ventilation and pulmonary function

Question 1

pulmonary function testing

Answer 1

• used to identify general breathing difficulties at rest and during exercise
• commonly assessed with a spirometer
• measures volumes (static) and flow (dynamic) while inhaling and exhaling

Question 2

increased ventilation

Answer 2

• with exercise you breath faster and deeper
• during maximal exercise, healthy individuals retain a ventilatory reserve
• reserve is normally %30 in normal individuals
• fittest women have less of a reserve because of smaller lungs and surrounding accessories
• uses many accessory muscles to breathe like the diaphragm, intercostals, sternocleidomastoid, etc.

Question 3

dynamic ventilation chart

Answer 3

• flows and volumes
• chart is smaller at rest and bigger during exercise
• need faster air flow to more volume of air

Question 4

spirometry

Answer 4

• in “normal” individuals, greater than 70% of FVC can be inhaled in 1s
• remaining 30% depends on how you move air through the airways
• uses the resting forced vital capacity test (FVC and FEV1)
• is a measure of expiratory ability and general resistance to expiration, expressed as a percent

Question 5

dynamic forced ventilation

Answer 5

• effort independent = small airways and troubles with resistance
• PL, Ppl, alveolar pressure, and transairway pressure

Question 6

PL

Answer 6

• pressure generated by lung recoil

Question 7

Ppl

Answer 7

• pleural pressure generated by active inspiration or expiration

Question 8

alveolar pressure

Answer 8

• the sum of PL and Ppl and expressed relative to atmospheric pressure

Question 9

transairway pressure

Answer 9

• the difference between Ppl and local alveolar pressure

Question 10

effort dependent and independent flow

Answer 10

• dependent : pressure differential pushes air out , lungs and ribs = more pressure b/c they recoil together
• independent: as lungs recoil, pressure decreases and returns to normal, balances pressure and compression
• see pics for more details*

Question 11

basic spirometry

Answer 11

• uses the resting forced vital capacity test
• maximal exhalation (preceded by a max inhalation ) around 6 sec
• should be done in a sitting position (obese people will have better values standing )
• nose-clips should be used
• participant should exhale as forcefully as possible and for as long as possible
• ratio of FEV1/FVC should be greater than or equal to 85%
• if it is less than %70 it represents some pulmonary obstruction (like asthma)
• a bunch of prediction equations to compare against norms

Question 12

end of test criteria for basic spirometry

Answer 12

• when participant can no longer exhale or plateau in exhaled flow (less than 0.025L/s)
• test should be repeated at least 3x (2-3 min of recovery between)
• two best performances should be within 150ml
• if not continue with additional tests to look for maximal values
• take highest values

Question 13

exercise spirometry

Answer 13

• used to investigate breathing difficulties during exercise
• influences O2 uptake
• perform a resting FVC test, want people to breathe hard
• perform a single stage exercise test of 6-8 min duration at 80-90% of HR max or predicted
• perform post-exercise FVC tests at 5, 10, and 15, and 20 min
• see how FVC test changes and if it changes
• onset of these conditions can happen late not not immediately after exercise

Question 14

Eucapnic voluntary hyperventilation test

Answer 14

• also used to assess breathing difficulties
• mimics an exercise challenge
• perform resting FVC test
• perform of 6 min of hyperventilation (air + 5% CO2)
• tidal volume fixed at 85% of TCL or FEV1
• breathing rate fixed at 30 bpm
• perform post-exercise FVC tests at 5, 10, and 15, and 20 min
• dries and cools airways = bronchoconstriction

Question 15

Exercised induced bronchoconstriction

Answer 15

• a drop in FEV1 10% from pre-exercise values
• narrowing of bronchi due to smooth muscle contraction that can be induced by exercise, heavy breathing, cold dry air, and or “bad air”

Question 16

exercised induced asthma

Answer 16

• FEV1 is reduced by 15% or more
• higher in athletes involved in winter sports

Question 17

pulmonary pathophysiology; COPD

Answer 17

• chronic obstructed pulmonary disease
• breakdown and loss of lung tissue / structure , influences effort independent flow and flow volume loops
• narrowing and compression of small airways
• airway obstruction (mucus)
• elevated resistance = harder to move air/ exhale volume

Question 18

emphysema

Answer 18

• “pink puffer”
• problems with alveoli (structural damage)
• breaks down and expand
• cuts down on area for gas exchange

Question 19

chronic bronchitis

Answer 19

• “blue bloater”
• contract it through pulmonary illness/smoking
• pulmonary branches become thicker, lumen = smaller
• mucus secretion \