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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/statpearls/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-statpearls-lrg.png" alt="Cover of StatPearls" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>StatPearls [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK608009_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK608009_dtls__"><div>Treasure Island (FL): <a href="https://www.statpearls.com/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">StatPearls Publishing</a>; 2025 Jan-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/statpearls/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK608009_"><span class="title" itemprop="name">Pulmonary Function Tests and Thoracic Cage Abnormalities</span></h1><p class="contrib-group"><span itemprop="author">Shafia Arshad</span>; <span itemprop="author">Abdulghani Sankari</span>.</p><a data-jig="ncbitoggler" href="#__NBK608009_ai__" style="border:0;text-decoration:none">Author Information and Affiliations</a><div style="display:none" class="ui-widget" id="__NBK608009_ai__"><p class="contrib-group"><h4>Authors</h4><span itemprop="author">Shafia Arshad</span><sup>1</sup>; <span itemprop="author">Abdulghani Sankari</span><sup>2</sup>.</p><h4>Affiliations</h4><div class="affiliation"><sup>1</sup> College of Physicians and Surgeons</div><div class="affiliation"><sup>2</sup> Wayne State University</div></div><p class="small">Last Update: <span itemprop="dateModified">February 27, 2024</span>.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="article-161798.s1"><h2 id="_article-161798_s1_">Summary / Explanation</h2><p>The respiratory system is an essential component of the human body, responsible for maintaining oxygen levels and removing carbon dioxide.<a class="bk_pop" href="#article-161798.r1">[1]</a> Pulmonary function tests (PFTs) are a set of diagnostic tools used to diagnose and assess the functionality of the respiratory system. By combining these tests with the knowledge of thoracic cage abnormalities, healthcare professionals can gain valuable insights into pulmonary health and make informed treatment decisions with their patients.</p><p>
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||
<b>Pulmonary Function Test Overview</b>
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||
</p><p>PFTs encompass a range of tests designed to evaluate the performance of the lungs and the respiratory muscles. These tests are instrumental in diagnosing respiratory disorders, monitoring disease progression, and assessing treatment effectiveness. The primary PFTs include spirometry, lung volume measurements, and gas exchange studies.<a class="bk_pop" href="#article-161798.r2">[2]</a><a class="bk_pop" href="#article-161798.r3">[3]</a><a class="bk_pop" href="#article-161798.r4">[4]</a></p><p>
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||
<b>Spirometry</b>
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||
</p><p>Spirometry is a fundamental PFT that measures the amount and speed of air an individual can inhale and exhale. This test is essential for diagnosing and monitoring patients with chronic obstructive pulmonary disease (COPD), asthma, and restrictive lung diseases. Common parameters obtained from spirometry include forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and the FEV1/FVC ratio. The results are then represented on a graph.<a class="bk_pop" href="#article-161798.r5">[5]</a><a class="bk_pop" href="#article-161798.r6">[6]</a><a class="bk_pop" href="#article-161798.r7">[7]</a><a class="bk_pop" href="#article-161798.r8">[8]</a></p><p>
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<b>Lung Volume Measurements</b>
|
||
</p><p>Two methods are used to measure lung volumes: body plethysmography and gas dilution (nitrogen washout and inert gas dilution).<a class="bk_pop" href="#article-161798.r9">[9]</a><a class="bk_pop" href="#article-161798.r10">[10]</a> These tests assess the total air the lungs can hold and how well air moves in and out of the lungs. Lung volume measurements include total lung capacity (TLC), functional residual capacity (FRC), and residual volume (RV). The diagnosis of restriction often involves the use of lung volumes. In obstructive lung disease cases, lung volumes are used to evaluate hyperinflation. Other clinical conditions cause changes in lung volumes as well.<a class="bk_pop" href="#article-161798.r11">[11]</a><a class="bk_pop" href="#article-161798.r12">[12]</a></p><p>
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<b>Gas Exchange Studies</b>
|
||
