MAKERERE UNIVERSITY

COLLEGE OF HEALTH SCIENCES (MakCHS)

DEPARTMENT OF PHYSIOLOGY
A REPORT ON THE PRACTICAL CARRIED OUT BY GROUP FOURTEEN
ON 26TH FEBRUARY 2020 IN THE PHYSIOLOGY LABORATORY 3.

AUTHORS;
NAME REG NO. PROGRAM
TUKASHABA SETH 19/U/19349/PS BMAM
TAMALE JOSHUA 19/U/0266 BMAM
NABYONGA LOYDA NAMUKWAYA 19/U/29335/PS BMAM
MUKIIBI SIMON BLAIR 19/U/0874 BPHA
SEBAIRAWO SAUL 19/U/30088/PS BPHA
MWANJA MOSES 19/U/10183/PS BOPT
MAYANJA CAROLINE HOPE 19/U/20400/PS BMAM
WATABA PEACE LYDIA 19/U/12274 BSB
VICTOR COLLINS 19/U/28696 BMAM
LAMALALI MIRISHI 18/T/40769/PS BMAM
NASIIMA JOSEPH 19/U/0339 BMR
KASOZI JOHN PAUL 18/U/26412/PS BMAM
ATIMANGO JACKLINE 19/U/0950 BMR
KIBENGE FRANK NICHOLAS 19/U/12377/PS BSB
BABINGA GOZAN WILSON 19/U/0806 BMAM
AGABA JIM PATRICK 19/U/0327 BMAM
MAYAMBALA DERRICK 19/U/0794 BMAM
AUMA DOROTHY 19/U/29578/PS BSB

TITLE: AN EXPERIMENT TO DETERMINE RESTING METABOLIC RATE OF

MAN USING A RECORDING SPIROMETER

ABSTRACT
The purpose of this experiment was to apply the knowledge of spirometry in determining
the different lung volumes and capacities of a given test subject and the clinical implication
of the results obtained. In this experiment the subject was connected in a closed circuit to

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the apparatus via a mouth piece and a one – way valve system through two lengths of
corrugated rubber tubing. The expiratory air was passed through a soda lime canister, which
absorbed all the carbon dioxide. The decrease in volume in the spirometer thus reflected
the oxygen removal by the subject. Recordings of the different respiratory volumes were
made on a calibrated paper which was fixed to the kymograph. It was observed that the
subject had the normal lung volumes and capacities with an expected lower value since she
was a female subject. Spirometry is used to determine the basal metabolic rate by using the
amount of oxygen consumed by the subject.

INTRODUCTION

Spirometry as a pulmonary function test used to illustrate the different lung volumes and
capacities

Resting metabolism is measured by a recording spirometer. This consists of a spirometer

bell suspended in water and connected by a cord to a counter balance with the recording
pen attached. The pen writes a tracing of the respiratory movements on a kymograph drum.

AIM
 Determine the volume of oxygen consumed in a given time
 To determine normal end expiratory level
 To determine normal end inspiratory level
 To determine maximum expiratory level
 To determine maximum inspiratory level.

From the above aims, we can determine the basal metabolic rate of an individual, vital
capacity of the lungs and normal lung capacities.

BACKGROUND

Spirometry is a pulmonary function test that measures lung functions specifically volume
and the speed or flow of air that can be inspired or expired.

It involves a test subject breathing into a spirometer which does the recording of the
amount and speed or flow of inspired and expired air on a graph paper.

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Pneumotachographs are simply charts that plot the volume and flow of air coming in and
out of the lungs from the spirometry.

The technique is used in the diagnosis of COPD, asthma, restrictive lung diseases such as
interstitial pulmonary fibrosis bronchitis emphysema among others. It’s also often used in
finding the causes for shortness in breath, assessing the effects of contaminants on lung
function medication and disease prognosis. It’s often done once year or once every two
years to monitor changes in breathing in people with well controlled COPD or asthma.

