Biomedical Instrumentation
BME-301
Lecture -8
Dr. Muhammad Umair Ahmad Khan
23-10-2024
• Pulmonary function tests
• Plethysmography
• Spirometry
• Nebulizer
Respiratory system
Respiratory system
• The respiratory system has many different parts that work together to help you breathe.
Each group of parts has many separate components.
• Your airways deliver air to your lungs. Your airways are a complicated system that
includes your:
• Mouth and nose: Openings that pull air from outside your body into your respiratory
system.
• Sinuses: Hollow areas between the bones in your head that help regulate the
temperature and humidity of the air you inhale.
• Pharynx (throat): Tube that delivers air from your mouth and nose to the trachea
(windpipe).
• Trachea: Passage connecting your throat and lungs.
• Bronchial tubes: Tubes at the bottom of your windpipe that connect into each lung.
• Lungs: Two organs that remove oxygen from the air and pass it into your blood.
Respiratory system
• From your lungs, your bloodstream delivers oxygen to all your organs
and other tissues.
• Muscles and bones help move the air you inhale into and out of your
lungs. Some of the bones and muscles in the respiratory system
include your:
• Diaphragm: Muscle that helps your lungs pull in air and push it out.
• Ribs: Bones that surround and protect your lungs and heart.
• When you breathe out, your blood carries carbon dioxide and other
waste out of the body. Other components that work with the lungs
and blood vessels include:
Respiratory system
• Alveoli: Tiny air sacs in the lungs where the exchange of oxygen and
carbon dioxide takes place.
• Bronchioles: Small branches of the bronchial tubes that lead to the
alveoli.
• Capillaries: Blood vessels in the alveoli walls that move oxygen and
carbon dioxide.
• Lung lobes: Sections of the lungs — three lobes in the right lung and
two in the left lung.
• Pleura: Thin sacs that surround each lung lobe and separate your
lungs from the chest wall.
Respiratory system
• Some of the other components of your respiratory system include:
• Cilia: Tiny hairs that move in a wave-like motion to filter dust and
other irritants out of your airways.
• Epiglottis: Tissue flap at the entrance to the trachea that closes when
you swallow to keep food and liquids out of your airway.
• Larynx (voice box): Hollow organ that allows you to talk and make
sounds when air moves in and out
Pulmonary function tests
• What are pulmonary function tests?
• Pulmonary function tests (PFTs) are noninvasive tests that show how well
the lungs are working. The tests measure lung volume, capacity, rates of
flow, and gas exchange. This information can help your healthcare provider
diagnose and decide the treatment of certain lung disorders.
• There are 2 types of disorders that cause problems with air moving in and
out of the lungs:
• Obstructive. This is when air has trouble flowing out of the lungs due to
airway resistance. This causes a decreased flow of air.
• Restrictive. This is when the lung tissue and/or chest muscles can’t expand
enough. This creates problems with air flow, mostly due to lower lung
volumes.
Pulmonary function tests
• PFT can be done with 2 methods. These 2 methods may be used
together and perform different tests, depending on the information
that your healthcare provider is looking for:
• Spirometry. A spirometer is a device with a mouthpiece hooked up to
a small electronic machine.
• Plethysmography. You sit or stand inside an air-tight box that looks
like a short, square telephone booth to do the tests.
Pulmonary function tests
• 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.
• PFT measures:
• 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.
•
Inspiratory Reserve Volume (IRV): The extra volume of air that can be inhaled with maximal effort
after a normal inhalation.
Tidal Volume (TV): The amount of air inhaled or exhaled during a normal, resting breath.
Expiratory Reserve Volume (ERV): The additional volume of air that can be exhaled with maximal
effort after a normal exhalation.
Residual Volume (RV): The amount of air remaining in the lungs after a maximal exhalation; it
cannot be voluntarily expelled.
Inspiratory Capacity (IC): The total amount of air that can be inhaled after a normal exhalation (IRV
+ TV).
Functional Residual Capacity (FRC): The volume of air remaining in the lungs after a normal
exhalation (ERV + RV).
Vital Capacity (VC): The total amount of air that can be exhaled after a maximal inhalation (IRV + TV
+ ERV).
