this study details about all the aspects of pulmonary function test, lung volumes& capacities , tests such as spirometry , carbon monoxide diffusion capacity, chest x ray, body plethesmography , nitrogen washout etc
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This presentation describes the indications, contraindications, methods of performing spirometry. It explains the interpretation of spirometry with examples.
What are the pulmonary function tests used?
What are the indications?
What are the contraindications?
How to perform each and prepare patients?
How to interpret and reach a diagnosis?
How to clean and calibrate devices?
This presentation describes the indications, contraindications, methods of performing spirometry. It explains the interpretation of spirometry with examples.
What are the pulmonary function tests used?
What are the indications?
What are the contraindications?
How to perform each and prepare patients?
How to interpret and reach a diagnosis?
How to clean and calibrate devices?
PULMONARY FUNCTION TESTS - LAB DATA INTERPRETATIONLincyAsha
PULMONARY FUNCTION TESTS
LAB DATA INTERPRETATION
CLINICAL PHARMACY PRACTICE
M.PHARMACY
PHARMACY PRACTICE
1ST YEAR
Pulmonary function tests are a series of tests performed to examine a patient’s respiratory system and identify the severity of pulmonary impairment.
These tests are performed to measure a patient’s lung volume, capacity, flow rate and gas exchange.
This allows medical professionals to obtain an accurate diagnosis and determine the best course of medical intervention for the patient.
In general there are two types of lung disorders that these tests can be used to assess
Obstructive lung diseases
Restrictive lung diseases
1.OBSTRUCTIVE LUNG DISEASES
It include conditions that make it difficult to exhale air out of the lungs
This results in shortness of breath that occurs from narrowing and constriction of the airways and causes the patient to have decreased flow rates. Eg. COPD, Asthma
2.RESTRICTIVE LUNG DISEASES
It include conditions that make it difficult to fully fill the lungs with air during inhalation.
When the lungs aren’t fully able to expand it causes the patient to have decreased lung volumes. Eg. Pulmonary fibrosis, interstitial lung disease
Pulmonary function tests would be indicated for the following:
On healthy patients as part of a routine physical exam
Evaluate signs and symptoms of lung disease
Diagnosis of certain medical conditions
Measure current stage of disease and evaluate its progress
Assess how a patient is responding to different treatments
Determine patient’s condition before surgery to assess the risk of respiratory complications
Screen people who are at risk of pulmonary disease
Determine how much a patient’s airways have narrowed due to disorders
In certain types of work environments to assess the health of employees.
Additionally PFTs may be indicated for the following
Chronic lung conditions
Restrictive airway problems
Asthma
COPD
Shortness of breath
Impairment or disability
Early morning wheezing
Chest muscle weakness
Lung cancer
Respiratory infections
STATIC LUNG VOLUMES
Lung volume is the amount of air breathed by an individual under a specific condition.
1.Tidal Volume (TV)
It is the volume of air inspired or expired during normal breathing at rest.
2.Inspiratory Reserve Volume (IRV)
It is the volume of air inspired with maximum effort over and above the normal tidal volume.
3.Expiratory Reserve Volume (ERV)
It is the volume of air expired forcefully after a normal respiration.
4.Residual Volume (RV)
It is the volume of air remaining in the lungs after a forceful expiration
STATIC LUNG CAPACITIES
1.Inspiratory capacity (IC)
It is the amount of air a person can inspire forcefully after a normal respiration.
IC = TV+IRV
2.Functional Residual Capacity (FRC)
It is the amount of air that remains in the lungs at the end of normal respiration.
FRC = ERV+RV
3.Vital Capacity (VC)
It is the maximum volume of air exhaled forcefully from the lungs after a maximum inspiration.
4.Total Lung Capacity
Pulmonary function testing is the process of having the patient perform specific inspiratory and expiratory maneuvers while breathing in and out of tubing attached to the equipment that measure a variety of variables
Pulmonary function tests (PFT) are series of tests that measure lung function and aid in the management of patients with respiratory disease.
They are performed using standardized equipment and can be used for diagnosis, prognostication, management and follow-up of patients with pulmonary pathology.
Although PFT may not identify the exact pathology, it broadly classifies respiratory disorders as either obstructive or restrictive. In this session , the role of PFT in the measurement of lung mechanics and diagnosis of various diseases will be discussed in detail.
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Wilsons disease- A brief medical study. martinshaji
this brief study describes all the basic aspects of Wilsons disease , including management. as this is a congenital abnormality associated with severe complications on the future proper diagnosis management , and lifestyle modifications , …..surgical options are also needed ,if necessary .
