Define FVCForce Vital Capacity=Ttal volume of air that can be exhaled forcefull from TLC
Describe FVCTake the deepest breath you can in and blast it out as fast and long as you can
List the information obtained during a FVC maneuverIRV=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 capacityIRV=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 diseaseFlow 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 diseaseFEV1= 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 functionspressure, flow, volume
What is the predicted values of the FEF of the large airways200-1200
Of the three air ways which is the most effort dependentLarge Airways
Which Of the airways should show normal values of 25-75%Medium airways
which of the airways is the least effort dependentSmall (smallest)
What are the normal values of FVC80-120-normal 70-80-mild 50-70-moderate less than 50- severe
Why do we use spirometrySimple 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 PFTHealth Screen Doctors Office Hospital bedside PFT Spirometry Plethysmography
What are some acceptable test when producing reproducibilityBiggest 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 testGood 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 testChoose the largest for the FVC Largest FEV1 Other values the best when you add FVC + FEV1`
List the indications for a PFTIdentify 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 FEV1Forced 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%


Primary uses of PFTquanitify 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 PFTsevere 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 VTamount 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 testingGender, 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 spirometry1 Slow vital capacity (called enhanced spirometry) 2. FVC 3. Max voluntary ventilation
Forced expiratory volume 1 sechow much air pt can blow out in one second after they have taken a max breath
forced expiratory volume 3 sechow much air pt can blow out in 3 sec after they have taken a max breath
Forced expiratory flow 200-1200 mLmachine 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 ventilationlargest 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 atATPS
PFTS are reported atBTPS
Pt’s who are candidates for methacholine challengeasthma, fireman, assess severe of hyper responsiveness, to determine relative risk of developing asthma, to asses response to therapy
How is methacholine delivereddosimeter- only on inspiration and only 5 breaths of each dose level 25 mg/ml
Substances that can be used for bronchoprovacation testinghistamine – 10 mg/ml 2. antigens 6-8mm wheel 3. cold air 4. exercise
Avoid short acting bronch6-8 hours
avoid long acting bronch48 hr
avoid anticholinergic aerosols24 hr
avoid tiotropiumup to 1 week
avoid disodium cromglycate8 hr
avoid nedocromil48 hr
avoid oral beta 2 adrenergic agonist24 hr
avoid theophyllines12-24 hr
avoid leukotriene modifiers24 hr
Pt that is candidate for exercise studyDyspnea with exertion where past tests are normal.2 asthma and being athletic, 3. known exercise induced asthma
AVERAGE tidal volumeVe/f
ATS criteria for PFT testingSpirometer 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 PFTmeets end of criteria, no coughing during 1st second inhalation, no closing of glottis, no leak, no obstruction of mouthpiece opening