6A: RLD I Flashcards
What is the primary impairment with all restrictive disorders?
Ventilatory pump
What is decreased compliance?
Lungs and rib cage cannot expand as much, so it takes more pressure to expand the lung
What happens to pulmonary ventilation with RLD, and what does it cause?
Pulmonary ventilation is reduced which results in diminished inspiratory reserve volume
What mechanical changes happen with RLD?
Decreased chest wall motion and impaired diaphragm motion
What happens to breathing with RLD?
Increased work, will present as labored breathing
What are the two primary symptoms of RLD?
SOB and dyspnea
Why will people with RDL present with weight loss?
There is increased energy costs due to the increased work of breathing
What is cachexia?
Wasting appearance usually in cheeks and around the rib cage
What is a pneumothorax?
Air in the pleural cavity, causes lung to collapse
What are the three types of pneumothorax?
- Spontaneous
- Traumatic
- Iatrogenic
What is an iatrogenic pneumothorax?
Lung collapse as a complication from diagnostic testing or surgery where there is increased pressure in the thoracic cage
What are the three consequences of pneumothorax?
- Increased RR
- Decreased volumes
- Hypoxemia
What is an open pneumothorax?
Air is able to enter and leave the cavity
What impairments are associated with an open pneumothorax?
Impairments with pressure in the cavity and the lung
Which condition is more serious, an open or tension pneumothorax?
Tension - is life threatening
What is a tension pneumothorax?
Air enters the cavity but cannot leave, so the trapped air puts pressure on the outside of the lungs and does not allow them to expand
What physical changes happen with a tension pneumothorax?
Pressure causes collapse and pushes the mediastinum to the contralateral side
What are the four sings of pneumothorax?
- Acute SOB
- Pleuritic chest pain unilaterally
- Increased RR
- If trauma, can hear air entering and leaving
What RLD effects can anesthesia, drug OD, or head injury cause?
Decreased RR and depth
What happens to lung volumes as a result of anesthesia, drug OD, or head injury?
Decrease in all inspiratory volumes
What are the signs and symptoms of RLD due to anesthesia, drug OD, or head injury?
Decreased endurance, dizziness, confusion, SOB, difficulty taking a deep breath
What are the two categories of decreased chest wall compliance?
- Muscular
- Bony thorax
What are some conditions that can lead to muscular changes leading to decreased compliance?
Muscular dystrophy, ALS, SCI, Guillain Barre, Polio, MS
Injury to what nerve can cause muscular changes resulting in decreased compliance?
Phrenic - diaphragm
What is the results of muscular changes and decreased compliance?
Decreased ability to take a deep breath, hold upright posture, cough, clear fluids
What happens to lung volumes with muscular weakness?
Decreased TV, RV, IRV, TLC
What muscles atrophy with RLD due to muscular weakness?
Both the trunk and accessory muscles
What postural changes can happen with RLD due to muscular weakness?
Mostly flexion that will also have a lateral or rotary component
What are the clinical signs of RLD due to muscular weakness?
Decreased breath sounds and cough, may hear crackles or rales, decreased endurance
What are examples of bony thorax changes leading to RLD?
Kyphoscoliosis, pectus excavatum, pectus carinatum, rib fractures, flail chest, scarring from burns
What is the effect of bony thorax changes?
Decreased chest wall motion that causes decreased ability for fill inspiration
What is the effect of pain due to bony thorax changes?
Decreased ability to clear secretions with an effective cough
What happens to lung volumes with bony changes?
Decrease
What are the clinical signs of RLD due to bony changes?
- Decreased breath sounds and cough
- Crackles and rales
- Decreased endurance
- Pain with rib fractures or scarring
- Postural changes
