clm b r e a t h i n g

what is tidal volume

normal breathing

waht is irv

inspirary reserve volume— max volume of air above tidal volume (normal breathing)

what is erv

EXPIRATORY RESERVE VOLUME— MAX COLUME OF AIR EXPLELED BEYOND TIDAL

WHAT IS RV

VOLUME OF AIR IN LUNNGS AFTER MAX FORECED EXHALATION

WHAT IS FEV1

VOolume of air expelled in one second after max inhalaiton

• usually about 80% of lung volume

what are lung capacities

combos of lung voumes!

what is fvc

forced vital capacity

• irv+tv+erv

• max you can breathe in and out

what is total lung capacity

all 4 lung volumes

what is IC

inspiratory capacity

• IRV+TV

• max air in

what is FRC

functional residual capacity

• ERV+RV

• max air left after breahting

how does IRV, ERV, and Rv change with obstructive lung disease

• irv decreases

• ERV increases

• RV increase

air is trapped in the lungs

what are examples of obstrictive lung diseases

asthma, copd

what does ostrucitve lung disease do to FVC and FRC

total capacity is actually up— lungs are distended

• FRC is higher bc can’t expell air

what are examples of restrutice lung disease

scarring of lung— lung volume is small bc of pulmonary damage, congenital

how does IRV, ERV, RV change iwith restrictive lung disease

EVERYTHING decfeases

• also TLC

what does spirometry assess

volume/speed of air taht can be inhaled and exhaled

• FEV1, FVC and ratio

• purpose is diagnosis and assess disease progression

what is FEV1

forced expiratory volume in 1 second

what is normal value for fev1

80% of normal value (fvc)

what is the fev1:fvc ratio

the 80% or above you want

• how much you breathe out in one second vs how much you can get out that is not your reserve

• in obstructive— it will be lower bc slower to expell

• normal-ish in restritive bc can expell, just hit a cieling

Body Plethysmography

measure all lung capacities

• also gives TLC, FRC, RV— rly just giving residual volume so you can find total lung capacity

  • spirometry only gives tv, irc, erc FVC

how does Body Plethysmography work

detects pressure change in airtight box lollll

bronchodilator responsiveness test steps

• no saba for 4 hours; laba for 24-36 hours

• perform spirmetry

• give drug, wait 15-30

• repeat spirometry

what is a positive repsonse for Body Plethysmography

positive means asthma

• incomplete repsonse means more COPD

  • proves reversiblility- looking for improvement in FEV1 and FVC

methacholine challenge test use

for suspected asthma but normal baseline spirometry

how Methacholine Challenge Test work

an Ach derive that induces bronchoconstriction

• spirometry measured with ingestion

what does positive response of Methacholine Challenge Test mean

asthma

• decreased FEV1 over 20%

• if negative test you can rule out asthma

what does DLCO stand for

Lung Diffusion Testing

where does gas exhangel take place

alveoli

Lung Diffusion Testing how determine

how well gas exchange on alveloi

Lung Diffusion Testing wha are causes of low? (low surface area)

smoking

cystic fibrociss

durgs (amiodarone)

copd

sarcoidosis (that thickens alveloi membrane)

pulmonary embolism

what can Lung Diffusion Testing DETECT

restructive OR destructive disease

Lung Diffusion Testing MOA

inhale carbon monoxide, measure how much CO is exhaled after

• normally you should exhale 70-75%

• if low it means you are not getting good oxygen diffusion into blood

what can also effect Lung Diffusion Testing resutls

changes in blood volume, Hgb can change results

how does restrictive lung disease present??

fev1/fvc ratio normal

fvc is decreased

what is FeNO test

Fractional Exhaled Nitric Oxide

what does Fractional Exhaled Nitric Oxide help idenitify

asthma, bronchitis, allergic rhinitis, eczema

• shows presentation of inflammation

what cna Fractional Exhaled Nitric Oxide be used to help in thearpy/what drug

asthma resposne to corticosteriods

what is 6MWT

six min walk test

what does six min walk test measure

• quality of life— ability to do daily things

  • predict morbidity/mortality

what does BODE for COPD mortality include

bmi

obstruction (fev1)

dyspnea

E—exercise— 6 min walk test

what is PEFR

Peak Expiratory Flow Rate

what does Peak Expiratory Flow Rate measure

air expelled from lungsin one quick exhalation

Peak Expiratory Flow Rate when useful

asthma pts with hard time recognizing signs/symptoms

what does yellow zone of Peak Expiratory Flow Rate mean

50-80% of personal best— may need meds

what is red zone Peak Expiratory Flow Rate mean

less than 50% of personal best— REFERRAL TO URGENT CARE

carbon monoxide breath test

measures how much CO in everyday breath

• if above 10 ppm it means smoking

pneumon/o

lung

cpap

continuous positive airway pressure

PaO2

arterial partial pressure of oxygen

SARS

severe acute respiratory syndrome

-capnia

level of carbon dioxide

-oxia

level of oxygen

-pnea

breathing

copd

chronic obstructuve pulmonary disease

DTaP

diphtheria, tetanus, pertussis

(vaccine)

aer/o

air, gas

myc/o

fungus, mold

vir/o

virus

staphylo-

grape-like cluster

strepto-

chain

Bacill/i-, bacill/o-

bacillus

• rod-shaped, gram + bacteria

• spore-formin’!

Ig

immunoglobin

Ab

antibody

Ag

antigen

HLA

hyman leukocyte antigen

HLB

hydrophlilic- lipophilic balance

HIT

heparin-induced thrombocytopenia

LMWH

low molecular weight heparin

aPTT

activated partial thromboplastin time

INR

international normalized ratio

VTE

venous thromboembolism

• (movin’!)