Core Pulmonary Concepts
Lung volumes and capacities
Pulmonary Function
Lung volumes Tidal volume (Vt) Inspiratory reserve volume (IRV) Expiratory Reserve volume (ERV) Residual volume (RV)
Lung capacities Vital capacity (VC) Inspiratory capacity (IC) Functional Residual Capacity Total lung capacity (TLC)
Spirometery
Core measurements FVC Forced vital capacity: maximum volume that can be exhaled forcefully (aka VC) FEV 1 : forced expiratory volume 1 second maximum volume exhaled in the first second of the test
Core measurements Peak expiratory flow rate (PEFR): Maximum flow rate during a FVC maneuver; varies with sex, age, height, etc. FEF 25-75% : forced expiratory flow, %-the average flow rate dudring the mid portion of the test
Flow-volume loop
Diagnostic terms Obstructive Flow-limited defect Difficulty getting the air out of the lungs The following values are all diminished: FVC, PEFR, FEV 1, FEF Restrictive Volume-limited defect Difficulty getting the air into the lung The following values are diminished: FVC, FE 1, TLC Flows are normal
Lung disease via PFT Flow-limited All flows are diminished PEFR FEF Hallmark: air trapping Volume-limited Flows are normal to super-normal (elasticity of lungs is increased) Volumes are small Hallmark: “tiny” lungs
Key values FEV 1 --gold standard All research in lung function reports this value FEF 25-75% -another standard Reflects, anatomically, the small to medium size airways (bronchi)