Professional Documents
Culture Documents
Objectives
Review basic pulmonary anatomy and physiology. Understand the reasons pulmonary function tests (PFTs)
are performed. Understand the technique and basic interpretation of spirometry. Know the difference between obstructive and restrictive lung disease. Know how PFTs are clinically applied.
occurs.
For this, you need a normal ribcage and respiratory
Conducting Airways
Air travels through the
conducting airways comprised of the following: nose,larynx, trachea, lobar bronchi, segmental bronchi, subsegmental bronchi, small bronchi, bronchioles, and terminal bronchioles.
transitional/respiratory bronchioles. The transitional/respiratory zones are made up of respiratory bronchioles, alveolar ducts, and alveoli.
a surface area of 2.8 square meters at birth increased to about 75 square meters in adult male!
Gas Exchange
Why PFTs?
Help in diagnosis of diseases.
May help guide management of a disease process. Can help monitor progression of disease and
effectiveness of treatment.
Spirometry
Spirometry is a medical test that measures the
reserve volume, tidal volume, expiratory reserve volume, and residual volume
4 capacites: vital capacity,
air inhaled or exhaled with each breath during quiet breathing Inspiratory Reserve Volume (IRV): maximum volume of air inhaled from the end-inspiratory tidal position Expiratory Reserve Volume (ERV): maximum volume of air that can be exhaled from resting end-expiratory tidal position
Lung Volumes
Residual Volume (RV): Volume of air remaining in lungs after maximium exhalation.
Lung Capacities
Total Lung Capacity (TLC): Sum
of all volume compartments or volume of air in lungs after maximum inspiration Vital Capacity (VC): TLC minus RV or maximum volume of air exhaled from maximal inspiratory level Inspiratory Capacity (IC): Sum of IRV and TV or the maximum volume of air that can be inhaled from the end-expiratory tidal position
developmental age of child. Patients need a calm, relaxed environment and good coaching. Patience is the key. Even with the best of environments and coaching, a child may not be able to perform spirometry. Results are affected also by posture and neck position.
Flow-Volume Curves
Flow-volume curve---flow meter measures flow rate in
Spirometry Interpretation:
Normal values vary and depend on: Height Gender Ethnic origin
Measurements Obtained
FEV1---the volume exhaled during the first second of the
FVC maneuver
half of the FVC maneuver; reflects flow through the small (<2 mm in diameter) airways
FEV1/FVC---the ratio of FEV1 to FVC (expressed as a
percent); an important value because a reduction of this ratio from expected values is specific for obstructive rather than restrictive diseases
Restrictive Disorders
Characterized by reduced
of expiratory airflow so that airways cannot empty as rapidly compared to normal (such as through narrowed airways from bronchospasm, inflammation, etc.) Examples: Asthma Emphysema Cystic Fibrosis
lung volumes/decreased lung compliance Examples: Interstitial Fibrosis Scoliosis Obesity Lung Resection Neuromuscular diseases Cystic Fibrosis
predicted:
80-120% Normal
70-79%
FEV1/FVC
Interpretation : 80 or higher Normal 79 or lower Abnormal
predicted:
>79% Normal 60-79% Mild
much as able. This makes an inspiratory curve. The expiratory and inspiratory flow volume curves put together make a flow volume loop.
Flow-Volume Loops
and expiration
In addition to obstructive and restrictive patterns, flow-
such as in vocal cord dysfunction Variable intrathoracic obstruction: flattening of expiratory limb; tracheomalacia
Calculate percent change (FEV1 most commonly used---so % change FEV 1= [(FEV1 Post-FEV1 Pre)/FEV1 Pre] X 100).
Reversibility is with 12% or greater change.
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