PFT, Chest X-Ray, and EKG exam

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84 Terms

1
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What are the four Volumes of the lungs? page. 166

Residual volume (RV)

Inspiratory reserve volume (IRV)

Expiratory reserve volume (ERV)

tidal volume (Vt)

2
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What are the four capacities of the lungs? page. 166

Total lung capacity (TLC)

Vital capacity (VC)

Functional residual capacity (FRC)

Inspiratory capacity (IC)

3
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What is tidal volume (Vt)? page. 167

volume of air inhaled or exhaled during each normal breath

4
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What is inspiratory reserve volume (IRV)? page. 167

maximal volume of air that can be inhaled over and above the inspired tidal volume

5
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What is expiratory reserve volume (ERV)? page. 167

maximal volume of air that can be exhaled after exhaling a normal tidal breath

6
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What is residual volume (RV)? page. 167

volume of air remaining in the lungs after a maximal exhalation

7
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What is total lung capacity (TLC)? page. 167

maximal volume of air in the lungs at the end of a maximal inhalation

8
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What volumes is TLC a sum of? page. 167

RV + Vt + ERV + IRV

9
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What is functional residual capacity (FRC)? page. 167

volume of air present in the lung at end-expiration during tidal breathing

10
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What volumes is FRC a sum of? page. 167

RV + ERV

11
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What is inspiratory capacity (IC)? page. 167

maximal volume of air that can be inhaled from the resting end-expiratory level

12
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What volumes is IC a sum of? page. 167

Vt + IRV

13
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What is vital capacity (VC)? page. 167

maximal volume of air that can be exhaled after a maximal inhalation

14
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What volumes is VC a sum of? page. 167

IRV + Vt + ERV

15
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STUDY THIS!!!

know all of the volumes and capacities as well as their normal values.

<p>know all of the volumes and capacities as well as their normal values.</p>
16
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What are the normal values of the volumes of the lungs? page. 166

IRV- 3100 ml

Vt- 500 ml

ERV- 1200 ml

RV- 1200 ml

17
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What are the normal values of the capacities of the lungs? page. 167

TLC- 6000 ml

VC- 4800 ml

IC- 3600 ml

FRC- 2400 ml

18
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What is Forced vital capacity (FVC)? page. 168

total volume of air that can be exhaled during a maximal forced expiration effort

19
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What is Forced expiratory volume (FEV1)? page. 168

volume of air exhaled in the first second after a maximal forced inhalation

20
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What is FEV1/FVC? page. 168

proportion or percentage of the FVC expired during the first second of the maneuver

21
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What is FEF25%-75%? page. 168

average flow occurring between 25% and 75% of the FVC

22
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What does FEF25%-75% measure?

It measures the function of the small airways, which are crucial for airflow resistance in obstructive lung disease.

23
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What does the X-axis on a flow volume loop show? page. 169

Volume

24
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What does the Y-axis on a flow volume loop show? page. 169

Flow

25
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What is true during an FVC vs. SVC measurement?

In an obstructive disease pattern, the SVC will be greater than the FVC

26
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What are the normal values for a PFT?

Normal: 80-100%

Mild: 60-79%

Moderate: 40-59%

Severe: less than 40%

27
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In restrictive lung patterns are volumes increased or decreased? page. 173

Decreased

28
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In obstructive lung patterns is flow increased or decreased? page. 173

Decreased

29
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Can FRC be directly measured? page. 174

No, they cannot be directly measured

30
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What are the three ways that FRC can be measured? pages. 174-176

Closed-Circuit Helium Dilution

Open-Circuit Nitrogen Washout

Body Plethysmography

31
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What is Boyles law?

at constant temperature, pressure and volume of a gas are inversely related

32
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What is Charles law?

at constant pressure, the volume of a gas varies directly with its temperature

33
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What is Gay-Lussac's law?

at constant volume, the pressure of a gas varies directly with its temperature

34
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Changes in lung volumes and capacities

Understand how restrictive, normal and obstructive are impacted

<p>Understand how restrictive, normal and obstructive are impacted</p>
35
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What is the normal airway resistance in healthy adults?

0.5 to 2.5 cm H20/L/S

36
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What is a normal DLCO?

80-120%

37
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How do you calculate airway resistance? page. 179

PIP - Pplat/flow

38
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What is the minimum compliance a patient can have in order to wean?

20 ml/cm H2O

39
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What is bronchoprovocation test? page. 181

A test that uses a methacholine to try and trigger a bronchospasm that helps determine the level at which airway response occurs

40
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What does bronchoprovocation testing help with? page. 181

rule out a diagnosis of asthma

assess the severity of airway hyperresponsiveness (AHR)

evaluate for occupational asthma

assess response to airway hyperresponsiveness (AHR) treatment

41
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What is a common test done for asthma patients?

