#### Cardiopulmonary a&p Exam 2

Tidal Volume (TV)

amount of air inhaled or exhaled with each breath under resting conditions

male=500 mL
female=400-500

Inspiratory Reserve Volume (IRV)

Amount of air that can be forcefully inhaled after a normal tidal volume inhalation

Male 3100
Female 1900

Expiraotry reserve volume

amount of air that can forcefully exhaled after a normal TV

normal expiratory reserve volume (ERV)

Male=1200 mL
Female= 800mL

Residual Volume (RV)

Amount of air remaining in the lungs after a forced exhalation

normal residual volume

1200 mL (Females 1000 mL)

Vital Capacity (VC)

max amount of air exhaled after a maximal inspiration

normal vital capacity

4800ml (Female= 3200 mL)

inspiratory capacity

the volume of air inhaled after a normal exhale

normal inspiratory capacity volume

M= 3600 mL
F=2400 mL

Functional Residual Capacity (FRC)

volume of air remaining in the lungs after a normal tidal volume expiration

normal functional residual capacity

Males: 2400 ml
Females: 1800 ml

Total Lung Capacity (TLC)

maximum amount of air contained in lungs after a maximum inspiratory effort
M=6000mL F=4200mL

closed circuit helium dilution

way of measuring FRC. Closed circuit system where spirometer is filled w/ mixture of Helium and o2

Open circuit nitrogen washout method

Determines FRC
Pt breaths 100% O2 for about 7 min or until all the nitrogen is washed out of pt's lungs while a PFT measures the exhaled nitrogen
Test calculations depend on fact: air is 79% nitrogen so amt of nitrogen exhaled should be 79% of TLC
Test ig

Body Plethysmography (Body Box)

Individual is enclosed in a small, airtight chamber. The person's nostrils is clipped, and h/she is breathes against a mouthpiece. As the individual breathes, the air pressure and volume in the chamber change in accordance with the movements of the chest

FEV1

forced expiratory volume in 1 second

FVC (forced vital capacity)

The amount of air forcefully expired after a maximal inspiration

FEV1/FVC ratio

The fraction of air exhaled in the first second relative to the total volume exhaled

FEF 25-75% (Forced Expiratory Flow)

-average flow that occurs during middle 50 of FVC measurement
-this measurement reflects the condition of the MEDIUM to SMALL airways
-decreases w/ age and obstructive lung disease

This measurement reflects the condition of medium to small airways

FEF 25%-75%

In which test would the patient be instructed to exhale as forcefully, rapidly, and completely as possible after taking in a maximal inspiration?

FVC

Which test is the most commonly performed pulmonary function measurement?

FVC

Which pulmonary measurement reflects the status of the medium to small airways?

FEF25-75%

How does the general shape of a flow-volume loop in restrictive lung disease compare to a normal pattern?

Shorter and narrower

Which of the following would you expect to be reduced during an acute asthma episode?

PEFR (peak expiratory flow rate)

Which gas law is the law of partial pressures?

Dalton's Law

When breathing FIO2 1.0 at seal level, what would the PN2 in the alveoli equal?

0

What does the PH2O equal in alveolar gas if the FIO2 is 0.21?

47 mm Hg

What is the normal value for the respiratory exchange ratio?

0.8

For a healthy adult at rest, what is the normal pressure gradient for oxygen across the alveolar-capillary membrane when breathing room air at sea level?

60 mm Hg

In a healthy adult at rest at sea level, what is the normal carbon dioxide gradient across the alveolar capillary membrane?

6 mm Hg

Which law states that the amount of gas that dissolves in a liquid is directly related to the partial pressure of the gas?

Henry's Law

In a healthy 20 year old male, what would the FRC equal?

2.4 L or 2400 mL

In a healthy 20 year old male, what would the IRV equal?

3100 mL

In a healthy 20 year old male, what would the ERV equal?

1200 mL

In a healthy 20 year old male, what would the RV equal?

1200 mL

What is the best indicator of an obstructive lung disorder?

FEV1/FVC

What device is most commonly used to monitor airway function at home?

peak flow meter

Which maneuvers form a flow-volume loop?

