Question: Large airways

So large airways are what helps push the air to the vocal cords to make vibrations and sounds?

The constriction of small airways limits? deep breaths, exhaling completely, what all does the small airways do with breathing besides supply oxygen to the aveoli.

Oh not sure if its exhaustion but I have been sleeping till 3, then fall asleep till wife gets up.

I have been forcing self to do a walk at night after work but before dinner. Temperature has been changing getting ready for winter and is getting cooler. Not sure how i feel about winter. might have to find a treadmill.

Current wife is on the crossfit exercise program, not something i can do.l

Good to know, thanks

You think you hurt me, that is not ever the case. I know I drive you crazy with questions that are repeated or have little bearing on things. but when I hear or read a comment on something like large airways affect the vibrations in voice, I then want to know more. I am a very curious person.

It's morning. Yuk. I've noticed over that past few months I get a coughing spell in the morning after I get up. After coughing on and off for about 15 minutes with nothing but throat clearing happens and then it's done for day. Is that night irritants I breathed in while sleeping?

I cough and cough and cough until I feel as if I have the dry heaves. Then at the conclusion i may get a little spit. nothing much. Then i get to clear my throat for a few minutes.

Yes I feel better, mostly because the coughing is over.

Not sure, I sleep on side so not to snore or to lessen snore.

Can I ask you a question about total lung volume on pft and volume amount inspired when breathing

Using my pft for example, if the lung volume is normal, what is the cause of only partial volume entering my lungs if
a. I have no RV or Air Tapping
B I only have mild hyper inflation
c. I have great total volume that is normal, my fev1 is basically normal.
but i get only a small inspiration. Is this the airways inflammed or airways suddenly closing when I try to breath or breath quickly.

OH. I heard something of FEV3 and Fef 3 where does that fit in regards to the FEV1 and FEF 25/75

I had a message come through the XXXXXXX lung association regarding using FEV3 and a new FEF level instead of FEV1

TRy the other question in a new form. My lung volume on the pft shows normal lung volumes.

My pft shows no air trapping and slight hyper inflation so why do I only have a reduced amount of air coming into lungs than what is capable from with normal Volume

Small Airway Disease

COPDGene was an observational study that enrolled more than 10,000 cigarette users with and without chronic obstructive pulmonary disease (COPD).[1] The study was designed to explore genetic associations with COPD and to refine our understanding of COPD phenotypes. All patients had expiratory and inspiratory CT of the chest. The resulting dataset has provided insights into COPD physiology and genetics.

I have been writing a lot recently about small airway disease (SAD)—its measurement and significance in the setting of asthma or COPD. The CHEST journal just published more data from COPDGene that evaluated markers for SAD.[2] The study is important for several reasons. First, the investigators compared measures of SAD using more than one modality. They also expanded on what we already know about the forced expiratory volume in 3 seconds (FEV3). Perhaps of greatest importance, they correlated small airway dysfunction with functional outcomes.

For the past 40 years it has been dogma that SAD can affect respiratory function.[3] It has also been acknowledged that these patients are hard to assess, and that standard spirometric measures won't detect SAD until it has progressed. For a long time, the forced expiratory flow at mid-expiration (FEF25%-75%) was considered a surrogate for SAD, but this measure shows wide variability and overlap between normal and abnormal values.[4] Impulse oscillometry (iOS), plethysmography, FEV3, and CT imaging with air-trapping/mosaicism have all been used to establish SAD. Unfortunately, little in the way of comparative research between modalities has been done, and little correlation with clinical outcomes has been found.

FEV3, the SAD Measure of Choice

Enter the most recent installment from the COPDGene study published in CHEST.[2] The investigators compared FEV3 with CT and established good correlation. It's reassuring that the two modalities are measuring the same phenomenon. In addition to what we already know about FEV3 and SAD,[5,6] they found that FEV3/FVC6 was superior to FEV3/FVC for predicting clinical outcomes in patients with COPD. Among patients with otherwise normal spirometry, the 15.4% with a low FEV3/FVC6 had increased symptoms (St George's Respiratory Questionnaire and modified Medical Research Council [mMRC] dyspnea score) and BODE index score,[7] as well as shorter 6-minute walk distance compared with those with normal FEV3/FVC6. The importance of the relationship with functional status and symptoms cannot be overstated. All of the modalities used to measure SAD are short on clinical outcomes data; without those data, how do we know whether the deficits we believe we are identifying are clinically relevant?

This is more evidence that SAD is clinically relevant and supports using FEV3 as the small airway measure of choice. It's easy; it has already been reported with spirometry and, in my opinion, is backed by the best data.[2,4,7] There is no radiation risk and it doesn't require advanced equipment like iOS or plethysmography. For all you pulmonologists out there, start looking at the FEV3 when you get spirometry on your tobacco users and patients with unexplained dyspnea.

http://www.medscape.com/viewarticle/868507?src=wnl_edit_tpal&uac=187613FK


I found it on XXXXXXX lung but i see its from medscape

My report does not include that number