Pulmonary Function Tests (PFT): Lesson 2 - Spirometry

A discussion of FEV1, FVC, FEV1/FVC ratio, and the flow volume loop, including how these are used in the diagnosis of various lung diseases, with a particular focus on the distinction between obstructive and restrictive lung disease. A summary of flow volume loop patterns in upper airway obstruction is covered as well.

[@StrongMed]

Errata: @1:52, "functional RESERVE capacity" should be instead labeled "functional RESIDUAL capacity"

[@anonymousroy3976]

@10:33 : Don't you think the loop for 1-'restrictive' disorders should shift right (as RV decreases) and 2-'obstructive' disorders left (as TLC increases) ?

[@simrankundan8900]

I must say... your series on PFT's is probably one of the best out there...you have elucidated it so well. Kudos.

[@JoelRomelus]

This is literally one of the best videos I have seen taught on this material. thank you so much for your help and clarity in understanding this stuff :)!!

[@user-nm7mg7kg5o]

Doctor Eric, I can safely say that you are one of the best teacher I ever met. Thank you for being an amazing.

[@viraltiktokviraltiktok1524]

u said this 5 years agoooooo? wow

[@Movement_Hygiene]

I really loved the way you slowly incorporated each line and plot point rather than showing an overcrowded picture and graph

[@samarmattar]

wow. its the first time in my life that I actually understand this. I'm full of gratitude:)

[@bdm993]

Very high quality teaching. Tons of thanks!

[@justinclark2763]

Great videos. I use them to understand the basic concepts found within our lectures.

[@sunving]

Thank you Dr Strong. I seem to get from second listening , and it is wonderful that you point out Gold system lack predictive value for individual.

[@xoxo0414]

Just started learning this in class last week with the spirogram..I finally understand this :) thanks.

[@hiwariatattibwaladab]

very informative and usefull ,thank you very much dr.Ali attaee from Iraq

[@doktornadia1999]

Спасибо огромное Вам!

[@nellyhoffman6194]

When i saw This for the first time it was like reading chinese .... But when i read it again and again it became easy :) Thanks a lot DOCTOR

[@laurentiu244]

Excellent clinical and physo explanation which I could not find on other resources. Formality is not an issue .You are clear and eloquent no matter if the audience is English first or second language .

[@mustafamassadi2965]

thank you very much great efforts & beautiful logical presentation note : the flow loop for restrictive pattern ( minute 10 ) should be shifted to the right because there is reducing residual capacity *.*

[@8538pmam]

Excellent lesson! Thank you

[@doktornadia1999]

Спасибо огромное за качественное объяснение сложных моментов!👍 Рисунки понятные!

[@danig4338]

i have a test tomorrow. i hope this will help! thanks!

[@Movement_Hygiene]

Wow beautifully taught video. Thank you for your wisdom!

[@tufghbv]

I loved the Bach intro!

[@MrUseruseruser]

Awesome! Thank you, thank you, thank you!

[@chrisdavis96]

excellent teaching thank you

[@Brozer999]

Your explanation is excellent

[@anikajaved15]

Thank u so much that was actually helpful in understanding the basics

[@filmmaker5457]

Very very helpful! Makes it quite clear: thank you for the video.

[@mcsmama]

Thanks so much for this video! At 12:09 when you give etiologies for the various upper airway obstruction patterns, as all 3 list "airway tumor", I would find it very helpful to have you elucidate the characteristics of the tumor in each scenario, that would cause it to elicit the type of pattern shown. Thank you. :)

[@tutoantimaduro7749]

Muchas gracias. Muy bueno.

[@nakisekacissy2832]

Wow, so informative. Thank you so much

[@Scully69]

very helpful!! thank you so much :)

[@agd712]

Lol Don Draper as the patient with abnormal PFT's thanks to his smoking history. Lovely touch to an amazing channel. - MS4 interested in Pulm Crit

[@fatimamajid9870]

Thanx 👍 u made it so clear 😊

[@myopinion2173]

Thank you so much 👍👍👍

[@juancho1309]

I cannot say with words how helpful is this video. Thank you so much!!!! (BTW How could I Reference this in a presentation? Found it really helpful and would like to show where I got some of the basic info you teach here

[@al-hassanhaider9327]

Thank you so much

[@Avihosia]

Exceptional Elucidation

[@ahmedgamal5212]

thank you so much... from egyptian med student

[@mcsmama]

7:17 FEV1/FVC ratio: decr'd in obstructive & NORMAL TO INCR'D in RESTRICTIVE dz 9:34 6 Flow Volume Loop patterns

[@lauracarrillo884]

THANK YOU SO MUCH :D

[@MrSkaja001]

Best video ever

[@ehsanzandifarm.d.2587]

Thanks for your fantasitic videos. My question is if FVC and VC are the same ( FVC is VC which is expired forcefully) why their amounts are different on the spirometry paper ?

