Functional Level Assessment in Pulmonary Health
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Questions and Answers

Which lung volume is NOT measured by spirometry?

  • Total Lung Capacity (TLC) (correct)
  • Residual Volume (RV) (correct)
  • Functional Residual Capacity (FRC) (correct)
  • Tidal Volume (TV)

What happens to the Residual Volume (RV) in emphysema?

  • It decreases
  • It fluctuates significantly
  • It increases (correct)
  • It remains the same

In a restrictive lung disease pattern, what do both FEV1 and FVC indicate?

  • Both are proportionately decreased (correct)
  • Both are increased
  • FEV1 is decreased, FVC is normal
  • FEV1 is increased, FVC is decreased

Which measurement indicates a patient's ventilation and gas exchange status?

<p>Arterial Blood Gases (ABGs) (D)</p> Signup and view all the answers

What does the FEV1/FVC ratio indicate in obstructive lung diseases?

<p>Lower than average (B)</p> Signup and view all the answers

How is pH related to the hydrogen ion concentration in the blood?

<p>Inversely proportional (D)</p> Signup and view all the answers

What is the primary role of bicarbonate ions (HCO3-) in blood?

<p>Indicator of metabolic function (B)</p> Signup and view all the answers

What does a high Paco2 level indicate about a patient's respiratory status?

<p>Hypercapnia (B)</p> Signup and view all the answers

What is the tidal volume (TV) in a healthy adult?

<p>500 ml (A)</p> Signup and view all the answers

What does the functional residual capacity (FRC) represent?

<p>Volume remaining after quiet expiration (B)</p> Signup and view all the answers

Which measurement indicates the maximum volume exhaled after maximum inhalation?

<p>Vital capacity (A)</p> Signup and view all the answers

As a person's age increases, how is lung volume and capacity generally affected?

<p>Decreases overall (A)</p> Signup and view all the answers

What is the volume of air that can be forcibly exhaled after a normal tidal volume expiration called?

<p>Expiratory reserve volume (D)</p> Signup and view all the answers

What is the total lung capacity (TLC) in a healthy adult?

<p>6000 ml (A)</p> Signup and view all the answers

The inspiratory capacity (IC) is defined as the maximum amount of air that can be inspired after which phase?

<p>Normal expiration (C)</p> Signup and view all the answers

Which lung volume reflects the air remaining in the lungs after maximal exhalation?

<p>Residual volume (B)</p> Signup and view all the answers

What does a low PaO2 level indicate?

<p>Abnormal oxygenation of blood (D)</p> Signup and view all the answers

At what PaO2 level should supplemental oxygen be administered?

<p>60 mmHg (B)</p> Signup and view all the answers

What condition is characterized by inadequate alveolar ventilation leading to the retention of carbon dioxide?

<p>Respiratory acidosis (D)</p> Signup and view all the answers

What is a potential outcome of hyperoxia?

<p>Lung damage (B)</p> Signup and view all the answers

Which of the following symptoms is NOT commonly associated with respiratory acidosis?

<p>Skin rash (C)</p> Signup and view all the answers

What primarily indicates the effectiveness of the lungs in oxygenating blood?

<p>PaO2 levels (B)</p> Signup and view all the answers

What can cause respiratory acidosis due to impaired respiratory muscle function?

<p>Neuromuscular diseases (D)</p> Signup and view all the answers

What physiological change occurs during metabolic acidosis?

<p>Excess quantities of acid production (B)</p> Signup and view all the answers

What is the primary cause of respiratory alkalosis?

<p>Hyperventilation (B)</p> Signup and view all the answers

Which symptom is associated with metabolic alkalosis?

<p>Polyuria (D)</p> Signup and view all the answers

What pH value would indicate an acidemic state?

<p>7.25 (A)</p> Signup and view all the answers

What distinguishes respiratory acidosis from metabolic acidosis?

<p>High PCO2 levels (C)</p> Signup and view all the answers

Which of the following conditions can result in metabolic alkalosis?

<p>Diuretic therapy (A)</p> Signup and view all the answers

In a patient with pH 7.32, PCO2 57, and HCO3 32, which interpretation is correct?

<p>Respiratory acidosis partially compensated by metabolic alkalosis (C)</p> Signup and view all the answers

What is a common symptom of respiratory acidosis?

<p>Cardiac arrhythmias (C)</p> Signup and view all the answers

Which of the following causes an increase in bicarbonate levels leading to metabolic alkalosis?

<p>Excess use of antacids (D)</p> Signup and view all the answers

What does a pH level of 7.43 indicate?

<p>Alkalosis (A)</p> Signup and view all the answers

What is the primary process when both high pH and high bicarbonate levels are present?

