Lecture 5 - Spirometry

Question 1

What are some examples of obstructive airways diseases?

Answer 1

Asthma, COPD, chronic bronchitis, emphysema, bronchiectasis and cystic fibrosis

Question 2

What are some examples of restrictive lung diseases?

Answer 2

Interstitial lung disease, musculoskeletal diseases, neuromuscular diseases, obesity and diaphragmatic weakness

Question 3

What is bronchiectasis?

Answer 3

Mucus secretion, airways become more blocked

Question 4

What is cystic fibrosis?

Answer 4

Excess production of the mucus

Question 5

Define restrictive lung diseases

Answer 5

Affect the ability of the lungs to expand and contract

Question 6

How many different types of interstitial lung diseases are there and what is the most common?

Answer 6

200 types and pulmonary fibrosis is the most common

Question 7

What is musculoskeletal disease (MS)?

Answer 7

Muscles are affected by neurogenerative diseases and so don’t work as well e.g. the diaphragm

Question 8

What is diaphragmatic paralysis?

Answer 8

Where the diaphragm gets stuck and can’t open the lungs properly

Question 9

What is spirometry?

Answer 9

Measures airflow and can be used for athletes and also patients to diagnose asthma

Question 10

What does spirometry measure?

Answer 10

Measures the responsiveness of airways to medication, measures the severity of airways disease and monitor disease progression

Question 11

What is used for preparing the spirometer?

Answer 11

Calibration and verification, and infection control

Question 12

What is calibrating?

Answer 12

When you check the vales are the reading values it is supposed to be reading

Question 13

What can affect calibration?

Answer 13

BTPS - barometric, temperature and water saturation - the environment affects these things which is why calibration needs to take place

Question 14

What is used for infection control?

Answer 14

A single use filter and a nose clip

Question 15

What can stop a spirometer from taking place?

Answer 15

If you had recently had a pneumothorax, recent MI, any aneurysms, eye surgery or thoracic/ abdominal surgery and if you have been experiencing vomiting or nausea

Question 16

What needs to happen pre-test of the spirometer?

Answer 16

Avoid smoking 24 hours, alcohol 4 hours, vigorous exercise (30 mins), large meal 2 hours and the use of an inhaler 4-12 hours

Question 17

How is the procedure carried out - position of the patient?

Answer 17

Patient will be seated sitting upright

Question 18

What does the physiologist need to know about the patient?

Answer 18

Needs to know age, height, birth sex and whether they are a smoker, non smoker or ex smoker

Question 19

How do you reach resting vital capacity?

Answer 19

3 resting breathes

Question 20

How is the test taken?

Answer 20

With a nose clip on during tidal breathing, inhale to maximal inspiration and forced expiration (really hard blows)

Question 21

PEF =?

Answer 21

Peak expiratory flow

Question 22

FEV1 =

Answer 22

Forced expiratory volume in one second - the max volume of air exhaled in the first second of a forced expiration from a position of full inspiration

Question 23

FVC =

Answer 23

Forced vital capacity - the max volume of air exhaled with max forced effort from a max inspiration

Question 24

What is a volume time graph?

Answer 24

Traditionally used in older more simple equipment which provides information on volume and time

Question 25

What is a flow volume loop?

Answer 25

Found on most modern equipment - had extra information, had a peak flow and extra breathe in but also uses a differential pressure pnenomotachograph

Question 26

What is Dynamic airway compression?

Answer 26

After the initial blast of air has been exhaled flow is then limited by dynamic airway compression

Question 27

What determines the flow?

Answer 27

The elastic recoil force of the lung and the resistance of the airways upstream

Question 28

Is peak flow dependent or independent?

Answer 28

Peak flow is entirely effort dependent

Question 29

Is FEV1 independent or dependent?

Answer 29

FEV1 is relatively independent of expiratory effort

Question 30

What is FEV1 reduced by?

Answer 30

By an increase in airway resistance e.g. asthma/COPD or a reduction in elastic recoil of the lung e.g. emphysema

Question 31

What are the guidelines for spirometry?

Answer 31

Need a minimum of 2 acceptable results and the reproducibility of RVC, FVC and FEV1 need to be within 150ml of the next best value

Question 32

What is the normal range calculated?

Answer 32

By the predicted value, standard deviations (z scores)

Question 33

What is the equation for standard residuals (SR)

Answer 33

SR = (observed - predicted)/ SD

Question 34

What does a positive SR indicate?

Answer 34

A value higher than predicted, a negative value indicates a value lower then predicted

Question 35

What should the flow volume loop be in a normal person?

Answer 35

Shape should be vertical, smooth descent to baseline, the peak should be sharp

Question 36

What is the normal for a volume time graph?

Answer 36

The shape should have a vertical rise, the plateau should be reaches within 6-15 seconds

Question 37

In an obstructive disease what are the FEV1, FVC and FEV1/FVC ratio like?

Answer 37

FEV1 = reduced, FVC = normal, FEV1/FVC is reduced

Question 38

In a restrictive disease what should the FEV1, FCV and FEV1/FVC ratio be?

Answer 38

FEV1 = reduced, FVC = reduced and FEV1/FVC ratio would be normal