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