</p><p>Gas exchange studies evaluate how efficiently the lungs transfer oxygen to the bloodstream and remove carbon dioxide. Diffusing capacity for carbon monoxide (DLCO) is a common parameter measured in these studies. This test employs inhaled CO because of its strong attraction to hemoglobin, which is 200 to 250 times greater than oxygen. Reduced DLCO may suggest conditions such as pulmonary fibrosis or emphysema.<a class="bk_pop" href="#article-161798.r13">[13]</a> An association exists between DLCO and more severe respiratory symptom scores. As the DLCO worsens, this association is stronger, indicating that impaired gas exchange can significantly harm one's quality of life.<a class="bk_pop" href="#article-161798.r14">[14]</a></p><p>
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<b>Understanding Thoracic Cage Abnormalities</b>
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</p><p>The thoracic cage, comprising the ribcage and sternum, serves as the structural foundation for the respiratory system. Abnormalities in the thoracic cage can alter respiratory mechanics and impact lung function.</p><p>
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<b>Kyphosis and Scoliosis </b>
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</p><p>Kyphosis, an excessive outward curvature of the spine, and scoliosis, a lateral curvature, can affect the thoracic cage's shape.<a class="bk_pop" href="#article-161798.r15">[15]</a> These conditions may restrict lung expansion, reducing vital capacity and potentially leading to respiratory compromise. Improvements in PFTs and increases in lung volume were seen after deformity correction in patients with local kyphosis.<a class="bk_pop" href="#article-161798.r16">[16]</a></p><p>
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<b>Pectus Excavatum and Pectus Carinatum</b>
|
||
</p><p>Pectus excavatum is characterized by a sunken sternum, while pectus carinatum presents as a protruding chest.<a class="bk_pop" href="#article-161798.r17">[17]</a><a class="bk_pop" href="#article-161798.r18">[18]</a> Both conditions can impact lung function by altering the space for lung expansion. Individuals with these abnormalities may experience decreased lung volumes and compromised respiratory efficiency.</p><p>
|
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<b>Thoracic Deformities and Chest Wall Rigidity</b>
|
||
</p><p>Certain congenital or acquired thoracic deformities, such as thoracic insufficiency syndrome, can limit chest wall expansion. Additionally, conditions causing chest wall rigidity, such as ankylosing spondylitis, can restrict lung movement, leading to decreased lung volumes.<a class="bk_pop" href="#article-161798.r19">[19]</a></p><p>
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<b>The Interplay Between PFTs and Thoracic Cage Abnormalities</b>
|
||
</p><p>Understanding the relationship between PFTs and thoracic cage abnormalities is crucial for comprehensive respiratory assessment. PFT results can often pinpoint the specific nature and severity of respiratory dysfunction, while thoracic cage abnormalities provide insights into the structural factors contributing to these issues.<a class="bk_pop" href="#article-161798.r6">[6]</a></p><p>
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||
<b>Diagnostic Value</b>
|
||
</p><p>PFTs help clinicians differentiate between obstructive and restrictive respiratory disorders. For example, conditions like asthma and COPD primarily exhibit obstructive patterns on spirometry, while restrictive lung diseases, including those associated with thoracic cage abnormalities, result in reduced lung volumes.</p><p>
|
||
<b>Treatment Planning</b>
|
||
</p><p>Identifying thoracic cage abnormalities through imaging studies, such as x-rays or CT scans, in conjunction with PFTs guides treatment planning. Surgical interventions, physical therapy, or respiratory exercises may be recommended based on the underlying structural issues affecting respiratory function.</p><p>
|
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<b>Monitoring Progression</b>
|
||
</p><p>PFTs are crucial in monitoring disease progression and treatment effectiveness in individuals with thoracic cage abnormalities. Changes in lung function parameters over time can inform clinicians about the impact of interventions and guide adjustments to the treatment plan. Some lung diseases may also present with mixed lung capacities over time, elucidating long-term treatment strategies.</p><p>
|
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<b>Integrating Assessments for Holistic Respiratory Care</b>
|
||
