phgy355 lab #2
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Group #9
PHGY 355
Lab #2: Spirometry
February 1, 2024
20281088, 20262527, 20269911, 20289920
Contributions:
20281088: Introduction, Results, Question 1 and 2, Final Edits
20262527: Methods, Results, Figure 2, Final Edits
20269911: Results, Question 3 and 4
20289920: Question 5 and 6
2
Introduction:
Pulmonary function testing is a noninvasive procedure that provides information on how
well the lungs are working by evaluating respiratory function. The test measures lung volume,
lung capacity, rates of flow, and gas exchange. This provides the healthcare professional with a
proper diagnosis to assess a response treatment plan of specific lung disorders (Ponce et al.,
2023). The two main types of respiratory disorders are obstructive and restrictive. Obstructive
respiratory disorders describe the difficulty of air flowing out of the lungs due to airway
resistance which causes a decreased flow. A restrictive respiratory disorder occurs when the lung
tissue and/or chest muscles restrict air flow due to not being able to expand enough causing
lower lung volumes (Johns Hopkins Medicine, 2024). The lungs are vital organs in the
respiratory system, primarily responsible for exchanging gasses between the environment and the
bloodstream. Oxygen moves from the alveoli air sacs into small blood vessel capillaries and then
enters the arterial system to reach and nourish body tissues. Spirometry is the test that will
measure static lung volumes and is used to detect, follow, and manage patients with lung
disorders. This test measures the changes in volume rate with the movement of air into and out of
the lungs during various breathing maneuvers (McCarthy & Kamangar, 2020). To start, the
patient begins with a full inhalation, followed by a forced expiration that continues for as long as
possible until a plateau in exhaled volume is reached and the patient feels as though their lungs
have emptied (Barreiro & Perillo, 2004). Spirometry measures: forced expiratory volume in 1s
(FEV
1
), forced vital capacity (FVC), viral capacity (VC), FEV
1
/FVC ratio, peak expiratory flow,
forced expiratory flow, and inspiratory vital capacity (IVC) (Moore, 2012). Residual volume and
functional residual cannot be measured by spirometry (Lamb et al., 2023). In addition, some
other common tests of lung function include the measurement of lung volumes, airway
3
resistance, carbon monoxide diffusing capacity, and arterial-blood gasses (Crapo, 1994). The
three main factors that affect pulmonary function testing are age, gender, and height. To be
specific, FVC and FEV1 decline with age, while volume and the other capacities increase. VC,
RV, FVC, and FEV1 are affected by height as they are proportional to body size (Barroso et al.,
2018). The group hypothesis for this lab is that male ratio for spirometry lung function testing
will be at a higher percentage than the women’s ratio as a result of the lungs having a greater
surface area. Our theory uses age, sex and height to determine if lung function will be at a higher
ratio, due to taller people having larger lungs. It is stated that since men have bigger lungs per
unit of stature, they will have a larger total number of alveoli and alveolar surface area for a
given age (Hibbert et al., 1995). It is also noted that not only in terms of absolute volume but in
terms of volume variations, men have significantly larger mean values for both flows and
volumes with a lower resistance (LoMauro & Aliverti, 2018). Therefore, this lab is to test all
factors included in pulmonary function to discover whether males have higher ratios than women
and confirm the hypothesis.
Methods:
All procedures used are outlined within the PHGY 355 Laboratory Manual for
Experiment 2. The steps of the procedure listed were unaltered and data analysis was done
manually. Manual calculations were based upon flow-volume curve analysis using LabChart.
Furthermore, the BTPS conversion factor was used to adjust all calculated values based upon
ambient room temperature.
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Results:
A participant who is breathing normally into the spirometer is instructed to inhale
maximally at the end of a normal exhalation before exhaling maximally. The peak lung volume
that is achieved during a normal inhalation is the IRV. The minimal lung volume achieved during
a normal exhalation is the ERV. The difference between these two values is the tidal volume.
This represents the amount of air that is moved through the lungs in each breathing cycle. The
difference between the IRV and the maximal inhalation that is performed by the patient is the IC.
The difference in volume between the maximum inhalation and exhalation performed by the
patient is the VC. These values can be observed using a volume vs. Time curve derived from the
participants flow data.
Figure 1. Volume vs. Time curve obtained from spirometry of participant 9.1.
Volume was
obtained using the integral of flow data directly from the participant’s breathing pattern. From
this curve various measurements can be taken: Tidal Volume (TV), Expiratory Reserve Volume
(ERV), Inspiratory Reserve Volume (IRV), Inspiratory Capacity (IC), and Vital Capacity (VC).
The sharp peak before 10s indicates the maximum inhalation exhibited by the participant,
followed by the lower plateau indicating the lowest lung volume achieved. The participant was
male with mild asthma.
