Pulmonary Flow Volume Loops.. Dr.Padmesh

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Pulmonary Flow Volume Loops

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Pulmonary Flow Volume Loops.. Dr.Padmesh

  1. 1. Pulmonary Flow Volume Loops Dr.Padmesh http://oscepediatrics.blogspot.in/
  2. 2. The abnormality can be due to either Obstructive or Restrictive ventilatory defects. • In Obstructive ventilatory defect, -Level of obstruction ie., intrathoracic (below 6th tracheal ring) or extrathoracic, -Fixed or variable -Reversibility to bronchodilators • In Restrictive defect, -Stage of disease (early or late)
  3. 3. • Peripheral Obstructive Flow Volume curves are recorded in diseases such as asthma, chronic bronchitis and emphysema. • Most characteristic feature is the curvilinear shape (up- ward concavity) of descending limb of curve . • This loss of linearity is related to the severity of the obstruction as well as the type of disease.
  4. 4. • i) Fixed upper airway obstruction: Both the inspiratory and expiratory limbs are truncated. The shape is quite characteristic with more or less equal restriction of both inspiratory and expiratory flow rates. • ii) Intrathoracic variable obstruction : Obstruction at expiration. Expiratory limb is flattened and inspiratory limb is normal. • iii) Extra thoracic variable obstruction : Obstruction at inspiratory phase. Inspiratory limb is flattened and expiratory limb is normal.
  5. 5. • Eg: Tracheal stenosis
  6. 6. • Extra thoracic variable obstruction : Obstruction at inspiratory phase. Inspiratory limb is flattened and expiratory limb is normal. • Eg: vocal cord paralysis, extrinsic compression from cervical tumour, goiter, etc.
  7. 7. • Intrathoracic variable obstruction : Obstruction at expiration. Expiratory limb is flattened and inspiratory limb is normal.
  8. 8. • Restrictive Ventilatory Defect • Any disease which decreases the lung expansion either by chest wall diseases or by space occupying lesion in the pleural cavity or lung causes restrictive type of abnormality. • In early interstitial lung disease (curve a) even before lung volumes are decreased, the FV curves usually show super maximal expiratory airflow associated with a steep descending limb of the curve (due to increase in lung elastic recoil) and the curve becomes tall and narrow or vertically oriented with respect to the volume axis. • In severe reduction of lung volumes (curve b), the FV curve may maintain a relatively normal shape but appears miniatured in all directions.
  9. 9. • Examples of restrictive lung disease are pulmonary fibrosis, pneumonias, pleural effusion, obesity, damage to the nerve supply to the respiratory muscle, etc.
  10. 10. • Mixed Ventilatory Defects • This is a combination of both obstructive and re-strictive abnormalities. Both curvilinear and miniature shapes are seen in the these situations, e.g. pneumoconiosis
  11. 11. •Thank you! http://oscepediatrics.blogspot.in/

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