Division of Respirology

Diagnostic: Physiology and Pulmonary Function

St. Joseph’s Healthcare and MUMC
McMaster University Medical Center: During the diagnostics rotation, the resident will develop expertise in theory, performance and interpretation of pulmonary function testing including cardio pulmonary exercise testing. There will also be exposure to thoracic imaging (both plain film and CT scanning) with access to a large volume of radiographic material on the PACS digital imaging and data storage system. The resident will be assigned to a dedicated Chest Radiologist during the radiology component of the rotation.

Medical Expert

  1. To obtain a detailed understanding of concepts of lung physiology as they relate to the measurement of lung function and to be able to apply these concepts I n the interpretation of pulmonary function tests. These concepts include:
    • hyperinflation and gas trapping
    • lung and chest wall restriction
    • airflow limitation
    • reduction of lung compliance
    • abnormalities of diffusion
    • maldistribution of ventilation and perfusion
    • exercise limitation
    • respiratory muscle fatigue
    • airway hyperresponsiveness
    • abnormalities of control of breathing
  2. To be able to supervise, perform, and interpret measurements of spirometry and flow-volume curves.
  3. To be able to supervise, perform, and interpret measurements of lung volumes by plethysmography and gas dilution methods.
  4. To be able to supervise, perform, and interpret measurements of single breath carbon monoxide diffusing capacity.
  5. To be able to supervise, perform, and interpret methacholine challenge tests.
  6. To be able to supervise, perform, and interpret measurements of respiratory muscle strength.
  7. To be able to supervise, perform, and interpret stage I exercise tests.
  8. To be able to supervise, perform, and interpret testing for exercise-induced asthma.
  9. To know the indications for performing tests after bronchodilator administration and to be able to interpret the results.
  10. To be able to supervise, perform, and interpret tests of control of breathing.
  11. To be able to interpret arterial blood gases, including clinical physiologic significance of the measurements.
  12. To apply transfer knowledge of basic respiratory physiology and to apply it to respiratory diseases.
  13. To be able to explain the clinical indications for pulmonary function testing.
  14. To be able to explain the limitations of pulmonary function testing.

Communicator

To be able to effectively communicate the results of pulmonary function testing to referring physicians in the form of concise written or verbal interpretation.

Collaborator

To learn to effectively work with the pulmonary laboratory staff with the common goal of providing reliable, valid and meaningful pulmonary function test results.

Manager

To obtain a detailed understanding of the principles of quality control as they apply to the pulmonary function laboratory, including testing equipment performance, calibration, sterilization and technical pitfalls.

Health Advocate

To understand the role of spirometry in the community for early detection of obstructive lung disease.

Scholar

To know the most recent American Thoracic Society standards regarding equipment and performance of tests.

Professional

To recognize the responsibility of the role of the r espirologist as a pulmonary function lab supervisor to ensure that high quality results are produced on a consistent basis.