Restrictive Lung Dysfunction

Question 1

T/F: RLD is a disease.

Answer 1

FALSE, just dysfunction

Question 2

RLD is an abnormal reduction in __ __, or to simply put it a ventilatory pump dysfunction.

Answer 2

Pulmonary ventilation

Question 3

The pathogenesis of RLD includes an increased resistance to lung expansion, decreasing lung and/or chest wall __. In addition, all lung volumes and capacities are (incr./decr.) and work of breathing is increase due to need for greater ___ pressure.

Answer 3

1) compliance
2) decreased
3) transpulmonary

Question 4

PFT values in RLD:
FVC = __ %
FEV1 = low, but compared to FVC is __
FEV1/FVC = __ %

Answer 4

FVC = ≤ 80%
FEV1 = low, but FVC decline is GREATER than FEV1
FEV1/FVC = ≥ 80%

Question 5

Signs of RLD include __pnea, __exmia, decreased breath __, decr. vol/capacities, decr. diffusing capacity, __ __ (think R-sided HF), reticulonodular pattern on imaging, & pulmonary __tension.

Answer 5

1) TACHYpnea
2) HYPOxemia
3) sounds
4) cor pulmonale
5) HYPERtension

Question 6

4 symptoms of RLD are…

Answer 6

Dyspnea
Cough
Wt loss
Muscle Wasting

Question 7

One maturational cause of RLD is __ or hyaline membrane disease. This is a disorder of prematurity with a lack of complete lung maturation. Its linked to gestational age and caused by surfactant abnormalities and reduced production.

Answer 7

Infant respiratory distress syndrome

Question 8

Another maturational cause of RLD normal aging, which is complicated by ___ factors like pollution, gases, job exposures, drugs, & smoking. Lung changes with normal aging include decreased __ at 20 y/o, max voluntary __ & __ __ decreased, less sensitive chemoreceptors, decalcification/arthritic changes in the __, enlargement of air spaces, and decreased ___ __ (think elasticity).

Answer 8

1) environmental
2) compliance
3&4) ventilation & Vital Capacity (VC)
4) ribs
5) elastic recoil

Question 9

Pulmonary causes include fibrosis, asbestosis, pneumonia, atelectasis, PE, pulmonary edema, bronchogenic carcinoma, etc. Pretty much any the makes __ more difficult.

Answer 9

inspiration/inhalation

Question 9

3 types of bronchogenic carcinoma are what?
Which one is the most common?
Which one is the rarest type?

Answer 9

1) SCLC (small cell), NSCLC (non-small cell), & carcinoid tumors
2) NSCLC
3) carcinoid tumors

Question 10

NM causes include amyotrophic lateral sclerosis, poliomyelitis, tetanus, and myastenia gravis. Name 3 more NM causes.

Answer 10

1) SCI C3-C5 keep the body alive
2) GBS
3) Duchenne Muscular Dystrophy and other muscular dystrophies

Question 11

What N innervates the diaphragm?

Answer 11

Phrenic N

Question 12

Some MSK causes include kyphoscoliosis, pectus excavatum/carinatum, SC fx, lung contusion, burns, surgery, & penetrating wound. What are 2 more MSK causes of RLD?
Hint: 1 deals with a fx. We’ve talking about both conditions in MSK 3

Answer 12

1) rib fx
2) ankylosing spondylitis

Question 13

Name 3 connective tissue causes of RLD besides polymyositis and dermatomyositis.
Hint: one has a unique S&S involving the skin

Answer 13

1) RA
2) Regular or drug induced SLE (lupus)
3) scleroderma

Question 14

T/F: Pregnancy can also be a cause of RLD. A contributing factor is a decrease in chest wall compliance d/t decr. downward excursion of the diaphragm. In the 1st trimester ventilation to dependent regions of lungs is impaired d/t fetus.

Answer 14

FALSE; everything is true EXCEPT ventilation to dependent region is impaired in the THIRD trimester.

Question 15

Obesity, or body wt __% or more over ideal body wt, is another cause of RL. The extra tissue requires additional __ and excess tissue on chest wall decreases __ of thorax

Answer 15

1) 20%
2) oxygen
3) compliance

Question 16

More than 100 drugs can cause RLD. The lung __ is adversely affected cause drug-induced __ lung disease. The ventilatory pump, drive, or chest wall compliance is affected.

Answer 16

1) parenchyma
2) interstitial

Question 17

Radiological causes of RLD include radiation __ and __ which are primary complaints of irradiation to thorax.

Answer 17

Radiation pneumonitis & fibrosis

Question 18

PT examination for RLD should include vitals, __O2 readings, dyspnea scales, __MWT, RPE, and auscultation.
Name 3 PT interventions that may be used to tx RLD.

Answer 18

1) SaO2
2) 6MWT
3) airway clearance techniques, chest wall stretching, posture edu, inspiratory muscle training, CVP endurance training, energy conservation techniques