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?

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