Restrictive Lung Disease Flashcards
Restrictive lung disease effect on residual volume:
Decrease residual volume
Restrictive lung disease effect on total lung capacity:
Decrease
Restrictive lung disease effect on forced vital capacity:
Decrease
Restrictive lung disease effect on inspiratory reserve volume (IRV) and Expiratory reserve volume (ERV)
Decrease
What is restrictive lung disease?
Reduced lung volumes and decreased compliance (less air moved & more work done)
With inadequate alveolar ventilation in Restrictive lung disease what happens to O2 to tissues?
Hypoxemia 20 to inadequate alveolar ventilation (older air = less O2 to tissues)
How do you medically manage restrictive lung disease? (2)
- Symptom management
2. Corticosteroids
How do you treat restrictive lung disease?
- Insuring adequate oxygenation (ventilator), maintaining an airway, and obtaining maximal physical function
- Surgical modification of MS deformities
- Heart-lung transplants
- Most cases not reversible
What is the restrictive lung disease pneumoconiosis? What does is result in?
- Chronic interstitial lung disease caused by breathing in certain kinds of dust particles that damage the lungs.
- It is often called an occupational lung disease.
- Results in interstitial fibrosis (inflammation and fibrosis of the pulmonary interstitium)
- Blood vessel and alveolar damage-become thicker and stiffer
Pneumoconiosis Signs and Symptoms?
- Cough
- Phlegm
- SOB contributing to reduced physical functional capacity
- Progressive respiratory failure
- Lung cancer
- TB
- Heart failure (cor pulmonale)
Examples of Pneumoconiosis:
Black Lung disease (coal dust)
Brown Lung disease (agricultural dust)
Asbestoses (asbestosis)
Silicosis (silica)
Treatment for restrictive chronic interstitial lung disease Pneumoconiosis?
- Medications:
- Theophylline (beta2 agonist - relax bronchial smooth muscles)
- Oral or inhaled sympthomemetics (stimulates the sympathetic NS and opens up the bronchioles
- Corticosteroids
- Inhalable cromolyn sodium (inhibits immune response) - Chest physiology - Mobilize and remove secretions
- Exercise
Describe honeycomb lung:
- Wide spread fibrous
- Dilated and thickened terminal and respiratory bronchioles
What is pulmonary fibrosis?
Refers to a variety of disorders in which ongoing epithelial damage or chronic inflammation of lung tissue leads to progressive scarring (fibrosis) of the lungs resulting in respiratory failure
What environmental, genetic, and age factors that lead to pulmonary fibrosis?
- Environmental factors - Cigarette smoking
- Genetic factors - Smoking + gene variants
- Age - Rarely occurs in individuals under the age of 50
Describe how pulmonary fibrosis can be both idiopathic or caused by scar tissue from recovery or other active disease -
- Idiopathic - accounts for 66% of all cases
2. Scar tissue resulting from recovery from active disease (TB, ARDS, RA, Chemo)
Describe the clinical course of idiopathic pulmonary fibrosis:
- Begins insidiously with gradual increasing dyspnea on exertion and dry cough
- Unpredictable progression
- Hypoxemia, cyanosis and clubbing (decreased O2 to tissues)
- Median survival rate - 3 yrs after dx
What is the only definitive therapy for idiopathic pulmonary fibrosis?
Lung transplantation
What are Restrictive Lung DiseaseChest Wall Disorders? (Give examples)
decrease expansion of lungs -> decreased inspiratory reserve vl goes down
- Neuromuscular (ALS, polio, Guillain-Barre)
- Skeletal deformities (scoliosis, chest wall injury)
- Postsurgical status (abdominal/thoracic)
- Obesity
- Collagen vascular diseases (RA, systemic lupus, scleroderma)
What is systemic sclerosis (scleroderma)?
An autoimmune disease of connective tissue characterized by excessive collagen deposition in the skin and internal organs, particularly the kidneys and lungs
systemic sclerosis (scleroderma) causes organ damage by what 3 mechanisms?
- Inflammation
- Severe thickening and obstruction of vessels (Cor pulmonale; pulmonary hypertension)
- Cutaneous fibrosis occurs
RA and pulmonary involvement:
- 30-40% have pulmonary involvement
- Chronic pleuritis, pneumonitis & fibrosis, pulmonary HTN
- Screen for pulmonary function
What is systemic lupus erythematosus (lupus or SLE)?
autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs
Systemic Lupus erythematosus (lupus or SLE) and pulmonary involvement:
- About 50% of people with SLE will experience lung involvement during the course of their disease.
- Most distinctive sign of lupus — a facial rash that resembles the wings of a butterfly unfolding across both cheeks