<p>Metabolic alkalosis (A)</p> Signup and view all the answers

What characterizes mixed respiratory and metabolic acidosis based on arterial blood gas results?

<p>High PCO2 and low HCO3 (B)</p> Signup and view all the answers

What is considered hypoxemia in terms of arterial blood oxygen saturation levels?

<p>Below 90 percent (A)</p> Signup and view all the answers

How does pulse oximetry measure oxygen saturation?

<p>By assessing light absorption patterns (C)</p> Signup and view all the answers

What is a major advantage of using pulse oximetry over arterial blood gas analysis?

<p>No pain for the patient (B)</p> Signup and view all the answers

What could occur if arterial blood oxygen levels drop below 80 percent?

<p>Compromise of organ function (D)</p> Signup and view all the answers

Why is direct measurement of arterial blood gases considered the best method for assessing gas exchange?

<p>It provides comprehensive information (A)</p> Signup and view all the answers

Flashcards

Tidal Volume (TV)

The amount of air inhaled and exhaled during normal breathing, typically around 500 ml.

Inspiratory Reserve Volume (IRV)

Additional air forcefully inhaled after a normal breath, typically around 3000 ml.

Expiratory Reserve Volume (ERV)

Additional air forcefully exhaled after a normal breath, typically around 1000 ml.

Residual Volume (RV)

Air remaining in the lungs after a maximum exhale, typically around 1500 ml.

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Inspiratory Capacity (IC)

Maximum air inhaled after resting exhalation, approximately 3500 ml (IRV + TV).

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Functional Residual Capacity (FRC)

Air remaining in the lungs after a normal exhale, around 2500 ml (ERV + RV).

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Vital Capacity (VC)

Maximum air exhaled after a maximum inhale, approximately 4500 ml (IRV + TV + ERV).

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Total Lung Capacity (TLC)

Maximum capacity of the lungs, around 6000 ml (IRV + TV + ERV + RV).

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What is PaO2?

The partial pressure of oxygen in arterial blood, indicating the amount of oxygen dissolved in the blood. It reflects the efficiency of the lungs in transferring oxygen to the blood.

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What is Hypoxemia?

A condition where the blood has lower than normal oxygen levels. This can be due to poor oxygenation of blood in the lungs, as seen with a low PaO2, or due to problems with oxygen delivery to tissues, like in ischemia.

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What is Hyperoxia?

A condition where there is damage to the lungs caused by inhaling too much supplemental oxygen. It can lead to coughing, breathing difficulty, and even death.

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What is Respiratory Acidosis?

A condition caused by inadequate ventilation, leading to a buildup of carbon dioxide in the blood. It results in a decreased blood pH.

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What is Metabolic Acidosis?

A condition where the body produces too much acid or the kidneys are not effectively removing acid. It leads to a decreased blood pH.

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FEV1/FVC Ratio

A ratio of FEV1 to FVC (Forced Vital Capacity). This ratio assesses the lung's ability to empty quickly. It is reduced in obstructive lung diseases.

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Obstructive Lung Disease

A lung condition where the airways are narrowed, making it difficult to exhale quickly. This leads to a reduced FEV1/FVC ratio.

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Restrictive Lung Disease

A lung condition where the lungs are restricted in their expansion, which reduces the amount of air they can hold. This leads to a reduced FVC but a normal FEV1/FVC ratio.

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Arterial Blood Gas (ABG) test

A blood test that measures the partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2) in arterial blood. It helps assess ventilation, gas exchange, and acid-base balance.

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Blood pH

A measurement of the acidity or alkalinity of blood. It's expressed as a pH value: below 7.35 is acidic, above 7.45 is alkaline.

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Respiratory Acidosis

A decrease in blood pH caused by an increase in carbon dioxide levels in the blood. This can occur due to inadequate ventilation, leading to a buildup of CO2.

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Metabolic Acidosis

A decrease in blood pH caused by either an increase in acid production or a decrease in the body's ability to remove acid. This can be due to conditions like kidney failure or diabetic ketoacidosis.

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Respiratory Alkalosis

An increase in blood pH caused by a decrease in carbon dioxide levels in the blood. This can happen due to hyperventilation, where you're breathing out more CO2 than normal.

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Metabolic Alkalosis

An increase in blood pH caused by an increase in bicarbonate levels in the blood. This can be due to factors like excessive vomiting or the overuse of antacids.

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Respiratory Acidosis (Partially Compensated by Metabolic Alkalosis)

A condition where the blood pH is below normal, but the primary cause is a change in CO2 levels. The body may try to compensate by altering bicarbonate levels.

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Respiratory Acidosis (Fully Compensated)

A condition where the blood pH is within the normal range, despite having a primary imbalance in CO2 levels. The body successfully adjusts bicarbonate levels to balance the pH.

