22 - Obstructive and Restrictive Lung Disease

Question 1

What is tidal volume

Answer 1

• Tidal volume – 7ml/kg

Question 2

What is vital capacity

Answer 2

• Full inspiration to full expiration = Vital Capacity (everything – residual volume)

Question 3

How do you measure forced expiratory volume

Answer 3

Vitalograph

Question 4

FEV1 and FVC in obstructive lung disease

Answer 4

FEV1 is reduced due to narrowed airways. FVC is usually normal or nearly normal, so FEV1/FVC ratio is reduced

Question 5

FEV1 and FVC in restricted lung disease

Answer 5

FEV1 is reduced but so is FVC. FEV1/FVC ratio is not decreased

Question 6

Normal FEV1/FVC ratio

Answer 6

> = 70% of predicted

Question 7

Why give a spacer

Answer 7

Improve penetration of drugs into lungs + reduce adverse effectrs

Question 8

Why use nebuliser

Answer 8

For severe asthma

Produce a mist

Question 9

What is COPD

Answer 9

Obstructive chronic bronchitis and emphysema

Question 10

What is chronic bronchitis

Answer 10

Chronic productive cough
o Irritants damage epithelium and cause proliferation of squamous cells
o Stimulates massive mucus gland enlargement

Question 11

Features of chronic bronchitis

Answer 11

o Hypertrophy of bronchial glands
o Hypersecretion
o Mucous plugs
o Inflammation

Question 12

What is emphysema

Answer 12

Enlargement of airspaces distal to terminal bronchioles
o Destruction of lung stroma – bullae – Walls of alveoli damaged so creates one
o Floppy Airways – cause obstruction

Question 13

What causes emphysema

Answer 13

Cigarette smoking

Question 14

How does smoking cause emphysema

Answer 14

 Cigarette smoke stimulates leucocytes to release serine elastase
 Smoke also inactivates elastase inhibitor = alpha1-antitrypsin
 This lets serine elastase destroy elastic tissue of lung
 The alveoli fuse into each other to create a large one called bullae

Question 15

Examples of restrictive disorders

Answer 15

pneumonia, pneumothorax, fibrosis, ankylosing spondylitis