Spirometry is a test that measures lung function by having the patient forcefully exhale air into a mouthpiece. It was originally developed in the 1840s and has since been improved with electronic devices. It is used to diagnose asthma and COPD by measuring airflow obstruction. The test involves withholding some medications beforehand, having the patient blow hard into the device multiple times, and may show a normal pattern or patterns indicating obstruction, restriction, or both. Reversibility testing with a bronchodilator helps distinguish asthma from COPD. Spirometry provides important information about lung health and disease.
A technique used to measure air flow in and out of the lungs.
A recording of lung volumes and capacities defined by the respiratory process. These recordings may be static (untimed) or dynamic (timed).
Assesses the integrated mechanical functions of lungs, chest wall and respiratory muscles.
The gold standard for diagnosis, assessment and monitoring of COPD.
Better than PEFR (which is effort dependent) for demonstrating airway obstruction in BA.
The most commonly used PFT
Pulmonary function tests (PFTs) are noninvasive tests that show how well the lungs are working. The tests measure lung volume, capacity, rates of flow, and gas exchange. This information can help your healthcare provider diagnose and decide the treatment of certain lung disorders.
A technique used to measure air flow in and out of the lungs.
A recording of lung volumes and capacities defined by the respiratory process. These recordings may be static (untimed) or dynamic (timed).
Assesses the integrated mechanical functions of lungs, chest wall and respiratory muscles.
The gold standard for diagnosis, assessment and monitoring of COPD.
Better than PEFR (which is effort dependent) for demonstrating airway obstruction in BA.
The most commonly used PFT
Pulmonary function tests (PFTs) are noninvasive tests that show how well the lungs are working. The tests measure lung volume, capacity, rates of flow, and gas exchange. This information can help your healthcare provider diagnose and decide the treatment of certain lung disorders.
Test to Check the lung volume capacity. It is also known as Pulmonary Function Test. Spirometery is also used to increase the Lung capacity and Respiratory Muscle Strength. This device also used as a Breathing training exercise and Breathing resistance Exercise.
Mechanical ventilation ppt including airway, ventilator, tubings and connections, nursing management, trouble shooting common problems and issues, suctioning etc.
Pulmonary rehabilitation is a comprehensive intervention based on a thorough patient assessment followed by patient tailored therapies that include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviors”
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. The spirogram will identify two different types of abnormal ventilation patterns, obstructive and restrictive.
Test to Check the lung volume capacity. It is also known as Pulmonary Function Test. Spirometery is also used to increase the Lung capacity and Respiratory Muscle Strength. This device also used as a Breathing training exercise and Breathing resistance Exercise.
Mechanical ventilation ppt including airway, ventilator, tubings and connections, nursing management, trouble shooting common problems and issues, suctioning etc.
Pulmonary rehabilitation is a comprehensive intervention based on a thorough patient assessment followed by patient tailored therapies that include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviors”
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. The spirogram will identify two different types of abnormal ventilation patterns, obstructive and restrictive.
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
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 PLAY A VERY IMPORTANT ROLE IN ESTIMATING THE FUNCTION OF LUNGS ESPECIALLY IN ASTHAMA AND COPD, One of the frequent reasons patients see their primary care physicians is for the symptom of dyspnea. Among the objective tests to quantify this symptom is the pulmonary function test
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
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
- 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
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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.
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.
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
2. DEFINITION
Spirometry is derived from the Latin words
SPIRO (to breathe) and METER (to
measure).
Spirometry is a method of assessing lung
function by measuring the volume of air that
the patient can expel from the lungs after a
maximal inspiration.
a method of assessing lung function
3. HISTORY
The spirometer was originally invented in the 1840’s by John
Hutchinson an English surgeon. The volume of exhaled air from
fully inflated lungs could accurately be measured by exhaling into a
tube leading into the bucket. Helped in measurement of Vital
Capacity.
In 1950 Dr. Tiffeneau of France introduced the forced
measurement of air volume during a given time frame, i.e., forced
expiratory volume in 1 second, FEV1.
Wright B.M. and McKerrow C.B. introduced the peak flow
meter in 1959.
In 2008, Advanced Medical Engineering developed the world's
first wireless spirometer with 3D Tilt-Sensing for far greater
quality control in the testing environment.
5. INDICATIONS
Spirometry is the best way of detecting the presence of airway obstruction
and making a definitive diagnosis of asthma and COPD. In COPD its uses
are
Measure airflow obstruction to help make a definitive diagnosis of
COPD.
Confirm presence of airway obstruction.
Assess severity of airflow obstruction in COPD.
