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33 Cards in this Set

  • Front
  • Back
We think of asthma as ____ obstruction.
reversible
We think of emphysema as ___ obstruction.
irreversible
Physiologic statement about patients who have emphysema.
COPD
Often called emphysema and chronic bronchitis.
centrilobular emphysema
Presentation of centrilobular emphysema.
hypoxemic, hypercarbic, prone to RH failure, complain of CHRONIC COUGH
Presentation of panacinar emphysema.
Usually thin, not hypoxemic until late in course, rarely hypercarbic until very late, typically complain of DYSPNEA
Pure coal inhalation is an _____ disease according to OSHA.
obstructive
Non-cardiogenic pulmonary edema.
ARDS
Three things that can cause trouble with the bellows and resp failure.
ascending paralysis, ALS, SC trauma
Five fxns of resp tract
warming and humidification of air
O2 intake and CO2 secretion
Metabolic fxn of lung
acid/base balance
host defenses
The end of a TIDAL expiration what volume remains in lung?
functional residual capacity
Patient takes in a deep breath and forces it all out. Volume that is blown out?
forced vital capacity (FVC)
Two methods to calculate residual volume (RV):
1)measure FVC and measure total lung capacity in a body box -> TLC - FVC = RV
2)Solve for Functional Residual Capacity by gas dilution method and subtract the expiratory reserve volume (ERV)
The amount of air that you breathe in and out at rest.
Tidal Volume
The amount of air that can be inspired in addition to tidal volume.
Inspiratory Reserve Volume (IRV)
Normal FEV1/FVC
0.8
Definition of obstruction by FEV1/FVC
<0.7
In an obstructed patient, after maximum inspiration, they start out at a ____ volume and have a ____ exhalation.
higher, slower
A restricted patient, after maximum inhalation, starts out at a ____ volume and has a _____ exhalation.
smaller, more rapid
T/F: More effort will not bring about faster exhalation after the equal pressure point.
True. This is due to the distortion of the airways due to the positive pressure put on them.
Compared to a normal patient, an obstructed person has an equal pressure point closer/further from the mouth.
Further, because the support structures have been damaged and more malleable.
Why do obstructed patients breathe w/ their lips pursed?
This increases pressure at the mouth, moving the equal pressure point closer to the mouth.
What is a method for determining FRC?
helium dilution method
How does helium dilution method work?
Breathe tidally a known concentration of helium of known volume. Allow things to come to equilibrium and measure new concentration at exhalation. Solve for FRC w/ this equation.
C1*V1 = C2*(V1 + V2)
How does body box work?
Patient pants against a closed shutter for 15 seconds. There are pressure sensors in the box, and using Boyle's Law, we are able to calculate TLC.
What is FEF 25-75%?
rate of flow from the first quarter to fourth quarter of exhalation.....decreased in obstruction, normal or increased in restriction
FEV1/FVC in obstruction?
decreased
FVC in restriction?
decreased
TLC in obstruction?
normal or increased
TLC in restriction?
decreased
RV in obstruction? restriction?
increased, decreased
Diffusion increased by?
polycythemia, mild asthma, increased capillary blood flow, pulmonary hemorrhage
Diffusion decreased by?
anemia, thickened diffusion barrier, decreased capillary blood volume, loss of surface area, V/Q mismatch