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Spirometry is the measurement of the flow and
volume of air entering and leaving the lungs
Test of pulmonary function (PFT)
• Indicator of health status or disease
• Exercise fitness
Respiratory system is functions include gas exchange ,
pH regulation, vocalization , and protection from
foreign substances.
Respiration:
CellularCellular
is the cellular mechanism of energy conversion
ExternalExternal
is the exchange of gases between atmosphere and
cells, Includes ventilation, gas
exchange at lungs and cells, and transport of gases in
the blood.
The process of exchange of air between the lungs
and the ambient air
 Airflow in respiratory system is directly proportional
to the pressure gradient and inversely related to
the resistance of the airways.
 A single respiratory cycle = inspiration + expiration
 Lung air pressure < Atmosphere air pressure
Diaphragm & inspiratory muscles contract →
Thoracic cavity expands negative pressure→ →
air flows into lungs
Passive process resulting from natural elastic
recoil of the expanded lung walls.
 During rapid breathing, internal intercostal and
abdominal muscles contract to help force air out at
a more forceful, rapid rate
Age
 Body size (height & weight)
 Gender
 Pulmonary health
 Altitude(height)
 Irritants
Or Maximum Mid-ExpiratoryOr Maximum Mid-Expiratory
Flow (MMEF)Flow (MMEF)
Apparatus used to measure static & dynamic lung
volumes/capacities using a closed system
• Registers the amount and rate of air moved into
or out of the lungs
• 2 main types;
1. Volume: records the amount of air exhaled or
inhaled within a certain time*
2. Flow: measures how fast the air flows in or out
as the volume of air inhaled or exhaled
increases
Key features:
 Real time tracings record volume in relation to time
Some are portable versions
 Leak tests and calibrations are easy to perform
 Many can produce flow/volume curves and loops
with the addition of special electronic or
digital circuitry.
 Volume spirometers hold their calibration months to
years better than flow spirometers
Not practical by hand to determine peak expiratory
flow or instantaneous volumes,
Coughs and submaximal efforts are not as obvious
 Some are heavy, cumbersome and may be prone to
fostering mold or bacterial growth if not cleaned
properly
Key features
 Measure how quickly air flows past a detector and
then derives the volume by electronic means.
 Records flow rate at brief intervals (30-300x/sec)
and use data to reconstruct the flow rate at each
point in time and volume (digitization).
 Tracings measure flow in relation to volume
 Computer can produce volume-time
tracings
 Tend to be lighter and more portable
 Disposable, single-use flow sensors, available on
some floe spirometers eliminate the risk (low)
of cross-contamination.
 No real-time or hard copy tracings
 Reliance on electronic equipment
FEV1.0 cannot be calculated by hand unless the
time is indicated in seconds on a flow-volume
tracing
 Some flow spirometers are more difficult to
calibrate and may lose their calibration over time
if not well maintained
 Test results are not disease specific
 May not be sensitive enough to show
abnormalities before extensive and in some
cases irreversible damage has been done
(mostly for restrictive diseases)
∴ Should not be used as the sole screening tool of
a respiratory surveillance program.
Obstructive deficits
Restrictive deficits
Mixed deficits
A reduction of FEV1
 In relation to the forced vital capacity will result in a
low FEV1/FVC%
The lower limit of normal for FEV1/FVC is around 70-
75%
 The exact limit is dependent on age.
Normal or high FEV1/FVC% ratio
 Reduction in both FEV1 and FVC
Interstitial lung disease
 Respiratory muscle weakness
Thoracic cage deformities such as kypho-scoliosis
A combination of both obstruction and restriction
resulting in gas trapping, rather than as a result of
small lungs.
A reduced FVC together with a
 low FEV1/FVC% ratio
It is necessary to measure the patient's total lung
capacity to distinguish between these two
possibilities.
Severity of Airway Obstruction FEV1 (% of Predicted)
Mild >70
Moderate > 60 and < 70
Moderately severe > 50 and < 60
Severe > 34 and < 50
Very severe < 34
Severity of Chest Restriction* FVC (% of Predicted)
Mild >70 but < LLN
Moderate > 60 and <70
Moderately severe > 50 and < 60
Severe > 34 and < 50
Very severe < 34
Type of response FEV1 FVC FEV1/FVC %
Normal > 80 % > 80 % > 75 %
Obstructive < 80 % > 80 % < 75 %
Restrictive > 80 % < 80 % >75 %
Mixed < 80 % < 80 % < 75 %
spirometry (measurements of the flow and volumes of air)

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spirometry (measurements of the flow and volumes of air)

  • 2. Spirometry is the measurement of the flow and volume of air entering and leaving the lungs Test of pulmonary function (PFT) • Indicator of health status or disease • Exercise fitness
  • 3. Respiratory system is functions include gas exchange , pH regulation, vocalization , and protection from foreign substances. Respiration: CellularCellular is the cellular mechanism of energy conversion ExternalExternal is the exchange of gases between atmosphere and cells, Includes ventilation, gas exchange at lungs and cells, and transport of gases in the blood.
