Spirometry is used to analyze lung function by measuring airflow during breathing. A flow-volume loop graph shows airflow on inspiration and expiration. Key measurements include forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and their ratio (FEV1/FVC). Changes in these values can indicate obstructive lung diseases like asthma which reduce FEV1/FVC ratio, or restrictive lung diseases which preserve FEV1/FVC ratio.
it contains all the physiology of lung volume and capacity.
in this we study:-
introduction
lung volume
lung capacities
measurements of lung volume and capacities.
measurement of FRC and RV.
vital capacity.
FEV
RMV
MBC
PEFR
restrictive and obstructive respiratory disease.
it contains all the physiology of lung volume and capacity.
in this we study:-
introduction
lung volume
lung capacities
measurements of lung volume and capacities.
measurement of FRC and RV.
vital capacity.
FEV
RMV
MBC
PEFR
restrictive and obstructive respiratory disease.
Discussion #11. What physical findings might be indicative of a .docxmecklenburgstrelitzh
Discussion #1
1. What physical findings might be indicative of a patient with emphysema? The diagnosis is made on patients that usually are long term smokers, and they complaint of dyspnea, cough, and mucus expectoration. Most patients seek medical attention late in the course of their disease, usually ignoring smoldering symptoms that start gradually and progress over the course of years. The cough typically is worse in the morning with finite production of clear-to-white sputum. Dyspnea, emphysema's most significant symptom, does not generally occur until the sixth decade of life. However, patients with emphysema due to alpha 1 -antitrypsin deficit will exhibit the following characteristics: early presentation (< 45 y), predilection of emphysematous changes in the lung bases, and the panacinar morphological pattern.
Although the sensitivity of the physical evaluation in mild-to-moderate disease is relatively poor, the physical signs are quite sensitive and specific in severe disease. Patients with severe disease may experience tachypnea and dyspnea with mild exertion.
The respiratory rate increases in proportion to disease severity with the use of accessory respiratory muscles and paradoxical contraction of lower intercostal spaces becoming evident during exacerbations.
In end-stage emphysema, cyanosis, elevated jugular venous pressure, atrophy of limb musculature, and peripheral edema due to the development of pulmonary hypertension, right-to-left shunting, and/or right heart failure can easily be observed.
Thoracic examination reveals a 2:1 increase in anterior to posterior diameter (“barrel chest”), diffuse or focal wheezing, diffusely diminished breath sounds, hyperresonance upon percussion, prolonged expiration, and/or hyperinflation on chest radiographs.
2. What is the purpose and interpretations of the pulmonary function test? Pulmonary function tests will test the mechanical function of the lungs, chest wall, and respiratory muscles by measuring the total volume of air exhaled from a full lung (total lung capacity [TLC]) to maximal expiration (residual volume [RV]). This volume, the forced vital capacity (FVC) and the forced expiratory volume in the first second of the forceful exhalation (FEV1), In Emphysema, spirometry may show typical obstructive pattern due to the blockage of the air during expiration. As a result of the air trapping, the spirometry will show decreased in FVC, but less than the FEV 1, and increased FRC and RV.(McCance, & Huether, 2013).
3. What are the pathophysiological findings specifying emphysema? As a result of the cellular apoptosis, and early cellular senescence, the alveolar cells are damaged, and a reduced surface of gas exchanged occurred. The destruction of the alveoli creates bullae, which are large spaces in the lung parenchyma and air spaces adjacent to pleurae(blebs). Both elements bullae, and blebs difficult the air exchange. In addition, areas of the lungs that are bad perfused contributes to w.
a detailed study on pulmonary function testmartinshaji
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
please comment
thank u
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?
Here is a presentation about the double lung ventilation or independent lung ventilation
I hope it will be helpful
There are some videos in the presentation , here is the links :)
http://www.youtube.com/watch?v=w1cgx2AVC6k&list=UUUIWCsRV3siWB-jzBmNg6pA
http://www.youtube.com/watch?v=JZkOiy4PXxg&list=UUUIWCsRV3siWB-jzBmNg6pA
http://www.youtube.com/watch?v=mlS35eUUxqA&list=UUUIWCsRV3siWB-jzBmNg6pA
1. Computer
Analysis of Lung Function
21
Spirometry is a valuable tool for analyzing the flow rate of air passing into and out of the lungs.