Detect airflow obstruction in smokers who may have few or no
symptoms.
Monitor disease progression in COPD.
Assess one aspect of response to therapy.
Assess prognosis (FEV1) in COPD.
Perform pre-operative assessment.
6. ADDITIONAL USES
Make a diagnosis and assess severity in a range
of other respiratory conditions
Distinguish between obstruction and restriction as
causes of breathlessness
Screen workforces in occupational environments
Assess fitness to dive
Perform pre-employment screening in certain
professions
7. Types of Spirometers
Bellows spirometers:
Measure volume; mainly in lung function units
Electronic desk top spirometers:
Measure flow and volume with real time display
Small hand-held spirometers:
Inexpensive and quick to use but no print out
12. LUNG VOLUMES AND CAPACITIES
Tidal volume: that volume of air moved into or out of the lungs during
quiet breathing
Inspiratory reserve volume: the maximal volume that can be inhaled
from the end-inspiratory level
Inspiratory capacity: the sum of IRV and TV
Expiratory reserve volume: the maximal volume of air that can be
exhaled from the end-expiratory position
Vital capacity: the volume of air breathed out after the deepest
inhalation.
Total lung capacity: the volume in the lungs at maximal inflation, the
sum of VC and RV.
Residual volume: the volume of air remaining in the lungs after a
maximal exhalation
13.
14. Standard Spirometric Indicies
FEV1 - Forced expiratory volume in one second: The volume of air
expired in the first second of the blow
FVC - Forced vital capacity: The total volume of air that can be forcibly
exhaled in one breath
FEV1/FVC ratio: The fraction of air exhaled in the first second relative to
the total volume exhaled
FEV6 – Forced expired volume in six seconds:
Often approximates the FVC. Easier to perform in older and COPD
patients but role in COPD diagnosis remains under investigation
MEFR – Mid-expiratory flow rates:
Derived from the mid portion of the flow volume curve but is not useful
for COPD diagnosis
16. Withholding Medications
Before performing spirometry, withhold:
Short acting β2-agonists for 6 hours
Long acting β2-agonists for 12 hours
Ipratropium for 6 hours
Tiotropium for 24 hours
Optimally, subjects should avoid caffeine and
cigarette smoking for 30 minutes before performing
spirometry
17. Performing Spirometry - Preparation
1. Explain the purpose of the test and demonstrate
the procedure
2. Record the patient’s age, height and gender and
enter on the spirometer
3. Note when bronchodilator was last used
4. Have the patient sitting comfortably
5. Loosen any tight clothing
6. Empty the bladder beforehand if needed
18. Breath in until the lungs are full
Hold the breath and seal the lips tightly
around a clean mouthpiece
Blast the air out as forcibly and fast as
possible. Provide lots of encouragement!
Continue blowing until the lungs feel empty
19. Watch the patient during the blow to assure
the lips are sealed around the mouthpiece
Check to determine if an adequate trace
has been achieved
Repeat the procedure at least twice more
until ideally 3 readings within 100 ml or 5%
of each other are obtained
20. Spirometry - Possible Side Effects
Feeling light-headed
Headache
Facial redness
Fainting: reduced venous return or vasovagal
attack (reflex)
Transient urinary incontinence
Spirometry should be avoided after recent heart attack or
stroke
26. Diseases Associated With
Airflow Obstruction
COPD
Asthma
Bronchiectasis
Cystic Fibrosis
Post-tuberculosis
Lung cancer (greater risk in COPD)
Obliterative Bronchiolitis
27. Spirometric Diagnosis of COPD
COPD is confirmed by post–bronchodilator
FEV1/FVC < 0.7
Post-bronchodilator FEV1/FVC measured 15
minutes after 400µg salbutamol or
equivalent
28. Bronchodilator Reversibility Testing
Provides the best achievable FEV1
(and FVC)
Helps to differentiate COPD from
asthma
Must be interpreted with clinical history
- neither asthma nor COPD are
diagnosed on spirometry alone
29. Bronchodilator Reversibility Testing
Can be done on first visit if no diagnosis has
been made
Best done as a planned procedure: pre- and
post-bronchodilator tests require a minimum of
15 minutes
Post-bronchodilator only saves time but does not
help confirm if asthma is present
Short-acting bronchodilators need to be
withheld for at least 4 hours prior to test
30. Bronchodilator Reversibility Testing
Bronchodilator* Dose FEV1 before and
after
Salbutamol 200 – 400 µg via
large volume
spacer
15 minutes
Terbutaline 500 µg via
Turbohaler®
15 minutes
Ipratropium 160 µg** via
spacer
45 minutes