Quiz

Spirometry

Gelöschter Nutzer 27 Fragen Aktualisiert am 25 Aug 2016

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1Physical Description
1. Age
2. Height or [blank_start]Arm[blank_end] Span. Without [blank_start]shoes[blank_end]. Multiply by [blank_start]2.54[blank_end] to get cm
3. Gender
4. Weight
5. Race

3.
1. AArm
2. Bshoes
3. C2.54
2[blank_start]Occupational[blank_end] History
Inquire about:
Mine / [blank_start]Quarry[blank_end] work
Mill [blank_start]Work[blank_end]
Farming
Gas / Fume exposure
Dusty [blank_start]Environment[blank_end]
1. AEnvironment
2. BWork
3. CQuarry
4. DOccupational
3Smoking History
Differentiate between cigars, pipes and [blank_start]cigarettes[blank_end]
Pack [blank_start]years[blank_end]
Does pt still [blank_start]smoke[blank_end]
1. Asmoke
2. Byears
3. Ccigarettes
4Medical / Surgical History
Disease: [blank_start]Asthma[blank_end], TB, Chronic [blank_start]Bronchitis[blank_end], Recurrent Colds, pneumonia, infections
Record presence of: Hay [blank_start]fever[blank_end] / allergies
1. AAsthma
2. BBronchitis
3. Cfever
5Withholding Medications
SABA: [blank_start]4[blank_end] hrs
LABA: [blank_start]12[blank_end] hrs
Methylxanthines: [blank_start]12[blank_end] hrs
Slow Release Methylxanthines: [blank_start]24[blank_end] hrs
Anticholinergics: [blank_start]8[blank_end] hrs
Cromolyn Sodium: [blank_start]8[blank_end] - [blank_start]12[blank_end] hrs
Other Meds: Inquire about Inhaled steroids, cardiac meds, antibiotics, beta blockers
1. A4
2. B12
3. C12
4. D24
5. E8
6. F8
7. G12
6Vital Signs
RR: [blank_start]10[blank_end] - [blank_start]20[blank_end]
HR: [blank_start]60[blank_end] - [blank_start]100[blank_end]
BP: 120/80
Sensorium: Alert, oriented and able to follow [blank_start]commands[blank_end]
1. A10
2. B20
3. C60
4. D100
5. Ecommands
7Other Respiratory Modalities:
Evaluate O2 [blank_start]therapy[blank_end], aerosol [blank_start]therapy[blank_end], pulmonary [blank_start]rehab[blank_end]
Contraindications:
[blank_start]Hemoptysis[blank_end] within 24 hrs, unstable [blank_start]vitals[blank_end], unable to [blank_start]cooperate[blank_end]
Prohibited activities
No alcohol within [blank_start]4[blank_end] hrs, no exercise within [blank_start]30[blank_end] minutes, don't wear [blank_start]tight[blank_end] clothing, don't eat large meal within [blank_start]2[blank_end] hours.

Other considerations:
Room [blank_start]temperature,[blank_end] barometric [blank_start]pressure[blank_end], dentures stay in unless they are [blank_start]loose[blank_end], wear nose clips, sitting position
1. Atherapy
2. Btherapy
3. Crehab
4. DHemoptysis
5. Evitals
6. Fcooperate
7. G4
8. H30
9. Itight
10. J2
11. Ktemperature,
12. Lpressure
13. Mloose
8Testing:

Slow Vital Capacity (SVC):
Max [blank_start]expiration[blank_end] after a [blank_start]full[blank_end] inspiration
L or mL corrected to [blank_start]BTPS[blank_end]
ATPS x [blank_start]factor[blank_end] = BTPS
BTPS is based on: ambient [blank_start]temperature[blank_end], Barometric [blank_start]Pressure[blank_end], Humidity