Flow rates vary over the course of a respiratory cycle (a single inspiration followed by a single
expiration) and are dependent upon a variety of factors. Maximal inspiration results from
contraction of the diaphragm downward and the movement of the ribs upward and outward, both
of which expand the chest cavity. Forced expiration is the result of the rapid contraction of chest
and abdominal muscles, as well as the relaxation of the diaphragm.
Lung flow rates are graphed as a flow volume loop,
in which air flow is graphed as a function of volume.
Because volume (graphed on the x axis) is increased
with inspiration and decreased with expiration, the
completed graph forms a loop (see Figure 1). As is
demonstrated in the flow volume loop, in normal
lungs air is rapidly expelled early in the process of
forced expiration, with a tapering of flow rate as the
lungs are emptying. This latter part of the expiration
curve represents the emptying of small airways
(terminal bronchioles). Inspiration shows a different
pattern, with the maximum air flow occurring half-
way through the cycle.
Information about disease states can be obtained
through examination of flow volume loop graphs. Figure 1
Data that can be obtained or calculated from the
graph include:
• forced vital capacity (FVC), the total exhaled air, from maximum inhalation to maximum
exhalation;
• forced expiratory volume (FEV1), the volume of air expelled in the first second of a forced
exhalation;
• FEV1/FVC, measured as a percentage;
• peak expiratory flow (PEF), the highest point on the exhalation graph.
Changes from expected values can be used to diagnose a variety of pulmonary conditions and to
follow their progress over time.
Important: Do not attempt this experiment if you are currently suffering from a respiratory
ailment such as the cold or flu.
Human Physiology with Vernier 21 - 1
2. Computer 21
OBJECTIVES
In this experiment, you will
• Obtain graphical representation of a flow volume loop.
• Find the forced expiratory volume at 1 s (FEV1) and the forced vital capacity (FVC).
• Calculate FEV1/FVC.
• Find the peak expiratory flow rate (PEF).
• Create flow volume loops for several clinical scenarios.
MATERIALS
computer disposable mouthpiece
Vernier computer interface disposable bacterial filter
Vernier Spirometer nose clip
Logger Pro
PROCEDURE
Select one person from your lab group to be the subject.
1. Connect the Spirometer to the Vernier computer interface. Open the file
“21 Analyze Lung Function” from the Human Physiology with Vernier folder.
2. Attach the larger diameter side of a white bacterial filter to the side of the Spirometer head
marked “Inlet.” Attach a disposable mouthpiece to the other end of the bacterial filter (see
Figure 2).
Figure 2
3. Hold the Spirometer in one or both hands. Brace your arm(s) against a solid surface, such as a
table, and click . Note: The Spirometer must be held straight up and down (see
Figure 2) and not moved during data collection.
4. Collect exhalation and inhalation data.
a. Put on the nose clip and put your mouth against the mouthpiece.
b. Click to begin data collection.
c. Take the deepest breath possible and exhale forcefully as quickly as possible through the
Spirometer mouthpiece. Important: Force ALL of the air out of your lungs. Your
exhalation will trigger data collection. Without removing your mouth from the mouthpiece,
inhale as deeply as possible.
21 - 2 Human Physiology with Vernier
3. Analysis of Lung Function
5. If your data does not approximate Figure 1, repeat Step 4. It is helpful to watch the screen
while performing this test. Important: It is essential that maximum effort be expended when
performing tests of air flow.
6. Find FEV1 by scrolling down the data table to 1.00 s. Scroll to the right to see the volume.
Record this value to the nearest 0.01 L in the data table.
7. Click the Examine button, . Move the examine line to the rightmost point of the flow
volume loop. This is the FVC. Record the volume value to the nearest 0.01 L in the data
table. Close the Statistics box by clicking the X in the corner of the box.
