Restrictive Lung Disease Flashcards
What is RLD?
Restrictive lug dysfunction- abnormal reduction in pulmonary ventilation
-volume of air moving in and out is reduced
**is not a disease- can result from many different diseases, trauma, or drugs
Lung compliance with RLD
-chest wall and/or lung compliance decreased
-lungs stiff and difficult to expand
-resistance to lung expansion increased
**lung volumes and capacities are decreased
Work of breathing
The work of breathing must increase due to a greater need for transpulmonary pressure (difference between alveolar pressure and intrapleural pressure in lungs)
Overall S/S of RLD
Signs:
-tachypnea
-hypoxemia
-decreases breath sounds
-decreases lung volumes and capacities
-R sided HF
-decreases gas exchange
Symptoms:
-dyspnea*
-cough*
-weight loss
Examples of abnormalities in fetal lung development that may cause RLD
- Agenesis: absence of bronchus and lung parenchyma
- Aplasia: rudimentary bronchus w/o normal pung parenchyma
- Hypoplasia: incomplete development- lungs function by not normally (most common)
What is restrictive distress syndrome?
A disorder of prematurity or lack of complete lung maturation- a hyaline membrane disease
-caused by abnormalities in surfactant system and inadequate surfactant production
**a possible cause of RLD
What is the treatment of respiratory distress syndrome?
Surfactant replacement therapy within 2 hours of birth- given as aerosol via endotracheal intubation
Signs and symptoms of respiratory distress syndrome
Signs:
-increased RR
-decreased lung compliance
-decreases lung volumes
-increased work of breathing
-decreased oxygen concentration & increased carbon dioxide
Symptoms:
-nasal flaring
-grunting
-crying (decreased in volume and strength)
-cyanotic
T/F normal aging is considered another cause of RLD?
True- compliance of lungs decreases at about 20 yrs, pts has been exposed to numerous environmental factors, decalcification of ribs and arthritic changes (decreases chest wall compliances)
What are the maturational causes of RLD?
- abnormalities in fetal lung development
- respiratory stress syndrome
- normal aging
Treatment for normal aging that causes RLD
No specific treatment required
-keep aerobically exercising and strength training
What are the pulmonary causes of RLD?
- Idiopathic pulmonary fibrosis
- Coal worker’s Pneumoconiosis (black lung diseass)
- Asbestosis
- Bronchopulmonary dysplasia
- Bronchiolitis Obliterans
- Atelectasis
- Pneumonia
- Adult respiratory distress syndrome
- bronchogenic carcinoma
- Pleural effusions
- Sarcoidosis
What are the cardiovascular causes of RLD?
- Pulmonary edema
- Pulmonary emboli
What are the neuromuscular causes of RLD?
- SCI
- ALS
- Guillain-Barre Syndrome
- Myasthenia Gravis
- Tetanus
- Duchenne Muscular Dystrophy
MSK causes of RLD
- Diaphragmatic Paralysis or Paresis
- Kyphoscoliosis
- Ankylosing Spondylitis
- Pectus Excavatum (sternal depression)
- Pectus Carinatum ( sternum protruding anteriorly)
Connective tissue causes of RLD
- RA
- Scleroderma (armored skin)
T/F pregnancy can cause RLD
True- during the third trimester ventilation to dependent regions of the lungs is impaired due to the fetus and there is a decrease in chest wall compliance due to decreases downward excursion of diaphragm
Nutritional and Metabolic caused of RLD
- Obesity
- DM
Traumatic causes of RLD
- crash injuries/blunt trauma
- lung contusion
- penetrating wounds (shooting or stabbing)
- thermal trauma
Therapeutic causes of RLD
- surgical therapy
- lung transplantation
Pharmaceutical causes of RLD
- cardiovascular drugs
- chemotherapeutics
- poisons
- anesthetics
- muscle relaxants
- illicit
What is the overall treatment approaches for RLD?
- If the cause is permanent: treatment consists of supportive measures
- If the cause is reversible: treatment consists of corrective and supportive measures
What is idiopathic pulmonary fibrosis?
Inflammatory process of alveolar wall
Treatment: corticosteroids, oxygenation/ventilation, good nutrition, smoking cessation, lung transplant
What is Coal Worker’s Pneumoconiosis?
Interstitial lung disease caused by inhalation of coal dust
Treatment: cessation of exposure to coal dust, good nutrition, adequate oxygenation/ventilation, progressive exercise
What is asbestosis?
Diffuse interstitial pulmonary fibrotic disease caused by asbestos exposure
Treatment: no cure! symptomatic support
What is bronchopulmonary dysplasia?
Chronic pulmonary syndrome in neonates who have been ventilated and received high concentrations of O2- survivors of RDS
What is bronchiolitis Obliterans
Fibrotic lung disease that affects small airways- produces restrictive and obstructive lung dysfunction due to necrosis of respiratory epithelium
-peds: viral infection
-adults: toxic fume inhalation
Treatment:
-peds: corticosteroids
-adults: oxygen, fluid balance, corticosteroids
What is Atelectasis?
Incomplete expansion of lung or loss of volume (partial or complete collapse of lung)
Treatment: deep breathing, incentive spirometry, coughing
What is Pneumonia?
Inflammatory process of the lung parenchyma that begins as an infection in the lower respiratory tract
Treatment: drug therapy, oxygen, mechanical ventilation, postural drainage, airway clearance
What is adult respiratory distress syndrome?
Severe hypoxemia caused by acute lung injury (trauma, aspiration, inhaled toxins, drugs, metabolic pneumonias)
Treatment: treat due to cause, support adequate gas exchange and tissue oxygenation, nutrition and fluid balance
What is a bronchogenic carcinoma?
malignant growth of abnormal cells in the bronchus
Treatment: surgery, radiation, chemo
What are pleural effusions?
Accumulation of fluid within the pleural space
Treatment: target underlying cause
What is sarcoidosis?
A mysterious multisystem disease characterized by the presence of non-necrotic epithelioid granulomas in many organs
Treatment: corticosteroids
What is pulmonary edema?
Increased amount of fluid within the lung
Treatment: aimed at decreasing cardiac preload and maintaining oxygenation
What is a pulmonary emboli?
A complication of venous thrombosis- the thrombi travels from systemic veins to the pulmonary circulation
