Review of Critical Care Medicine

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Lung Volumes

Posted by Dr KAMAL DEEP on June 19, 2013

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Lung volumes and capacity measurements.Top left: A cartoon figure representing lung space divided into lung volumes. Dead space refers to areas where gas exchange does not occur; all other spaces are defined in the accompanying table. Top right: Spirometer recordings are shown with marked lung volumes and capacities. Table at bottom defines individual measurements and values from the top graphs. Note that residual volume, total lung capacity, and function residual capacity cannot be measure with a spirometer.[Widmaier EP, Raff H, Strang KT: Vander’s Human Physiology: The Mechanisms of Body Function, 11th ed. McGraw-Hill, 2008]

 

 

 

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Pressure-volume curves of the isolated lung, isolated chest wall, combined respiratory system, inspiratory muscles, and expiratory muscles. FRC, functional residual capacity; RV, residual volume; TLC, total lung capacity

 

 

 

 

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Flow-volume curves in different conditions: O, obstructive disease; R(P), parenchymal restrictive disease; R(E), extraparenchymal restrictive disease with limitation in inspiration and expiration. Forced expiration is plotted in all conditions; forced inspiration is shown only for the normal curve. TLC, total lung capacity; RV, residual volume. By convention, lung volume increases to the left on the abscissa. The arrow alongside the normal curve indicates the direction of expiration from TLC to RV.

 

Questions:-

Which tends to decrease with increasing
age – (AIIMS 85)
a) Vital capacity b) Systolic B.P.
c) Pulse pressure d) Residiial volume

All of following tend to increase in old age
except – (Delhi 96)
a) Residual volume b) Systolic BP
c) Pulse pressure d) Vital capacity

The hall mark of generalised obstructive lung
disease is- (PGI 80, AIIMS 81)
a) Reduced tidal volume
b) Reduced residual volume
c) Reduced timed vital capacity
d) Reduced vital capacity

For diagnosis of obstructive airway disease which
of the following measurement is usuala)
Vital capacity (PGI 81, UPSC 86)
b) Timed vital capacity
c) Tidal volume
d) Blood gas analysis

The hallmark of generalized obstructive disease
is reduced (PGI 81, Delhi 84)
a) Vital capacity
b) Arterial 02 saturation
c) Timed vital capacity
d) Tidal volume

Spirometry is useful to calculate all the except –
a) Tidal volume b)FEV (AI 97)
c) Residual volume d) Vital capacity

Total vital capacity is decreased but timed vital
capacity is normal in — (JIPMER 80, UJPSC 87)
a) Bronchial Asthma b) Scoliosis
c) Chronic bronchitis d) All of the above

In diffuse pulmonary fibrosis all are decresed excepta)
Vital capacity (AIIMS 97)
b) Diffusion capacity
c) Compliance
d) Alveolar arterial 0 2 gradient

All are seen in emphysema except – (Kerala 95)
a) Decreased vital capacity b) Hyper inflation
c) Rhonchi d) Damage to alveoli

In COPD all are affected except— (A189)
a) FEV b) Ratio of FEV to vital capacity
c) FVC d) None

Lung function test in emphysema reveals -(PGI 01)
a) Increased vital capacity
b) Decreased diffusion capacity for carbon monoxide
c) Increased diffusion capacity for carbon monoxide
d) Decreased total lung capacity
e) FEV, decreased

Which is not characterstic of interstitial lung
diseasea)
Decreased vital capacity
b) Decreased total lung capacity
c) Increased diffusion capacity of carbon
d) All

Vital capacity of the lung is very low in
a) prone b) lithotomy c) trendelenberg d) supine

All of the following differ in males and females except
(a) Tidal volume (b) vital capacity (c) residual volume (d) Expiratory reserve volume

Trendelenberg position produces decrease in all of the following except: AIIMS – 04
a. Vital Capacity b. Functional residual capacity c. Compliance d. Respiratory rate

Which is not increased in pregnancy UP. 96
(a) vital capacity (b) blood volume (c) Extracellular fluid (d) weight

In upper air way obstruction all of the following changes
are seen except :
(A) Decreased Maximum breathing capacity
(B) RV decreased
(C) Decreased FEV
(D) Decreased vital capacity

Tidal volume is calculated by
A. Inspiratory capacity minus the inspiratory reserve .
volume
B. Total lung capacity minus the reserve volume
C. Functional residual capacity minus residual
volume
D. Vital capacity minus expiratory reserve volumes

