https://www.youtube.com/watch?

v=Afy1iKVg8sc
[spondilitis]

https://www.slideshare.net/VishwanathAnkola/dr
ug-induced-pulmonary-diseases

Spirometry

Your PFTs may include spirometry, which measures the amount of air you
breathe in and out. For this test, you’ll sit in front of a machine and be fitted
with a mouthpiece. It’s important that the mouthpiece fits snugly so that all
the air you breathe goes into the machine. You’ll also wear a nose clip to
keep you from breathing air out through your nose. The respiratory
technologist will explain how to breathe for the test.

You may then breathe normally. Your doctor will ask you to breathe in and
out as deeply or as quickly as you can for several seconds. They may also
ask you to breathe in a medication that opens your airways. You’ll then
breathe into the machine again to see if the medication affected your lung
function.

Plethysmography test

A plethysmography test measures the volume of gas in your lungs, known

as lung volume. For this test, you’ll sit or stand in a small booth and breathe
into a mouthpiece. Your doctor can learn about your lung volume by
measuring the pressure in the booth.

Diffusion capacity test

This test evaluates how well the small air sacks inside the lungs, called
alveoli, work. For this part of a pulmonary function test, you will be asked to
breathe in certain gases such as oxygen, helium, or carbon dioxide.

You may also breathe in a “tracer gas” for one breath. The machine can
detect when you breathe out this gas. This tests how well your lungs are
able to transfer oxygen and carbon dioxide to and from your bloodstream.

PFT measures:

 Tidal volume (VT). This is the amount of air inhaled or exhaled during

normal breathing.
 Minute volume (MV). This is the total amount of air exhaled per minute.
 Vital capacity (VC). This is the total volume of air that can be exhaled after
inhaling as much as you can.
 Functional residual capacity (FRC). This is the amount of air left in lungs
after exhaling normally.
 Residual volume. This is the amount of air left in the lungs after exhaling as
much as you can.
 Total lung capacity. This is the total volume of the lungs when filled with as
much air as possible.
 Forced vital capacity (FVC). This is the amount of air exhaled forcefully
and quickly after inhaling as much as you can.
 Forced expiratory volume (FEV). This is the amount of air expired during
the first, second, and third seconds of the FVC test.
 Forced expiratory flow (FEF). This is the average rate of flow during the
middle half of the FVC test.
 Peak expiratory flow rate (PEFR). This is the fastest rate that you can
force air out of your lungs.

Measurements[edit]
Spirometry[edit]
Main article: Spirometry

Spirometry includes tests of pulmonary mechanics – measurements of FVC, FEV 1, FEF values,
forced inspiratory flow rates (FIFs), and MVV. Measuring pulmonary mechanics assesses the
ability of the lungs to move huge volumes of air quickly through the airways to identify airway
obstruction.
The measurements taken by the spirometry device are used to generate
a pneumotachograph that can help to assess lung conditions such as: asthma, pulmonary
fibrosis, cystic fibrosis, and chronic obstructive pulmonary disease. Physicians may also use the
test results to diagnose bronchial hyperresponsiveness to exercise, cold air, or pharmaceutical
agents.[4]
Complications of spirometry[edit]
Spirometry is a safe procedure; however, there is cause for concern regarding untoward
reactions. The value of the test data should be weighed against potential hazards. Some
complications have been reported, including pneumothorax, increased intracranial
pressure, fainting, chest pain, paroxysmal coughing, nosocomial infections, oxygen desaturation,
and bronchospasm.

Lung volumes[edit]
Main article: Lung volumes

There are four lung volumes and four lung capacities. A lung's capacity consists of two or more
lung volumes. The lung volumes are tidal volume (VT), inspiratory reserve
volume (IRV), expiratory reserve volume (ERV), and residual volume (RV). The four lung
capacities are total lung capacity (TLC), inspiratory capacity (IC), functional residual
capacity (FRC) and vital capacity (VC).

Maximal respiratory pressures[edit]

Main article: Respiratory pressure meter

Measurement of maximal inspiratory and expiratory pressures is indicated whenever there is an

unexplained decrease in vital capacity or respiratory muscle weakness is suspected clinically.
Maximal inspiratory pressure (MIP) is the maximal pressure that can be produced by the patient
trying to inhale through a blocked mouthpiece. Maximal expiratory pressure (MEP) is the
maximal pressure measured during forced expiration (with cheeks bulging) through a blocked
mouthpiece after a full inhalation. Repeated measurements of MIP and MEP are useful in
following the course of patients with neuromuscular disorders.

Diffusing capacity[edit]
Main article: Diffusing capacity

Measurement of the single-breath diffusing capacity for carbon monoxide (DLCO) is a fast and

safe tool in the evaluation of both restrictive and obstructive lung disease.

Oxygen desaturation during exercise[edit]

The six-minute walk test is a good index of physical function and therapeutic response in patients
with chronic lung disease, such as COPD or idiopathic pulmonary fibrosis.[5][6][7]

Arterial blood gases[edit]

Arterial blood gases (ABGs) are a helpful measurement in pulmonary function testing in selected
patients. The primary role of measuring ABGs in individuals that are healthy and stable is to
confirm hypoventilation when it is suspected on the basis of medical history, such as respiratory
muscle weakness or advanced COPD.
ABGs also provide a more detailed assessment of the severity of hypoxemia in patients who
have low normal oxyhemoglobin saturation.

Techniques[edit]
Helium Dilution[edit]
Main article: Helium dilution technique

The helium dilution technique for measuring lung volumes uses a closed, rebreathing circuit.
[8]
 This technique is based on the assumptions that a known volume and concentration of helium
in air begin in the closed spirometer, that the patient has no helium in their lungs, and that an
equilibration of helium can occur between the spirometer and the lungs.

Nitrogen Washout[edit]
Main article: Nitrogen washout

The nitrogen washout technique uses a non-rebreathing open circuit. The technique is based on
the assumptions that the nitrogen concentration in the lungs is 78% and in equilibrium with the
atmosphere, that the patient inhales 100% oxygen and that the oxygen replaces all of the
nitrogen in the lungs.[9]

Plethysmography[edit]
Main article: Plethysmograph

The plethysmography technique applies Boyle's law and uses measurements of volume and

pressure changes to determine lung volume, assuming temperature is constan