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RCA Test 2 > Restrictive lung diseases > Flashcards

Restrictive lung diseases Flashcards

1
Q

Parenchymal lung disease

A

Alveolitis-extrinsic and intrinsic
interstitial lung disease
pulmonary fibrosis

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2
Q

chest wall diseases

A

Pleural
skeletal deformities
obesity
neuromuscular

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3
Q

Skeletal abnormalities

A 
kyphoscoliosis 
scoliosis 
ankylosing spondylitis
pectus excavatum
pectus carinatum
diaphragmatic paralysis 
obesity
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4
Q

chest wall diseases (physiological abnormalities)

A

increase WOB, restricted lung volumes, exercise limitations, VQ mismatch, hypoventilation

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5
Q

Kyphoscoliosis

A

twisting of spine, distortion of thoracic cage
idiopathic is the most common form
adolescence
poliomyelitis was most common cause

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6
Q

kyphosis

A

little effect on lung function

diaphragm and rib movement uniform

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7
Q

Kyphoscoliosis (physiological abnormalities)

A 
gradual resp failure 
carbon dioxide accumulation 
chronic resp acidosis 
hypoxia 
corpulmonale
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8
Q

Kyphoscoliosis (general)

A 
reduction in TLC and VC
NO obstruction of airflow
V/Q mismatch
Hypoxemia, Corpulmonale 
Decrease chem drive to breath
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9
Q

Scoliosis (general)

A

lateral deviation of the spine

attention to good posture may be effective in preventing the disorder in children + adults

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10
Q

Scoliosis (etiology)

A

congenital - spina bifida

aquired

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11
Q

Scoliosis (types)

A

idiopathic - most common type (adolescence)
functional (postural) - develops temp, correctable
structural - changes in spine structure (by arthritis)
paralytic- develops by neurological disease, polio

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12
Q

Scoliosis (pathology)

A

localized/whole areas of the spinal column
curves are S or C shaped
Cardiac or pulmonary restrict possible
effects gait

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13
Q

Scoliosis (clinical)

A

slight, mild, severe
early deformity not obvious sometimes
clothing not fitting correctly.
no pain usually

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14
Q

Scoliosis (Postural/early)

A

amenable to exercise or exercise combined with traction - Cotrel’s traction
less than 40 degrees
milwaukee brace, risser cast or halofemoral or halopelvic traction

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15
Q

Scoliosis (management)

A 
corrective surgery when curve exceeds 40 degrees and bracing fails 
Harrington rod instrumentation 
Dwyer instrumentation- 
Luque instrumentation 
Cotrel-Dubosset
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16
Q

Harrington rod instrumentation

A

series of rods and hooks that apply compression to the posterior spinal elements

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17
Q

Dwyer instrumentation

A

titanium cables passed though heads of titanium screws embedded in the vertebral bodies

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18
Q

Luque instrumentation

A

two L shaped rodes and a series of sublaminar wires that apply transverse traction to the vertebral bodies
used with Harrington rod instrumentation

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19
Q

Cotrel-Dubosset instrumentation

A

de-rotates the spine

20
Q

Scoliosis (degree of severity mild)

A

asymptomatic >35 deg rotation

no vent required

21
Q

Scoliosis (degree of severity moderate-mild)

A

Restrictive >70 deg rotation

22
Q

Scoliosis (degree of severity Severe)

A

RLD and cardio-respiratory failure

>120 deg

23
Q

Ankylosing Spondylitis (General)

A 
Occurs mainly in men
fusion of  vertebral bodies+costovertebral joints
GOOD DIAPHRAGMATIC MOVEMENT
VC and TLC slightly reduced 
Thoracic wall compliance low
MINOR ventilation effect, Reg ABG
24
Q

Ankylosing Spondylitis (Patho)

A 
inflammation of the spine 
bones of spine fuse (ankylose)
begins @ sacroiliac joint, obliterate cartilage
new bony growths 
progress up spine-complete fusion
25
Q

Ankylosing Spondylitis (clinical manifestations)

A

low back pain, swelling of the hips, knees, shoulder
mild fever, loss of appetite
low back pain flares+subsides intermittently
decrease motion of back
takes 10 to 20 years to fuse spine

26
Q

Ankylosing Spondylitis (Clinical manifestationsl)

A

Poker back with possible kyphosis

knees flexed as person attemps to move head upright

27
Q

Ankylosing Spondylitis (diagnostic test)

A

Presence in serum of HLA-B27

28
Q

Ankylosing Spondylitis (diagnostic test)

A

xray films showing bony growths called syndesmorphytes that bridge adjacent vertebrae to give the spine a bamboo appearance

29
Q

Ankylosing Spondylitis (medical management)

A 
relieve pain (rest, heat)
achieve/maintain alignment of spine
strengthen paraspinal muscles 
prone lying 3 to 4 times a day 15-30 
anti inflammatory analgesics
30
Q

Ankylosing Spondylitis (medical management)

A

spinal osteotomy or hip arthroplasty for person with severe symptoms

31
Q

Pectus Excavatum

A

congenital depression of the sternum, no effect on lung function

32
Q

Pectus Carinatum

A

Pigeon chest, no effect on ventilation

33
Q

Diaphragmatic paralysis (general)

A

Unilateral paralysis may not be detected
Bilateral paralysis less common easily recognized
lung volumes reduced 25%
increase A-aDo2

34
Q

Diaphragmatic paralysis (causes)

A

invasive lesions of mediastinum
trauma,
post surgical dissection
rarely herpes zoster

35
Q

Diaphragmatic paralysis (breathing pattern)

A

rapid shallow breathing due to higher position of paralysed muscle
reduce lung vol, hypercapnia, vent failure, hypoxia

36
Q

Diaphragmatic paralysis (symptom)

A

orthopnea prominent in this condition
reduced chest wall compliance
lowered FRC

37
Q

Diaphragmatic paralysis (causes)

A

The cause may be central
hypo ventilation worse at night, REM
high spinal cord lesion, invasive lesions to mediastinum, polyneuropathies, trauma

38
Q

Diaphragmatic paralysis (diagnosis)

A

transdiaphragmatic pressure mesurements
fluoroscopy,
phrenic nerve conduction time
MRI of cervical spine

39
Q

Obesity (general)

A

Normal lungs
develop severe resp failure
reduced chem drive to breath
upper airway obstruction during sleep

40
Q

Obesity (general)

A

Adipose neck tissue encroach on pharynx
thoracic cage compliance is reduced
FRC + ERV reduced
RV and TLC is normal

41
Q

Normal BMI

A

19-24

42
Q

Overweight

A

25-34

43
Q

Borderline obesity

A

35-39

44
Q

Morbid obesity

A

> 40

45
Q

Obesity rate

A

42% normal weight
55% overweight
23% morbidly obese

RCA Test 2 (4 decks)

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