A patient presents with decreased vital capacity and
total lung volume. What is the most probable
diagnosis ?
A. Bronchiectasis
B. Sarcoidosis
C. Cystic fibrosis
D. Asthma

Volume of air taken into the lungs in normal
respiration is known as – (PGI 88)
a) Vital capacity
b) Timed vital capacity
c) Tidal volume
d) Inspiratory reserve volume

The following are acceptable as normal resultsa)
PO, 100 mm Hg (JIPMER 79, AIIMS 85)
b) V/Q ration 1.0
c) Resting tidal ventilation 5L/min
d) FEVI 60% of vital capacity

All of the following differ in males and females
except – (Assam 95)
a) Tidal volume
b) Vital capacity
c) Residual volume
d) Expiratory reserve volume

Vital capacity is a measure of (Kerala 91)
a) Total volume
b) Inspiratory reserve volume plus expiratory reserve
volume
c) Tidal volume plus inspiratory reserve volume plus
expiratory reserve volume
d) Expiratory reserve volume plus reserve volume

The instrument used for measuring the vital
capacity and FEV is – (JIPMER 78, DNB 90)
a) Wright peak flow meter
b) Vitalograph
c) Carlen’s catheter
d) None of the above

Vital capacity is – (ROHATAK 97)
a) Tidal Volume+Expiratory Reserve Volume
b) Tidal Volume+Inspiratory Reserve Volume
c) I.R.V+E.R.V.
d) T.V.+I.R.V.+E.R.V.
e) Tidal volume

Physiological effects of emphysma may include
all of the following, except – (SGPGI 05)
a) increased vital capacity
b) Irregular ventilation
c) Impaired gas diffuse
d) Pulmonary hypertension

Pulmonary function abnormalities in interstitial
lung diseases include all of the following except –
a) Reduced vital capacity (AIIMS NOV 05)
b) Reduced FEV I/FVC ratio
c) Reduced diffusion capacity
d) Reduced total lung capacity

A 12 year old girl presents with acute rheumatic
fever and carditis with severe mitral insufficiency.
She is likely to have which of the following functional
disability ? (AIIMS Nov 07)
a) Increased residual volume
b) Increased PEFR
c) Increased TLC
d) Decreased functional residual capacity

In cryptogenic fibrosing alveolitis which is not seena)
Decreased lung capacity- (PGI 89)
b) Decreased diffusing capacity
c) Decreased arteliolar oxygen tension
d) Decreased FEV I/FVC ratio

Most common cause of hypoxemia is- (Kerala 2K)
a) Lowered inspired P0 2
b) Hypoventilation
c) Intracardiac shunting
d) Ventialtion perfusion mismatch
e) Decreased diffusing capacity

Total lung capacity depend on – (Al 98)
a) Size of airway b) Closing tidal volume
c) Lung compliance d) Residual volume

True about interstitial lung disease – (PG1 :June 07)
a) Decreased FVC
b) Decreased FEV,
c) Decreased diffusion capacity
d) Presence of end inspiratory crackles

Which pulmonary function change is not seen in
COPD- (Al 92)
a) Decreased Residual volume
b) Decreased FEV
c) Low mid expiratory flow rate
d) Decreased diffusion capacity

Regarding pectus Excavatum all are true except –
a) Gross CVS dysfunction (PGI 9 7)
b) Depression in chest
c) Cosmetic defromity
d) Decrease in lung capacity

An 18 year old male presents with pectus excavatum.
He denies history of any dyspnoea or chest pain. On
examination there is mild pectus excavatum and
intermittent wheezing on exertion. Surgery in this
patient is indicated if he has – (AIIMSNov 07)
a) FEV i/FVC less than 0.60
b) Limiation of maximum inspiration during exercise
c) Peak physical work capacity 60% of

Which muscle is not punctured during a thoracic
procedure in the mid-axillary line ? (AIIMSNov 07)
a) Internal intercostal
b) External intercostal
c) Transverse thorasis
d) Innermost intercostals

All the following are true about Chronic Obstructive
lung disease except
A. Decreased FeV i
B. Decreased MEFR
C. Increased RV
D. Decreased diffusion capacity

Total lung capacity depends upon :
(A) Size of airway
(B) Closing volume
(C) Lung compliance
(D) Residual volume

Normal functional Residual capacity is – (Al 93)
a) 0.5 Litres b) 1.5 Litres
c) 2.2 Litres d) 4.0 Litres

Nitrogen washout method is used for estimatinga)
Dead space volume (PGI 98)
b) Functional residual capacity
c) Tidal volume
d) Diffusion capacity

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