Internal Medicine

Prof. Salih Bin Salih

DEFINITION

These are some tests done to see the functioning of the lungs. They tell us about the amount of air moving in & out of the lungs, the amount of air inside the lungs & also the diffusion of air in the alveoli. They are very useful in the following situations:

  • To diagnose certain lung diseases
  • To monitor the response to treatment

They also tell us if the pathology is in small airways or large ones.

LUNG VOLUMES & CAPACITIES

Definitions of volumes & capacities

  1. Tidal Volume (TV): amount of air moving in & out of the lungs with each breath ( N: 500cc)
  2. Inspiratory reserve vol.(IRV): Extra air which you can inhale with full force, after a normal inspiration ( after TV). (N is about 3000 cc)
  3. Expiratory reserve vol.(ERV): Extra air which can be blown out forcefully, at the end of normal expiration(after TV). (N is about 1000cc)
  4. Residual volume(RV): Even after full forceful blowing out, some air remains in the lungs, which is called RV.

CAPACITIES

2 or more volumes, added together, give a capacity. Remember two most important capacities:

  1. Vital Capacity( V.C.): Maximum forceful

    • inhaling + maximum forceful exhaling
    • ( TV + IRV + ERV)
  2. Capacities contd.

    • b) Total lung capacity(TLC): Maximum amount of air which the lungs can hold after a deep inspiration
    • ( T.V. + IRV + ERV + RV) or ( VC + RV)
    • When you take a deep breath in & then hold, this is the total capacity of your lungs.
    • (N: about 5700cc)

NAMES OF PULM. FUNC. TESTS

  1. Spirometry
  2. Peak expiratory flow
  3. DLCO ( diffusing lung capacity of carbon monoxide). Here we check how good is the diffusion of gases in the alveoli)
  4. ABGs
  5. Pulse oximetry

*In practice, PFT usually means spirometry *




THERA

Classification A) Ventilatory function tests:

  • Lung volumes & capacities
  • Test based on mechanical efficiency in breathing (PEFR)

B) Respiratory function test:

  • measurement of arterial PO2, PCO2, pH

RESP sys function

  • Ventilation; Spirometry
  • Diffusion; DLCO - once air inside lung, oxygen is absorbed and CO2 thrown away
  • Transport
  • Regulation; brain center

RESP Sys Diseases

  • Obstructive lung diseases
  • Restrictive lung diseases

PFT

  • Spirometry for ventilation
  • DLCO for diffusion