Spirometry Explained

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Questions and Answers

The measurement of air entering and leaving the lungs, including forced airflow and volumes during inspiration and expiration is known as ______.

spirometry

In a Forced Vital Capacity Maneuver, coaching the ______ capacity enthusiastically helps achieve the optimal TLC.

inspiratory

[Blank] is the maximum amount of air that can be exhaled quickly and forcefully as possible after a minimum inspiration.

forced vital capacity

The percent of total FVC volume exhaled within a specified time from the start of the maneuver is known as Forced ______ Volume Percent.

<p>expiratory</p> Signup and view all the answers

A decreased ______ ratio is indicative of obstructive disease.

<p>FEV1/FVC</p> Signup and view all the answers

The average expiratory flow rate between the first 0.2 and 1.2L of the FVC volume is known as Maximum ______ Flow Rate.

<p>expiratory</p> Signup and view all the answers

The average expiratory flow rate between 75% and 85% of FVC volume is the ______ Expiratory Flow Rate.

<p>maximum end</p> Signup and view all the answers

The volume of air that is inhaled and then exhaled with each normal breath is known as ______ volume.

<p>tidal</p> Signup and view all the answers

The maximum volume of air that can be inhaled following and above a normal tidal breath is the ______ reserve volume.

<p>inspiratory</p> Signup and view all the answers

The maximum volume of air that can be exhaled from the resting end-expiratory level is the ______ reserve volume.

<p>expiratory</p> Signup and view all the answers

The volume of air remaining in the lungs after a maximum expiration is known as ______ volume.

<p>residual</p> Signup and view all the answers

The maximum volume of air that can be inhaled from the normal resting end-expiratory level, which combined Tidal Volume (VT) and Inspiratory Reserve Volume (IRV), is called ______ capacity.

<p>inspiratory</p> Signup and view all the answers

The volume of air remaining in the lungs at the resting end-expiratory level, which is the sum of Expiratory Reserve Volume (ERV) and Residual Volume (RV), is known as ______ residual capacity.

<p>functional</p> Signup and view all the answers

The maximum volume of air that can be exhaled following a maximum inspiration or inhaled following a maximum expiration is called ______ capacity.

<p>vital</p> Signup and view all the answers

The volume of air contained within the lungs following a maximum inspiration is referred to as total ______ capacity.

<p>lung</p> Signup and view all the answers

When palpating the chest for tactile fremitus, the patient is typically asked to repeat the words '______'.

<p>ninety-nine</p> Signup and view all the answers

During chest palpation, ______ fremitus is assessed using the ulnar border of the hand.

<p>tactile</p> Signup and view all the answers

When assessing chest mobility, the evaluation focuses on the ______ of chest movements.

<p>symmetry</p> Signup and view all the answers

In auscultation, decreased breath sounds may indicate ______ or air trapping, as seen in COPD.

<p>hyperinflation</p> Signup and view all the answers

Murmurs usually occur when blood flows in ______ fashion through heart structures that have a decreased cross-sectional area.

<p>turbulent</p> Signup and view all the answers

Flashcards

Spirometry

Measurement of air entering/leaving lungs, including forced airflow and volumes during breathing.

Forced Vital Capacity (FVC)

Maximum air exhaled forcefully after maximum inspiration.

FEV1%

Percentage of FVC exhaled within a specific time frame.

FEV1

Volume of air exhaled in the first second of FVC.

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FEF 200-1200

Average expiratory flow rate between 200-1200 ml of FVC.

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Tidal Volume (VT)

Volume of air that is inhaled and then exhaled with each normal breath.

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Inspiratory Reserve Volume (IRV)

Max volume of air that can be inhaled after a normal breath.

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Expiratory Reserve Volume (ERV)

Maximum volume of air that can be exhaled from resting end-expiratory level.

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Residual Volume (RV)

Air remaining in lungs after maximal expiration.

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Inspiratory Capacity (IC)

Max volume of air inhaled from resting end-expiratory level.

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Functional Residual Capacity (FRC)

Volume of air in lungs at resting end-expiratory level.

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Vital Capacity (VC)

Maximum air exhaled after maximum inspiration or inhaled after max expiration.

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Total Lung Capacity (TLC)

Total air volume in lungs after maximum inspiration.

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Tactile Fremitus

Palpation with the ulnar border to assess vibrations.

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Chest Mobility

Assessment of chest symmetry during breathing.

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Bruit

Sound heard over arteries/veins due to turbulent flow.

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Bronchophony (Normal)

Voice sound intensity decreases from apex to base of lungs.

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Egophony (Normal)

"Ee" sounds like "ee".

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Mediastinal/Tracheal Shifting

Inspection and palpation to ensure midline position.

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Normal Breath Sounds

Breath sounds auscultated over normal, air-filled lungs.

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Study Notes

Spirometry

  • Measures air volume entering and leaving the lungs
  • Assesses forced airflow and volumes during breathing

Forced Vital Capacity Maneuver

  • Common test for pulmonary mechanics
  • Patient breathes normally up to three times, then inhales and exhales completely into a spirometer, followed by maximal inhalation
  • Encouraging optimal inspiratory capacity and forceful exhalation is necessary for accurate results

Forced Expiratory Volumes

  • Forced Vital Capacity (FVC): Maximum air exhaled quickly and forcefully after inspiration
  • Forced Expiratory Volume Percent (FEVt%): Percentage of total FVC exhaled within a specific time (0.5, 1, 2, and 3 seconds)
  • Timed Forced Expiratory Volume (FEVt): Air volume exhaled within a specific time (0.5, 1, 2, and 3 seconds) during FVC
  • FEV1: Gas volume expired in the first second of FVC; reduced in obstructive and restrictive lung diseases; Normal is 5.6L for a 20 year old man

Severity of Obstruction (FEV1)

  • Mild: 70% to 74% of predicted value
  • Moderate: 60% to 69% of predicted value
  • Moderately Severe: 50% to 59% of predicted value
  • Severe: 35% to 49% of predicted value
  • Very Severe: Less than 35% of predicted value

FEV1/FVC Ratio (FEV%)

  • Percentage of FEV1 relative to FVC

  • FEV1/FVC x 100 = FEV1/FVC ratio

  • Normal Values:

    • 50% to 60% of FVC exhaled in 0.5 seconds
    • 75% to 85% of FVC exhaled in 1 second
    • 94% of FVC exhaled in 2 seconds
    • 97% of FVC exhaled in 3 seconds
Measurement Minimum Acceptable
FEV0.5/FVC 60%
FEV1/FVC 70%
FEV2/FVC 94%
FEV3/FVC 97%
  • Decreased FEV1/FVC indicates obstructive disease
  • Normal values do not rule out restrictive disease

Forced Expiratory Flow Rates

  • Maximum Expiratory Flow Rate (FEF 200-1200 or MEFR 200-1200): Average expiratory flow between 0.2 and 1.2L of FVC volume; Normal is 6 to 7 L/s (400L/min); Relates to disorders in large upper airways
  • Maximum End-Expiratory Flow Rate (FEF 75%-85%): Average expiratory flow between 75% and 85% of FVC volume; Relates to disorders in smaller bronchioles

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