  • 4.
  • 5.
  • 6. The process of exchange of air between the lungs and the ambient air  Airflow in respiratory system is directly proportional to the pressure gradient and inversely related to the resistance of the airways.  A single respiratory cycle = inspiration + expiration
  • 7.
  • 8.  Lung air pressure < Atmosphere air pressure Diaphragm & inspiratory muscles contract → Thoracic cavity expands negative pressure→ → air flows into lungs
  • 9. Passive process resulting from natural elastic recoil of the expanded lung walls.  During rapid breathing, internal intercostal and abdominal muscles contract to help force air out at a more forceful, rapid rate
  • 10.
  • 11.
  • 12.
  • 13.
  • 14. Age  Body size (height & weight)  Gender  Pulmonary health  Altitude(height)  Irritants
  • 15. Or Maximum Mid-ExpiratoryOr Maximum Mid-Expiratory Flow (MMEF)Flow (MMEF)
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21. Apparatus used to measure static & dynamic lung volumes/capacities using a closed system • Registers the amount and rate of air moved into or out of the lungs • 2 main types; 1. Volume: records the amount of air exhaled or inhaled within a certain time* 2. Flow: measures how fast the air flows in or out as the volume of air inhaled or exhaled increases
  • 22. Key features:  Real time tracings record volume in relation to time
  • 23.
  • 24. Some are portable versions  Leak tests and calibrations are easy to perform  Many can produce flow/volume curves and loops with the addition of special electronic or digital circuitry.  Volume spirometers hold their calibration months to years better than flow spirometers
  • 25. Not practical by hand to determine peak expiratory flow or instantaneous volumes, Coughs and submaximal efforts are not as obvious  Some are heavy, cumbersome and may be prone to fostering mold or bacterial growth if not cleaned properly
  • 26. Key features  Measure how quickly air flows past a detector and then derives the volume by electronic means.  Records flow rate at brief intervals (30-300x/sec) and use data to reconstruct the flow rate at each point in time and volume (digitization).  Tracings measure flow in relation to volume
  • 27.  Computer can produce volume-time tracings  Tend to be lighter and more portable  Disposable, single-use flow sensors, available on some floe spirometers eliminate the risk (low) of cross-contamination.
  • 28.  No real-time or hard copy tracings  Reliance on electronic equipment FEV1.0 cannot be calculated by hand unless the time is indicated in seconds on a flow-volume tracing  Some flow spirometers are more difficult to calibrate and may lose their calibration over time if not well maintained
  • 29.  Test results are not disease specific  May not be sensitive enough to show abnormalities before extensive and in some cases irreversible damage has been done (mostly for restrictive diseases) ∴ Should not be used as the sole screening tool of a respiratory surveillance program.
  • 31. A reduction of FEV1  In relation to the forced vital capacity will result in a low FEV1/FVC% The lower limit of normal for FEV1/FVC is around 70- 75%  The exact limit is dependent on age.
  • 32. Normal or high FEV1/FVC% ratio  Reduction in both FEV1 and FVC Interstitial lung disease  Respiratory muscle weakness Thoracic cage deformities such as kypho-scoliosis
  • 33. A combination of both obstruction and restriction resulting in gas trapping, rather than as a result of small lungs. A reduced FVC together with a  low FEV1/FVC% ratio It is necessary to measure the patient's total lung capacity to distinguish between these two possibilities.
  • 34. Severity of Airway Obstruction FEV1 (% of Predicted) Mild >70 Moderate > 60 and < 70 Moderately severe > 50 and < 60 Severe > 34 and < 50 Very severe < 34 Severity of Chest Restriction* FVC (% of Predicted) Mild >70 but < LLN Moderate > 60 and <70 Moderately severe > 50 and < 60 Severe > 34 and < 50 Very severe < 34
  • 35. Type of response FEV1 FVC FEV1/FVC % Normal > 80 % > 80 % > 75 % Obstructive < 80 % > 80 % < 75 % Restrictive > 80 % < 80 % >75 % Mixed < 80 % < 80 % < 75 %