Respiration 3 phases:

1. Ventilation spirometry only looks at

2. Diffusion
3. Perfusion
Tidal volume 500ml
Inspiration reserve volume
Expiratory reserve volume
Residual volume never collapses
4 volumes
Also have others:
Vital capacity: tidal + insp + exp
Functional Residual Capacity: Exp + residual cant check with
spirometer
Inspiratory capacity= tidal + insp
Total lung capacity = ALL cant check with spirometer
Volume vs. capacity: if add things together capacity. Volume you
measure
Residual volume cant count in spirometer need to use nitrogen
washout
Static volume Vital capacity is important.
Restrictive and Obstructive:
-Restriction: expansion of lungs is restricted
-Use vital capacity if vital capacity decreases = restrictive
carry out survey not clinical trials to get the normal values.
Tinggi badan, umur- 21- peaks up and down, gender, race.
FVC < 80% than predicted = restrictive
Deformities in lung itself lung fibrosis no longer elastic(Fibrosis in
TB, silicosis, asbesthosis), tumor, pulmonary edema, pleural
effusion, pneumothorax, pleural tumor, Mediastinal( cardiomegaly,
tumor-timoma LT3- lymphoma, teratoma, timoma, thyroid)
Chest wall: muscles and bones: fractures, myasthenia gravisweakens, inerrvations cut.
diaphragm-hepatomegaly, hernia, paralysis of the diaphragmphrenic nerve, pregnancy,
Items: fluid or gas:
Pleuraeffusion and pneumothorax
Lung Tumor/fibrosis etelectasis and pulmonary edema, abscess,
bullae
Mediastinum tumor, pericardial effusion, pneunom-mediastinum
Diaphargm pregnancy, ascites, ileus,

Bones scoliosis, kyphosis,pectus excavatum

Muscles luhgerigs ,Duschenne muscular dystrophy,
Restrictive mostly from outside of the lungs itself the problem, little
that is caused y the lung itself.
Take an xray to rule out lung causes.
Obstructive:
Perlambatan aliran udara expiration.
FEV1/FVC ration decreases <70% = Obstructive
3L/5L = 60%
2L/5L= 40%
the more landai- osbtrcutive
the more steeper the more normal
balloon anology- if lose elasticity, recoils slower, if still elastic,
recoils fast.
Emphysema.
Foregins objects kelereng, koin, bakso ,gigi palsu,
Tumor that presses on the respiratory tracts, saluran nafas
Bronchiectasis: bronchus widens- mucus
Always problmes o the lung itself in obstructive- restrictive is
outside of the lungs.
Problems: normal, restrictive, obstructive, restrictive + obstructive,
Spirometry: 1. Alat, 2. Subject 3. Operator
Criteria for a good spirometer data: ATS
Good if the line going up is close to the Y axis, that means hes
blowing fast, no space
2. peak, there needs to be a peak, have a max, 1 max, saa tinggi
3. the end has to be one line only
trapezium- if theres a tumor in upper respiratory tract- no peak, like
a trapezium shows in spirometry
steeper steeper spirometry normal, smoker Asma, PPOK, cough
up and down
Restiction- small volume just a triangle.
Atelectasis+ fibrosis+bronchiectasis
Reproducible if diff is less than 150ml