5
A flow volume curve can be generated using the flow data determined through
spirometry. The y axis of the curve represents the flow of air into the spirometer (l/s). Negative
values of flow represent inhalation and positive values of flow represent exhalation by the
participant. The x axis of the graph represents the volume (l) of air that has been exhaled, which
shows the change in volume during breathing. When performing a forced expiration the flow
will rise steeply from the x axis before reaching a peak at the peak expiratory flow rate. The flow
will then gradually decrease until the vital capacity of the lungs has been exhaled. Inhalation will
cause the flow rate to decrease before reaching a plateau and increase to a flow rate of 0 (l/s)
after the vital capacity of air has been inspired.
Figure 2. Flow Volume curve of restrictive lung disease modeled from participant 9.1.
Using
the curve generated from spirometry (Figure 1) along with the corresponding flow data, a loop
can be generated. This loop shows similar measurements to that in Figure 1, where Vital
Capacity (VC) is shown, Peak Expiratory Flow (PEF), and Tidal Volume (TV) are shown.
Furthermore, Residual Volume (RV), and Total Lung Capacity (TLC) can be visualized on the
flow volume loop. This curve is shifted right and down from a normal curve as participant 9.1
has mild asthma, therefore, the loop is representative of a restrictive lung disease.
6
Table 1. Table summarizing flow values obtained from the spirometry testing.
In order to observe if males had higher flow rate than females due to the correlation of
larger airway diameter with larger lung size a table was generated to look at the overall study
data. The PEF and FEV1 parameters were focused on as they directly related to the flow, which
is useful in comparison as a higher flow rate would be indicative of larger airways. From the
averages in Table 1 there is a 1.64-fold difference between the PEF of males and females, with
the males being higher. Furthermore, males have a higher FEV1 overall with a 1.575-fold
difference between the two.
Sex (male:
M, female:
F)
PEF - Peak
Expiratory
Flow (L/s)
FEV1 -
Forced
Expiratory
Flow in 1s
Sex (male:
M, female:
F)
PEF - Peak
Expiratory
Flow (L/s)
FEV1 -
Forced
Expiratory
Flow in 1s
F
6.96
3.81
M
–
3.92
F
6.08
2.64
M
9.17
5.29
F
5.01
3.01
M
6.58
3.66576
F
–
2.63
M
9.36
4.32
F
4.67
2.2
M
5.01
3.45
F
7.24
3.69
M
6.76
3.73
F
5.68
2.44
M
7
4.76
F
1.52
1.254
M
8.66
2.89
F
5.66
2.48
M
13.55
4.91
F
6.7
4.05
M
5.19
4.8
F
3.06
2.27
M
6.083
4.510
F
4.25
2.93
Average
7.7363
4.20416
F
4.07
2.60
Standard Dev.
S.
2.55661043
0.73071349
F
2.05
1.56
F
2.8
1.85
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F
5.460
3.504
F
4.570
2.560
F
4.599
2.560
Average
4.72817647
2.66877778
Standard
Dev. S.
1.65958776
0.74888879
A bar graph was generated to visualize the variations between the various flow rate
averages from Table 1, which were obtained from the spirometry data. In order to compare to the
hypothesis that males will have higher flow rates, a direct comparison between males and
females was necessary for proper conclusions to be drawn. Furthermore, error bars are included
to determine the accuracy of the given results and if the difference between the males and
females is significant enough to draw conclusions from it.
Figure 3. Bar graph obtained from FEV1 and PEF averages found in Table 1.
The averages
from Table 1 were plotted on the same chart and error calculations were performed. The averages
calculated were Peak Expiratory Flow in L/sec (PEF) and Forced Expiratory Volume in 1s
(FEV1). In both average conditions, the blue bar represents the male population within the study,
and the red bar represents the female population.
8
Study Questions
1.
What lung volumes cannot be measured by spirometry?
Residual volume and functional residual cannot be measured by spirometry (Lamb et al., 2023).
Residual volume cannot be measured by spirometry as there is no way to measure the remaining
volume in the lungs after maximal expiration. Therefore, it is difficult to measure with the
spirometer as the residual volume is the amount of air that cannot be exhaled from the lungs.
2.
What three factors are used to predict the values for FEV
1
between normal
participants?
Age, height, and gender are three factors used to predict the values for FEV
1
between normal
participants (Ponce et al., 2023). Age is a factor where FEV
1
values decrease with age due to
lung function changes. Height is a factor where the size of the person’s lungs correlates with
their height, therefore taller individuals are expected to have larger lung volumes affecting FEV
1
values. Gender is a factor where there may be gender-based differences, as men on average tend
to have larger lung volumes and higher FEV
1
values than women due to the differences in
anatomy and body composition.
3.
Using the FVC, FEV
1.0
and the FEV
1
/FVC ratio, how does one differentiate normal
from obstructive and restrictive lung disease using the FEV
1.0
and the FEV
1
/FVC
ratio?
