PULMONARY FUNCTION TESTS
AIMS OF THE EXPERIMENT
1. To measure various lung volumes and
capacities using Spirometer.
2. To measure Vital capacity, forced vital
capacity using vitalogragh.
3. Peak flow meter.
Introduction
• Pulmonary function tests or Lung function
tests are useful in assessing the functional
status of the respiratory system both in
physiological and pathological conditions.
• It is based on the measurement of volume
of air breathed in and out in quiet and forced
breathing.
• The air in the lung is classified into 2
divisions: Lung Volumes and Lung Capacities.
LUNG VOLUMES
• Lung volumes are the static volumes of air
breathed by an individual.
• Each of these volumes represents the volume
of air present in the lung under a specified
static condition. The lung volumes are of four
types:
1.Tidal volume
2.Inspiratory reserve volume
3.Expiratory reserve volume
4.Residual volume
• T I DA L VO LU M E : I s t h e v o l u m e o f a i r
breathed in and out of lungs in a single
normal quiet respiration. Tidal volume
signifies the normal depth of breathing.
Normal value = 500mL (0.5 litres).
• INSPIRATORY RESERVE VOLUME (IRV): Is an
additional volume of air that can be
inspired forcefully after the end of normal
inspiration.
Normal value = 3300mL (3.3 litres)
• EXPIRATORY RESERVE VOLUME (ERV) : This is the
additional volume of air that can be expired out
forcefully after normal expiration. Normal volume
=1000mL (1 litre)
• RESIDUAL VOLUME (RV): is the volume of air remaining
in the lungs even after forced expiration. Normally lungs
cannot be emptied completely even by forceful
expiration. Some quantity of air always remains in the
lungs even after the forced expiration. Residual volume is
significance because of two reasons:
• 1. It helps to aerate the blood in between breathing and
during expiration
• 2. It maintains the contour of the lungs
• Normal Value = 1200mL (1.2 litres)
LUNG CAPACITIES
• Lung capacities are the combination of 2 or
more lung volumes
• Lung capacities are of 4 types:
1.Inspiratory capacity
2.Vital capacity
3.Functional residual capacity
4.Total lung capacity
1. INSPIRATORY CAPACITY (IC)
This is the maximum volume of air that is
inspired after normal expiration.
• It includes tidal volume and inspiratory
reserve volume.
IC = TV + IRV
= 500 + 3300 = 3800mL
2. VITAL CAPACITY (VC): Vital capacity
is maximum volume of air that can
be expelled out forcefully after a
deep (maximum) inspiration. Vital
capacity includes tidal volume,
inspiratory reserve volume and
expiratory reserve volume.
VC = TV +IRV + ERV
= 500 +3300 + 1000 = 4800mL
3.FUNCTIONAL RESIDUAL CAPACITY
(FRC)
This is the volume of air remaining in
the lungs after normal expiration
(normal tidal expiration). Functional
residual capacity includes expiratory
reserve volume and residual volume.
FRC = ERV + RV
= 1000 + 1200 = 2200mL
4. TOTAL LUNG CAPACITY (TLC)
This is the volume of air present in
the lungs after a deep (maximal)
i n s p i ra t i o n . I t i n c l u d e s a l l t h e
volumes.
TLC = IRV + TV +ERV + RV
= 3300 + 500 + 1000 + 1200
= 6000mL
MEASUREMENT OF LUNG VOLUMES AND
CAPACITIES
• Spirometry is the method used to measure lung
volumes and capacities. The simple instrument
used for this purpose is called Spirometer.
• APPARATUS
1. Spirometer
2. Nose clips,
3. Mouth piece.
4. Vitalograph
5. Peak flow meter
SPIROMETER
NOSE CLIP
MOUTH PIECE
VITALOGRAPH
PEAK FLOW METER
PATIENT’S PREPARATION AND PROCEDURES
DURING LUNG FUNCTION TEST
When the patient arrives for the test, briefly and
politely explain the procedure in the language that
he/she understands better.
Below are the precautions to be taken:
1. Instruct the patient not to eat large quantity of meal
within 2 hours of carrying out the test.
2. Recommend loose and unrestricted clothing.
3. The patient, if a smoker, must refrain from smoking
an hour to the time of carrying out the test.
4. Politely solicit for maximum cooperation from the
patient.
5.Patient’s information to be recorded include:
Name, age/date of birth, height, weight,
gender/sex, race.
6.Proper positioning and sitting
7. Show mouth piece, nose clips, explain proper
mouth piece insertion and head positioning.
8.Fill your lungs as deep as you can, the patient is
fitted with nose clip on the nose, place the
mouth piece in your mouth, seal your lips
around it and breath in and out quietly,
forcefully, continue to breath in and out until
you can no longer blow any air out. Repeat for 3
times.
FACTORS AFFECTING LUNG VOLUMES AND
CAPACITIES
• HIGH ALTITUDE
• AGE
• SEX
• PHYSICAL ACTIVITY
• BODY SIZE
• ETHNIC ORIGIN
• POSTURE
CLINICAL SIGNIFICANCES
• Restrictive lung disorder: An impairment of
the ventilatory ability of the lungs so that the
volume of air which can be inspired or expired
is diminished. e.g. Spinal cord diseases ,
pleural effusion, Polio myelitis, paralysis of
diaphragm.
• Obstructive lung disorder: This is the
narrowing of the respiratory passages, thus
making it difficult to expire freely. e.g. asthma,
chronic bronchitis and emphysema.
There are 2 main methods for the
determination of the presence of
airway obstruction:
• By measurement of timed vital
capacities namely the forced expiratory
volume in 1 second (FEV1) and in 3
seconds (FEV3), or
• By measurement of the peak flow rate.
• Forced Expiratory Volume or Timed Vital
Capacity
• Is the volume of air which can be expired
forcefully in a given unit of time (after a
deep inspiration). FEV is the maximum
volume of air that can be forced out of the
lungs in one seconds after maximal
inspiration.
• The standard equipment is the Vitalograph
Spirometer
• The subject inspires maximally and fully with
force. As the pen moves down the volume scale,
the chart paper moves laterally at constant
speed (1cm/s) so that the force takes the form
of a curve which reaches a maximum at the FEV.
The timed volumes exhaled are read from the
chart i.e. the volume exhaled in the first second
is FEV1 and the volume exhaled in 3 seconds is
FEV3.
PEAK EXPIRATORY FLOW RATE (PEFR)
• The maximum velocity of air flow during a
forced expiration after maximal inspiration. It
Is also a measure of the patency of the air
passages. It is commonly measured using
wright’s peak flow meter
• In normal young males, the value is 6 – 15
liters/minute, in females, = 2.8 – 10
liters/minutes.
• In restrictive diseases, the PEFR is 200
liters/minutes, while in obstructive diseases, it
is only 100 liters/minutes.