Measures:
Vital [blank_start]Capacity[blank_end]
[blank_start]Tidal[blank_end] Volume
Inspiratory [blank_start]Reserve[blank_end] Volume
Expiratory [blank_start]Reserve[blank_end] Volume
1. Aexpiration
2. Bfull
3. CBTPS
4. Dfactor
5. Etemperature
6. FPressure
7. GCapacity
8. HTidal
9. IReserve
10. JReserve
9Slow Vital Capacity ATS Standards
End Level of [blank_start]3[blank_end] breaths before SVC must not vary more than [blank_start]100[blank_end] mL
Large Variances may indicate a [blank_start]leak[blank_end]
At least 2 acceptable maneuvers within [blank_start]5[blank_end]% or [blank_start].15[blank_end] L
SVC should be within [blank_start]5[blank_end]% of best FVC
SVC higher than FVC indicates [blank_start]obstructive[blank_end] disease, but evaluate pt effort
1. A3
2. B100
3. Cleak
4. D5
5. E.15
6. F5
7. Gobstructive
10Vital Capacity (VC)
Max [blank_start]inspiration[blank_end] then max [blank_start]expiration[blank_end]
Typical Value: 4800 mL
decreased with restrictive disease
VC = [blank_start]IRV[blank_end] + Vt + ERV
VC = IC +[blank_start]ERV[blank_end]
VC = TLC - [blank_start]RV[blank_end]

Tidal Volume (Vt)
Normal resting breathing voume
Typical value: 500 mL
Decreased with restrictive disease
Vt x RR = [blank_start]Minute Volume[blank_end]
Vt - [blank_start]IC[blank_end] - IRV
Vt = VC - IRV - [blank_start]ERV[blank_end]
Vt = TLC - [blank_start]IRV[blank_end] - ERV - RV

Inspiratory Reserve Volume (IRV)
Largest volume of air that can be inspired above VT
Typical Value 3100 mL
Decreased with restrictive disease
IRV = IC - [blank_start]Vt[blank_end]
IRV = VC - [blank_start]ERV[blank_end] - Vt

Expiratory Reserve Volume (ERV)
Largest volume of air that can be expired from [blank_start]resiting[blank_end] end level
Typical Value: 1200 mL
Decreased with restrictive diseases
ERV = [blank_start]VC[blank_end] - IC
ERV = FRC - [blank_start]RV[blank_end]
1. Ainspiration
2. Bexpiration
3. CIRV
4. DERV
5. ERV
6. FMinute Volume
7. GIC
8. HERV
9. IIRV
10. JVt
11. KERV
12. Lresiting
13. MVC
14. NRV

11Inspiratory Capacity (IC)
Largest Volume of air that can be inspired from resting end level [blank_start]expiratory[blank_end].
Typical Value [blank_start]3600[blank_end] mL
Decreased with restrictive disease
IC = [blank_start]IRV[blank_end] + Vt
IC = VC - [blank_start]ERV[blank_end]
IC = [blank_start]TLC[blank_end] - FRC
1. Aexpiratory
2. B3600
3. CIRV
4. DERV
5. ETLC
12Forced Vital Capacity (FVC):
Max inspiration followed by a [blank_start]forced[blank_end] expiration
If SVC [blank_start]>[blank_end] FVC suspect obstructive disease
If SVC [blank_start]<[blank_end] FVC question pt effort
Exhale until a volume pleateau OR [blank_start]15[blank_end] seconds
Modified maneuver: After [blank_start]4[blank_end] seconds, relax and exhale gently.
1. Aforced
2. B<
3. C>
4. D15
5. E4
13FVC Measurements:
Peak Expiratory Flowrate (PEFR)
Maximum [blank_start]flowrate[blank_end] achieved during FVC
10 L/s
Nonspecific in significance because it is very dependent on [blank_start]patient[blank_end] effort
Measured in L/s ATPS corrected to BTPS

Forced Expiratory Flow 200-1200
Average flowrate that occurs during FVC after the first [blank_start]200[blank_end]mL has been expired
Typical: 6 L/s
Significance: Measures airflow in [blank_start]big[blank_end] airways. Decreased with mechanical airway problems and [blank_start]obstructive[blank_end] disease, can be decreased d/t poor effort

Forced Expiratory Flow 25%-75%
Average flowrate during the [blank_start]middle[blank_end] half of FVC
Typical: 4-5 L/s ATPS corrected to BTPS
Significance: Measures flow in the [blank_start]small[blank_end] airways, is [blank_start]decreased[blank_end] in obstructive disease. Most sensitive to detect [blank_start]small[blank_end] airway disease. Can appear erroneously [blank_start]decreased[blank_end] if FVC and FEV1 are greatly increased in post bronchodilator studies.

