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Respiratory lab and questionnaire (Lab 10)

Spirometry is a common and effective diagnostic test that can easily be done in your doctor's office or at a nearby hospital or clinic. You will be asked to take in a big breath, and then blow as hard and long as you can into a machine. The machine measures how much air you can blow out from your lungs and how fast you can blow it out. Spirometry is the most reliable way to test your lungs for COPD (chronic obstructive pulmonary disease) and asthma. Your doctor may call spirometry by another name including: pulmonary function test (PFT) or lung function test.

Why is spirometry important?

Spirometry is a useful respiratory test to diagnose and manage many different types of lung disorders. The earlier spirometry is done, the earlier lung disease can be diagnosed and treated. There are numerous treatments to ease respiratory problems, to prevent lung disease from becoming worse, and to improve your quality of life.

Who should have spirometry testing?

• Asthma

• COPD (chronic obstructive pulmonary disease)

• Chronic bronchitis

• Emphysema

• Pulmonary fibrosis

• Smokers and former smokers

What happens in a spirometry test?

Spirometry is a quick and painless test, which can be performed in a doctor’s office. The entire test usually takes less than 10 minutes, although sometimes it is repeated after taking medication. You will be asked to breathe through a bacteriological filter and mouthpiece while wearing a nose clip. The tester will coach you to take several tidal volume breaths, followed by taking in as deep a breath as possible. You will then exhale as deeply and fast as you can until your lungs are completely empty, followed by several tidal volume breaths. You may then be asked to take another deep breath in again. You will do this three times or more to make sure the results are accurate. You may also be given a medication to breathe in. The test would then be repeated to show if your lungs have responded to the medication.

What does spirometry measure?

Spirometry can help determine if your lungs are functioning normally, and it does this through different breathing volume measurements. Some of the most common spirometry measurements are shown in Table 1. If you have already been diagnosed with asthma or COPD, spirometry can be useful to determine if your current treatment is working.

In the YouTube respiration lab, there are three experiments conducted:

1. Normal spirometry

In this experiment, the subject takes 4 normal tidal volume breaths, followed by a deep inhalation, then followed immediately by a deep exhalation, and then ends with 3 tidal volume breaths. The spirometry values recorded were TV, IRV, and ERV. Based on those values recorded, you can calculate additional spirometry values of VC, IC, FRC, TLC. Residual volume is a constant of 1.2 for men, and 1.1 for women.

2. Examine minute ventilation before and after 40 seconds of hypoventilation (breath holding).

In this experiment, the subject takes 4 normal tidal volume breaths, followed by 40 seconds of hypoventilation, and then takes 4 more tidal breaths. Minute ventilation is calculated before and after the respiratory challenge. During the 40 seconds in which the subject was not ventilating (breathing) CO2 builds up in the blood, which can make blood pH become too low (acidic). Normal blood pH is between 7.35 – 7.45. Why do you think that minute ventilation changed immediately after the hypoventilation? The answer to this question can be found in your respiratory lecture PowerPoint.

3. Examine minute ventilation before and after 40 seconds of hyperventilation (rapid breathing).

In this experiment, the subject takes 4 normal tidal volume breaths, followed by 40 seconds of hyperventilation, and then takes 4 more tidal breaths. Minute ventilation is calculated before and after the respiratory challenge. During the 40 seconds in which the subject was hyperventilating (rapid breathing) too much CO2 is lost from the lungs, which can make blood pH become too high (alkaline). Why do you think that minute ventilation changed immediately after the hyperventilation? The answer to this question can be found in your respiratory lecture PowerPoint.

|Table 1 | |

|Tidal volume (TV) |= the volume of air breathed in and out without conscious effort. |

|Inspiratory reserve volume (IRV) |= The additional volume of air that can be inhaled with maximum effort after a normal inhalation. |

|Expiratory reserve volume (IRV) |= the additional volume of air that can be forcibly exhaled after a normal exhalation. |

|Vital capacity (VC) |= the total volume of air that can be exhaled after a maximum inhalations. VC = TV + IRV + ERV. |

|Inspiratory capacity (IC) |= IRV + TV |

|Functional residual capacity (FRC) |= ERV + RV |

|Residual volume (RV) |= the volume of air remaining in the lungs after maximum exhalation. (The lungs can never be completely |

| |emptied). See normal RV listed below. |

|Total lung capacity (TLC) |= VC + RV |

|Minute ventilation (MV) |= the volume of air breathed in 1 minute. It is simply the tidal volume multiplied by respiratory rate. MV = |

| |TV X respiratory rate |

|Table 2. Normal spirometry values (in L) for adult men and women. |

|Men |Women | |Men |Women | |TV |0.5 |0.5 |IC |3.8 |2.4 | |IRV |3.3 |1.9 |FRC |2.4 |1.8 | |ERV |1.0 |0.7 |RV |1.2 |1.1 | |VC |4.8 |3.1 |TLC |6.0 |4.2 | |



For questions 1 - 7 answer based on the results of the normal spirometry exercise shown in the YouTube video (). All blanks worth 1 pt.

1. What was my TV (in L)? ________________

2. What was my IRV (in L)? ________________

3. What was my ERV (in L)? ________________

4. Calculate my VC (in L): ________________

5. Calculate my IC (in L): ________________

6. Calculate my FRC (in L): ________________

7. Calculate my TLC: ________________

8. How do my values compare to the normal values for women, shown above?

A) TV ________________

B) IRV ________________

C) ERV ________________

D) VC ________________

E) TLC ________________

9. In order to calculate spirometry values:

A) What does (Y stand for? ________________

B) What does (T stand for? ________________

For questions 10 – 11, answer based on the results of the respiratory challenges shown in the YouTube video.

10. For the hypoventilation challenge, what was my minute ventilation before versus after the 40 seconds of breathholding?

A) Tidal volume before: ________ D) Tidal volume after: ________

B) Respiratory rate before: ________ E) Respiratory rate after: ________

C) Minute ventilation before: ________ F) Minute ventilation after: ________

Based on the respiratory lecture PowerPoint, can you explain WHY minute ventilation changed after hypoventilation? In your answer, explain the following:

G) What happens to blood CO2 and blood pH after holding your breath? _____________________

____________________________________________________________________________

H) Why would the change in minute ventilation correct the problem encountered with hypoventilation? __________________________________________________________ ____________________________________________________________________________

11. For the hyperventilation challenge, what was my minute ventilation before versus after the 40 seconds of rapid breathing?

A) Tidal volume before: ________ D) Tidal volume after: ________

B) Respiratory rate before: ________ E) Respiratory rate after: ________

C) Minute ventilation before: ________ F) Minute ventilation after: ________

Based on the respiratory lecture PowerPoint, can you explain WHY minute ventilation changed after hyperventilation? In your answer, explain the following:

G) What happens to blood CO2 and blood pH after rapid breathing? _____________________

____________________________________________________________________________

H) Why would the change in minute ventilation correct the problem encountered with hyperventilation? __________________________________________________________

____________________________________________________________________________

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Figure 1

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