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Flashcards by Rachel Nall, updated more than 1 year ago
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Created by Rachel Nall
over 8 years ago
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| Question | Answer |
| What is the maximal volume of all the airways in the adult? | 5 to 6 L |
| What does a simple spirometer do? | It measures volume of air inspired and expired, thus measuring changes in lung volume. |
| What are the four standard lung volumes? | Tidal volume, inspiratory reserve volume (IRV), Expiratory reserve volume (ERV), and residual volume (RV) |
| What are the four lung capacities? | Inspiratory capacity, functional residual capacity, total lung capacity, and vital capacity |
| What is a tidal volume? What is the average tidal volume of an adult breathing quietly? | Tidal volume is the volume of air entering and leaving the nose or mouth per normal breath. It is 500 mL in the average adult. |
| How do you calculate total ventilation? | Tidal Volume X respiratory rate = total ventilation in Liter |
| What is the inspiratory reserve volume What is the normal amount? | The additional volume of air a person can inhale above a tidal volume with maximal effort. The normal IRV is 2.5 to 3L |
| What is expiratory reserve volume and what is the normal value? | The volume forcefully exhaled below tidal volume after a quiet exhalation. The normal value is 1,200 mL. |
| How do you calculate expiratory reserve volume? | The difference between FRC and RV. In a healthy, 70 kg adult, the normal volume is 1.5 L. |
| What is residual volume? What is the average volume? | The volume of air left in lungs after forced exhalation/air that remains in lung no matter what you do unless the lungs collapse. The average volume is 1.5 liters |
| What is a disease state that increases residual volume? | Emphysema |
| What is the purpose of residual volume? | It keeps the lungs from collapsing at very low lung volumes. It maintains the potency of alveoli. |
| What is total lung capacity? | The volume of air in lungs after maximal inspiratory effort. It is approximately 6 Liters. |
| What are the two components of total lung capacity? | Vital capacity + residual lung volume |
| What is the functional residual capacity? What is its usual measurement? | Functional residual capacity is the volume of gas remaining in lungs at end of normal tidal exhalation. It is approximately 3 liters. Much larger than the tidal volume. |
| What is the purpose of functional residual capacity? | It prevents dramatic changes in o2 and po2 with each breath. |
| What happens if FRC becomes very low? | PO2 increases with inspiration and decreases with expiration. |
| What is inspiratory capacity? How is it calculated? | It is the maximal amount of air that one could still inspire or inhale. It is tidal volume + IRV |
| What is the vital capacity? What is its usual volume? | It is the amount of air that can be exhaled with maximum effort after maximum inspiration. The volume is 4.5 L. |
| What are some ways to calculate vital capacity? | TLC - RV Vt + IRV + ERV |
| What does vital capacity assess? | Strength of thoracic muscles as well as pulmonary function |
| What factors increase vital capacity? | Body size Male gender Physical conditioning |
| What factors decrease vital capacity? | Smoking, obesity, supine position, and poor posture |
| What is FEV? | Forced expiratory volume in one second. The volume of air exhaled in 1 second following maximum inspiratory effort and rapid, complete as possible exhalation. |
| What percentage of vital capacity is FEV? | 80 percent |
| What lung volumes can spiromety measure? | tidal volume, IRV, ERV, IC, VC |
| What lung volumes can spirometry NOT measure? | RV, TLC, and FRC |
| What are the gas dilution techniques used to measure lung volumes? | Helium-dilution Nitrogen-Washout |
| What is the purpose of body plethysmography? | It measures FRC; It is an example of Boyle's Law applied. |
| What is Boyle's Law? | P1 X V1 = P2 X V2 increases in volume, decreases in pressure decreases in volume, increases in pressure volume is inversely proportional to pressure |
| How does body plethysmography work? | A patient is placed in closed chamber, makes inspiratory effort against closed airway. Measures pressure and volume changes that occur during this. |