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Communicable diseases and causative agents- a detailed chart martinshaji
A communicable disease is one that is spread from one person to another through a variety of ways that include contact with blood and bodily fluids; breathing in an airborne virus or by being bitten by an insect................................................................this chart provides a clear idea regarding almost all communicable disease and their causative agents
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TDM of drugs used in organ transplantation-detailed studymartinshaji
Therapeutic drug monitoring (TDM) is testing that measures the amount of certain medicines in your blood. It is done to make sure the amount of medicine you are taking is both safe and effective. Most medicines can be dosed correctly without special testing. the slide explain all the tdm aspects of the drug in detail / Therapeutic drug monitoring (TDM) is testing that measures the amount of certain medicines in your blood. It is done to make sure the amount of medicine you are taking is both safe and effective. Most medicines can be dosed correctly without special testing.
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Organophosphate poisoning - a brief toxicological study martinshaji
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this case study describes about maxillofacial trauma , which details about the treatment, management , diagnosis, surgical options, patient counselling, pharmacist interventions & discussions are followed in this case .
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Sleep disorders - a brief medical study martinshaji
A sleep disorder is any condition that involves difficulty experienced when sleep , such disorders involve daytime fatigue causing severe distress and impairment to work.
SD also have an impact upon social and personal functioning
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A case study on Pangastritis with pancreatitis martinshaji
this case study describes about Pangastritis with pancreatitis , which details about the treatment, management , diagnosis, patient counselling, pharmacist interventions & discussions are followed in this case .
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Blood transfusion-MANAGEMENT FOR PEOPLE LIVING WITH SICKLE CELL DISORDER/DISE...martinshaji
Sickle cell disease is caused by a genetic mutation that leads to the production of abnormal hemoglobin known as sickle hemoglobin . Blood transfusion is the transfer of blood from one individual to another ..
Red blood cell transfusions help lessen anemia and reduce the blood’s viscosity, allowing it to flow more freely and ease disease symptoms.
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Compartment syndrome,- a detailed medical study .martinshaji
Compartment syndrome is a condition that occurs when injury causes generalized painful swelling and increased pressure within a compartment to the point that blood cannot supply the muscles and nerves with oxygen and nutrients. Muscles in the forearm, lower leg and other body areas are surrounded by fibrous bands of tissues. This creates distinct compartments. The fibrous tissue is very inflexible and cannot stretch to accommodate the generalized swelling. If left untreated, muscles and nerves fail and may eventually die.
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Muscles -A LONG CHART ON IMAGES OF DIFFERENT MUSCLES- Myology|, kinesiology- ...martinshaji
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P h value- a long chart on different ph. values martinshaji
pH is a measure of how acidic/basic water is. The range goes from 0 - 14, with 7 being neutral. pHs of less than 7 indicate acidity, whereas a pH of greater than 7 indicates a base. pH is really a measure of the relative amount of free hydrogen and hydroxyl ions in the water .
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12 basic facts about tetracyclines - medical information martinshaji
Tetracyclines are a class of broad-spectrum antibiotics used in the management and treatment of a variety of infectious diseases. Naturally occurring drugs in this class are tetracycline, chlortetracycline, oxytetracycline, and demeclocycline. used to treat infections caused by susceptible microorganisms such as gram positive and gram negative bacteria, chlamydiae, mycoplasmata, protozoans, or rickettsiae.
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8 signs and symptoms of breast cancer you - medical information martinshaji
After skin cancer, breast cancer is the most common cancer diagnosed in women in the United States. hence it is necessary to know its major symptoms which will help you to avoid a life threatening condition easily .....
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How to have a Clear Skin....HEALTH INFORMATION martinshaji
Clear skin is possible for everyone if you follow a basic good skincare routine for your unique skin type. these are some common methods for having good clear skin on considering medical aspects ,
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Liver failure is a life-threatening condition that demands urgent medical care.
Alcoholic liver disease (ALD) is a leading cause of cirrhosis, liver cancer, and acute and chronic liver failure and as such causes significant morbidity and mortality.
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Natural ways to build healthy bones - health information martinshaji
Bone health is important throughout life. While you can never regain the bone density you had in your youth, you can help prevent rapidly thinning bones, even after your diagnosis. Calcium is a crucial building block of bone tissue. Vitamin D helps the body absorb and process calcium. Together, these two nutrients are the cornerstone of healthy bones.
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Sleep According To your Age-health information | images martinshaji
Sleep plays an important role in your physical health. For example, sleep is involved in healing and repair of your heart and blood vessels.
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Doctors once thought bony growths called heel spurs brought on the pain. Now they believe that heel spurs are the result -- not the cause -- of plantar fasciitis.
Plantar fasciitis is inflammation of the thick band of tissue (also called a fascia) at the bottom of your foot that runs from your heel to your toes.
