Spirometry and disease

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  • Created by: Amh
  • Created on: 11-04-16 22:01
In normal quite breathing inspiration is ________ and expiration is _________
Active, passive
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Airflow is___
Q=deltaP / R (pressure gradient over resistance)
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True or false; In normal, healthy lungs the radius is large enough that resistance is very low. As such, the primary factor affecting airflow is the pressure gradient
true
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In normal lungs ther is ________compliance and ____ airway resistance
High compliance low airway resistance
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What is work of breathing WOB influenced by
Pulmonary compliance, airway resistance, elastic recoil, and need for ventilation
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When does pulmonary compliance change and what does it mean
It is decreased in CF meaning it take more energy to expand lungs
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When does airway resistance change change and what does it mean
COPD, It causes a greater airway resistance, meaning more work to achieve greater pressure gradient to ensure adequate airflow
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When does elastic recoil change change and what does it mean
Emphysema = decreased elastic recoil means passive expiration is indadequare to expel col of air normally exhaled and therefore abdominals muscles must work to empty lungs at rest
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When does need for ventilation change and what does it mean
Exercise = need for increased ventilation, means more work to achieve greater deeper & faster breaths
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The energy required for breathing increases with exercise and pulmonary disease. For which of these is the energy required for breathing a higher % of total energy expenditure.
pulmonary disease
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during strenuous exercise how much more energy is required for pulmonary ventilation
An increase of 25 fold
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during strenuous exercise how much more EE is used
total EE increases 15-20, energy used for ↑ ventilation still only represents 5% total EE
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What is EE
Energy expenditure (i think)
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In the diseased state energy required for breathin greatly increases, how much of the EE does it now consume
30%
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What is our total lung capacity
– approx 5.7L (4.2L females)
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Can lungs work efficiently at 'half ful'l
yes
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How much air moves in and out in quiet breathin
500ml
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How much air is there at the end of expiration
2,200ml in lungs
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What is the max expiration
1200ml in men and 1000ml in women
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what does this mean
it means are lungs can never maximally deflate
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Why can our lungs never maximmaly deflate
1. gas exchange happens continuously 2. reduced WOB
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What factors affect lung volume
Age, gender, anatomic build, smoking, fitness, high altitude, resp disease
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Outline a traditional wet spirometer
There is an air filled drum and a water chamber. The person breaths in/out of the tube into the air chamber, causes the drum to rise and faall during resp cycle, and this data forma a spirogram
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What does a spirogram show you
a volume time curve. It will show us volume change across ins/exp the volume change will be about 500ml • volume (ml) along the Y-axis & time (secs) along the X-axis
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Should be able
to draw a healthy spirogram
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What does TV stand for
tidal volume, volume of air entering/leaving lungs during single breath
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What does IRV stand for
Inspiratory Reserve Volume, extra volume of air that can be maximally inspired (above TV)
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what does IC stand for
inspiratory capacity, IRV + TV
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What does ERV stand for
expiratory reserve volume, extra volume of air that can be maximally expired (beyond TV)
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what does RV stand for
residual volume, = min volume of air remaining in lungs after max expiration
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what does FRC STAND FOR
Functional residual volume,(ERV + RV)
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what does VC stand for
vital capacity, = TV + IRV + ERV
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what does TLC stand for
total lung capacity, maximal volume of air lungs can hold (VC +RV)
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Can residual volume be measured by spirometry
No because does not move in/out of lungs.
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how can you measure residual volume
gas dilution technique
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What is a normal TV (of a 70kg male)
500ml
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What is a normal IRV (of a 70kg male)
3000ml
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What is a normal IC (of a 70kg male)
3500ml
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What is a normal ERV (of a 70kg male)
1000ml
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What is a normal RV (of a 70kg male)
1200ml
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What is a normal FRC (of a 70kg male)
2200ml
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What is a normal VC (of a 70kg male)
4500ml
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What is a normal TLC (of a 70kg male)
5700ml
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which of these lung volumes varies with age
IRV, ERV, RV
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How does RV change with age
increases
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How does IRV + ERV change with age
decrease
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What is FEV1
forced expiratory volume in 1 sec – ‘volume of air that can be expired during the first second of expiration in a VC determination’
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What is VC
maximal vol of air that can be exhaled following maximal inspiration
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How do we calculate maximal airflow rate
FEV1/VC. It should be 80% of air should be expelled in 1st sec
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What happens to your lungs if there is an obstructioun
there is an increased resistance to airflow, it reduced airflow rate, and leads to difficulty emptying lungs
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Why is it diffucut to empty your lungs when they are obstructed
resistance during inspiration is less than resistance during expiration. resistance increased with obstructive pathology, problem more apparent with expiration, difficulty emptying lungs
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What kind of obstruction could it be and why
inflammation, mucous plugging, oedematous thickening of airway lining e.g. COPD, asthma, bronchitis, emphysema
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how does an obstruction effect TLC
It doesn't usually might be slightly increased
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how does an obstruction effect RV and frc
It increases them
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how does an obstruction effect FEV1
Big decrease
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how does an obstruction effect VC
decrease
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How is FEV1/VC affected in obstructive pathology
it is reduced - it is lesss than 80%
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What is an example of a restricitve pathology
Pulmonary fibrosis, pneumonia, pulmonary oedema
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What happens in restricitve pathology
compliance is reduced, and there is a difficulty filling the lungs
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What happens to TLC, IC, + VC in restrictive pathology
They are decreased
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What happens to RV and FRC IN restrictive pathology
IT stays the same
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How is FEV1 affected in restrictive pathology
increased or normal
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how is FEV1/VC affected in restrictive pathology
increased - greater than or equal to 80%
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What are come other pathologies that cause resp dysfunction
1. diseases that impair gas E across pul membranes. 2. decreased ventillation due to mechanical failure. 3. inadegquate perfusion 4. ventilation-perfusion imbalances
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How do we identify these other pathologies
X-ray, blood gas determination tests, tests 2 measure diffusion capacity of alveolar membranes
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Other cards in this set

Card 2

Front

Airflow is___

Back

Q=deltaP / R (pressure gradient over resistance)

Card 3

Front

True or false; In normal, healthy lungs the radius is large enough that resistance is very low. As such, the primary factor affecting airflow is the pressure gradient

Back

Preview of the front of card 3

Card 4

Front

In normal lungs ther is ________compliance and ____ airway resistance

Back

Preview of the front of card 4

Card 5

Front

What is work of breathing WOB influenced by

Back

Preview of the front of card 5
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