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호흡기계 정리
호흡기계 정리폐기능 검사폐쇄성 환기장애
호흡기계 정리
호흡 생리와 폐기능 검사를 한 노트에서 이어서 봅니다.
폐쇄성 패턴과 스파이로메트리 소견을 함께 정리합니다.
폐포 환기
사강을 제외한 실제 폐포 환기를 계산하고 PaCO2와 연결합니다.
가스 교환
확산 제한, V/Q 불균형, 션트를 구분해 저산소혈증 원인을 정리합니다.
폐기능 검사
FEV1/FVC와 기관지 확장제 반응을 기준으로 폐쇄성 패턴을 정리합니다.
폐쇄성 환기장애
기도 저항 증가로 FEV1/FVC가 감소하고 호기 시간이 길어지는 패턴입니다.
FEV1/FVC 감소가 핵심입니다.
호기 시간이 길어지고 공기 포획이 생깁니다.
기관지 확장제 반응과 증상 변화를 함께 봅니다.
스파이로메트리
폐쇄성 패턴은 FEV1 저하와 FEV1/FVC 감소를 함께 확인합니다.
천식가역적 기도 폐쇄야간/운동 후 악화
COPD비가역적 기류 제한흡연력, 만성 기침
폐쇄성 환기장애
기도 저항 증가로 FEV1/FVC가 감소하고 호기 시간이 길어지는 패턴입니다.
FEV1/FVC 감소가 핵심입니다.
호기 시간이 길어지고 공기 포획이 생깁니다.
기관지 확장제 반응과 증상 변화를 함께 봅니다.
스파이로메트리
폐쇄성 패턴은 FEV1 저하와 FEV1/FVC 감소를 함께 확인합니다.
천식가역적 기도 폐쇄야간/운동 후 악화
COPD비가역적 기류 제한흡연력, 만성 기침
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Respiratory review
Physiology, testing, and respiratory support in one note
Physiology → gas exchange → PFT → disease patterns
Connect cause → test → disease for exam review
Before exams, scan formulas, patterns, and differentiators
Alveolar ventilation
VA = (VT − VD) × RR
More dead space lowers effective alveolar ventilation
Higher PaCO₂ · respiratory acidosis
A–a gradient may remain normal
Rapid shallow breathing wastes more ventilation in dead space
Gas exchange
V/Q mismatch · shunt · diffusion
Increased A–a gradient
Usually improves with supplemental oxygen
Limited response to high-concentration oxygen
Diffusion limitation worsens hypoxemia during exercise
Pulmonary function tests
FEV₁/FVC · TLC · DLCO
Separate obstructive and restrictive patterns
Lower TLC with a preserved ratio
Read ratio → volumes → diffusion in order
Use DLCO to refine parenchymal or vascular causes
Obstructive ventilatory defect
Airway resistance → expiratory flow limitation
Lower FEV₁/FVC
Prolonged expiration
Dynamic hyperinflation
Air trapping can increase residual volume
Spirometry
Check lower FEV₁ and FEV₁/FVC
Compare FEV₁ before and after bronchodilator
Review the expiratory limb of the flow-volume loop
Bronchodilator response
Check effort and repeatability before interpretation
Asthma
Reversible airway obstruction
Worse at night or after exercise
Assess symptom variability with reversibility
Track functional recovery after treatment
COPD
Persistent airflow limitation
Smoking history · chronic cough
DLCO may fall with emphysema
Record exacerbation history with symptom burden
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Respiratory review
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Respiratory reviewObstructive ventilatory defect
Obstructive ventilatory defect
Higher airway resistance lowers FEV₁/FVC and prolongs expiration.
Spirometry
In an obstructive pattern, FEV₁ falls and FEV₁/FVC sits below the lower limit of normal.
A clear FEV₁ recovery after a bronchodilator suggests reversible airway obstruction.Add to chatMod-J
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Respiratory summary
Respiratory summary
Obstructive ventilatory defect
A lower FEV1/FVC is the key finding.
Synced
Respiratory summary
Obstructive ventilatory defect
A lower FEV1/FVC is the key finding.
Mobile coming soon
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호흡기계 요약
폐포 환기
폐포 환기량은 호흡수와 일회호흡량에서 사강 환기를 제외한 값입니다. 얕고 빠른 호흡은 분당환기가 같아 보여도 실제 가스 교환을 떨어뜨립니다.
VA = (VT - VD) x RR
저환기에서는 PaCO2가 상승하고 호흡성 산증이 동반될 수 있습니다.
가스 교환과 산소해리곡선
O2는 폐포에서 혈액으로, CO2는 혈액에서 폐포로 확산됩니다. 산소해리곡선은 pH 감소, CO2 증가, 온도 상승에서 우측 이동합니다.