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Chapter 4. Pulmonary Function Tests

Ruchir Gupta, MD

Figure 4-1. Normal Spirogram
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Reproduced from Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J. Harrison’s Principles of Internal Medicine. 18th ed. Figure 252-2. Available at: www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.

Figure 4-2. Normal Lung Volumes
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Reproduced from Levitzky MG. Pulmonary Physiology. 7th ed. Figure 3-1. Available at: www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.

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Pulmonary Function Tests in Disease States
Respiratory variableObstructive (i.e., asthma, COPD)Restrictive (i.e., pulmonary fibrosis, pneumonia)
Vital capacityN or ↓↓
Total lung capacity↑↓
FEV1/FVC ratio↓N or ↓
Mid-maximal expiratory flow↓N
Maximum breathing capacity↓N
DLCO

Asthma: N or ↓

COPD: ↓↓

↓↓↓

N, normal; ↓, decreased; ↑, increased.

Figure 4-3. Components of the Flow–Volume Loop
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By convention, expiration is up and inspiration is down.

Figure 4-4. Alterations of Flow–Volume Loop in Disease States
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Figure 4-5. Preoperative Testing Algorithm to Predict Surgical Outcome for Pneumonectomy
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