The technique of lung capacities dates way back to 200 – 129 AD when Galen Claudius a
roman doctor and philosopher did volumetric experiments on human ventilation. He was
closely followed by scientists like;

 Burelli in 1681 who tried to measure the volume of air inspired in one breathe
 Kentish E in 1813 who used a simple pulmometer to study the effect of lung diseases
on pulmonary lung volumes
 Thockra C.T in 1831, Vierordt in 1845 who employed similar techniques
 In 1846, Jean Hutchinson a surgeon developed the water spirometer measuring the
vital capacity
 Later on, in 1854 and 1859, Wintrich and Smith developed portable and easier to
use spirometers
 In 1879, Gad J published a pneumograph which allowed recording of the different
lung volumes.

It should be noted that lung volumes widely vary among people of various ages, height,
gender, weight, altitude and the different spirometry devices. The lung capacities as an
example may very temporarily increasing and then decreasing in one person’s life time.

The procedure requires exertion and may or may not make the subject dizzy, have shortness
of breath immediately after performing the test. It’s not recommended for patients with
recent heart conditions, heart problems and pneumothorax.

Various types of spirometer have been identified and used in different conditions such as

 Simple spirometer (student spirometer); low-cost instrument, either a metallic or

a bellows type, used in colleges, hospitals, sports facilities, and gymnasia.

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  Recording spirometer. It is a sophisticated, electrically-driven, recording system
used in Respiratory physiology laboratories, hospitals, etc. It provides a graphic
record of various lung volumes and capacities.
 Wright’s peak flow meter; gives information about the state of respiratory
passages

In this experiment a recording spirometer was used which consists of;

a) Double-walled cylindrical chamber; containing water between its two walls to

maintain an airtight seal.
b) A counter-weight and a pen writer which moves down and up on the surface of the
paper that passes under it.

Graph paper calibrated for both volume of air and time.

I. Soda lime tower; fitted within the spirometer and removes CO 2 from the
expired air so that one can continue to breathe into and out of the
spirometer.
II. The kymograph with an on/off switch and a pilot lamp on the front of the
apparatus whose speed is adjusted depending on the instructions.
III. Breathing assembly; with a mouthpiece which is connected to the
spirometer, via a Y piece, by 2 rubber-canvas corrugated tubes, one carrying
a unidirectional valve for inspiring air from the bell and the other carries a
unidirectional valve for expiring air into the atmosphere.

Spirometry is useful in accessing breathing patterns as part of a system of health

surveillance in which breathing patterns are measured over time.

It measures two kinds of factors that is

 Forced expiratory vital capacity (FVC)

 Forced expiratory volume in one second (FEV1). These two are combined into a ratio
(FEV1/FVC) which is an important ratio in determining obstructive and non –
obstructive types of lung disease.

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Forced expiratory vital capacity (FEVC) is defined as the greatest total amount of air you
can forcefully breathe out after breathing in as deeply as possible. The normal values
according to the various ages are;

 For children ages 5 – 18, 80% and above is normal below that its abnormal
 For adults 18+, FVC is greater than or equal to the lower limit of the normal
otherwise its considered abnormal

Forced expiratory volume (FEV) on the other and is the amount of air you can force out of
your lungs in one second. Percentages greater than 80% are considered normal and those
less are said to be abnormal.

Abnormalities in FVC and FEV1 indicate obstructive or restrictive lung diseases and other
types of spirometry measurements may be required to determine which type of lung
disease it could be. The spirometer will identify two types of abnormal ventilation patterns’
obstructive and restrictive.

The main feature of obstructive lung diseases is decrease in the expiratory flow rate
throughout expiration. More and more air tends to remain in the lungs which increases the
reserve volume and total lung capacity.

Often a bronchodilator to open up the lungs is given after the first round of tests then tests
repeated after period of at least 15 minutes. Conclusions are drawn after these tests and
one can comfortably rule out whether it’s an obstructive or non-obstructive lung disease
especially during expiration. The bronchodilator aids in increasing the subject’s airflow.