Total Lung Capacity (TLC): The total volume of air in the lungs after a maximal inhalation (IRV + TV +
ERV + RV).
Plethysmography
• Plethysmography is used to measure changes in volume in different
parts of the body. Plethysmography may be done to check for blood
clots in the arms and legs. Plethysmography is also done to measure
how much air you can hold in your lungs.
Plethysmography
• Plethysmography is a lung
test (pulmonary function
test) performed to measure
the compliance of the lungs
by determining how much air
your lungs can hold. It may be
used to help in the diagnosis
of lung disease, to determine
its severity, to see whether
treatment is working (or if
the condition is getting
worse), or to evaluate the
lungs before lung surgery. It is
most often used along with
other lung tests to determine
the absolute volume of air in
the lungs.
Plethysmography
• The volume-constant whole-body plethysmograph is a chamber
resembling a glass-walled telephone box in shape and volume. During
measurement the box is closed with an airtight seal, except for a
small controlled leak that is used to stabilize the internal pressure by
allowing for equilibration of slow pressure changes, e.g. due to
warming-up. One pressure transducer serves to measure the pressure
inside the box relative to ambient pressure, another one is placed
close to the mouth for recording mouth pressure during a shutter
maneuver. The shutter mechanism can be used to deliberately block
the airflow by transient occlusion.
Plethysmography
• Lung plethysmography is also called pulmonary plethysmography or
body plethysmography and differs from impedance plethysmography,
a test for blood clots in the legs.
Plethysmography
• Measurements that can be made using this test include:
• Functional residual volume: Functional residual volume is the
amount of air left in your lungs after you exhale as much air as you
can.
• Functional residual capacity (FRC): It is a measure of how much air is
left in your lungs after you have exhaled as much as the possible
expiratory reserve volume plus the amount of air left in your lungs
after you breathe out normally (the residual volume).
• Total lung capacity (TLC): This is a measure of the total amount of air
in your chest after you've taken the deepest breath you possibly can.
Volume-time display showing the
following sequence: quiet breathing
for recording specific airway resistance
loops, a period when the shutter is
closed for the determination of
FRCpleth, and subsequently a period
during which the patient performs an
expiratory reserve volume (ERV)
maneuver, followed by a slow vital
capacity maneuver (SVC) in order to
determine inspiratory vital capacity
(IVC) and to derive residual volume
(RV) and total lung capacity (TLC).
Commonly this is followed by a forced
vital capacity (FVC) maneuver that also
yields the forced expiratory volume in
1 s (FEV1) and the maximum expiratory
flows (MEFs) at different lung volumes
• IRV (Inspiratory Reserve Volume): The additional amount of air that can be
inhaled after a normal inhalation.
• VT (Tidal Volume): The amount of air inhaled or exhaled during normal
breathing.
• ERV (Expiratory Reserve Volume): The additional amount of air that can be
forcibly exhaled after normal exhalation.
• RV (Residual Volume): The volume of air remaining in the lungs after a
maximal exhalation.
• IC (Inspiratory Capacity): The maximum amount of air that can be inhaled
after a normal exhalation. It is the sum of the tidal volume and the
inspiratory reserve volume.
• TLC (Total Lung Capacity): The maximum amount of air the lungs can
hold; it is the sum of the vital capacity and the residual volume.
• FRCpleth (Functional Residual Capacity measured by
plethysmography): The volume of air present in the lungs at the end
of passive expiration. This is measured using a body plethysmograph.
• SVC/FVC Maneuver: SVC stands for Slow Vital Capacity, and FVC
stands for Forced Vital Capacity. This maneuver involves the patient
exhaling as forcefully and quickly as possible after a full inhalation.
SPIROMETERY
• Spirometry is a simple test used to help diagnose and monitor
certain lung conditions by measuring how much air you can breathe
out in one forced breath.
SPIROMETERY
• Doctors use spirometry tests to diagnose these conditions:
• COPD Chronic obstructive pulmonary disease, or COPD, refers to a
group of diseases that cause airflow blockage and breathing-related
problems.
• asthma
• restrictive lung disease
• other disorders affecting lung function
SPIROMETERY
• Spirometry measures two key factors: expiratory forced vital capacity
(FVC) and forced expiratory volume in one second (FEV1). Doctor
also looks at these as a combined number known as the FEV1/FVC
ratio.
