Pulmonary - Restrictive Disorders Flashcards
Background information with interstitial lung disease
How common is restrive lung disease?
Accounts for smaller % of patients than obstructive lung disease
What is the cause of restrictive lung disease?
Intrinsic impairments or extrinsic conditions that affect:
- chest wall mobility
- neuromuscular function
- obesity
What is the primary impaired function?
reduced lung expansion and lung volumes = hard time getting air into the lungs
What is restrictive disorders?
fibrous deposits caused by interstitial restrictive lung disease which is due to inflammation process
Contributes to fibrosis and lung stiffness
What is the normal work of breathing?
takes 5% of total VO2 max
What is the work of breathing for RLD?
take as much as 40% of VO2 max
Respiratory volume and capacity chart
Restrictive vs normal
Tidal volume chart
Restrictive vs obstructive vs normal
Changes in lung volume and capacities
How is lung volume affected?
Decreased
How is lung compliance affected?
Reduced
- normal elasticity but hard to get air in
How is work of breathing affected?
Increased
- this can lead increased HR = higher resting HR
What is FVC?
FVC = forced vital capacity
how much air that can be exhaled very fast and hard after full breath
What is FEV1?
FEV = forced expiration volume
amount of air that can be exhaled forcibly in 1 sec after max breath
How does FEV1 indicate COPD?
Greater reduction in forced expiration amount in 1 sec cuz of air tapping = lowering the ratio
What FEV1/FVC ratio is indicated for restrictive lung disease?
A normal ratio or increased with decreased FVC
75-80% or higher
Volumes are reduced with less air in and out
What FEV1/FVC ratio is indicated with mixed lung disease?
A low ratio with low TLC
What is the FEV1/FVC ratio for obstructive disease?
ratio affected because of the trapped air
FEV1 and FVC reduced
< 70-80%
What are the classic signs for RLD?
tachypnea
hypoxemia
fatigue
weight loss
decreased lung volumes
chronic dry cough
pulmonary HTN
can see: clubbing, cyanosis, decreased chest wall expansion
What are the hallmark sx of RLD?
- Dyspnea
- Cough
- potenially wasted and emaciated appearance
What are the effects of scarred interstitium?
What are the 3 types of interstitial lung disease?
Exposure related
Autoimmune related
Idiopathic
What are some of the exposure related causes of interstitial lung disease?
Can be drug induced or occupational/environmental causes
What are some of the autoimmune related causes of interstitial lung disease?
What are some of the idiopathic causes of interstitial lung disease?
What is the cause of idiopathic pulmonary fibrosis?
Inflammatory process of alveolar wall = “scarring” -> fibrotic
Progressive disease
How common is idiopathic pulmonary fibrosis?
Most common of the over 200 different fibrosis lung diseases
falling into larger group of interstitial lung diseaes
What are the risk factors of idiopathic pulmonary fibrosis?
age
smoking
genetic predisposition
air pollution
viral infections
GERD
What is the prevalence and clinical presentation of idiopathic pulmonary fibrosis?
- affects 1 out of 200 adults over age of 70
- typically between 50-70 y/o
- common in men
- sx of (constant dry cough, weight loss, fatigue, clubbing and edema)
What is indicated to be irreversible damage for idiopathic pulmonary fibrosis?
- Enlarged airways and deformed alevoli
- honeycombing clustered appearance in air spaces
- decreased gas exchange = O2 transferred into blood