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Metabolic Acidosis

A state where the body's pH is below normal, mainly due to an imbalance in bicarbonate levels. This can be caused by factors like kidney failure or diarrhea.

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Metabolic Alkalosis

A state where the body's pH is above normal, primarily due to an imbalance in bicarbonate levels. This can be caused by factors like excessive vomiting or overuse of antacids.

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Oxygen Saturation (SpO2)

The measure of oxygen saturation in the blood, represented as a percentage. It indicates the proportion of oxygen-carrying hemoglobin that is bound to oxygen.

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Hypoxemia

A condition where the SpO2 level falls below 90%, indicating insufficient oxygen in the blood.

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Pulse Oximeter

A medical device that non-invasively measures SpO2 by shining light through a finger and analyzing the absorption patterns.

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Acidosis

An imbalance in blood pH where the pH is below 7.35, indicating an excess of acid in the blood.

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Alkalosis

An imbalance in blood pH where the pH is above 7.45, indicating an excess of base (alkaline) in the blood.

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Study Notes

Functional Level Assessment

  • Presented by Dr. Eman Rashad, lecturer at Horus University in Egypt.
  • Her qualifications include a PhD, MSc, CMP, CMTP, CSMT, KCMT, and CLT.
  • Assessment includes lung volume and capacities, arterial blood gases, and pulse oximetry.

Lung Volume and Capacities

  • Lung volumes and capacities relate to a person's age, weight, sex, and body position.
  • Disease can affect lung volumes and capacities.
  • Volumes combined are described as capacities.
  • Understanding measurements and their values is crucial for therapists treating pulmonary dysfunction.
  • Diagrams and explanations for specific volumes (IRV, TV, ERV, RV, IC, VC, TLC, FRC) are shown in the presentation.

Spirometry

  • Spirometry measures how quickly and how much air a person breathes out.
  • A technician monitors and encourages the patient during the test.
  • The machine records spirometry test results.
  • A technician takes a deep breath and exhales as hard as possible into a tube.

Pulmonary Function Tests

  • Non-invasive tests demonstrating lung function.
  • Measure lung volume and capacity.
  • Healthcare providers use this information to diagnose and decide upon treatments for lung conditions.
  • Predicted values rely on factors like age, sex, height, and race.

Results Classification

  • Results are categorized into normal, obstructive, restrictive, and combined.

Pulse Oximetry

  • A noninvasive technique measuring oxygen saturation (SpO2).
  • The SpO2 reading might not perfectly mirror the arterial oxygen saturation (SaO2).
  • It's vital in monitoring a person's oxygen saturation, often used for patients with potential oxygen-related difficulties.
  • The presentation features images of different pulse oximeters (desktop, finger, wrist).
  • The oximeter passes specific light wavelengths through the patient's finger.
  • Oxygenated and deoxygenated hemoglobin have distinct light absorption patterns.

Arterial Blood Gases (ABGs)

  • ABGs provide insight into ventilation, gas exchange, and acid-base status.
  • A sample is drawn from an artery and analyzed with an ABG analyzer.
  • The line is usually inserted into the radial or femoral artery.
  • It helps assess patient type (hypoxemia or hypercapnia).

ABG Definitions

  • pH: Measures blood's acidity/alkalinity.
  • PaCO2: Partial pressure of carbon dioxide (acidic component).
  • HCO3: Bicarbonate ion concentration (basic/alkaline component).
  • Base Excess: Required strong acid/base to return pH to normal.

PaO2

  • Partial pressure of oxygen in the arterial blood.
  • Reflects oxygen movement from lungs to blood.
  • Reflects dissolved oxygen in the blood; shows how well the lungs function in oxygen transfer.
  • Elevated PaO2 indicates increased oxygen levels in inhaled air.
  • Normal range is 80-100 mmHg.
  • Low levels necessitate supplemental oxygen.

PaCO2

  • High PaCO2 indicates inadequate alveolar ventilation (hypoventilation).
  • Low PaCO2 signifies hyperventilation.

Acid-Base Imbalances (Respiratory Acidosis & Alkalosis, Metabolic Acidosis & Alkalosis)

  • Presented in detail with causes, symptoms, and compensatory mechanisms.

Problems and Solutions

  • Different patient scenarios (problems), illustrating how to interpret ABG results (solutions) to diagnose conditions like respiratory acidosis, metabolic alkalosis, and others.

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Functional Level Assessment PDF

Description

This quiz covers functional level assessment methods including lung volume and capacities measurement, as well as spirometry. Understand how these assessments relate to various factors such as age, sex, and body position. Essential information for therapists dealing with pulmonary dysfunction is emphasized.

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