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Pulmonology · Respiratory Therapist

Respiratory Therapy: Pulmonary Function Testing

Spirometry, lung volume measurement, and diffusion capacity test interpretation tested on respiratory therapist certification exams.

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What is FVC (forced vital capacity)?
The total volume of air a person can forcibly exhale after maximal inhalation.
What is FEV1?
The volume of air forcibly exhaled in the first second of an FVC maneuver.
What is a normal FEV1/FVC ratio in a healthy adult?
About 70 to 80 percent (roughly 0.70 to 0.80).
How does the FEV1/FVC ratio change in an obstructive lung disease pattern?
It is reduced below the normal range (below about 70 percent).
How does spirometry typically appear in a restrictive lung disease pattern?
FVC is reduced, but the FEV1/FVC ratio is normal or even increased.
What does PEF (peak expiratory flow) measure?
The maximum speed of airflow during a forced exhalation.
What does FEF25-75% measure?
The average forced expiratory flow over the middle half of the FVC maneuver, a marker of small airway function.
What reproducibility criterion must the two largest FVC and FEV1 values meet for an acceptable spirometry test?
They must be within 150 mL of each other.
What is the minimum number of acceptable exhalation maneuvers required for a valid spirometry test?
Three (up to a maximum of eight attempts).
What defines a positive bronchodilator response on spirometry?
An increase in FEV1 or FVC of at least 12 percent and 200 mL after bronchodilator administration.
Name three diseases that produce an obstructive spirometry pattern.
Asthma, COPD, and bronchiectasis.
Name three conditions that produce a restrictive spirometry pattern.
Pulmonary fibrosis, chest wall deformity, and neuromuscular disease.
What shape does the expiratory limb of the flow-volume loop take in obstructive lung disease?
A concave, scooped-out shape.
In GOLD COPD staging, what FEV1 percent predicted defines severe (GOLD 3) airflow limitation?
30 to 49 percent predicted.
What is total lung capacity (TLC)?
The total volume of air in the lungs after a maximal inhalation.

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