The Respiratory System and Its Disorders
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
Physical assessment is significant m diagnosing disorders of the respiratory tract. Terms often encountered include auscultation, percussion, rhonchi (wheezes), rales (crackles), stridor, pleural rub, and sputum. Laboratory diagnostic tests used to evaluate the respiratory system include measurement of the arterial blood gases (ABGs), PO (partial pressure of oxygen, oxygen tension), PaCQ, (arterial carbon dioxide tension), and serum pH. Oximetry measures the oxygen saturation of hemoglobin in a sample of blood. Pulmonary function tests determine the presence, type, and extent of dysfunction in the airways, alveoli, and pulmonary vascular bed caused by obstruction or restriction or both. These tests are of three general types: (1) airway flow rates measure flow to assess airway patency and resistance; (2) lung volume and capacity measure compartments of the lung to assess air-trapping and differentiate impairments; and (3) gas exchange (diffusion capacity) measures rate of gas transfer across the alveolar-capillary membranes. The spirometer is a device used to measure lung volume; the procedure is called spirometry. The peak expiratory flow rate (PEFK, maximal flow that can be produced during forced expiration), pulmonary venous congestion (PVC), forced expiratory vol ume (FEv), and the mean forced expiratory flow (FEF) during the middle of the forced vital capacity (FVC) can be measured by flow meters. Exercise stress testing is done to evaluate fitness, functional capacity, and other limiting factors in obstructive and restrictive disorders. This assesses ventilation, gas exchange, and cardiovascular function during increased demands. It can also provide nonspecific responses to assist in diagnosing many conditions. Body plethysmography, using a pneumotachometer, is another diagnostic technique used to measure airway mechanics, although this procedure is primarily used only in research laboratories. The specific airway conductance (SGAW) can be determined by this method. Roentgenographic examination (radiographs? of the chest, sometimes referred to as simply chest X ray, provides assistance in diagnosis of pulmonary disease. Magnetic resonance imaging (MRI), laminagraphy, computerized tomography, and pulmonary pfaotoseanning are also useful procedures. The fiberoptic bronchoscope is an instrument utilized for visual examination of the bronchi through the procedure of bronchoscopy and may be used to obtain bronchial brushings and biopsies.
How to Develop a Tobacco Cessation Center
Rajmohan Panda, Manu Raj Mathur in Tobacco Cessation, 2019
Flip books/charts for counselingPatient education materials (take away message)Counseling registerFollow-up registerPatient case history recordMonthly activity reporting formatTobacco cessation intervention (TCI) card for cessation among people with tobacco-related comorbiditiesFor physical examination, the following TCC-specific equipment should be provided:Carbon monoxide (CO) monitor (Smokerlyzer): CO is easily measured through the breath test using a CO monitor: It is quick to carry out, and provides a cost-effective means of validating the smoking status of a significant number of clients, and it is also noninvasive. It measures the amount of carbon monoxide in the breath (ppm), which is an indirect measure of blood carboxyhemoglobin (%COHb), which is the level of CO in the blood (Figure 6.1). Spirometer: A spirometer is an apparatus that measures the volume of the air inspired and expired by the lungs. It measures ventilation, the movement of air into and out of the lungs. Performing a spirometry test and providing information on pulmonary function may increase the awareness of the effect of smoking among smokers who are asymptomatic or have fewer symptoms, and provide further motivation in their attempt to quit. If airflow obstruction is present (as evidenced by a reduction in [FEV] 1.0), this can be shown to patients as an indicator of the damage induced to their lungs by smoking. Based on a spirometer, lung age can also be calculated and provided to the patient. Telling a 35-year-old male smoker that his lung function is similar to that predicted for a 70 year old is likely to be more of an eye-opener than telling him that his FEV 1.0 is 77% of the predicted figure (Figure 6.2). What is lung age? The accompanying predictive formula was derived from normal Caucasian subjects (Crapo RO 1981). It allows you to enter the patient's gender, height, and measured FEV1.0, then derive the age for which that FEV1.0 value is 100% predicted. So, the lung age = (2,87 × height in inches) − (31,25 × observed FEV1) − 39,375. Sphygmomanometer: Used to measure blood pressure.
