Lung Volumes and

Capacities

Suyasning HI

Lung Volumes and

Capacities
The total volume contained in
the lung at the end of a
maximal inspiration is
subdivided into volumes and
subdivided into capacities.

There are 4 volume

subdivisions
They do not overlap
They can not be further divided
When added together equal total
lung capacity

Lung Capacities
Are

subdivisions of the total

volume that include two or
more of the 4 basic lung
volumes

Pulmonary Volumes

Tidal volume

Inspiratory reserve volume

Amount of air inspired forcefully after inspiration of normal

tidal volume

Expiratory reserve volume

Volume of air inspired or expired during a normal inspiration

or expiration

Amount of air forcefully expired after expiration of normal

tidal volume

Residual volume

Volume of air remaining in respiratory passages and lungs

after the most forceful expiration

23-8

Spirometer and Lung

Volumes/Capacities

23-9

Basal Lung Volume

VT (tidal volume): 500ml

IRV (inspiratory reserve volume)
ERV (expiratory reserve volume)
RV (residual volume)

Basic Lung Volumes

Tidal Volume: TV
The amount of gas inspired or
expired with each normal breath.
About 500 ml

Basic Lung Volumes

Inspiratory

Reserve Volume: IRV

Maximum amount of additional
air that can be inspired from the
end of a normal inspiration.

Basic Lung Volumes

Expiratory

Reserve Volume: ERV

The maximum volume of
additional air that can be expired
from the end of a normal
expiration.

Basic Lung Volumes

Residual Volume: RV
The volume of air remaining in the lung after
a maximal expiration. This is the only lung
volume which cannot be measured with a
spirometer.
Gas dilution tech
nitrogen
helium

Body Plethysmograph

Basal Lung Capacity

IC (inspiratory capacity): VT+ IRV

FRC (functional residual capacity):
ERV + RV
VC (vital capacity) : IC + ERV
normal men: 4217ml
women: 3105ml
TLC (total lung capacity): VC + RV

Lung Capacities

Total Lung Capacity: TLC

The volume of air contained in the
lungs at the end of a maximal
inspiration.
Called a capacity because it is the
sum of the 4 basic lung volumes
TLC= RV+IRV+TV+ERV

Lung Capacities

Vital Capacity: VC
The maximum volume of air that can be
forcefully expelled from the lungs
following a maximal inspiration.
Called a capacity because it is the sum
of inspiratory reserve volume, tidal
volume and expiratory reserve volume.
VC= IRV+TV+ERV = TLC - RV

Lung Capacities

Functional Residual Capacity: FRC

The volume of air remaining in the
lung at the end of a normal expiration.
Called a capacity because it equal
residual volume plus expiratory
reserve volume.
FRC= RV+ERV

Lung Capacities

Inspiratory Capacity: IC
Maximum volume of air that can be inspired
from end expiratory position.
Called a capacity because it is the sum of
tidal volume and inspiratory reserve
volume.
This capacity is of less clinical significance
than the other three.
IC= TV+IRV

Factors affecting
respiratory volumes?

Architecture:
Architecture skeletal build, gender, height,
muscle strength, etc.
Age (esp. muscle strength and elasticity of
body wall)
Extensibility (while breathing in) of lungs (and
thoracic cage) = COMPLIANCE
Elasticity of lungs (during exhalation)

Respiratory Function Test

Lung volumes
Ventilation function
Gas exchange
Blood flow
Respiratory motive force

Spirometry Interpretation:
Obstructive vs. Restrictive Defect

Obstructive Disorders
Characterized by a
limitation of expiratory
airflow so that airways
cannot empty as rapidly
compared to normal (such
as through narrowed
airways from
bronchospasm,
inflammation, etc.)
Examples:
Asthma
Emphysema
Cystic Fibrosis

Restrictive Disorders
Characterized by reduced
lung volumes/decreased
lung compliance
Examples:
Interstitial Fibrosis
Scoliosis
Obesity
Lung Resection
Neuromuscular diseases
Cystic Fibrosis

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Respiratory Diseases

Restrictive Disease:
Makes it more difficult to get air in to the
lungs.
They restrict inspiration.
Decreased VC; Decreased TLC, RV, FRC
Includes:
Fibrosis
Sarcoidosis
Muscular diseases
Chest wall deformities

Respiratory Diseases

Obstructive Disease
Make it more difficult to get air out of the
lungs.
Decrease VC; Increased TLC, RV, and
FRC
Includes:
Emphysema

Chronic bronchitis
Asthma

Normal vs. Obstructive vs.

Restrictive

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(Hyatt
,
2003)

Spirometry Interpretation:
Obstructive vs. Restrictive Defect

Obstructive Disorders

FVC nl or
FEV1
FEF25-75%
FEV1/FVC
TLC nl or

Restrictive Disorders

FVC
FEV1
FEF 25-75% nl to
FEV1/FVC nl to
TLC

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Spirometry Interpretation: What

do the numbers mean?

FVC
Interpretation of %
predicted:

FEV1
Interpretation of %
predicted:

80-120% Normal
70-79% Mild reduction
50%-69% Moderate
reduction
<50% Severe reduction

>75% Normal
60%-75% Mild obstruction
50-59% Moderate
obstruction
<49% Severe obstruction

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<25 y.o. add 5% and >60

y.o. subtract 5

Spirometry Interpretation:
What do the numbers mean?

FEF 25-75%
Interpretation of %
predicted:

>79% Normal
60-79% Mild
obstruction
40-59% Moderate
obstruction
<40% Severe
obstruction

FEV1/FVC
Interpretation of
absolute value:

80 or higher
Normal
79 or lower
Abnormal

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FORCED VITAL CAPACITY

(FVC)
Max vol. Of air which can be expired out as forcefully
and rapidly as possible, following a maximal
inspiration to TLC.
Exhaled volume is recorded with respect to time.
Indirectly reflects flow resistance property of
airways.
Normal healthy subjects have VC = FVC.
Prior instruction to patients, practice attempts as it
needs patient cooperation and effect.
Exhalation should take at least 4 sec and should not
be interrupted by cough, glottic closure or
mechanical obstruction.
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FORCED VITAL CAPACITY

IN 1 SEC. (FEV1)

Forced expired vol. In 1 sec during fvc

maneuver.
Expressed as an absolute value or % of fvc.
N- FEV1 (1 SEC)- 75-85% OF FVC
FEV2 (2 SEC)- 94% OF FVC
FEV3 (3 SEC)- 97% OF FVC

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Ventilation
Minute ventilation (VE ) = Total volume of air
expired in one minute
Respiratory rate x tidal volume Normal
minute ventilation = 12 x 500 ml = 6000ml
Note: (hypoventilation can occur with normal
respiratory rate)

Alveolar Ventilation (VA )

VA = VT anatomical dead space
Approximately 350 ml per breath