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
2. The primary function of the respiratory system is to maintain
normality of arterial blood gases, that is, arterial pressure of oxygen
(PaO2) and arterial pressure of carbon dioxide (PaCO2). To achieve
this goal, several processes must be accomplished, including alveolar
ventilation, pulmonary perfusion, ventilation–perfusion matching,
and gas transfer across the alveolar–capillary membrane.
Different pulmonary function tests (PFTs) are used to evaluate the
physiologic processes of the respiratory system. Physiologic
abnormalities that can be measured by pulmonary function testing
include obstruction to airflow, restriction of lung size, and decrease in
transfer of gas across the alveolar–capillary membrane.
3. Potential uses of pulmonary function testing include evaluation of
patients with known or suspected lung disease; evaluation of symptoms
such as chronic cough, dyspnea, or chest tightness; monitoring of the
effects of exposure to dust, chemicals, or pulmonary toxic drugs; risk
stratification prior to surgery; monitoring of the effectiveness of
therapeutic interventions.
4. PFTs can help diagnose:
Asthma
Allergies
chronic bronchitis
respiratory infections
lung fibrosis
bronchiectasis, a condition in which the airways in the lungs stretch
and widen
5. COPD, which used to be called emphysema
asbestosis, a condition caused by exposure to asbestos
sarcoidosis, an inflammation of your lungs, liver, lymph nodes, eyes,
skin, or other tissues
scleroderma, a disease that affects your connective tissue
pulmonary tumor
lung cancer
weaknesses of the chest wall muscles
6. Definitions of lung volumes and capacities :
The air within the lung at the end of a forced inspiration can be
divided into four compartments or lung volumes.
The volume of air exhaled during normal quiet breathing is the tidal
volume (VT).
The maximal volume of air inhaled above tidal volume is the
inspiratory reserve volume (IRV).
The maximal air exhaled below tidal volume is the expiratory
reserve volume (ERV).
7. The residual volume (RV) is the amount of air remaining in the
lungs after a maximal exhalation.
8. The combinations or sums of two or more lung volumes are termed
capacities
Vital capacity (VC) is the maximal amount of air that can be exhaled
after a maximal inspiration. It is equal to the sum of IRV, VT, and
ERV.
When measured on a forced expiration, it is called the forced vital
capacity (FVC).
When measured over an exhalation of at least 30 seconds, it is
called the slow vital capacity (SVC).
The VC is approximately 75% of the total lung capacity (TLC), and when the
SVC is within the normal range, a significant restrictive disorder is unlikely.
9. Normally, the values for SVC and FVC are very similar unless
airway obstruction is present.
TLC is the volume of air in the lung after the maximal
inspiration and is the sum of the four primary lung volumes (IRV,
VT, ERV, and RV). Its measurement is difficult because the
amount of air remaining in the chest after maximal exhalation
(RV) must be measured by indirect methods.
TOTAL LUNG CAPACITY
10. The functional residual capacity (FRC) is the volume of air remaining in
the lungs at the end of a quiet expiration. FRC is the normal resting
position of the lung; it occurs when there is no contraction of either
inspiratory or expiratory muscles and normally is 40% of TLC.
Inspiratory capacity (IC) is the maximal volume of air that can be
inhaled from the end of a quiet expiration and is the sum of VT and IRV.
FVC which represents the total amount of air that can be exhaled, can
be expressed as a series of timed volumes.
11. The forced expiratory volume in the first second of expiration (FEV1)
is the volume of air exhaled during the first second of the FVC
maneuver. Although FEV1 is a volume, it conveys information on
obstruction because it is measured over a known time interval. FEV1
depends on the volume of air within the lung and the effort during
exhalation;
The forced expiratory flow (FEF) during 25% to 75% of FVC
(FEF25%–75%) represents the mean flow during the middle half of the
FVC. FEF25%–75%, formerly called the maximal midexpiratory flow,
is reported frequently in the assessment of small airways.
12. What happens during pulmonary function tests?
You may have your procedure as an outpatient. This means you
go home the same day. Or it may be done as part of a longer
stay in the hospital. The way the procedure is done may vary. It
depends on your condition and your healthcare provider's
methods. In most cases, the procedure will follow this process:
1.You’ll be asked to loosen tight clothing, jewelry, or other things
that may cause a problem with the procedure.
2.If you wear dentures, you will need to wear them during the
procedure.
13. 3.You’ll need to empty your bladder before the procedure.
4.You’ll sit in a chair. A soft clip will be put on your nose. This
is so all of your breathing is done through your mouth, not
your nose.
5.You’ll be given a sterile mouthpiece that is attached to a
spirometer.
