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PEFR
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Peak Exp. Flow Rate
Max exp flow rate achieved during the FVC manuever Liters/ Sec (Spirometry) Obtained from spirometry or from a portable peak flowmeter Liter/Min (From peak flowmeter) -trended by asthma pt -males (400-600L/M) -females (300-500 L/M) |
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PIFR
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Max insp flow rate achieved during the flow volume loop
Liters/Sec (spirometry) |
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Classification of Abnormality
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Obstructive Lung Defects
Restrictive Lung Defects Both |
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Obstructive Lung Disease
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Characterized by decreased exp flow rates during a Forced Vital Capacity
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Restrictive Lung Disease
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Characterized by decreased lung vol during a FVC
-VC -RV -FRC -TLC Flow rates may be normal or mildly reduced FEV1/FVC is normal in purely restrictive defects |
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Obstructive and Restrictive Defects
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Characterized by decreased lung volumes and decreased flow rate during a forced vital capacity
-End Stage Sarcoidosis |
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Spirometry Measurements
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Flow Vol Loops
Slow Vital Capacity Forced Vital Capacity Max Voluntary Ventilation Peak Exp. Flow Rate |
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Slow VItal Capacity Technique
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Pt breaths normally for several breaths
Max Insp followed by Slow max exhalation |
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Slow Vital Capacity Benefits
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Slow exhalation helps reduce air trapping due to premature closure of small airways seen in obstructive airways disease
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In a healthy lung....
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FVC and SVC should be equal
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What is the most widely used PFT maneuver?
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FVC
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FVC technique
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Pt breathes normally for several breaths
Max Insp. followed by Forceful and complete max exhalation |
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Benefits of FVC
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Healthy lungs: FVC and SVC are within 200 mL
FRC may be normal or decreased due to -Obstructve or Restrictive Lung Disease |