8. Find FEV1/FVC, multiply by 100, and enter the calculated value in the data table.
9. Click the Statistics button, . Enter the maximum flow rate value to the nearest 0.01 L/s as
peak expiratory flow rate (PEF) in the data table.
DATA
FEV1 FVC FEV1/FVC PEF
(L) (L) (%) (L/s)
DATA ANALYSIS
1. Using the flow volume loops pictured below as guides, superimpose loops for the following
scenarios. In your answer consider whether the problem affects inspiration, expiration, or
both; whether it is likely to affect the first half of the curve, the second half of the curve, or
both. (Hint: It may be helpful to begin by estimating the maximum expected total lung
capacity for each situation and drawing this point on the graph first.)
a. There is a narrowing of the trachea, causing blockage in this large airway.
Human Physiology with Vernier 21 - 3
4. Computer 21
b. A small grape is lodged in the right mainstem bronchus, completely blocking off the right
lung.
c. Emphysema reduces all flow rates, but has a greater effect on small airways, many of
which are lost to the disease. (Acute asthma may show similar changes because of mucous
obstruction of these same small airways.)
d. Severe osteoporosis may result in kyphoscoliosis, in which there is a curvature of the
upper spine that limits the normal ability of the ribs to expand with inspiration.
21 - 4 Human Physiology with Vernier
5. Analysis of Lung Function
2. Lung disease is often divided into two broad categories: obstructive disease and restrictive
disease. Examples of obstructive disease are emphysema, chronic bronchitis, and asthma.
Examples of restrictive disease are abnormalities of the spine and chest and diseases within the
lungs that make them less elastic (“stiffer”), such as pulmonary fibrosis. Calculate the
FEV1/FVC in the table below for obstructive and restrictive disease and compare to your
values. How might these values be helpful diagnostically?
Volume (L) Normal (your data) Obstructive disease Restrictive disease
FVC (L) 4 4
FEV1 (L) 1.8 3.5
FEV1/FVC (%)
Human Physiology with Vernier 21 - 5
6. Analysis of Lung Function
2. Lung disease is often divided into two broad categories: obstructive disease and restrictive
disease. Examples of obstructive disease are emphysema, chronic bronchitis, and asthma.
Examples of restrictive disease are abnormalities of the spine and chest and diseases within the
lungs that make them less elastic (“stiffer”), such as pulmonary fibrosis. Calculate the
FEV1/FVC in the table below for obstructive and restrictive disease and compare to your
values. How might these values be helpful diagnostically?
Volume (L) Normal (your data) Obstructive disease Restrictive disease
FVC (L) 4 4
FEV1 (L) 1.8 3.5
FEV1/FVC (%)
Human Physiology with Vernier 21 - 5
7. Analysis of Lung Function
2. Lung disease is often divided into two broad categories: obstructive disease and restrictive
disease. Examples of obstructive disease are emphysema, chronic bronchitis, and asthma.
Examples of restrictive disease are abnormalities of the spine and chest and diseases within the
lungs that make them less elastic (“stiffer”), such as pulmonary fibrosis. Calculate the
FEV1/FVC in the table below for obstructive and restrictive disease and compare to your
values. How might these values be helpful diagnostically?
Volume (L) Normal (your data) Obstructive disease Restrictive disease
FVC (L) 4 4
FEV1 (L) 1.8 3.5
FEV1/FVC (%)
Human Physiology with Vernier 21 - 5
8. Analysis of Lung Function
2. Lung disease is often divided into two broad categories: obstructive disease and restrictive
disease. Examples of obstructive disease are emphysema, chronic bronchitis, and asthma.
Examples of restrictive disease are abnormalities of the spine and chest and diseases within the
lungs that make them less elastic (“stiffer”), such as pulmonary fibrosis. Calculate the
FEV1/FVC in the table below for obstructive and restrictive disease and compare to your
values. How might these values be helpful diagnostically?
Volume (L) Normal (your data) Obstructive disease Restrictive disease
FVC (L) 4 4
FEV1 (L) 1.8 3.5
FEV1/FVC (%)
Human Physiology with Vernier 21 - 5