Peak flow

42
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Which volumes can be directly measured?

Tidal volume

Expiratory reserve volume

Inspiratory reserve volume

43
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Which capacities can be directly measured?

Inspiratory capacity

Vital capacity

44
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Which volumes/capacities are indirectly measured?

Residual volume

Total lung capacity

Functional residual capacity

45
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What quality control must be done for a Levey Jennings chart?

If there is an outlier outside of the lines, the machine must be recalabrated

46
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What is the most important factor of PFT?

A well-trained energetic therapist

47
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What are the factors that affect PFT results?

Age

Gender

Height

Weight

48
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What are the four patterns for a PFT?

Normal

Obstructive

Restrictive

Mixed

49
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What happens when doing a methacholine challenge test?

The therapist gives a dose then records FEV1, then gives a bigger dose then records FEV1 and continues to do so until the capacities drop 12%, if they drop 12% a bronchodilator is given to bring the patient back to their baseline.

50
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How is a calibration test done for volume? page. 170

calibration check with a calibrated 3-L syringe

51
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When looking at a chest X-Ray what are the five things we look at?

A: Airway

B: Bones

C: Cardiac

D: Diaphragm

E: Everything else (that's important)

52
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What are the angles of the diaphragm called?

costophrenic angles

53
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What is the notch above the heart called?

cardiac notch

54
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What side does the trachea shift to if the patient has a pneumothorax?

The trachea shifts away from the affected side

55
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What side does the trachea shift to if the patient has atelectasis?

The trachea shifts towards the affected side

56
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How many ribs should be able to be counted on a chest X-ray?

8-10 Ribs

57
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If a patient has a visible artificial airway on a chest X-Ray how far above the carina should it be?

3-5 cm

58
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What is an enlarged heart on a chest X-Ray called?

cardiomegaly

59
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How can we determine if the heart is enlarged on a chest X-Ray?

More than half the diameter of the chest

60
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If the diaphragm on a chest X-Ray looks flattened what is that indicative of?

Air trapping, hyperinflated lungs

61
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What are five findings on a chest X-Ray of someone who has COPD that someone else may not have if they don't have COPD

flattened diaphragm

less curved ribs

can count more than 8-10 ribs

hyperinflated lungs

Increased intercostal space

Heart becomes more narrow due to hyperactivity inflation

62
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On a normal ECG rhythm, what are the events that occur for the P, QRS, and T waves?

P wave: atrial depolarization (contraction)

QRS: ventricular depolarization (contraction)

T: ventricular repolarization (relaxation)

63
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What is happening between the PR intervals on a normal ECG?

period between atrial depolarization (contraction) and ventricular depolarization (contraction)

64
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What is happening between the ST segment on a normal ECG?

period between ventricular depolarization (contraction) and ventricular repolarization (relaxation)

65
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When should an ECG be obtained?

physicians order or protocol

known or suspected cardiac patient

known or suspected overdose on a tricyclic medication

electrical injuries

drop in blood pressure (Syncope)

66
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What is PEA?

Pulseless electrical activity (looks normal on an ECG, but there is no heart activity going on)

67
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What is septal infarct?

Tissue of the heart is dead and can't contract

68
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What is angina pectores?

chest pain caused by decreased consistent low oxygenation to the heart (caused by ischemia)

69
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What is Ischemia?

decreased oxygenation to the heart

70
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What is infarction?

death of myocardial tissue. tissue is dead and cannot come back.

71
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What happens first infarction or ischemia?

Ischemia will happen before infarction; can be long before infarction or just shortly before.

72
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What are pacemaker cells?

specialized cells that can generate their own electrical activity

73
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Where are pacemaker cells located?

They are mostly consolidated in the SA node but there are some in the AV node as well

74
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What are conducting cells?

They are cells that conduct the electrical impulses throughout the heart

75
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What is the pattern of electrical conduction of the heart?

SA node -> Internodal pathways -> AV node -> Bundle of His-> right and left bundle branches-> Purkinje fibers

76
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What is the most important lead to respiratory therapists?

Lead II (2)

77
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What is important of the ST segment?

very important in determining a STEMI

78
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In terms of electrical impulse, what is important about the PR interval?

It is the time that it takes the SA node impulse to get to the AV node

79
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How many seconds is each box on an ECG?

0.04 seconds

80
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What are five important steps when interpreting an ECG?

looking at the rate

looking at the rhythm

looking at the shape of the QRS

looking at the PR interval

looking at the ST segment

81
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What is a uni-focal PVC vs. a multi-focal PVC

uni=1 pvc

multi= multiple PVC's

82
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What is cardioversion?

treatment that sends shock during R wave.

83
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What is defibrillation?

shocking to stop fibrillation

84
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Can asystole be shocked?

NO