25. Pulmonary function tests - spirometry. Chest X-ray and CT scan, bronchoscopy

I. Pulmonary Function Tests – Spirometry

➤ What is it?

• A non-invasive test that measures lung volumes and flow rates.
• Most commonly used to evaluate obstructive and restrictive lung diseases.

➤ Parameters Measured:

➤ Patterns:

➤ Common Conditions:

• Obstructive: Asthma, COPD, bronchiectasis
• Restrictive: Pulmonary fibrosis, neuromuscular disease, obesity

II. Chest X-ray (CXR)

➤ Indications:

• First-line imaging for most respiratory complaints:
• Cough, dyspnea, fever, chest pain, hemoptysis

➤ Views:

• PA view (posterior-anterior): Standard
• Lateral view: For hidden lesions
• AP view (in bedridden patients)

➤ Common Findings:

III. Chest CT Scan (High-Resolution CT – HRCT)

➤ When to Use:

• For detailed evaluation when X-ray is inconclusive or normal.
• Excellent for:
• Interstitial lung disease
• Pulmonary embolism
• Lung nodules and cancer staging
• Bronchiectasis

➤ Contrast-enhanced CT:

• Used in cancer evaluation, PE, or vascular abnormalities.

IV. Bronchoscopy

➤ What is it?

• Direct visualization of the tracheobronchial tree using a flexible or rigid endoscope.

➤ Diagnostic Uses:

• Visualization of tumors, strictures, foreign bodies
• Biopsy of lesions
• Bronchoalveolar lavage (BAL) in infections

➤ Therapeutic Uses:

• Removal of foreign bodies
• Management of bleeding (hemoptysis)
• Stent placement or tumor debulking

➤ Contraindications:

• Severe hypoxia, uncorrected coagulopathy, unstable cardiac status