The FVC represents the amount of air that can be forcefully exhaled by the patient after a
maximal inhalation. FEV1 represents the amount of air that is exhaled in the first second of the
FVC. Obstructive lung disease has a reduced FEV
1.0
and FEV
1
/FVC ratio but with a normal or
slightly decreased FVC value. The reduction in FEV
1.0
occurs due to increased airway resistance
in obstructive lung disease. Restrictive lung disease has a reduced FVC and FEV
1.0
but with a
9
normal or slightly increased FEV
1
/FVC ratio. Restrictive lung disease is also characterized by a
normal FEV
1
/FVC ratio that is coupled with a low FVC. In restrictive lung disease the FVC is
reduced compared to FEV
1
. This results in a FEV
1
/FVC ratio that is above 70%. Normal lung
function has all parameters within a normal range typically around 70-80% (David & Edwards,
2022).
4.
Describe the typical effects of airflow obstruction on lung volumes
Patients with chronic obstructive pulmonary disease exhibit increases in lung volume due to
expiratory airflow limitation (Bisel]li et al., 2015). Obstruction can be caused by abnormalities
within the airways such as secretions or mucosal thickening and decreased elastic recoil. Both of
these factors will result in a slower speed of exhalation. Since less air is able to leave the lungs
with each breath air can become trapped within the lungs increasing lung volumes.
5.
What additional diagnostic information is obtained by representing tidal volume within
the forced vital capacity flow-volume loop?
A graphical representation of lung function that illustrates the link between the volume of
air forcibly expelled and the accompanying flow rate during maximal forced expiration is
referred to as the forced vital capacity (FVC) flow-volume loop. The volume of air inspired and
exhaled during a typical breath is known as tidal volume, and it is usually not explicitly
represented in the FVC flow-volume loop. The FVC flow-volume loop in spirometry offers
crucial diagnostic data for a range of respiratory disorders.
A vital diagnostic tool, the Forced Vital Capacity (FVC) flow-volume loop provides a
graphical depiction of lung function. The forced ventilation volume (FVC), measured in liters, is
the total volume of air forcibly expelled from maximal inspiration to peak expiration. The
volume of air exhaled in the first second, or forced expiratory volume in one second, or FEV1 is
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10
important for determining the FEV1/FVC ratio, which is used to diagnose obstructive and
restrictive lung illnesses (Wood, 2023). While a lower FVC with a normal ratio may indicate a
restrictive problem, a reduced ratio is indicative of obstructive illnesses such as asthma or
COPD. Peak Expiratory Flow (PEF) measures the highest flow rate attained during the FVC
maneuver, which helps determine the degree of airflow restriction. The distribution of airflow
throughout the lungs may be understood by examining the mid-expiratory flow (MEF25,
MEF50, and MEF75) values at various stages during the middle part of the FVC maneuver
(Wood, 2023). While not expressly stated, tidal volume is essential to comprehending normal
breathing patterns when measured alone. Its correlation with other flow-volume loop parameters
facilitates the evaluation of respiratory function as a whole and the detection of problems in
breathing patterns.
6.
Discuss the change in IC with obstructive disease during exercise.
The largest quantity of air that can be inhaled from the end-expiratory position is known
as the inspiratory capacity, and it is an essential concept in the study of respiratory mechanics. In
the context of obstructive lung diseases such as chronic obstructive pulmonary disease (COPD),
there is a decrease in IC during exercise (Guenette et al., 2013). An abnormal rise in lung
volume, especially during the expiratory phase, is known as hyperinflation in obstructive lung
disorders. Higher end-expiratory lung volumes are frequently ascribed to air trapping and
dynamic hyperinflation, wherein inadequate exhalation causes this.
This hyperinflation effect is linked to the decrease in IC during exercise in patients with
obstructive lung disease. Increased exercise intensity raises the need for ventilation, and those
with obstructive disorders may find it difficult to exhale completely, which can result in dynamic
hyperinflation and a drop in IC (Guenette et al., 2013). Reduced interstitial carbon dioxide
11
during exercise has important implications for obstructive lung disorders. It causes symptoms
including dyspnea (shortness of breath), exercise intolerance, and reduced exercise capacity by
restricting the person's capability to meet the increased ventilatory demands during physical
activity (Guenette et al., 2013). Assessing the effect of obstructive lung disorders on functional
capacity and directing therapies targeted at enhancing exercise tolerance in afflicted persons
requires an understanding of the changes in IC during exercise.
12
References
Barreiro, T. J., & Perillo, I. (2004, March 1).
. . - definition of . . by The Free Dictionary
. The
Free Dictionary. Retrieved January 24, 2024, from
https://www.aafp.org/pubs/afp/issues/2004/0301/p1107.html
Barroso, A. T., Martin, E. M., Romero, L. M., & Ruiz, F. O. (2018, June).