Forced Expiratory Volume/Time (FEVtime)
Volume Expired of time interval
Common: FEV.5, FEV1, FEV2, FEV3, FEV6
ATPS corrected to BTPS
Significance: Decreased flows indicate obstructive disease, FEV1 used to assess improvement in post BD studies, allow 10-15 minutes in between pre/post tests.

FEVT / FVC%
Forced expiratory volume for time interval expressed as a percentage of total FVC
Minimum acceptable values:
FEV.5/FVC = [blank_start]60[blank_end]%
FEV1/FVC = [blank_start]70[blank_end]%
FEV2/FVC = [blank_start]94[blank_end]%
FEV3/FVC = [blank_start]97[blank_end]%
FEV6/FVC = [blank_start]99[blank_end]%
Significance: [blank_start]decreased[blank_end] with obstructive disease, [blank_start]normal[blank_end] with restrictive.
1. Aflowrate
2. Bpatient
3. C200
4. Dbig
5. Eobstructive
6. Fmiddle
7. Gsmall
8. Hdecreased
9. Ismall
10. Jdecreased
11. K60
12. L70
13. M94
14. N97
15. O99
16. Pdecreased
17. Qnormal
14FVC to Generate Flow-Volume Loop
A forced expiratory maneuver followed by forced inspiratory maneuver
Recorder plots flow ([blank_start]vertical[blank_end]) and volume ([blank_start]horizontal[blank_end]) for inspiration and expiration
Expiration is [blank_start]above[blank_end] baseline, inspiration [blank_start]below[blank_end] baseline
Important to coach max effort without [blank_start]coughing[blank_end]
PEF is measured with pt at [blank_start]TLC[blank_end]
PIF is measured with pt at [blank_start]RV[blank_end]
Forced Expiratory Flow at 25%, 50%, and 75% of VC
% is amount of [blank_start]FVC[blank_end] that has been exhaled
Decreases in FEF50% and FEF75% indicate [blank_start]obstructive[blank_end] disease
These values can be more sensitive in detecting small airway obstruction than FEV1.

