Pulmonary Function measurements Notes and powerpoint
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557 Terms
What is tidal volume (VT)?
The amount of air inhaled and exhaled with each breath during quiet breathing.
What is the average tidal volume for an adult male?
500 mL.
What is the average tidal volume for an adult female?
400–500 mL.
What is inspiratory reserve volume (IRV)?
The amount of air that can be forcibly inhaled beyond tidal volume.
What is the average inspiratory reserve volume for an adult male?
3100 mL.
What is the average inspiratory reserve volume for an adult female?
1900 mL.
What is expiratory reserve volume (ERV)?
The amount of air that can be forcibly exhaled after a normal tidal volume.
What is the average expiratory reserve volume for an adult male?
1200 mL.
What is the average expiratory reserve volume for an adult female?
800 mL.
What is residual volume (RV)?
The amount of air remaining in the lungs after a forced expiratory reserve volume maneuver.
What is the average residual volume for an adult male?
1200 mL.
What is the average residual volume for an adult female?
1000 mL.
What is vital capacity (VC)?
The maximum volume of air that can be exhaled after a maximal inspiration.
What is the formula for vital capacity?
VC = IRV + VT + ERV.
What is the average vital capacity for an adult male?
4800 mL.
What is the average vital capacity for an adult female?
3200 mL.
What is inspiratory capacity (IC)?
The volume of air that can be inhaled after a normal exhalation.
What is the formula for inspiratory capacity?
IC = VT + IRV.
What is the average inspiratory capacity for an adult male?
3600 mL.
What is the average inspiratory capacity for an adult female?
2400 mL.
What is functional residual capacity (FRC)?
The volume of air remaining in the lungs after a normal exhalation.
What is the formula for functional residual capacity?
FRC = ERV + RV.
What is the average FRC for an adult male?
2400 mL.
What is the average FRC for an adult female?
1800 mL.
What is total lung capacity (TLC)?
The maximum amount of air the lungs can accommodate.
What is the formula for total lung capacity?
TLC = VT + IRV + ERV + RV.
What is the average total lung capacity for an adult male?
6000 mL.
What is the average total lung capacity for an adult female?
4200 mL.
Which four lung volumes make up TLC?
VT, IRV, ERV, and RV.
Which three lung volumes make up VC?
IRV, VT, and ERV.
Which two volumes make up IC?
VT and IRV.
Which two volumes make up FRC?
ERV and RV.
Which lung volume cannot be exhaled?
Residual volume.
Why does residual volume exist?
To prevent complete lung collapse after exhalation.
Is residual volume located only in the lower lungs?
No, it is distributed throughout the lungs.
What misconception can occur when studying the lung volume diagram?
Thinking RV exists only in the lower portion of the lungs.
What would happen if RV existed only in the lower lungs?
Most of the lung would collapse during forceful exhalation.
What is the primary characteristic of obstructive disease?
Decreased expiratory flow.
What test can be used to evaluate decreased expiratory flow?
Forced Vital Capacity (FVC).
Which lung volumes commonly increase in obstructive disease?
VT, RV, and FRC.
Which lung capacity may increase in severe obstructive disease with hyperinflation?
TLC.
Why does work of breathing increase in obstructive disease?
Increased airway resistance.
How does the breathing pattern change in obstructive disease?
Breathing becomes deeper and slower.
Why do obstructed patients breathe slower?
More time is needed for exhalation.
What limits expiratory flow in obstructive disease?
Airflow limitation.
What is mucosal edema?
Swelling of airway mucosa that can limit airflow.
How can excess mucus contribute to obstruction?
It narrows airways and limits airflow.
How does bronchoconstriction affect airflow?
It decreases expiratory flow.
What happens to RV and FRC in obstructive disease?
Both usually increase.
What relationship often exists between RV and FRC?
They usually increase or decrease together.
What obstructive disease example is associated with reduced lung recoil?
Emphysema.
What obstructive disease example is associated with partial airway obstruction?
Asthma.
What is the primary characteristic of restrictive disease?
Overall reduction in lung volumes and capacities.
What structures can be involved in restrictive disease?
Lung tissue and chest bellows.
What are chest bellows?
The muscles of breathing and bony thoracic structures.
Why does work of breathing increase in restrictive disease?
Lung compliance is decreased.
How does the breathing pattern change in restrictive disease?
It becomes shallow and rapid.
Why do restrictive patients breathe faster?
The lungs are stiff and cannot tolerate large expansion.
What happens to RV in restrictive disease?
It decreases.
What happens to FRC in restrictive disease?
It decreases.
What restrictive disease example is associated with increased lung recoil?
Fibrotic lung disease.
What restrictive disease example involves thoracic cage deformity?
Kyphoscoliosis.
What restrictive disease example involves the chest bellows?
Diaphragm paralysis.
What restrictive disease example involves lung tissue?
Pulmonary fibrosis.
What nerve injury can cause diaphragm paralysis?
Phrenic nerve injury.
Do obstructive and restrictive diseases affect work of breathing?
Yes, both can significantly increase work of breathing.
Which diseases listed are restrictive because they involve chest bellows?
Myasthenia gravis, Guillain-Barre syndrome, pleural disease, flail chest, morbid obesity, and diaphragm paralysis.
Which diseases listed are restrictive because they involve lung tissue?
Atelectasis, sarcoidosis, pulmonary fibrosis, pulmonary edema, pneumonia, and CHF.
Can changes in one lung volume affect other volumes and capacities?
Yes.
Can residual volume be measured directly?
No.
Can any capacity containing RV be directly measured?
No.
What three methods are used to measure RV indirectly?
Helium dilution, nitrogen washout, and body plethysmography.
What is actually measured during RV testing methods?
Functional residual capacity (FRC).
How is residual volume calculated from FRC?
RV = FRC − ERV.
What additional test is needed to calculate RV?
Slow vital capacity test to determine ERV.
What breathing instruction is used during helium dilution?
Breathe normally.
Is helium dilution an open- or closed-circuit test?
Closed-circuit.
Why is a carbon dioxide scrubber used during helium dilution?
To maintain normal conditions while rebreathing.
Why is supplemental oxygen used during helium dilution?
To maintain normal oxygen levels.
Is helium normally present in the lungs?
No.
Why does helium move from the spirometer into the lungs?
It moves from high concentration to low concentration.
What ends helium movement during helium dilution?
Equilibrium.
Approximately how long does helium dilution take in a healthy lung?
About 7 minutes.
How is FRC determined during helium dilution?
By comparing beginning and ending volumes.
What device determines FRC during helium dilution?
A special spirometer.
What breathing instruction is used during nitrogen washout?
Breathe normally.
What gas does the patient inhale during nitrogen washout?
100% oxygen.
Does nitrogen washout involve rebreathing?
No.
Approximately what percentage of normal lung gas is nitrogen?
About 78%.
What happens to nitrogen during nitrogen washout testing?
It is washed out of the lungs.
What device determines when nitrogen washout is complete?
A nitrogen analyzer.
At what expired nitrogen concentration is the test complete?
Less than 1.5%.
Approximately how long does nitrogen washout take in a healthy lung?
About 3 minutes.
How is FRC determined during nitrogen washout?
By comparing beginning and ending volumes.
What type of circuit is used during nitrogen washout?
Open circuit.
What breathing instruction is used during body plethysmography?
Pant or breathe rapidly.
What type of chamber is used during body plethysmography?
An airtight body box.
Does body plethysmography require a special gas mixture?
No, room air is used.
What law is body plethysmography based on?
Boyle's Law.
What does Boyle's Law state?
At constant temperature, pressure and volume are inversely proportional.