in pulmonary clinic
Ventilation
Distribution
Diffusion
Ventilation deals with the measurement of the
body as an air pump, determining its ability to
move volumes of air and the speed with
which it moves the air
Distribution measurements quantify degrees
of lung obstructions and also determine the
residual volume (amount of air that cannot be
removed)
Diffusion measurements identify the rate at
which oxygen exchange takes place
Pulmonary function
Residual volume
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
Additional Spirometric Indicies
VC - Vital capacity:
A volume of a full breath exhaled in the patient’s own
time and not forced. Often slightly greater than the
FVC, particularly in COPD
Affected by:
Age
Height
Sex
Ethnic Origin
Criteria for Normal
Post-bronchodilator Spirometry
5 FVC
Volume, liters
4
FEV1 = 4L
3
FVC = 5L
2
FEV1/FVC = 0.8
1
1 2 3 4 5 6
Time, seconds
Diseases Associated With
Airflow Obstruction
Asthma
Bronchiectasis
Cystic Fibrosis
Post-tuberculosis
Lung cancer (greater risk in COPD)
Obliterative Bronchiolitis
Unacceptable Trace – Stop
Early
Normal
Volume, liters
Time, seconds
Unacceptable Trace – Slow
Start
Normal
Volume, liters
Time, seconds
Unacceptable Trace -
Coughing
Normal
Volume, liters
Time, seconds
Unacceptable Trace – Extra
Breath
Normal
Volume, liters
Time, seconds
Basic Spirometer
Normal Normal
FEV1
Reduced (<70%)
FVC reduced
Restrictive defect
Case 1
Case 2
a
A
A
A
A