[@kairavplays3483]

Your presentation was very helpful to understand PFT. I would aprreciate if you provided me with some referneces to this content.Thank you

[@demitriwelling1348]

Excellent

[@wahibaramtani6130]

thanks

[@chamin6553]

excellent

[@ruthiechurch7142]

I had one of these the LPN yes, LPN, gave me a complete PFT test incorrectly! did not tell me to take deep breath and blow hard...nor did I have a seal around the mouth piece which was the size of a galaxy cell phone, honestly .... the equipment is extremely old the techs will admit it....I am stuck with a diagnosis....it's like Hotel California!! they will not give me another test as the only pulmonologist in this area is egotistical, money hungry nightmare, that the hospital is afraid of due to his ethnicity, yes that's what I was given at a meeting with the CEO of the hospital and the board of directors. So thank you....for the graphics....I do believe, mine are normal looking. Thank with blessings.

[@denisecruz7759]

obtain a copy of your test and file a lawsuit. :)

[@SudiptaNaskar]

Thank you sir.. But at 09:38 --- will it not be 'flow vs volume' ??

[@werkuetafa2775]

It made me perfect in the area

[@butterswang3891]

Dr.stong, thanks a lot! Around 09:40，"... and flow versus time on the bottom", I guess it might should be "...flow versus volume on the bottom" ?

[@demitriwelling1348]

Thanks

[@DanielBender1984]

amazing piano into/outroduction. I would love to know what that is!

[@StrongMed]

It's Bach: Prelude in G major (BWV 860). (I know the music credit at the end is incorrect...)

[@SarkisKlinik]

Hello, what dosage should we give salbutamol aerosol for post dilation test? How many puffs? Is 4 puffs not dangerous? Usually obstructive patients get maximum 2 puffs at home for their Asthma treatment.

[@SarkisKlinik]

what is the bronchodilator dosage for after dilation test ?how many puffs salbutamol to give?

[@muhammadjunaidali769]

awesome

[@marklynch403]

This is great information however I have a delima , my spirometer only measures FEV1 and PEFR. how can I calculate my FVC??? Please Help :(

[@davejones4740]

my resting oxygen drops down to 80 and I was diagnosed with plurisy/pneumonia at xmas 2017. I had an x-ray and the hospital said there was nothing wrong with me and sent me of saying good luck... I'm still not able to go to work 4.5 months later. I have chest and back pains still months later.

[@aboubacarnabe8796]

Très important

[@tinkageorgewilliam871]

merci d'ouganda

[@kyawkyawmin2410]

I like it but in our country online is so interrupted. Nice to give time .

[@oJACKS0No]

I just took my first PFT today for a job. I was confused why I had to exhale for six seconds when it felt like I emptied my lungs after just a few seconds. The last few seconds were discomforting and painful. I'm pretty sure nothing came out the last few seconds. Is it possible to exhale the lungs in a few seconds and then just hold that position for the last few seconds and still come out with an acceptable reading?

[@Cardboardbocs]

what is the piano piece at the end of this?

[@en-yutan2735]

When they say "reversible obstruction" is it FEV1/FVC from 0.7, or FEV1 from 80%?

[@Kareemo227]

How does spirometry measure the flow-volume loop if it does not measure the residual volume? I don't understand that part

[@kl33jj67]

Shouldn't there be "flow versus volume" at the bottom graph at 9:35?

[@akhmetzhansugraliyev1438]

Thank you very much for very clear and very professional explanation. Is there any difference regarding technics of testing depending on type of spirometer device?

[@StrongMed]

I'm sure there are differences, but unfortunately, I know little about the specific technical aspects of actually performing the tests themselves beyond what is presented in the videos. A respiratory therapist would be a better resource for that information than I.

