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24

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Physiology

Respiratory

Question 20 of 180

The functional residual capacity (FRC) will be increased in which of the following:

Answer:

Factors increasing FRC:
  • Emphysema
  • Air trapping in asthma
  • Ageing (due to loss of elastic properties)
  • Increasing height of patient

Functional Residual Capacity

Physiology / Respiratory / Lung Volumes and Pressures

Last Updated: 21st April 2019

Definition

The volume left in the lungs at the end of a normal breath is called the functional residual capacity (FRC). At FRC, the respiratory muscles are relaxed and its volume is determined by the elastic properties of the chest wall (tending to spring outwards) and the lungs (tending to collapse).

If the elastic recoil of either the lungs or chest wall is abnormally large or small, the FRC will be abnormal. In fibrosis, the lungs are stiff and have decreased compliance, and so the FRC is reduced. In emphysema, there is loss of alveolar tissue, and with it elastic recoil of the lungs and hence the FRC is increased. As such, patients with emphysema often have noticeably broader chests due to the relatively unopposed outward recoil of the chest wall.

Factors Affecting FRC

Factors increasing FRC:

  • Emphysema
  • Air trapping in asthma
  • Ageing (due to loss of elastic properties)
  • Increasing height of patient

Factors decreasing FRC:

  • Restrictive ventilatory defects e.g. pulmonary fibrosis
  • Posture - lying supine
  • Increased intra-abdominal pressure (e.g. obesity, pregnancy, ascites)
  • Reduced muscle tone of diaphragm e.g. muscle relaxants in anaesthesia, neuromuscular disease

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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