Question Answer
Define FVC Force Vital Capacity=Ttal volume of air that can be exhaled forcefull from TLC
Describe FVC Take the deepest breath you can in and blast it out as fast and long as you can
List the information obtained during a FVC maneuver IRV=3000 ML VT=500ML OR 5-7 KG OF IBW ERV=1200 RV: NOT MEASURED 1200 ML IC=3500 VC=4700 TLC=NOT MEASURED 6L FRC=NOT MEASURED 2400 ML
What are the normal values for each volume and capacity IRV=3000 mL Vt=500 mL or 5-7 kg of IBW ERV= 1200 mL RV= 1200 mL IC=3500 mL TLC= 6L VC= 4700 mL FRC= 2400 mL
List what the characters you would see if you had a obstructive disease Flow reduced FEV1> 75% pred (could be low in both) FEV1%=<78% obstructive -some text say 80%
List what the characteristics you would see in Restrictive disease FEV1= may be low >75% FEV1%= NORMAL
What is the formula for FEV1% FEV1/FEV
What are the most common test to determine where a disease is restrictive or obstructive? FEV, FEV1, & FEV1%
What is measure to determine lung functions pressure, flow, volume
What is the predicted values of the FEF of the large airways 200-1200
Of the three air ways which is the most effort dependent Large Airways
Which Of the airways should show normal values of 25-75% Medium airways
which of the airways is the least effort dependent Small (smallest)
What are the normal values of FVC 80-120-normal 70-80-mild 50-70-moderate less than 50- severe
Why do we use spirometry Simple Reproducible Office Based Easy to interprety Cheapest and most reliable ATS stands Diagnose obstruction and rule out restrictive
Describe the various settings and ways to obtain a PFT Health Screen Doctors Office Hospital bedside PFT Spirometry Plethysmography
What are some acceptable test when producing reproducibility Biggest two test within 150-200 mL The largest FVC should be with 150-200 mL PEF- varible but with good effort Need 3 acceptable test with good FEV and FEV1 and take up to 8 tests
What is considered a good test Good start No coughing or hesitation within the 1st second At least 6 seconds with a 1 sec plat No valsalva, glottis closure, or early termination FIVC should show maximum effort
How do you choose the best test Choose the largest for the FVC Largest FEV1 Other values the best when you add FVC + FEV1`
List the indications for a PFT Identify the High Risk Smoker Early dectection of Lung disease Follow the course of lung disease measure therapy effectiveness Determine the cause of dyspnea Evaulate the effects of coocupational exposure Determine degree of impairment
Define FEV1 Forced Expiratory volume- the volume you can blast out in the 1st second of the FVC
A pts predicted FVC is 5L. They blow a FVC of 3L. What is their percent predicted? 3/5=60%



 

Question Answer
Primary uses of PFT quanitify changes in fxn and impairment. 2. screening of disease 3. assessment of post op 4. determination of pulm disability 5. evaluation of therapy effectiveness
Basic pt types who are unable to do PFT severe hypoxemia on room air 2. increased intracranial pressure 3. cardiac arrhythmias 4. inability to follow directions (age, disease) 5. untreatable TV or HIV
Tidal volume VT amount of air moved in and out of lungs during normal breathing
Inspiratory reserve volume (IRV) amount of air inspired from normal inspiration
Expiratory reserve volume (ERV) amount of air exhaled from normal exhalation
Residual volume (RV) amount of air left in the lungs after maximum exhalation
inspiratory capacity (IC) amount of air inspired from normal expiration
Functional residual capacity (FRC) amount of air left in the lungs after normal exhalation
vital capacity (VC) amount of air exhaled in one breath; the max amount of air that can be forcibly exhaled after breathing in as much as possible (max inhalation)
Total Lung capacity (TLC) amount of air in the lungs after max inhalation
Info you need to get before testing Gender, age, height, weight, race, exposure to chemicals, history of medicine, current symptoms, pack years of smoking
Volumes and capacities that CAN be measured with simple spirometry 1 Slow vital capacity (called enhanced spirometry) 2. FVC 3. Max voluntary ventilation
Forced expiratory volume 1 sec how much air pt can blow out in one second after they have taken a max breath
forced expiratory volume 3 sec how much air pt can blow out in 3 sec after they have taken a max breath
Forced expiratory flow 200-1200 mL machine disregards the first 200 ml that the pt exhales after max inhalation and then measures how fast the pt exhales the next 1000 mL (LARGE UPPER AIRWAY)
forced exp flow 25%-75% machine disregards the first 25% and the last 25% of the air that the pt exhales after max inhalation and then measures how fast the pt exhales (SMALL AIRWAY obstruction)
Maximum voluntary ventilation largest volume and rate that can be breathed per minute, in and out as fast as possible for 12-15 seconds (REPRESENTS STRENGTH OF RESP MUSCLES)
PfTs are measured at ATPS
PFTS are reported at BTPS
Pt’s who are candidates for methacholine challenge asthma, fireman, assess severe of hyper responsiveness, to determine relative risk of developing asthma, to asses response to therapy
How is methacholine delivered dosimeter- only on inspiration and only 5 breaths of each dose level 25 mg/ml
Substances that can be used for bronchoprovacation testing histamine – 10 mg/ml 2. antigens 6-8mm wheel 3. cold air 4. exercise
Avoid short acting bronch 6-8 hours
avoid long acting bronch 48 hr
avoid anticholinergic aerosols 24 hr
avoid tiotropium up to 1 week
avoid disodium cromglycate 8 hr
avoid nedocromil 48 hr
avoid oral beta 2 adrenergic agonist 24 hr
avoid theophyllines 12-24 hr
avoid leukotriene modifiers 24 hr
Pt that is candidate for exercise study Dyspnea with exertion where past tests are normal.2 asthma and being athletic, 3. known exercise induced asthma
AVERAGE tidal volume Ve/f
ATS criteria for PFT testing Spirometer must be 8 liters, must be capable of measuring 0-14 L/s, all tests reported by BTPS, min of 3 acceptable FVC 8 max, FVC must be .2 L (150 ml) of each other
Acceptable PFT meets end of criteria, no coughing during 1st second inhalation, no closing of glottis, no leak, no obstruction of mouthpiece opening