Flow rates and Pulmonary Function Tests

Restrictive Disorders

Can't expand lungs, smaller sonic cup, harder to inhale
Extrinsic disorders (outside of lungs)
-Scoliosis, Diaphragm paralysis & Obesity
Intrinsic disorders (inside the lungs)
-Pulmonary edema & fibrosis

Obstructive Disorders

Airway disorder, smaller straw, takes forever to exhale
Asthma
COPD
Cystic Fibrosis
FEV1 tests for this

Forced vital capacity (FVC) test

Amount of air that can be forcibly & rapidly exhaled after a full inspiration

Forced Expiratory Volume in 1 second (FEV1)

How much can u blow out in 1 sec.

Measures small airways

Measure of flow rate: tests Obstructive disorders

Diffusion carbon dioxide (DLCO)

Used to determine cross sectional surface area
Gas exchange from lungs to blood
DLCO = Surface Area over alveoli Thickness
DLCO low = less surface area or hypoventilation

If surface area increases what happens to DLCO?

Diffusion rate increases

If thickness increases what happens to DLCO?

Diffusion rate decreases

Extrinsic DLCO

Hypoventilation, Scoliosis, & Obesity
>80% DLCO/VA

Intrinsic DLCO

Low surface area or increased thickness. Emphysema, Pulmonary fibrosis, & Pulmonary hypertension
<80% DLCO/VA

PImax

Maximum Inspiratory Pressure. Max pressure during inspiration. Measures strength of muscles of inspiration

SIPmax

Maximal Sustained Inspiratory Pressure. Add resistance to inspirations. Measure of endurance of inspiratory muscles

PEF

Peak Expiratory Flow. Maximum flow of air during forced expiration

VE

Minute Volume Ventilation. Volume of air expired in 1 minute. VE = TV x Respiratory Rate

Normal Lung Sounds

Bronchial
Vesicular
Bronchovesicular

Bronchial

Loud tubular sounds that are hollow and higher pitched. Inspiration less than expiration - 1:3

Vesicular

Rustling and breezy sound that is soft and low pitched. Inspiration longer than expiration - 3:1

Bronchovesicular

Combo of bronchial & vesicular. Inspiration & Expiration are equal - 1:1

Adventitious (Abnormal Lung Sounds)

Continuous
-Pleural Friction Rub
-Rhonchi
-Stridor
-Wheeze
Discontinuous
-Crackles

Pleural Friction Rub

dry, crackling sound heard during both inspiration and expiration

Rhonchi

Low pitched sounds similar to snoring or gurgling

Stridor

High pitched wheeze

Wheeze

Musical or whistling sound

Crackles

High pitched popping during inspiration.
-Early: Bronchitis
-Late: Pneumonia, CHF, atelectasis

S1 (heart sounds)

AV valves close. LUB

S2

Aortic and pulmonary valves close. DUB

S3

early diastole. "Ventricular gallop". Due to distended ventricle wall during passive draining of blood from atrium. CHF

S4

late diastole. "Atrial gallop". Vibration heard during atrial contraction. Myocardial Infarction or Hypertension