FVC and FIC

What portion of the FVC maneuver is considered to be effort dependent?

first 30%

What would the partial pressure of oxygen equal in an air mixture at a depth of 99 feet under water?

159 x 4 or 636 mm Hg
At 99 feet under water, 4 atmospheres would be present so PO2 would equal 636 mm Hg.

-Good index of the integrity of large airway function
-Average flow rate that occurs between 200-1200 mL of FVC
"technically how fast we can get the first liter of the FVC out

FEF 200-1200

max flow rate that can be achieved during FVC
-can be done bed side using peak flow meter hand held device
-measures a pts max speed of expiration

PEFR (peak expiratory flow rate)

During acute asthma the PEFR would be

reduced

largest volume of gas that can be breathed voluntarily in and out of lungs in 1 minute

MVV (maximum voluntary ventilation)

Flow volume loop

Flow on vertical axis
Volume on horizontal axis
Loop shows both exhalation/inhalation
Both curve and loop show PEFR/FVC at highest point
FEF 25%,50%.75%
PIFR or PIF( peak inspiratory flow rate)
Highest insp flow generated during FVC

Maximum Inspiratory Pressure (MIP)

-125 cm H20 (Female -90 cm H20)

Maximum Expiratory Pressure (MEP)

230 cm H20 (Female 150cm H20)

Law of Partial Pressures

Dalton's Law

Dalton's Law

The total pressure of a mixture of gases is the sum of the individual pressures (Ptotal=P1+P2+P3...)

partial pressure of oxygen

160 mmHg

partial pressure of nitrogen

593 mmHg

atmospheric pressure _____ with increase in altitude

decreases

atmospheric pressure decreases w/ ______ in altitude

increases

As density of atmospheric gases decrease

p.p exerted by each has also decreases

% of 02 always approx 21 both at sea level or on top of mt Everest
what changes is the barometric pressure
True or false

True

1 atm =

760 mmHg

primary mechanism for moving in and out of lungs during ventilation
(movement of gas from area of high pressure/concentration to low)

gas diffusion

Movement of INDIVIDUAL gas molecules from an area of high pressure to an area of low pressure

Ideal Alveolar Gas Equation

PAO2 =
[PB-PH2O] FIO2 - PaCO2 (1.25)

PA=

Alveolus

Pa=

Arterial

FiO2

fractional inspired oxygen concentration.

Fick's Law

Essentially states that the rate of diffusion of a gas across a permeable membrane is determined by the chemical nature of the membrane itself, the surface area of the membrane, the partial pressure gradient of the gas across the membrane, and the thickne

less surface area=

less 02 gets transferred (through)

higher altitude=

lower alveolar 02 levels

perfusion limited

The transfer of gas across the alveolar wall is a function of the amount of blood that flows past the alveoli

When can the simplified alveolar gas equation be used?

When the PaCO2 less than 60 mm Hg and FIO2 0.6 or greater

Which law is represented by the equation below? V gas = [AD (P1-P2)] / T

Fick's Law

In a healthy individual, which of the lung volumes is the largest?
a. VT
b. RV
c. IRV
d. ERV

c. IRV

Which of the following is derived from closed circuit helium dilution method?
a. RV
b. VC
c. IC
d. ERV

a. RV

In the open circuit washout method, what gas mixture does the patient breathe for the test?
a. 100% O2
b. 100% N2
c. room air
d. He-O2 mixture

a. 100% O2

Which test/method is considered most accurate for measuring RV?
a. open circuit nitrogen washout
b. X-ray
c. closed circuit helium dilution
d. plethysmography

d. plethysmography

Which of the following can decrease the FEF 200-1200 ?
I. Obstructive disorders
II. Restrictive disorders
III. Age
a. I only
b. II and III only
c. I and III only
d. I, II, and III

d. I, II, and III

At what age do pulmonary volumes and expiratory flow rates start to decrease?

25 years

What portion of the FVC cannot be influenced by further muscular effort?
a. first 70%
b. last 70%
c. first 30%
d. last 30%

b. last 70%

Which pulmonary function test in essence assesses the status of the alveolar-capillary membrane?
a. MVV
b. bronchial provocation test
c. PEFR
d. DLCO

d. DLCO