Forced Inspiratory Flow at 25%, 50% and 75% of Inspiratory Vital Capacity
Measured on inspiratory side of loop
useful when compared to expiratory Values for determining a site of large [blank_start]obstruction[blank_end] - particularly the [blank_start]50[blank_end]% value
Maximum Forced Expiratory Flow (FEFmax)
Highest flow achieved on expiratory curve
Analagous to [blank_start]PEF[blank_end]
FEFmax used to determine [blank_start]effort[blank_end]
1. Avertical
2. Bhorizontal
3. Cabove
4. Dbelow
5. Ecoughing
6. FTLC
7. GRV
8. HFVC
9. Iobstructive
10. Jobstruction
11. K50
12. Leffort
13. MPEF
15Flow Volume Studies:
FEF50%/FIF50%
Ratio of forced expiratory flow to forced inspiratory flow at 50% of VC
Helpful in evaluating [blank_start]upper airway[blank_end] obstruction
Normal: [blank_start].8[blank_end] - [blank_start]1.2[blank_end]
Variable Extrathoracic Obstruction [blank_start]increases[blank_end] ratio > [blank_start]1.2[blank_end]
Variable intrathoracic obstruction [blank_start]decreases[blank_end] ratio < [blank_start].8[blank_end]
Fixed airway obstruction would cause equally reduced flows
Formula: FEF50% / FIF50%
1. Aupper airway
2. B.8
3. C1.2
4. Dincreases
5. E1.2
6. Fdecreases
7. G.8
16Fixed Airway Obstruction:
Appears as decreased FEF50% and decreased FIF50% with values approximately [blank_start]equal[blank_end].
Example: Tracheal [blank_start]Stenosis[blank_end]
1. AStenosis
2. Bequal
17Variable Extrathoracic Obstruction:
Appears as [blank_start]normal[blank_end] expiratory flows with [blank_start]decreased[blank_end] inspiratory flows
FEF50% / FIF50% is [blank_start]increased[blank_end] > [blank_start]1.2[blank_end]
Example: [blank_start]Vocal Cord[blank_end] paralysis
1. AVocal Cord
2. B1.2
3. Cincreased
4. Dnormal
5. Edecreased
18Variable Intrathoracic Obstruction
[blank_start]Normal[blank_end] inspiratory flows with [blank_start]decreased[blank_end] expiratory flows
FEF50% / FIF50% is [blank_start]decreased[blank_end] < [blank_start].8[blank_end]
Ex: Tumor near the carina
1. Adecreased
2. BNormal
3. C.8
4. Ddecreased
19Flow Vol. Loops
Restriction:
Decreased lung [blank_start]volumes[blank_end] with [blank_start]normal[blank_end] flows
Loop is [blank_start]tall[blank_end] and [blank_start]skinny[blank_end]

Asthma:
Increase in resistance in [blank_start]small[blank_end] airways causes a [blank_start]decrease[blank_end] in expiratory flows
[blank_start]Scooped[blank_end] out portion on expiratory loop

Emphysema:
Increased small airways [blank_start]resistance[blank_end] along with loss of [blank_start]elastic recoil[blank_end] = a reduction of expiratory flows more pronounced than asthma
1. Atall
2. Bskinny
3. Cnormal
4. Dvolumes
5. Esmall
6. Fdecrease
7. GScooped
8. Helastic recoil
9. Iresistance
20Pre/Post Bronchodilator testing:
Determines degree of [blank_start]reversible[blank_end] obstruction
Indications:
FEV1 <[blank_start]80[blank_end]%, cough of unknown [blank_start]etiology[blank_end], asthma, suspected hyperresponsiveness

Loops can be superimposed to readily detect improvement
SABA is given via MDI, SVN, or IPPB
FEV1 must improve by at least [blank_start]12[blank_end]% and [blank_start].2[blank_end] L to be considered reversible.
Forumla: (post FEV1 - pre FEV1) / pre FEV1 = % change
If FVC increases in post, it is suggestive of [blank_start]air trapping[blank_end]
1. Areversible
2. B80
3. Cetiology
4. D12
5. E.2
6. Fair trapping
21Spirometry Evaluation:
2 Major characteristics that Spirometry measures: Lung [blank_start]Volumes[blank_end] & [blank_start]Flows[blank_end]
Decreased [blank_start]Flows[blank_end] indicate obstructive disorder.
CBABE: [blank_start]Cystic Fibrosis[blank_end], [blank_start]Bronchitis[blank_end], [blank_start]Asthma[blank_end], [blank_start]Emphysema[blank_end]