</p><p>Integrating PFTs and evaluating thoracic cage abnormalities are essential for a comprehensive understanding of respiratory health. By combining the functional insights provided by PFTs with an awareness of structural issues affecting the thoracic cage, healthcare professionals can tailor interventions to address each patient's unique needs. This holistic approach enhances diagnostic accuracy, guides treatment strategies, and ultimately improves the quality of care for individuals with respiratory disorders and thoracic cage abnormalities.<a class="bk_pop" href="#article-161798.r20">[20]</a><a class="bk_pop" href="#article-161798.r21">[21]</a></p></div><div id="article-161798.s2"><h2 id="_article-161798_s2_">Review Questions</h2><ul><li class="half_rhythm"><div>
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</div></li></ul></div><div id="article-161798.s3"><h2 id="_article-161798_s3_">References</h2><dl class="temp-labeled-list"><dt>1.</dt><dd><div class="bk_ref" id="article-161798.r1">Hurley JJ, Hensley JL. <span class="ref-journal">StatPearls [Internet].</span> StatPearls Publishing; Treasure Island (FL): Nov 19, 2022. Physiology, Airway Resistance. [<a href="https://pubmed.ncbi.nlm.nih.gov/31194340" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31194340</span></a>]</div></dd><dt>2.</dt><dd><div class="bk_ref" id="article-161798.r2">Stanojevic S, Kaminsky DA, Miller MR, Thompson B, Aliverti A, Barjaktarevic I, Cooper BG, Culver B, Derom E, Hall GL, Hallstrand TS, Leuppi JD, MacIntyre N, McCormack M, Rosenfeld M, Swenson ER. ERS/ATS technical standard on interpretive strategies for routine lung function tests. <span><span class="ref-journal">Eur Respir J. </span>2022 Jul;<span class="ref-vol">60</span>(1)</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/34949706" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34949706</span></a>]</div></dd><dt>3.</dt><dd><div class="bk_ref" id="article-161798.r3">Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Enright P, van der Grinten CP, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J., ATS/ERS Task Force. General considerations for lung function testing. <span><span class="ref-journal">Eur Respir J. </span>2005 Jul;<span class="ref-vol">26</span>(1):153-61.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/15994402" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15994402</span></a>]</div></dd><dt>4.</dt><dd><div class="bk_ref" id="article-161798.r4">Ponce MC, Sankari A, Sharma S. <span class="ref-journal">StatPearls [Internet].</span> StatPearls Publishing; Treasure Island (FL): Aug 28, 2023. Pulmonary Function Tests. [<a href="https://pubmed.ncbi.nlm.nih.gov/29493964" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29493964</span></a>]</div></dd><dt>5.</dt><dd><div class="bk_ref" id="article-161798.r5">Paine NJ, Joseph MF, Bacon SL, Julien CA, Cartier A, Ditto B, Favreau H, Lavoie KL. Association Between Depression, Lung Function, and Inflammatory Markers in Patients with Asthma and Occupational Asthma. <span><span class="ref-journal">J Occup Environ Med. </span>2019 Jun;<span class="ref-vol">61</span>(6):453-460.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/30855523" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30855523</span></a>]</div></dd><dt>6.</dt><dd><div class="bk_ref" id="article-161798.r6">Lamb K, Theodore D, Bhutta BS. <span class="ref-journal">StatPearls [Internet].</span> StatPearls Publishing; Treasure Island (FL): Aug 17, 2023. Spirometry. [<a href="https://pubmed.ncbi.nlm.nih.gov/32809361" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32809361</span></a>]</div></dd><dt>7.</dt><dd><div class="bk_ref" id="article-161798.r7">Hegewald MJ, Gallo HM, Wilson EL. Accuracy and Quality of Spirometry in Primary Care Offices. <span><span class="ref-journal">Ann Am Thorac Soc. </span>2016 Dec;<span class="ref-vol">13</span>(12):2119-2124.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/27598295" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27598295</span></a>]</div></dd><dt>8.</dt><dd><div class="bk_ref" id="article-161798.r8">Firnhaber J. Performance and Interpretation of Office Spirometry. <span><span class="ref-journal">Prim Care. </span>2021 Dec;<span class="ref-vol">48</span>(4):645-654.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/34752275" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34752275</span></a>]</div></dd><dt>9.</dt><dd><div class="bk_ref" id="article-161798.r9">Lofrese JJ, Tupper C, Denault D, Lappin SL. <span class="ref-journal">StatPearls [Internet].</span> StatPearls Publishing; Treasure Island (FL): Feb 27, 2023. Physiology, Residual Volume. [<a href="https://pubmed.ncbi.nlm.nih.gov/29630222" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29630222</span></a>]</div></dd><dt>10.</dt><dd><div class="bk_ref" id="article-161798.r10">Olson JM, Warawa JM. Simplified Whole Body Plethysmography to Characterize Lung Function During Respiratory Melioidosis. <span><span class="ref-journal">J Vis Exp. </span>2023 Feb 24;(192)</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/36912512" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36912512</span></a>]</div></dd><dt>11.