Obstructive and Restrictive Lung disease Flashcards
Obstructive lung disease
increase in resistance to airflow, hard to get air out of the lungs
What happens to the pressure, resistance, and volume in obstructive lung diseases
pressure increases, resistance increases, volume decreases
What is the FEV1/FVC ratio in obstructive lung disease
Low
COPD
a combination of chronic bronchitis, emphysema, and a hyperactive airway
Treatment of COPD
stepwise approach starting with short-acting bronchodilators, then moving to long-acting bronchodilators and anticholinergic inhalers
Do you give low or high doses of O2 to COPD patients
low doses so the respiratory drive is not depressed, and hypercapnia stays the main breathing stimulus, not hypoxia
Asthma
persistent airway inflammation and bronchial hyperactivity through constricted/narrowed airways
Extrinsic/allergenic asthma reaction
type 1 hypersensitivity reaction
Intrinsic/non-atopic asthma reaction
no allergy component
What does each asthma attach cause
bronchial remodeling
Complications of asthma
status asthmaticus and persistent bronchoconstriction despite treatment
Status asthmaticus
severe asthma attack, can be fatal
Asthma treatment
maintenance or rescue
Maintenance asthma treatment
long-acting bronchodilators, corticosteroids, leukotriene antagonists, phosphodiesterase inhibitor
Rescue asthma treatment
short-acting bronchodilators, epinephrine, rapid-acting beta 2 agonist
Emphysema
irreversible enlargement of the air spaces beyond the terminal bronchioles
What does the inflammatory response during emphysema cause
proteinases to be released destroying the elastin in the lungs
What obstructive disease is the pink puffer
emphysema, CO2 retention
Chronic bronchitis
a persistent, productive cough that lasts for 3 months or greater for 2 or more consecutive years
What happens to the lung tissue in chronic bronchitis
the tissue becomes irritated and mucous membranes become edematous –> clogging the air passages and increasing mucus –> frequent mucous cough
What is the result of chronic bronchitis
destruction of cilia, bronchoconstriction, bronchial thickening
What obstructive lung disease is the blue bloater
chronic bronchitis, hypoxia
Restrictive lung disease
characterized by reduced expansion of the lung tissue with decreased total lung capacity or the lungs are stiff and non-compliant, difficulty getting air in/decreased compliance
Restrictive lung disease examples
pleural effusion, pneumothorax, pneumonia, atelectasis
Pneumothorax
collapsed lung with air in the pleural cavity
Primary spontaneous pneumothorax
air is present but there is no evidence of trauma or lung disease
Traumatic pneumothorax
penetrating wound of the thoracic cage and pleural membrane
Tension pneumothorax
escalating build-up of air in the pleural cavity that compresses the lungs, bronchioles, heart structures, and vena cava
Closed pneumothorax pressure
pleural cavity pressure is less than the atmospheric pressure
Diagnosis of a pneumothorax
chest x-ray, ABGs, CT
Treatment of a pneumothorax
chest tube, O2, needle decompression, needle aspiration
Pleural effusion
excess fluid in the pleural space, disrupting the hydrostatic and oncotic pressures
What can a pleural effusion cause
restrictive ventilatory defect, decreased total lung capacity, ventilation-perfusion mismatch
Transudate
clear fluid not caused by an inflammatory process
Exudate
yellow fluid, with a protein filled pus caused by an infection
Diagnosis of a pleural effusion
thoracentesis, CT
Causes of a pleural effusion
heart/liver/kidney failure, decreased absorption, increased fluid formation, infection, chest wall injury
Treatment of a pleural effusion is dependent on what
the type of fluid
Pleural effusion treatment
suction and drain, pleuralodesis
Pleuralodesis
injection of medication used to minimize the amount of fluid in the pleural space, a long time permanent solution
Pulmonary function testing measures what
ventilation, the volume and flow rate
What does incentive spirometry measure
how much air (ventilation) and how fast the air (flow) moves in and out of the lungs
FEV1
the forced expiration in 1 second
FVC
forced vital capacity
where should the FEV1/FVC ratio be at
75%