Decreased [blank_start]Volumes[blank_end] indicates restrictive disorder
Neuromuscular: Myasthenia Gravis, Gullian Barre, Muscular Dystrophy
Cardiovascular: CHF
Pulmonary: pneumonia, atelectasis, pulmonary fibrosis
Trauma: head trauma, rib fractures, flail chest
1. AVolumes
2. BFlows
3. CFlows
4. DCystic Fibrosis
5. EBronchitis
6. FAsthma
7. GEmphysema
8. HVolumes
22Interpretation:
>= [blank_start]80[blank_end]% Predicted : Normal
<[blank_start]80[blank_end]% Predicted: Mild dysfunction
<[blank_start]70[blank_end]% Predicted: Moderate dysfunction
<[blank_start]60[blank_end]% predicted: Moderate/severe dyfunction
<[blank_start]50[blank_end]% Predicted: Severe Dysfunction
<[blank_start]35[blank_end]% predicted: Very Severe Dysfunction
1. A80
2. B80
3. C70
4. D60
5. E50
6. F35
23FVC: ATS Standards
Maximal effort and smooth curve
Minimum of [blank_start]6[blank_end] seconds effort or [blank_start]2[blank_end] second plateau
Start of test needs to be [blank_start]abrupt[blank_end] with no hesitation
3 acceptable tests
Best Test has the highest [blank_start]FVC[blank_end] + [blank_start]FEV1[blank_end]
Adults should stand or sit
Coughing shows as an upward deflection
Early termination is a short horizontal line at end of expiration
Back extrapolation % = (back extrapolated vol / FVC) x 100

Spirogram acceptability:
Free from artifact: No [blank_start]cough[blank_end] or glottis closure in 1st seond. No early [blank_start]termination[blank_end]. No variable effort. No leak. no obstructed mouthpiece.
Good Start: Extrapolated volume of <[blank_start]5[blank_end]% of FVC OR time to PEF less than [blank_start]120[blank_end] ms
Satisfactory Exhalation: 6 seconds and or volume plateau, reasonable duration or plateau, OR subject cannot continue to exhale.
1. A6
2. B2
3. Cabrupt
4. DFVC
5. EFEV1
6. Fcough
7. Gtermination
8. H5
9. I120
24Maximum Voluntary Ventilation
Largest Volume of Air inhaled and exhaled over a [blank_start]12[blank_end] second period
Value is extrapolated to 1 minute and reported in L/min corrected to BTPS
Typical : [blank_start]170[blank_end] L/m
Provides info about: status of [blank_start]respiratory[blank_end] muscles, compliance of [blank_start]lungs[blank_end] and [blank_start]thorax[blank_end], airway [blank_start]resistance[blank_end]
Pt Breathes as DEEPLY and as RAPIDLY as possible for 12 seconds
Significance: Large reductions = sever obstruction.
Effort dependent: If FEV1 x [blank_start]35[blank_end] > MVV - question pt effort
1. A12
2. B170
3. Crespiratory
4. Dlungs
5. Ethorax
6. Fresistance
7. G35
25Obstructive Spiro Results: [blank_start]Normal[blank_end] FVC, [blank_start]decreased[blank_end] FEV1/FVC
Restrictive Spiro Results: [blank_start]Decreased[blank_end] FVC, [blank_start]normal[blank_end] FEV1/FVC
1. ANormal
2. Bdecreased
3. CDecreased
4. Dnormal
26Pediatric Spirometry
Same equipment
[blank_start]5[blank_end] years an older can usually perform acceptable spirometry
Loops that meet criteria for good start of test and are free from artifact in the first second are considered [blank_start]usable[blank_end].
If kid stops inhaling when flow is within [blank_start]10[blank_end]% of PEF it is early termination and [blank_start]unusable[blank_end].
1. A5
2. Busable
3. Cunusable
4. D10
27Spirometry ATS Standards
After [blank_start]3[blank_end] [blank_start]acceptable[blank_end] tests:
Check that the 2 largest FVC are within .[blank_start]15[blank_end] liters
Check that the 2 largest FEV1 are withink .[blank_start]15[blank_end] liters
Save best 3 maneuvers
1. A15
2. B15
3. C3
4. Dacceptable

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Beschreibung: Der Nutzer hat seine Fachbereichs-Information gelöscht. Quiz am Spirometry, erstellt von Gelöschter Nutzer am 19/08/2016.
Autor: Gelöschter Nutzer
Sprache: English
Aufrufe: 39
Verlauf: Erstellt am 19 Aug 2016 · aktualisiert am 25 Aug 2016
Schlagwörter: der nutzer hat seine fachbereichs-information gelöscht.

Spirometry

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