4.5 Spirometry Workshop
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Where does gas exchange occur?
Acinus - anatomic unit of the lung made of structures supplied by terminal bronchiole
What is the dead space?
Area that doesn't exchange gases
Understand the reasons pulmonary function tests (PFTs) are performed.
- Determine the cause of breathing problems
- Dx certain lung diseases (asthma, COPD)
- Evaluate a person's lung function before surgery
- Monitor the lung function of a person who is regularly exposed to substances such as asbestos that can damage the lungs
- Monitor the effectiveness of tx for lung diseases
Understand the technique and basic interpretation of spirometry. What volumes can and cannot be measured?
- First lung function test done
- Measures how much and how quickly you can move air out of your lungs
- Can - Tidal volume and vital capacity
- Cannot - TLC, FRC, RV
What is Total Lung Capacity?
Inspiratory Reserve Volume (IRV) + Tidal Volume (TV) + Expiratory Reserve Volume (ERV) + Residual volume (RV)
What is Vital Capacity?
Inspiratory Reserve Volume (IRV) + Tidal Volume (TV) + Expiratory Reserve Volume (ERV)
What is Inspiratory Capacity?
Inspiratory Reserve Volume (IRV) + Tidal Volume (TV)
What is Functional Residual Capacity?
Expiratory Reserve Volume (ERV) + Residual Volume (RV)
What is Tidal Volume and what is the average value?
- Volume of air entering or leaving lungs during a single breath
- 500 mL
What is Inspiratory Reserve Volume (IRV) and what is the average value?
- Extra volume of air that can be maximally inspired over and above the typical resting tidal volume
- 3000 mL
What is Inspiratory Capacity and what is the average value?
- Maximum volume of air that can be inspired at the end of a normal quiet expiration (IC = IRV + IV)
- 3500 mL
What is Expiratory Reserve Volume (ERV) and what is the average value?
- Extra volume of air that can be actively expired by maximal contraction beyond the normal volume of air after a resting tidal volume
- 1000 mL
What is Residual Volume and what is the average value?
- Minimum volume of air remaining in the lungs even after a maximal expiration
- 1200 mL
What is the Functional Residual Capacity (FRC) and what is the average value?
- Volume of air in lungs at end of normal passive expiration (FRC = ERV + RV)
- 2200 mL
What is Vital Capacity (VC) and what is the average value?
- Maximum volume of air that can be moved out during a single breath following a maximal inspiration (VC = IRV + TV + ERV)
- 4500 mL
What is Total Lung Capacity and what is the average value?
- Maximum volume of air that the lungs can hold (TLC = VC + RV)
- 5700 mL
What is Forced Expiratory volume in 1 second (FEV1)?
Volume of air that can be expired during the 1st second of expiration in a VC determination
What is obstructive lung disease?
- Airways are narrowed (usually causing an ↑ in the time it takes to empty the lungs)
- Ex. emphysema, bronchitis, infection, asthma, cystic fibrosis
What is restrictive lung disease?
- Loss of lung tissue, ↓ in the lungs' ability to expand, or a ↓ in the lungs' ability to transfer oxygen to the blood
- Ex. pneumonia, lung cancer, scleroderma, pulmonary fibrosis, sarcoidosis, MS, chest injuries, obesity, pregnancy, loss of lung tissue during surgery, interstitial fibrosis, scoliosis, cystic fibrosis
Predict changes in the flow-volume curves in obstructive disease.
- Volume - same but takes a longer time
- Flow - decreased
Predict changes in the flow-volume curves in restrictive disease.
- Volume - plateaus half of normal
- Flow - Quick flow and little less and short compared to normal
What is the whole body plethysmograph and how is it used?
- Functional residual capacity (FRC) - volume in lungs when the muscles of respiration are relaxed
- Total lung capacity
What is FVC and FEV1, FEV2, and FEV3? Why is this information useful?
- FVC - Forced expiratory volume
- FEV1 - volume of gas exhaled in 1 sec by a forced expiration from a full inspiration
- FEV2 - end of 2 sec
- FEV3 - end of 3 sec
How can these parameters FEV1, FEV2, FVC be used to aid in dx of pulmonary disease?
- FVC - 80-120% normal. Lower means reduction
- FEV1 - >75% normal. Lower means obstruction
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