A 155 lb., 60-year-old man had a chronic productive cough, exertional dyspnea, mild cyanosis, and marked slowing of forced expiration. His pulmonary function and laboratory tests follow:
Frequency
15 breaths/min
Alveolar ventilation
4.1 L/min
Vital capacity (VC)
2.2 L
Functional residual capacity (FRC)
4.0 L
Total lung capacity (TLC)
5.2 L
Maximum inspiratory flow rate
252 L/min
Maximum expiratory flow rate
21 L/min
PaO2
63 mm Hg
PaCO2
38 mm Hg
Pulmonary function tests after bronchodilator therapy:
Frequency
15 breaths/min
Alveolar ventilation
4.25 L/min
VC
2.4 L
FRC
4.0 L
TLC
5.2 L
Maximum inspiratory flow rate
252 L/min
Maximum expiratory flow rate
24 L/min
PaO2
63 mm Hg
PaCO2
37 mm Hg
Q1: What is the disorder of this man?
Q2: Is this mainly a restrictive or an obstructive disorder? Explain.
Q3: Why is the bronchodilator therapy ineffective for this patient?
Q4: What causes the hypoxemia?
Q5: Calculate the residual volume (RV) for this person before and after the bronchodilator therapy. RV = TLC - VC.
Q6: What is the cause of this altered RV?
Q7: Calculate the tidal volume (TV) for this person before and after the bronchodilator therapy. TV = AV/f + patient body weight. Hint: TV is calculated in mL, so you will need to convert L to mL before completing the equation.
Q8: Is each TV normal or altered?
Q9: Calculate the minute ventilation (MV) for this person before and after the bronchodilator therapy. MV = TV × f
Q10: Is each MV normal or altered?