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Diagnosis Of Lung Conditions With A Spirometer

By Jaclyn Hurley


One of the primary tests for assessing lung disorders is the use of spirometry. A spirometer measures the speed and volume of air inspired and expired by the pulmonary system. It plays a critical role in evaluating conditions like cystic fibrosis, pulmonary fibrosis, chronic obstructive pulmonary disease and asthma. A spirogram will tell the diagnostician whether a patient has one of two categories of abnormal lung function, obstructive or restrictive.

In persons suffering from restrictive lung disease (RLD), the expansion of the lungs is impaired when breathing in. This causes a decrease in lung volume, making it more difficult for the person to breathe, impairing both oxygenation and ventilation. One type of condition underlying RLD is pulmonary fibrosis. Pulmonary fibrosis is associated with scarring of the lungs, resulting in a honeycomb-like appearance. While rare, the disease is poorly understood and is frequently fatal.

Other diseases that fall under the definition of RLD include scoliosis, neuromuscular conditions such as amyotrophic lateral sclerosis (ALS), muscular dystrophy (MD), obesity and sarcoidosis. The common symptom that alerts people to the need to see a doctor is always shortness of breath. Sarcoidosis is an autoimmune condition in which the lungs become peppered with inflamed tissue referred to as granulomas. These mostly involve the lungs or the skin. Individuals may develop symptoms spontaneously and recover after a few months, maybe years. Other people never notice the condition and learn about it only after investigations for another condition.

The main features of obstructive lung disorders are obstructed and reddened airways. Airflow is obstructed, resulting in difficulty breathing out and, inevitably, numerous visits to the hospital. A diagnostic feature of OLD is the inability to expire 70% of breath in one second. Examples of OLD include COPD, bronchitis and asthma.

Asthma, caused by inflammation of the airways, is a common respiratory condition most often characterized by coughing, wheezing and shortness of breath. Less common symptoms include sighing, fatigue and rapid breathing. Asthma is occasionally life-threatening.

Cystic fibrosis (CF), a form of OLD, affects not only the lungs, but also the pancreas, intestine and liver. The most serious symptom is difficulty breathing. Advances in screening, diagnosis and treatment have resulted in a considerably improved prognosis for individuals with CF. In 1959, the the median age of survival was six months. By 2008, this had to risen to 37.5 years in the United States and, in Canada, from 24 to 47.7 in the years between 1982 and 2007. In Russia, where medical treatment is expensive and lung transplants are not performed, the median age of survival is 25 years of age.

The designation chronic obstructive pulmonary disease (COPD) includes conditions like chronic bronchitis and emphysema. With emphysema, the delicate lining of the lung becomes irreversibly damaged. This is usually a consequence of exposure to cigarette smoke, which restricts the patient's ability to breathe out. Although there is as yet no cure, removing the stimulus of cigarette smoke does bring improvement.

Spirometry is an essential screening tool for distinguishing between obstructive and restrictive lung diseases. Obstructive conditions include asthma, COPD and bronchitis. Both chronic bronchitis and emphysema contribute to chronic obstructive pulmonary disease. Restrictive lung diseases include pulmonary fibrosis, sarcoidosis, obesity hyperventilation syndrome, sarcoidosis, muscular dystrophy and amyotrophic lateral sclerosis (ALS).




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