00:01
I want to take a moment here and walk you
through what respiratory capacities are.
00:06
The first time I saw these,
it was really confusing for me.
00:10
So we worked up a way that
we can demonstrate this,
we can illustrate it for you.
00:14
So you can see how they
all relate to each other.
00:17
Now, fair warning, this is going to make
sense as we walk through it of course,
because we're together and
we're talking through it.
00:23
But I'm going to encourage you to try to
recreate a drawing that makes sense to you,
you're welcome to recreate ours or
you can make your own type of drawing.
00:31
But this is what it's going to take
for you to really commit this concept
to a high level of understanding and
have it encoded well in your brain.
00:40
So you can make
decisions based on it
and have it accessible when
you need it on your next exam.
00:45
So let's take a look at Jose
as a young healthy guy, right?
His total lung capacity
is that first big box,
and we're going to call that
total lung capacity of 6.0 L.
00:57
So that big box
represents 6.0 L.
01:00
We've already got that
written in there for you.
01:02
So you see what
we're working with.
01:04
Now, we're going to break the total
lung capacity into two categories.
01:09
It's about a 50/50
split as you'll see.
01:12
So we have inspiratory
capacity at about 3.0 L
and functional residual
capacity at 3.0 L.
01:19
So the first three concepts we're
talking about Jose's total lung capacity,
can be broken down to
his inspiratory capacity
and his functional
residual capacity.
01:30
Now I want to talk
about vital capacity.
01:33
Look at the components of vital
capacity where we have that box.
01:37
So for vital capacity,
it is all of the
inspiratory capacity,
plus a little bit of the
functional residual capacity
that gives us about 4.5 L.
01:50
Now we're going to add a lot to
the right side of your screen.
01:54
First of all go all the
way over to the right,
the bottom line represents if
there was no air in the lungs,
the next line above that
is the maximum expiration.
02:06
So look at that the line
of maximum expiration,
there's still air left in your lungs,
that's what residual volume is.
02:14
The air that's left in your lungs
after your maximum expiration.
02:19
Next line up is
your resting volume.
02:23
And the very top line is
your maximum inspiration.
02:27
Now remember, we divided those
up between inspiratory capacity
and functional
residual capacity.
02:33
So let's start at the bottom.
02:35
So for functional residual capacity of an
expiratory reserve volume of about 1.5 L
and residual volume of 1.5
L, that's again, split 50/50.
02:47
Now ask yourself, how much of that remains
in my lungs after maximum exploration?
Right,
1.5 L your residual volume.
02:56
If everything is
in a perfect world.
03:00
Now go back up to the top,
the difference between the resting
volume and the maximum inspiration.
03:06
That's your tidal volume of 0.5 L and
inspiratory reserve volume of 2.5 L.
03:12
So I know you tracked with me
because you're really sharp.
03:16
But please know that you're
going to need to go back
and spend some more
time with his concept,
just to make sure that it's
encoded solidly in your mind.
03:25
So let's take a look at
the respiratory capacities
as far as a forced expiratory
volume measurement.
03:31
Now look at what it is, right?
If Jose is a young
healthy fit man.
03:36
Now let's look at Jose as a
older healthy fit gentleman,
you'll see that his
FEV1 is definitely less.
03:47
Now let's talk about peak
expiratory flow rate.
03:51
Now you've got on the diagram,
you can see the difference between
the average for men and for women
and we've told you about their
body size there on the right.
03:58
These are the normal values
for peak expiratory flow.
04:02
Now we often use this
with asthmatic patients.
04:04
So the doctor can make decisions
or the healthcare provider
can make decisions on
medication adjustments
based on the patient's
baseline PEFR.
04:14
And then what's going on,
if they start to feel like they're having
some trouble breathing or some difficulty.
04:19
So PEFR for men and for women,
you see the normal values there.
04:25
And these would be
for like a young Jose.
04:29
Now let's take a look at
pulmonary function values.
04:32
Okay, I got to be honest.
04:34
When I see a chart like this,
my brain kind of just glosses over.
04:37
So I want to show you how to chunk
the information on this chart.
04:41
It's an easy strategy that
you can use on everything.
04:44
Look at that second column,
the shorter squattier one.
04:49
What are the options we have?
I have an equal sign a downward
arrow which means decreased
or an upward arrow
which means increased.
04:55
Alright,
that's not rocket science.
04:57
So what I would do in
my notes if I were you
is I would write
down the equal sign,
which volumes are equal,
whether you are older or younger,
which volumes are relatively equal.
05:11
Ah, you see that there's one at the top,
total lung capacity is usually equal.
05:19
Also we have Arterial
pH and Arterial PaCO2.
05:23
Okay, so those are three measures
that we see remain the same,
relatively the same when
you're growing older.
05:30
Now, which ones are decreased?
Right, vital capacity, FEV1,
PEFR and diffusing capacity,
and the pulmonary arterial
oxygen, the PaO2.
05:44
So the CO2 stays the same,
but the PaO2 decreases.
05:50
Okay, that's the way you
can chunk information.
05:53
Think through check,
your comprehension.
05:55
Ask yourself,
why do these stay this way?
Why is this equally the same?
Why would this go down?
That's the best way for
you to learn this content.
06:04
Just trying to memorize this chart is a
horrible and ineffective way to study.
06:10
You have to do some mental
gymnastics with the information
so that you can keep
it solid in your mind.
06:16
And one of those
strategies is chunking.
06:18
Put all the equals together, put all the
ups together, put all the downs together.
06:22
That's going to give
you a much better way
to hang on to that information
and to let it stick.