• FVC: One of the primary spirometry measurements is FVC, which is
the greatest total amount of air you can forcefully breathe out after
breathing in as deeply as possible. If your FVC is lower than expected,
something is restricting your breathing.
• FEV1: The second key spirometry measurement is FEV1. This is the
amount of air you can force out of your lungs in 1 second.
SPIROMETERY
• FEV1/FVC ratio
• Doctors analyze the FVC and FEV1 separately, then calculate your
FEV1/FVC ratio. The FEV1/FVC ratio is a number that represents the
percentage of your lung capacity you’re able to exhale in 1 second.
SPIROMETERY
SPIROMETER
• A spirometer is a diagnostic device that measures the amount of air
you're able to breathe in and out and the time it takes you to exhale
completely after you take a deep breath.
NEBULIZER
• A nebulizer is a piece of medical equipment that a person with
asthma or another respiratory condition can use to administer
medication directly and quickly to the lungs.
NEBULIZER
• A nebulizer is a small machine that creates a mist out of liquid
medication, allowing for quicker and easier absorption of medication
into the lungs.
• Typically, nebulizers come in both electric or battery-run versions, and
are either portable (so you can carry with you) or meant to sit on a
table and plug into a wall.
• nebulizers are made up of:
• a base that holds an air compressor
• a small container for liquid medication
• a tube that connects the air compressor to the medication container
NEBULIZER
• A nebulizer is helpful for a variety of conditions, including:
• COPD
• Asthma
• Types of nebulizers
• There are three main types of nebulizers available:
• Jet nebulizers make an aerosol out of medications using a compressed gas (like
air). These are the most common type of nebulizers.
• Ultrasonic nebulizers make an aerosol via high-frequency vibrations. These are
more commonly used in hospitals and typically are not for personal use.
• Mesh nebulizers use a mesh cap with tiny holes that help dispense medication in
a very efficient way. These nebulizers are newer and often more effective than jet
nebulizers.
NEBULIZER
• The Ultrasonic Wave Nebulizer is one of the first types of electrical
Nebulizer that were designed and available on the market from 1964.
An electronic oscillator creates a high frequency ultrasonic wave
which causes mechanical vibrations in a piezoelectric element that
breaks the liquid medication up into a fine mist.
•
The Vibrating Mesh Technology Nebulizer is one of the latest
innovations in the market and it uses a laser-drilled mesh membrane
which vibrates to refine the droplet size and force the liquid through,
thereby creating a very fine mist.
NEBULIZER
NEBULIZER
NEBULIZER
HOW TO USE IT
• First, make sure all your pieces are clean.
• Pour your liquid medication into the medicine cup.
• Connect the plastic tubing to the liquid container and compressor.
• Next, attach the mouthpiece or mask.
• Turn on the nebulizer to make sure it’s properly misting.
• Insert the the mouthpiece in your mouth, or put the mask securely
over your nose and mouth.
• Breathe in slowly, but normally, until all the medicine is gone.
NEBULIZER VS INHALER
A nebulizer delivers liquid medication via pressurized air. While
individuals with asthma typically use both nebulizers and inhalers,
occasionally, a nebulizer may be easier to use — especially when it
comes to young children who may not have the proper technique for
an inhaler.
However, when airways become narrow — like during an asthma attack
— an inhaler is most likely the best choice, because a nebulizer can
take some time to set up.
NEBULIZER VS INHALER
• What's an Inhaler?
• Inhalers are little devices that can fit in your hand and are small enough to
carry in a backpack, purse, or pocket. There are two types of inhalers:
• Metered dose inhalers (MDI) are the most commonly used. Like little
aerosol cans, these inhalers push out a spray of medicine.
• Dry powder inhalers deliver medicine in powder form, but it does not
spray out. The person must do more of the work by inhaling the powdered
medicine quickly and deeply.
• Dry powder inhalers can be a little easier to use than metered dose
inhalers, which are sometimes tricky. With practice, kids get very good at
using them, though. The best way to use an MDI properly is by using it with
a spacer.
NEBULIZER
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