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Physiology · Respiratory system: plethysmography versus helium dilution
Sample itemIn a smoker with large emphysematous bullae, functional residual capacity measured by body plethysmography is much larger than that measured by helium dilution. What explains the difference?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Plethysmography includes trapped gas that does not communicate with the airways
Plethysmography applies Boyle's law to the whole thoracic gas volume, including poorly ventilated or trapped air in bullae. Helium dilution reaches only gas that communicates with the airways within the test time, so it underestimates volume in obstructive disease. The gap between the two methods estimates trapped gas.
Option by option
A. Helium rapidly equilibrates with all thoracic gas in emphysema
In emphysema equilibration is slow and incomplete, which is why helium underestimates.
B. Plethysmography includes trapped gas that does not communicate with the airways (correct)
Correct. Boyle's law captures all thoracic gas, including bullae, whereas helium reaches only communicating spaces.
C. Helium dissolves in blood and is lost from the lung
Helium is poorly soluble in blood, so it is not significantly lost.
D. Plethysmography measures only the anatomical dead space
Plethysmography measures thoracic gas volume, not dead space.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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