Restrictive lung disease Flashcards
What is restriction
Defined by reductions in RV, FRC and TLC.
What are septa?
Septa is a thin layer of the membrane which makes up the lining of the lung
What are intralobular septa
septa which surround the alveoli and are a thin layer between the alveoli and capillaries.
What are interlobular septa
outlines the secondary lobules, this is where the lymphatics and veins of the lungs are.
What are the 3 categories of causes of interstitial lung disease
environmental exposure: organic (hay, bacteria etc) or inorganic (asbestos, silica etc)
idiopathic (ipf, ???)
systemic inflammatory diseases: autoimmune disease,
sarcoidosis
What are 3 dust particles that are of interest in interstitial lung disease?
asbestos, silica and coal
What causes coal miners lung
the coal dust is breathed into the airway where the macrophages phagocytose them in an attempt to break it down (which it cannot do), it stays there forever and the inflammation can cause fibrosis
Outline issues with asbestos
asbestos fibres cause asbestosis many years after exposure, they get into the lung and alveolus and causes scarring, they then get into the pleural space and stay there forever and poke the pleural cells every time you breathe (mesothelial cells become mesothelioma cells which are incurable cancer).
What is hypersensitivity pneumonitis
When a patient breathes in either bird dust or mould particles etc, the T cell detects the antigen and recruits macrophages which causes a granuloma and when the inflammatory response is strong enough it will then creates a long-lasting scar.
What is pleural effusion
A collection of fluid between the two layers of pleura and pleural effusion is the abnormal accumulation of this fluid.
What are causes of pleura effusion
congestive heart failure, liver disease with portal hypertension and cirrhosis, infection e.g. TB, empyema, parasitic infection,
malignancy (metastatic cancer), chylothorax and pleurisy
What are the categories of pleural effusion
transudative effusion: most common, the result of the non-pleural disease.
exudative effusion: usually needs fluid to be drained and can be done via needle aspiration or tube thoracotomy
What are the mechanisms of exudative effusion
infection: empyema (frank pus needs to be fully drained)
cancer, chylothorax due to spilling of lymphatic materials. most commonly due to thoracic duct injury.
What is pneumothorax
air collection in the pleural space due to rupture of alveoli near pleural surface.