The transport and exchange systems: respiratory and cardiovascular
Nick Draper, Helen Marshall in Exercise Physiology, 2014
A spirometer, diagrammed in Figure 6.6a, can be used to assess basic pulmonary function by measuring the static lung volumes (illustrated in Figure 6.7). Average total lung capacity for a male is around 6 L and approximately 4.2 L for females. Gender differences in lung volumes and capacities tend to be due to the smaller physical size of females. The spirometer, and the spirogram trace it creates, records a wide variety of lung volumes including total lung capacity. Spirometry is commonly used to assess changes in respiratory function, particularly for the identification of pulmonary disorders. In addition to the measurement of minute ventilation, spirometry is commonly used to determine an individual’s forced vital capacity (FVC) and forced expiratory volume (FEV). The FVC is a measure of the voluntary capacity of the lungs which involves maximal inhalation followed by the forceful exhalation of as much air as possible, as rapidly as possible. The forced expiratory volume in one second (FEV) measures lung efficiency. The volume of air expired in the first second is recorded and shown as a percentage of the total FVC. The higher the percentage of their FVC a person can exhale in one second the more efficient their lungs. In those with healthy lungs, around 80% of FVC can be expelled in the first second, with much lower volumes in those with obstructive pulmonary disease. A peak flow meter (Figure 6.6b) – cheaper, simpler and more readily available in the laboratory and clinical settings than a spirometer – is now more commonly used for the measurement of FEV.
Validation of spirometer calibration syringes
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2012
The volume calibration syringe is probably the single most important instrument in pulmonary function laboratories, yet no validation results have been published. In this study a sample of volume calibration syringes was validated. We weighed a 1-L and two 3-L calibration syringes before and after emptying them of water and determined the corresponding volume of gas by using a modified rolling seal spirometer. In this way we established an unbroken calibration chain between a certified weight of water and the corresponding volume of gas. The volume of a spirometer calibration syringe could be verified with an accuracy of ± 15 ml. The modified rolling seal spirometer had an accuracy of ±11 ml at a volume of 1 L and ±13 ml at a volume of 3 L. A sample of spirometer calibration syringes was validated and all syringes except for two small 1-liter syringes all had volumes within the label claimed volume ± 0.5%. Spirometer calibration syringes have a stable stroke volume even after many years of use and storage but have to be calibrated yearly to comply with international standard.
Inspiratory flow rate, not type of incentive spirometry device, influences chest wall motion in healthy individuals
Published in Physiotherapy Theory and Practice, 2010
Angela T Chang, Kerry R Palmer, Jessie McNaught, Peter J Thomas
This study investigated the effect of flow rates and spirometer type on chest wall motion in healthy individuals. Twenty-one healthy volunteers completed breathing trials to either two times tidal volume (2xVT) or inspiratory capacity (IC) at high, low, or natural flow rates, using a volume- or flow-oriented spirometer. The proportions of rib cage movement to tidal volume (%RC/VT), chest wall diameters, and perceived level of exertion (RPE) were compared. Low and natural flow rates resulted in significantly lower %RC/VT compared to high flow rate trials (p=0.001) at 2xVT. Low flow trials also resulted in significantly less chest wall motion in the upper anteroposterior direction than high and natural flow rates (p
Effects of air pollution on respiratory parameters during the wheat-residue burning in Patiala
Published in Journal of Medical Engineering & Technology, 2010
R. Agarwal, A. Awasthi, S. Mittal, N. Singh, P.K. Gupta
Effects of pollution produced by wheat-residue burning on respiratory parameters of healthy inhabitants were investigated for two consecutive wheat cultivation periods (February–July in 2007 and 2008) at Patiala city of Punjab, India. A total of 51 selected subjects of the age group 13–53 were selected from five sites of Patiala for pulmonary function tests (PFTs), including force vital capacity (FVC), force expiratory volume in one second (FEV1), peak expiratory flow (PEF) and force expiratory flow between 25 to 75% of FVC (FEF25–75%) using a spirometer. High volume samplers (HVS) and an Andersen cascade impactor were also used to measure the concentration of suspended particulate matter (SPM) and particulate matter (PM) of size less than 10 μm. PFTs show significant decrease and particulate matter shows a significant increase during the burning period of wheat residue. Decrease in FVC and FEV1 did not recover even after completion of the exhaustive burning period this is a more serious concern then PEF and FEF25–75%. The results showed that the public exposure to relatively high levels of pollutants during the exhaustive burning period of wheat residue influences the PFTs of even healthy inhabitants.