Factors Affecting
Lung Function: A Review of the Literature
. The Free Dictionary. Retrieved January 24,
2024, from https://www.sciencedirect.com/science/article/pii/S1579212918301320
Biselli, P., Grossman, P. R., Kirkness, J. P., Patil, S. P., Smith, P. L., Schwartz, A. R., &
Schneider, H. (2015, August 1).
The effect of increased lung volume in chronic
obstructive pulmonary disease on upper airway obstruction during sleep
. NCBI.
Retrieved January 22, 2024, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526705/
Crapo, R. O. (1994, July 7).
. . - definition of . . by The Free Dictionary
. The Free Dictionary.
Retrieved January 24, 2024, from
https://www.nejm.org/doi/full/10.1056/nejm199407073310107
David, S., & Edwards, C. W. (2022, August 8).
Forced Expiratory Volume - StatPearls
. NCBI.
Retrieved January 22, 2024, from https://www.ncbi.nlm.nih.gov/books/NBK540970/
Guenette, J. A., Chin, R. C., Cory, J. M., Webb, K. A., & O'Donnell, D. E. (2013, February 7).
Inspiratory Capacity during Exercise: Measurement, Analysis, and Interpretation
. NCBI.
Retrieved January 22, 2024, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3582111/
Your preview ends here
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13
Hallett, S., Toro, F., & Ashurst, J. V. (2023, May 1).
Physiology, Tidal Volume - StatPearls
.
NCBI. Retrieved January 22, 2024, from
https://www.ncbi.nlm.nih.gov/books/NBK482502/
Hibbert, M., Lannigan, A., Raven, J., Landau, L., & Phelan, P. (1995, February). YouTube:
Home. Retrieved January 24, 2024, from
https://onlinelibrary.wiley.com/doi/abs/10.1002/ppul.1950190208
Johns Hopkins Medicine. (2024).
Pulmonary Function Tests
. Johns Hopkins Medicine. Retrieved
January 22, 2024, from
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/pulmonary-functio
n-tests
Lamb, K., Theodore, D., & Bhutta, B. S. (2023, August 17).
Spirometry - StatPearls
. NCBI.
Retrieved January 22, 2024, from https://www.ncbi.nlm.nih.gov/books/NBK560526/
LoMauro, A., & Aliverti, A. (2018, June 14).
Sex differences in respiratory function - PMC
.
NCBI. Retrieved January 24, 2024, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980468/
McCarthy, K., & Kamangar, N. (2020, May 14).
Pulmonary Function Testing: Spirometry, Lung
Volume Determination, Diffusing Capacity of Lung for Carbon Monoxide
. Medscape
Reference. Retrieved January 24, 2024, from
https://emedicine.medscape.com/article/303239-overview
Moore, V.C. (2012).
. . - definition of . . by The Free Dictionary
. The Free Dictionary. Retrieved
January 24, 2024, from
https://breathe.ersjournals.com/content/8/3/232?fbclid=IwAR2v3kybw5gvOyBNb38xZg
14
RGYp83JQawfmkx0I5lofWiowyNkr6pnpI_cBY&utm_source=TrendMD&utm_medium
=cpc&utm_campaign=_Breathe_TrendMD_1
Ponce, M. C., Sankari, A., & Sharma, S. (2023, August 28).
Pulmonary Function Tests -
StatPearls
. NCBI. Retrieved January 22, 2024, from
https://www.ncbi.nlm.nih.gov/books/NBK482339/
Wood, K. L. (2023, December 8).
Airflow, lung volumes, and Flow-Volume loop
. Merck Manuals
Professional Edition.
https://www.merckmanuals.com/en-ca/professional/pulmonary-disorders/tests-of-pulmon
ary-function-pft/airflow,-lung-volumes,-and-flow-volume-loop
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Use the calibration curve or linear regression equation to determine the concentration of
FD&C blue dye No. 1 in Kool-aid.
Food Coloring is 0.026 M in FD&C blue dye No. 1
7.5 x 10 -5 M is 29 mL -> 1000 mL
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A student determines the concentration of an unknown sample using two different methods. Each method has three different trials; the average, standard deviation and percent error produced by each method is listed below.
Method 1
Average: 10.56 M NaOH
Standard deviation: 1.35 M NaOH
Percent error: 1.25%
Method 2
Average: 10.92 M NaOH
Standard deviation: 1.02 M NaOH
Percent error: 3.45%
Which method was more precise? How can you tell?
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Mg3(PO4)2 (s)
Mg2*(aq) + _ PO43- (aq)
Mg2* (aq)
PO43 (aq)
initial
change
eqm
Write Ksn in terms of x.
36 x5
12 x3
3x4
108 x5
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