PULMONARY FUNCTION TESTING
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1
it is the volume of gas that is exhaled slowly and completely after a maximal inspiration and can also be measured by maximal inspiration after a complete expiration
vital capacity
2
This reflects the movable portion of the total lung capacity
vital capacity
3
How is VC reported
largest acceptable volume obtained from atleast three acceptible maneuvers
4
largest volume inspired from the resting expiratroy level to maximal inspiration
Inspiratory Capacity
5
largest volume expired from the resting-end expiratory level to maximal expiration
Expiratory Reserve volume
6
IC and ERV are completely measured during?
Slow VC maneauver
7
How should IC and ERV be reported?
the average of at least three acceptible maneuver
8
VC patient Technique
1. Seat the patient upright with feet flat on the floor
2. Apply a nose clip when appropriate and establish a lip seal around the mouthpiece
3. Record at least three stable tidal breaths before beggining the maneuver
4. Coach the patient to inhale maximally
5. Instruct the patient to exhale slowly, continously, and completely to maximal expiration
6. VC may alternatively begin with maximal expiration followed by slow maximal inspiration
7. Use a graphic display when IC or ERV is needed becasue the tracing verifies stable tidal breathing and maximal inspiratory and expiratory plateaus
2. Apply a nose clip when appropriate and establish a lip seal around the mouthpiece
3. Record at least three stable tidal breaths before beggining the maneuver
4. Coach the patient to inhale maximally
5. Instruct the patient to exhale slowly, continously, and completely to maximal expiration
6. VC may alternatively begin with maximal expiration followed by slow maximal inspiration
7. Use a graphic display when IC or ERV is needed becasue the tracing verifies stable tidal breathing and maximal inspiratory and expiratory plateaus
9
Healthy VC may vary by approximately ___ % above or below predicted, but values must remain above the lower fifth percentile to be considered normal.
20
10
VC is indirectly related to ___, while it is directly related to ___.
age; height
11
VC decreseas decreses with age after approximately 20 years of age about
25-30 ml/yr
12
what vc testing may help evaluate diaphragmatic paralysis, neuromuscular disease, and unexplained positional dyspnea
prone or supine VC
13
How much is the decrease of VC during supine? (Healthy)
3-5%
14
If the decrease is greater than 10% it sugggest? (SUPINE)
diaphragmatic dysfunction
15
Pattern SIgnatures (Volume Time Trace)
Normal: Steep rise; high plateau
Obstructive: slow rise, delayed plateau
Restrictive: steep rise, low plateau
Obstructive: slow rise, delayed plateau
Restrictive: steep rise, low plateau
16
it describes how much gas moves
volume
17
it describes how rapidly gas moves
flow
18
Position: above tidal volume
IRV
19
Position: central oscillating level
VT
20
Position: Below tidal volume
IRV
21
Position: lowest fixed segment
Residual volume
22
Postion: Bracket from maximal inspiration to maximal expiration
VC
23
Position: bracket from top to bottom
TLC
24
Airway diseases (Obstructive) (4)
1. asthma
2. Chronic Bronchitis
3. Bronchiectasis
4. Cystic Fibrosis
2. Chronic Bronchitis
3. Bronchiectasis
4. Cystic Fibrosis
25
Parenchymal (Obstructive) (1)
1. Emphysema (panacinar, centriacinar)
26
Intrinsic - Pulmonary (Restrictive) (4)
1. Pulmonary Fibrosis
2. Sarcoidosis
3. Pnemoconioses
4. ARDS
2. Sarcoidosis
3. Pnemoconioses
4. ARDS
27
Extrinsic - Extrapulmonary (Restrictive) (4)
1. Kyphoscoliosis
2. Obesity
3. Neuromuscular Dz
4. Pleural Effusion
2. Obesity
3. Neuromuscular Dz
4. Pleural Effusion
28
If the FEV1/VC ration is reduced (<70%):
airflow obstruction is present
29
if the FEV1/FVC ratio is normal or elevated and VC is reduced:
restriction or respiratory muscle weakness
30
A large difference between VC and FVC suggest:
airway collapse and gas trapping during forced expiration
31
Poor effort can ___________ when the patient fails to inhale or fully stops exhaling before reaching a plateu
mimic restriction
32
Acceptable VC testing requires? (3)
1. stable tidal breaths 2. full inspiratory and expiratory plateaus 3. repeatable values within 150 mL
33
it is thr maximum volume of gas exhaled sd forcefully and rapidly as possible after a maximal inspiration
FVC
34
this begins after maximal expiration and continues through a rapid maximal inspiration
FIVC
35
in obstructive disease FVC may become what compared to slow VC?
lower than slow VC
36
the volume exhaled during the first second of the FVC maneuver
FEV1
37
the volume exhaled during the first six seconds of the FVC manuever
FEV6
38
this is the ratio of FEV1 to the largest acceptable vital capacity
FEV1/VC
39
reduced FEV1/VC ratio identifies?
airflow obstruction
40
FVC exhalation time (pedia, normal/adult, COPD)
Pedia: 3sec. Adult: 6sec. COPD: 10sec
41
this is the average expiratory flow during middle half of the FVC
FEF 25-75%
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