</dt><dd><div class="bk_ref" id="article-161798.r11">Flesch JD, Dine CJ. Lung volumes: measurement, clinical use, and coding. <span><span class="ref-journal">Chest. </span>2012 Aug;<span class="ref-vol">142</span>(2):506-510.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/22871760" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22871760</span></a>]</div></dd><dt>12.</dt><dd><div class="bk_ref" id="article-161798.r12">Yoshimi K, Seyama K. [Spirometry and other pulmonary function tests for the screening and evaluation of patients with chronic obstructive pulmonary disease (COPD)]. <span><span class="ref-journal">Nihon Rinsho. </span>2007 Apr;<span class="ref-vol">65</span>(4):664-9.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/17419385" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17419385</span></a>]</div></dd><dt>13.</dt><dd><div class="bk_ref" id="article-161798.r13">Modi P, Goldin J, Cascella M. <span class="ref-journal">StatPearls [Internet].</span> StatPearls Publishing; Treasure Island (FL): Oct 6, 2024. Diffusing Capacity of the Lungs for Carbon Monoxide. [<a href="https://pubmed.ncbi.nlm.nih.gov/32310609" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32310609</span></a>]</div></dd><dt>14.</dt><dd><div class="bk_ref" id="article-161798.r14">Byanova KL, Fitzpatrick J, Jan AK, McGing M, Hartman-Filson M, Farr CK, Zhang M, Gardner K, Branchini J, Kerruish R, Bhide S, Bates A, Hsieh J, Abelman R, Hunt PW, Wang RJ, Crothers KA, Huang L. Isolated abnormal diffusing capacity for carbon monoxide (iso↓DLco) is associated with increased respiratory symptom burden in people with HIV infection. <span><span class="ref-journal">PLoS One. </span>2023;<span class="ref-vol">18</span>(7):e0288803.</span> [<a href="/pmc/articles/PMC10353811/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC10353811</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/37463173" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 37463173</span></a>]</div></dd><dt>15.</dt><dd><div class="bk_ref" id="article-161798.r15">Issac S, Das JM. <span class="ref-journal">StatPearls [Internet].</span> StatPearls Publishing; Treasure Island (FL): Aug 28, 2023. Kyphoscoliosis. 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[<a href="https://pubmed.ncbi.nlm.nih.gov/31971714" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31971714</span></a>]</div></dd><dt>20.</dt><dd><div class="bk_ref" id="article-161798.r20">Bokov P, Delclaux C. [Interpretation and use of routine pulmonary function tests: Spirometry, static lung volumes, lung diffusion, arterial blood gas, methacholine challenge test and 6-minute walk test]. <span><span class="ref-journal">Rev Med Interne. </span>2016 Feb;<span class="ref-vol">37</span>(2):100-10.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/26657268" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26657268</span></a>]</div></dd><dt>21.</dt><dd><div class="bk_ref" id="article-161798.r21">Townsend MC., Occupational and Environmental Lung Disorders Committee. Spirometry in the occupational health setting--2011 update. <span><span class="ref-journal">J Occup Environ Med. </span>2011 May;<span class="ref-vol">53</span>(5):569-84.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/21555926" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21555926</span></a>]</div></dd></dl></div><div><dl class="temp-labeled-list small"><dt></dt><dd><div><p class="no_top_margin">
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<b>Disclosure: </b>Shafia Arshad declares no relevant financial relationships with ineligible companies.</p></div></dd><dt></dt><dd><div><p class="no_top_margin">
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<b>Disclosure: </b>Abdulghani Sankari declares no relevant financial relationships with ineligible companies.</p></div></dd></dl></div></div></div>
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<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © 2025, StatPearls Publishing LLC.<p class="small">
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This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
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(<a href="https://creativecommons.org/licenses/by-nc-nd/4.0/" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=uri">
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</a>), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.
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</p></div><div class="small"><span class="label">Bookshelf ID: NBK608009</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/39383276" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">39383276</a></span></div></div></div>
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