Topic 8: Pulmonary Function Testing

Laboratory Manual Section 08

HPHE 6720 Dr. Cheatham

Outline
Review of lung volumes Terminology relating to PFT Review of PFT Prediction of PFT values Interpretation of results Review of atmospheric conditions and calculations of volume (How volumes of air are expressed)

Lung Volumes

Some Terminology
Obstructed airflow
Narrowing of the airways due to bronchoconstriction (asthma) Narrowing of the airways due to inflammation Blockage of the bronchiol airways External compression of the airways (tumor or trauma) Obstructive lung diseases
Asthma Asthmatic bronchitis Chronic obstructive bronchitis Chronic obstructive pulmonary disease (COPD includes asthmatic bronchitis, chronic bronchitis, emphysema and the overlap between them). Cystic fibrosis Emphysema

Some Terminology
Restricted airflow
Always means a decrease in lung volumes Intrinsic restrictive lung disorders
Sarcoidosis Tuberculosis Pnuemonectomy (loss of lung) Pneumonia Scoliosis, Kyphosis Ankylosing Spondylitis Pleural Effusion (fluid in the pleural cavity) Pregnancy Gross Obesity Tumors Ascites Pain on inspiration - pleurisy, rib fractures

Extrinsic restrictive lung disorders

Some Terminology
Restricted airflow (contd)
Neuromuscular Restrictive Lung Disorders Generalized Weakness malnutrition Paralysis of the diaphragm Myasthenia Gravis - lack of acetylcholine or too much cholinesterase at the myoneural junction in which the nerve impulses fail to induce normal muscular contraction. These patients suffer from fatigability and muscular weakness. Muscular Dystrophy Poliomyelitis Amyotrophic Lateral Sclerosis - Lou Gehrig's Disease

Pulmonary Function Testing

Reasons to perform PFT
Screening for the presence of obstructive or restrictive lung disease Evaluating patients prior to surgery Documenting progression of lung disease Documenting the effectiveness of therapeutic intervention

PFT Testing

PFT Testing

PFT Testing

PFT Testing

PFT Testing

Patient Information

Patient Information

Prediction of PFT Test Values

Knudson Normset

Prediction of PFT Test Values

NHANES III Normset

Interpretation of PFT

Interpretation of PFT

How Volumes of Air are Expressed

How Volumes of Air are Expressed

Converting ATPS to BTPS

How Volumes of Air are Expressed

Converting ATPS to BTPS (contd)

How Volumes of Air are Expressed

Converting ATPS to BTPS (contd)

How Volumes of Air are Expressed

Converting ATPS to STPD

Laboratory Exercise
Each student will perform the following PFTs:
FVC (3 trials) MVV (1 trial)

Each student will perform these tests under the following conditions (at least 10 min b/t conditions):
Standing Sitting

Research Question:
Is there a significant difference b/t standing and sitting for the following variables:
FVC, FEV1, FEV1/FVC, MVV