Other Spirometry Patterns – Laboratory Diagnostics

00:01 Other important patterns that you want to keep in mind.

00:04 You will like this. Watch. The first one is called fixed obstruction.

00:09 What does this mean? Well, this could mean that first and foremost, let's begin the same way, organization.

00:18 The loop spirometry, different pathologic patterns that you are responsible for understanding.

00:23 We will begin with residual volume.

00:25 Okay. Does this even look normal? No, it doesn't.

00:29 Actually, the both, the bottom half and the top half look like they are kind of sandwiched, isn't it? It looks like a burger, doesn't it? Looks like buns. That's what it looks like.

00:40 And that black line in the middle that's your piece of bacon. I don't know, whatever.

00:43 So, the point is they are compressed.

00:45 What happened here? There is difficulty with inspiration, hence flattened and there is also difficulty with expiration.

00:52 What the heck kind of disease is going to give you a fixed obstruction? A ENT tumor. In other words, you have perhaps dangerous, a head and neck type of cancer.

01:05 When there is a head and neck type of tumor or cancer, this is then causing a fixed large obstruction of both inspiration which is the bottom half of the curve and the top half.

01:16 That is fixed. Let's move on to another one.

01:19 Now, first and foremost, dissect the curve, interpret this.

01:24 Where is my problem, please? Inspiration? Exhalation? Good. Inspiration only. You see that there is only a problem with inspiration.

01:33 Wow. What the heck kind of problem or disease or pathology has given me a problem with inspiration only? The problem is extra thoracic pathology.

01:45 Meaning, maybe with the vocal cords.

01:49 So, with the vocal cord type of dysfunction or maybe perhaps fibrosis or an upper airway mass, this is the most tested, well, please understand, that you are going to have a hard time inspiring.

02:02 Is that clear? So, therefore, the bottom half of the curve has not been affected.

02:06 But, you do not have problems at getting the air out.

02:09 This is not, not I repeat, anything to do with obstructive in terms of the pulmonary issue.

02:15 Obstructive here, I wouldn't even use this word.

02:18 I would just think of this as being inspiratory issues.

02:23 Now, when we do think about obstructive.

02:26 I want you to keep the theme of obstructive and inside the lung.

02:30 First and foremost, interpret the curve for me.

02:34 Where is my problem? Good. The top half.

02:38 What does that top half represent? Oh, exhalation. Interesting.

02:44 Earlier discussion, I just showed you obstructive lung disease with scalloped type of second half of exhalation with a left shift, meaning to say, an increase in TLC. That was obstructive.

03:00 Here, please understand, when you have such a obstructive pattern, that you will see at some point in time, that this is a problem inside my lung and this will be something like obstructive disease, or but also, intrathoracic tumor whereas the tumor in the first one, fixed.

03:17 Where was it? Oh, ENT. Ear, Nose, Throat. Clear? Blocking, fixed. What was the one with extrathoracic? That was vocal cord, problem with inspiration only.

03:27 Now, under the three main categories, take a look at lung volumes.

03:31 TLC, residual volume, and once again, the gold standard here for measuring lung volume will be your body box, plethysmography.

03:39 Lung volumes used in measuring residual volume, we talked about, that's spirometry cannot, report's out, your TLC and vital capacity will be two big ones.

03:48 Then reduced TLC seen in what kind of disease, please? Good. Restrictive.

03:55 Elevated TLC and residual volume will be seen in what kind of disease, please? Good. Obstructive. We will call this hyperinflation.