| How is FRC different from the supine position from a standing position? | FRC's decrease in the supine position - gravity is no longer pulling abdominal contents away from diaphragm, which decreases outward elastic recoil of the chest wall |
| What is the closing volume? | The volume where airway closure begins to occur |
| What is the closing capacity? | CV + RV; lung capacity where small airways begin to close |
| When does CV and CC increase? | With age, smoking, lung disease, body position (supine vs. upright) |
| What is the normal closing capacity? | Below FRC; increases steadily with increasing age. |
| At what age does CC = FRC in the supine position? | 44 years of age. |
| How are closing capacity and FRC related in neonates? | CC is greater than FRC in neonates |
| What is increased closing capacity probably linked with? | Age-related decline in Pa02. |
| What happens when lung volume is below CC? | Small airways readily close or collapse. This leads to a shunt which is a perfusion of non-ventilated airways. V/Q mismatch occurs and gas exchange worsens. |
| What factors increase closing capacity? | Age, smoking, asthma/emphysema, bronchitis, prolonged recumbency, increased left atrial pressure, decreased plasma oncotic pressure |
| What types of conditions will result in a decrease in physiologicaal 02 reserve, airway collapse, and atelectasis. | Reduction in lung volume, FRC, chest wall compliance or An increase in closing volume |
| What is the nature of pleural pressure in non-dependent zones? | More negative |
| What is the nature of pleural pressures in dependent zones? | Less negative; At end-expiration, alveoli in dependent zones are less inflated than those in non-dependent zones |
| What is the first to close during active expiration? | Alveoli at the bases |
| What is closing volume? | The lung volume above residual volume at which airways in the lower dependent parts of lung begin to close off. |
| What is ventilation? | The process by which 02 and C02 are transported to and from the lungs. |
| What is anatomical deadspace? | The volume of air occupying upper airways where there are no alveoli. |
| What is anatomical headspace equal to? | Approximately equal to a patient's weight in pounds. A 150 pound person would have 150 mL of anatomical headspace |
| How do you calculate physiologic deadspace? | Anatomical deadspace + alveolar deadspace |
| What is deadspace? | Wasted because it does not contribute to gas exchange |
| What is the symbol for physiologic deadspace? | Vd |
| How do you calculate minute ventilation? | Vt X RR |
| What is the normal value of minute ventilation? | 7,500 ml/Min (7.5 L/min) Calculated 500 mL X 15 bpm |
| What's another name for minute ventilation? | Total ventilation. |
| What is the symbol for minute ventilation? | Ve |
| What is alveolar ventilation? | Volume actually reaching respiratory zone of airways and involved in gas exchange per minute |
| What is the symbol for alveolar ventilation? | VA |
| How do you calculate alveolar ventilation? | VA = (tidal volume - VD) X RR The formula corrects for physiologic deadspace |
| What is the relationship of alveolar ventilation to PaCO2? | They are inversely related. hyperventilation lowers PaC02 and hypoventilation increases PaCO2 |
| What two factors are alveolar ventilation dependent on? | inspired air and alveolar or arterial C02 |
| How much alveolar deadspace will a healthy person have? | Virtually zero. |
| About what percentage of every tidal volume is deadspace? | 30 percent |
| What does a significant arterial-alveolar CO2 difference indicate? | Significant alveolar deadspace - some type of VQ mismatch |
| What situations cause V/Q Mismatch? | Pulmonary emboli Low venous return leading to low right ventricular output (hemorrhage) High alveolar pressure |
| What is Fowler's Method? | Measures anatomic deadspace by measuring volume of conducting zone by plotting the n2 concentration against the expired volume |
| What is Bohr's method? | Measures anatomic and physiologic deadspace. Any measurable volume of C02 in mixed expired gas. Bohr's method measures volume that does not eliminate C02 |
| How do the following affect anatomic deadspace: 1. Bronchoconstriction 2. Bronchodilation 3. Traction 4. compression of the airways | 1. decreases 2. Increases 3. increases 4. decreases |
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