An obstructive disease is seen in the following conditions;

 Asthma
 Chronic obstructive pulmonary disease such as chronic bronchitis and emphysema
 Cystic fibrosis.

In restrictive lung disease there is a reduced lung volume mainly the reserve volume and the
total lung capacity. There is no obstruction to the flow of air. FEV1 is normal though the FVC
is low.

A restrictive lung disease is seen in the following conditions

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  Interstitial lung disease
 Pneumoconiosis
 Sarcoidosis.

The above conditions involve the lungs

 Obesity
 Myasthenia
 Deformities such as those of the vertebrae ribs sternum.

These are outside the lungs.

The normal, obstructive and restrictive patterns of ventilation are shown below

NORMAL OBSTRUCTIVE RESTRICTIVE

FVC = 4.5 liters FVC = 3.0 liters FVC = 3.0 liters
FVC = 4.5 liters FEV1 = 1.2 liters FEV1 = 2.8 liters
% = 80 % = 40 % = 90
FEV1/FVC Normal = > 70%
Obstructive = < 70%
Restrictive = > 70%

The FEV1/FVC ratio simply is a number of that represents the percentage of one’s lung
capacity that can be exhaled in one second.

The higher the percentage derived from ones FEV1/FVC ratio in the absence of restrictive
lung disease the healthier one’s lungs are considered to be but lower ratios suggests
blockage of one’s airways.

Spirometry can also be part of a bronchial challenge test used to determine bronchial hyper
responsiveness to either vigorous exercises or inhalation of cold or dry air.

NOTE;

1. Lung volumes refers to the non-overlapping sub – divisions, or fractions of the total lung
air.

Lung capacities refers to combination of two or more lung volumes.

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2. Functional residual capacity, total lung capacity, and residual volume cannot be
measured via spirometry but can be determined on the plethysmograph or other
dilution tests such as helium dilution test.
3. Posture also has a noted effect on the vital capacity of the test subject as indicated
below;
a) In the sitting and supine positions, the muscles of respiration (both primary and
accessory) cannot be employed as forcefully and effectively for the expansion and
compression of lungs and chest.
b) In the supine position, the abdominal viscera push the diaphragm up and interfere
with its movements. The mobility of the chest is also reduced by the contact of the
back with the bed.
c) There is accumulation of more blood in the blood vessels of the lungs (especially
veins) in the supine position. This decreases the total lung capacity, and hence the
vital capacity.
4. Functional residual capacity is of specific importance since it’s increased in cases when
lungs are over inflated such as in old age and emphysema.
5. All pulmonary volumes and capacities are about 20 to 25% less in women than in men,
and they are greater in large and athletic people than in small and asthenic people.

MATERIALS AND REAGENTS

MATERIALS

A recording spirometer which consists of;

 Spirometer bell
 Oxygen cylinder
 Nose clip
 Barometer
 Kymograph drum
 Recording pen

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  Tracing paper
 Mouthpiece
 Rubber tubing.

Reagents

 Water
 Soda lime
 Oxygen.

PROCEDURE

1. The subject was set to rest on a couch for 30 minutes before the measurement. We
ensured that she was not disturbed and that she was fully relaxed.
2. With the valve on the inspiratory tube closed towards the spirometer, the
spirometer was filled with oxygen.
3. A paper was put on the kymograph and ink in the pen. The pen was checked to
ensure that it was working by letting it draw a “baseline”.
4. The pen was then lifted away from the paper.
5. With the valve, the mouthpiece was connected to the spirometer.
6. The mouthpiece was introduced and the subject instructed to breathe mainly
through his nose while doing this.
7. The subject was instructed to expire fully through her nose and then the nose clip
was applied so that her first contact with the spirometer would be in the inspiratory
phase.
8. The subject was connected to the spirometer for one minute to thermo equilibrate
the gas without registering on the drum.
9. The time was noted and then pen set to start writing. We registered for exactly two
minutes and lifted the pen away from the paper. The spirometer temperature was
then noted together with the pulse rate.
10. With the subject still in the circuit, oxygen was refilled.
11. Procedures 8 and 9 were repeated. With the recordings satisfactory, we
discontinued the experiment.