[@akhmetzhansugraliyev1438]

Eric's Medical Lectures Dear Dr. Eric. May I have your e-mail address for further communication?

[@StrongMed]

Akhmetzhan Sugraliyev I'm so sorry, just seeing this follow-up response now! I have no idea if this makes a difference, but I avoid posting my email address directly on KZbin comments out of concern for increasing spam. Instead, my email is listed here: med.stanford.edu/profiles/eric-strong

[@idosadras]

awesome video! I think you meant vocal cord dysfunction and not vocal cord paralysis

[@PankajSingh-mn6yl]

Sir how to flow the air in spirometer like ballon or any other method

[@StrongMed]

I'm really sorry but I don't understand the question.

[@uuuuuuuuuuuuuuuuuu61]

The nursing staff at my hospital would benefit from this education. Would it be possible to access these powerpoints?

[@StrongMed]

+Bryan Gaston I don't give out the PowerPoint files any more because I ran into too many people blatantly plagiarizing them. However, if you send me an email, I can send pdf versions of the videos (essentially high-res screen shots of each slide, stitched together in one document)

[@uuuuuuuuuuuuuuuuuu61]

+Strong Medicine Sorry it took so long to get back. The internet up here is quite limited. I will send you an email soon.

[@nellyhoffman6194]

Thank you Dr eric

[@kingfaisal7514]

@@StrongMed Hi, would you be able to send me the PowerPoint files by any chance? I'm currently writing them all by hand and this material is very helpful!

[@StrongMed]

@@kingfaisal7514 drive.google.com/drive/folders/0B9SDUwepGWeUU3FvMWVMeDRtV2c

[@user-qo3wz6sm1f]

thats right po

[@saraho3289]

thanks for the video! just a quick note, you are pronouncing "expiratory" as "ex-pah-to-ry" instead of "ex-pI-Ra-to-ry" (you are missing a syllable). People do this often with respiratory and incorrectly say "res-pah-to-ry" instead of "res-pir-a-to-ry"

[@StrongMed]

Appreciate the point, however, and maybe this is just us crazy laid-back Californians, but I actually find ex-pah-to-ry to be the more common pronunciation among my peers - though this is not to say that it's the "correct" pronunciation per se.

[@braedend7446]

***** get off his back

[@AmirKhan-dm5ce]

Very difficult topic to understand

[@sandralewis6454]

Hello, my pulmonologist won’t call to tell me about my tests. I get the worst cough at times. I have a nebulizer and Advair generic. I have no plan or diagnosis. Why would I go take tests if he won’t explain them? I explained my view before last week’s test, but I think that he was writing his grocery list.

[@bedooneesm6359]

Unideb has copy pasted this for us 😂😂😂

[@johnmichael5135]

excellent lecture, but please consider being less formal.

[@StrongMed]

John Michael, thanks for the message. I go back and forth with myself regarding the level of formality in these videos. On one hand, I totally get that a lot of viewers may find it easier to pay attention and connect with the video if the overall tone and style is more similar to Khan Academy, or on the other extreme from me, Crash Course. However, a significant number of my subscribers are from places where English is not their first language. I've always been concerned that speaking too rapidly, and adding more colloquialism and asides might make it more challenging for them to follow. Also, one of my goals with these videos has evolved into a desire to post the didactics of an entire medical school curriculum (yes, I realize that is insanely ambitious), and thus, this is meant to replace an in-class lecture. The problem with less formal approaches to complex material is that it risks not being as comprehensive as it needs to be in order to fulfill this goal. But I do sincerely appreciate your suggestion!

[@victorfigueroa2934]

+Strong Medicine Asi es, yo le entiendo muy bien a su voz. Gracias por sus aportes Saludos desde Mexico

[@mmaman6931]

+Strong Medicine your outlook is great, keep going!

[@berlinSunRise]

when you summarise please don't use the acronyms

[@gengiskunk2381]

CLAP CLAP CLAP

[@jiminlefttoe4138]

makes no sense

[@takeoneandaction2678]

cant believe these videos had such low likes this is excellence

[@user-mz4dv5cr2j]

Talk to fast

[@priyankarana3341]

Thanks

[@kyawkyawmin2410]

I like it but in our country online is so interrupted. Nice to give time .