Pulmonary function test ´ëÀå°æ Á¤¸®
1. Æó±â´É °Ë»çÀÇ ÃßÁ¤ Á¤»óÄ¡(predictive value)¸¦ °áÁ¤ÇÏ´Â °¡Àå Áß¿äÇÑ ¿ä¼Ò?
³ªÀÌ, ¼ºº°, Ű, Á¾Á·
2. ³ëÈ¿¡ µû¸¥ È£Èí±âÀÇ º¯È - ¹æ¾î±â´ÉÀÇ º¯È
»ó±âµµ ÈíÀÎÀÇ Áõ°¡, ±âµµ ¹× ÆóÆ÷ ¹æ¾î±â´ÉÀÇ ÀúÇÏ, ÀÚ°¡Ç×üÀÇ Áõ°¡
3. Æó±â´É °Ë»ç
- TLCÀÇ ÁÖ¿ä °áÁ¤ÀÎÀÚ´Â "Èí½Ä±ÙÀÇ °µµ"¿Í "ÆóÀÇ °æÁ÷¼º(stiffness) = inward recoil of lung"
ÀÌ´Ù.
- flow-volume curve¿¡¼ ¼Ò±âµµ Æó¼â¼º ÁúȯÀº "scooped out"¾ç»óÀ» ³ªÅ¸³»°í
´ë±âµµ Æó¼â¼º ÁúȯÀº "squared off"ÀÇ ¾ç»óÀ» ³ªÅ¸³½´Ù.
- FRCÀ̻󿡼 È£Èí½Ã °¡Àå È¿°úÀûÀÎ °ø±âÀÇ ÃâÀÔÀÌ »ý±ä´Ù.
4. forced expiratory flow rate¸¦ Áõ°¡½ÃŰ´Â Áß¿äÇÑ ÀÎÀÚ: muscle power, elastic recoil
cf. ±âµµÀúÇ×Àº È£±â·ù ¼Óµµ¸¦ °¨¼Ò½ÃŲ´Ù.
5. flow volume curveÀÌ»ó: ¿ÞÂʺÎÅÍ O-> E -> P
1) obstructive lung disease: TLC, RV¡è
2) extraparenchymal restrictive disease:
¿¹> inspiratory muscle weakness or chest wall stiffness, obesity
TLC¡é, RV À¯Áö, MIP, MEP¡é
3) parenchymal restrictive disease: TLC, RV¡é, VC¡é, FEV1À¯Áö
6. flow volume curve·Î´Â TLC, RVÀ» ±¸ÇÒ¼ö ¾ø´Ù.
7. flow volume curve¿¡¼
1) fixed obstruction
2) extrathoracic obstruction: Èí±â½Ã ¾ÇÈ, inspiratory stridor ¿¹>tracheal tumor, vocal
cord tumor
3) intrathoracic obstruction: È£±â½Ã ¾ÇÈ
8. emphysema¿¡¼´Â static lung compliance´Â Áõ°¡Çϰí, dynamic lung compliance´Â °¨¼Ò
ÇÑ´Ù.
9. obstructive lung disease: asthma, COPD, bronchiectasis, cystic fibrosis, bronchiolitis
10. parenchymal restrictive pattern: ILD, IPF, sarcoidosis
11. extraparenchymal restrictive pattern: neuromuscular(myasthemia, Gullain-Barre
syndrome), chest wallÀÌ»ó(kyphosis, obesity)
12. ÆóȰ·® °Ë»ç ÁöÇ¥
1) ±â·ùÆó¼â¸¦ ¿¹¹ÎÇÏ°Ô ¹Ý¿µ = FEV1
2) Á¦ÇѼº ÆóÁúȯ¿¡¼ °¨¼Ò = FVC
3) °¡½º°¡ ÆóÆ÷¿¡¼ capillary·Î ¾ó¸¶³ª ¿ëÀÌÇÏ°Ô À̵¿Çϴ°¡¸¦ ÃøÁ¤ÇÏ´Â ÁöÇ¥ = DLco
4) ȯÀÚ°¡ ÀÚ¹ßÀû ³ë·ÂÀ¸·Î 1ºÐ°£ ÃÖ´ë·Î È£ÈíÇÒ¼ö ÀÖ´Â ±â·®, ±ÙÀ°ÀÌ»ó, Èä°ûÀÌ»ó¿¡ ÀÇÇÑ
È£ÈíÀÌ»óÀÇ Áø´Ü¿¡ µµ¿òÀÌ µÇ´Â ÁöÇ¥: MVV(maximal voluntary volume)
5) ȯÀÚÀÇ ³ë·Â¿¡ °ü°è¾øÀÌ ¼Ò±âµµ Á¶±âº´º¯ÀÇ Áø´Ü¿¡ µµ¿òÀÌ µÇ´Â ÁöÇ¥
: MMEFR(maximal midexpiratory flow rate) or FEF25-75%
13. ºñ¸¸È¯ÀÚÀÇ Æó±â´É: extraparenchymal restrictive pattern
FRC, ERV¡é, RVÀº À¯Áö
V/Q mismatch¡è, DLco¡è(d/t RBC mass¡è)
14. FRC ÃøÁ¤¹ý
1) Inert gas : helium dilution method, nitrogen washout test
2) body plethysmography
3) planimetry
15. ȯ±â°¡ Àß µÇÁö ¾Ê´Â bullae³ª pneumothoraxÀÇ ¿ëÀûÀ» ÃøÁ¤Çϱâ À§ÇÑ °Ë»ç
: body plethysmography
16. lung°ú chest wallÀÇ elastic recoilÀÌ °°¾ÆÁö´Â lung volume: FRC
17. small airway disease¸¦ Áø´ÜÇÒ¼ö ÀÖ´Â ¹æ¹ý
1) FEF25-75% : maximal-effort expiratory spirogram
2) dynamic compliance:
3) closing volume: single breath nitrogen washout test
4) volume of isoflow: helium oxygen flow-volume curve
5) Vmax50
18. ¼Ò±âµµ ÁúȯÀÇ °¡Àå Ãʱ⿡ ³ªÅ¸³ª´Â Æó±â´É º¯È? FEF25-75%
19. single breath nitrogen washout test
phase I : anatomic dead space
phase II : mixed alveolar and dead space
phase III: alveolar plateau
phase IV : closing volume
20. phase IIIÀÇ slopeÀÌ ÀǹÌÇÏ´Â °Í? ventilatory homogeneityÀÇ index
21. diffusion¿¡ ¿µÇâÀ» ¹ÌÄ¡´Â ÀÎÀÚ
i) alveolar-capillary surface area
ii) pulmonary capillary blood volume
iii) alveolar-capillmary membrane thickness
iv) V/Q mismatchÁ¤µµ
v) ȯÀÚ Hgb level
22. DLcoÃøÁ¤¿¡ ¿µÇâÀ» ¹ÌÄ¡´Â ÀÎÀÚµé
Hb, PAO2, lung volume, C.O, smoking, CO pressure µî
23. DLco¡é : DILD, emphysema, pulmonary vascular disease
DLco¡è: CHF, Goodpasture's syndrome, asthma, supine position
24. hysteresisÀÇ Á¤ÀÇ
µ¿ÀÏÇÑ ¾Ð·Â¿¡¼ È£±â½ÃÀÇ Æó¿ëÀûÀÌ Èí±â½ÃÀÇ Æó¿ëÀûº¸´Ù Å©°Ô ³ªÅ¸³ª´Â Çö»ó
25. Cstat = tidal volume/(plateau pressure - end expiratory pressure)
Cdyn = tidal volume/(peak airway pressure - end expiratory pressure)