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 12. The subject was then asked to relax.
13. On the tracing paper, the subject’s name, age, sex, height in centimeters, and weight
in kilograms, spirometer temperature, barometer pressure, pulse rate were noted.
The water vapor at the spirometer temperature was also noted.

RESULTS

A graph of the recorded results (spirogram) is attached.

Terms:
Tidal volume –volume of air inspired or expired during normal breathing
Inspiratory reserve volume (IRV) – volume of air that can be maximally inspired above volume
inspired tidally
Expiratory reserve volume (ERV) – volume of air maximally expired forcibly beyond normal tidal
expiration
Total(TLC) lung capacity– Maximum Volume of air that can be held within lungs at a given time
TLC =(IRV+VT+ERV+RV
Vital capacity(VC) – amount of air that can be exchanged between the lungs and atmosphere in a
single breath
VC =IRV+VT+ERV
Inspiratory capacity – maximum amount of air that can be inspired following a normal tidal
expiration
Functional residual capacity-volume of air remains in the lung following normal tidal expiration

DISCUSSION

When a person is breathing, they take in different volumes of air as they inspire and expire.
These volumes include four pulmonary lung volumes that, when added together, equal the
maximum volume to which the lungs can be expanded. The significance of each of these
volumes is the following:

1. Tidal volume is the amount of air inspired or expired during normal quiet breathing; it
amounts to about 500 milliliters in the adult male.

2. Inspiratory reserve volume is the extra volume of air that can be inspired over and above
the normal tidal volume when the person inspires with full force; it is usually equal to about
3000 milliliters.

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3. Expiratory reserve volume is the extra volume of air that can be expired by forceful
expiration after the end of a normal tidal expiration; this normally amounts to about 1100
milliliters.

4. Residual volume is the volume of air remaining in the lungs after a maximum voluntary
expiration; this volume averages about 1200 milliliters.

In describing events in breathing, it is sometimes desirable to consider two or more of the

volumes together. Such combinations are called lung capacities. The important pulmonary
capacities include;

I. Inspiratory capacity equals the tidal volume plus the inspiratory reserve volume.
This is the amount of air a person can breathe in, beginning at the normal expiratory
level and distending the lungs to the maximum amount. It is about 3500 milliliters.
II. Functional residual capacity equals the expiratory reserve volume plus the residual
volume. This is the amount of air that remains in the lungs at the end of normal
expiration about 2300 milliliters.
III. Vital capacity equals the inspiratory reserve volume plus the tidal volume plus the
expiratory reserve volume. This is the maximum amount of air a person can expel
from the lungs after first filling the lungs to their maximum extent and then expiring
to the maximum extent, about 4600 milliliters.
IV. Total lung capacity is the maximum volume to which the lungs can be expanded
with the greatest possible effort, about 5800 milliliters. It is equal to the vital
capacity plus the residual volume.

CONCLUSION

In this experiment, accuracy in the different volumes may have been altered because of a
few errors including;

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  The subject wasn’t from rest when the experiment was done.
 Presence of a few leakages in the rubber tubing
 The subject was not conversant with the experimental requirements required out of
him.

REFERENCE MATERIAL

 Textbook of Practical Physiology 8th edition by C. L Ghai, MD.

Ganong’s Review of Medical Physiology 24TH edition by Kim E. Barret, Susan
M. Barman, Scott Boitano, Heddwen L. Brooks.
 Guyton Arthur Clifton, & Hall John E. (2016). Textbook of medical
physiology 13th edition. Philadelphia: Elsevier,inc.
 K Sembulingam & Prema Sembulingam . (2012). Essentials of Medical
Physiology 6TH edition. New Delhi: Jaypee Brothers Medical Publishers
(P) LTD.

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