6.You’ll form a tight seal over the mouthpiece with your
mouth. You’ll be instructed to inhale and exhale in different
ways.
14. 7.You will be watched carefully during the procedure for
dizziness, trouble breathing, or other problems.
8.You may be given a bronchodilator after certain tests. The
tests will then be repeated several minutes later, after the
bronchodilator has taken effect.
16. Spirometry is used to diagnose asthma, chronic obstructive
pulmonary disease (COPD) and other conditions that affect
breathing. Spirometry may also be used periodically to monitor your
lung condition and check whether a treatment for a chronic lung
condition is helping you breathe better
17. Spirometry is the most widely available and useful PFT. It takes only 15
to 20 minutes, carries no risks, and provides information about
obstructive and restrictive disease. Spirometry allows for measurement
of all lung volumes and capacities except RV, FRC, and TLC; it also
allows assessment of FEV1 and FEF25%–75%. Spirometry
measurements can be reported in two different formats—standard
spirometry and the flow–volume loop.
18. A spirometer is an apparatus for measuring the volume of air inspired and
expired by the lungs. A spirometer measures ventilation, the movement of air
into and out of the lungs.
19. In standard spirometry, the volumes are recorded on the vertical (y)
axis and the time on the horizontal (x) axis. In flow–volume loops,
volume is plotted on the horizontal (x) axis, and flow (derived from
volume/ time) is plotted on the vertical (y) axis. The shape of the
flow–volume loop can be helpful in differentiating obstructive and
restrictive defects and in diagnosing upper airway obstruction. This
curve gives a visual representation of obstruction because the
expiratory descent becomes more concave with worsening
obstruction.
20. Spirometry measures three of the four basic lung volumes but cannot
measure RV. RV must be measured to determine TLC. TLC should be
measured anytime VC is reduced.
The four methods for measuring TLC are
helium dilution,
nitrogen washout,
body plethysmography,
and chest x-ray measurement (planimetry).
21. The first two methods are called dilution techniques and only
measure lung volumes in communication with the upper airway.
In patients with airway obstruction who have trapped air,
dilution techniques will underestimate the actual volume of the
lungs.
22. Body plethysmography:
Body plethysmography, or body box, is the most accurate
technique for lung volume determinations. It measures all the air in
the lungs, including trapped air. The principle of the measurement of
the body box is Boyle’s gas law (P1V1 = P2V2): A volume of gas in
a closed system varies inversely with the pressure applied to it.
23.
24. Diffusion capacity test
This test evaluates how well the small air sacks inside the lungs,
called alveoli, work. For this part of a pulmonary function test, you
will be asked to breathe in certain gases such as oxygen, helium, or
carbon dioxide.
You may also breathe in a “tracer gas” for one breath. The machine
can detect when you breathe out this gas. This tests how well your
lungs are able to transfer oxygen and carbon dioxide to and from
your bloodstream
25. CARBON MONOXIDE DIFFUSING CAPACITY:
The diffusing capacity of the lungs (DL) is a measurement of the
ability of a gas to diffuse across the alveolar–capillary membrane.
Carbon monoxide is the usual test gas because normally it is not
present in the lungs and is much more soluble in blood than in lung
tissue. When the diffusing capacity is determined with carbon
monoxide, the test is called the diffusing capacity of lung for carbon
monoxide (DLCO). Because DLCO is directly related to alveolar
volume (VA), it frequently is normalized to the value DL/VA, which
allows for its interpretation in the presence of abnormal lung volumes
(e.g., after surgical lung resection).
26. The diffusing capacity will be reduced in all clinical situations where gas
transfer from the alveoli to capillary blood is impaired.3 Common
conditions that reduce DLCO include lung resection, emphysema (loss
of functioning alveolar–capillary units), and interstitial lung disease
(thickening of the alveolar–capillary membrane). Normal PFTs with
reduced DLCO should suggest the possibility of pulmonary vascular
disease (e.g., pulmonary embolus) but also can be seen with anaemia,
early interstitial lung disease, and mild Pneumocystis carinii pneumonia
(PCP) infection in patients with acquired immune deficiency syndrome.
27. What are the risks of pulmonary function tests?
A PFT can cause problems if:
you’ve recently had a heart attack
you’ve recently had eye surgery
you’ve recently had chest surgery
you’ve recently had abdominal surgery
you have a severe respiratory infection
you have unstable heart disease
PFTs are usually safe for most people. However, because the test may
require you to breathe in and out quickly, you may feel dizzy and
there’s a risk that you may faint. If you feel lightheaded, tell your
doctor. If you have asthma, the test may cause you to have an asthma
attack. In very rare cases, PFTs may cause a collapsed lung.