Restrictive Pulmonary Flashcards
Pathologies that typically INTRINSICALLY restrict the ability of the lungs to expand are called
restrictive lung disease
Restrictive lung disease can be caused by:
increased stiffness of chest wall
weak muscles
damaged nerves
symptoms of Restrictive Lung Disease are:
shortness of breath
dry cough
reduced lung volume and TLC
symptoms of Restrictive Lung Disease are:
shortness of breath
dry cough
reduced lung volume and TLC
Restrictive Lung Disease is characterized by:
decrease in TLC
FEV1 remains unchanged
FEV1 –> FVC is preserved
Reduced lung compliance
What 2 conditions regarding O2 will most likely occur in an individual w RLD?
hypoxemia and hypoxia
Recite the hypoxemia levels in terms of PaO2 and SaO2 and what might look normal - severe.
What are external causes of restrictive lung disease?
- kyphoscoliosis
- pleural conditions such as effusion, pleural scarring
- obesity
- neuromuscular disorders
- ascites
- rib cage deformation
- neurological pathologies limiting activation of resp. muscles
- reduced ability of the diaphragm to descend.
What is pickwickian syndrome?
a conditon consisting of hypoventilation, daytime hypercapnia and daytime hypoxemia in an obese pt with a sleep disorder in the absence of other causes of hypoventilation such as COPD
what are the 3 conditions an individual with Pickwickian syndrome will have?
hypoventilation
daytime hypercapnia
daytime hypoxemia
What are the internal causes of RLD?
destruction or scarring of lung parenchyma
idiopathic fibrotic disease
connective tissue diseases
drug-induced lung disease
environmental exposure
sarcoidosis
Describe the process of developing RLD.
Inflammation →
recruitment of fibroblasts→
pulmonary fibrosis →
sclerotic injury/ abnormal hardening of the alveolar wall → reduced ability to expand/ sclerotic injury creates a physical barrier to gas exchange →
↓DLCO (diffusing capacity for carbon monoxide) and
↓ the ability of the alveoli to expand
What is sarcoidosis?
disease characterized by the presence of granulomas or tiny clusters of WBC and other tissues in response to chronic inflammation.
What are the complications of restrictive lung disease?
- hypoxemia (reduce PaO2)
- Compensated for by inc. respiration rate
- increased energy expenditure by respiratory muscles that may lead to muscle wasting and weight loss
- chronic respiratory failure
- pulmonary hypotension and cor pulmonale
Use TLC levels to classify each stage of RLD.
Restrictive disease:
mild restrictive disease:
moderate restrictive disease:
moderately severe restrictive disease:
severe restrictive disease:
Restrictive disease: <80%
mild restrictive disease: 70 - 80%
moderate restrictive disease: 60 - 70%
moderately severe restrictive disease: 50 - 60%
severe restrictive disease: <50%
During a physical examination, how might we tell if someone has restrictive lung disease?
velcro crackles in lungs
inspiratory squeaks
gurgling during inspiration/expiration
cyanosis
Digital clubbing
What is a cardiac dysfunction of RLD?
Cor pulmonale
What condition has a median survival rate of 3 - 5 years after diagnosis?
Interstitial pulmonary fibrosis
what condition has a 70% mortality rate in 3 months and will lead to acute respiratory distress syndrome?
acute interstitial pneumonia
What is included in medical management of RLD?
symptom management
corticosteroids
anti-inflammatories
adequate oxygenation
surgery
heart-lung transplant
What is a pneumoconiosis?
a lung disease caused by breathing in certain kinds of dust particles that damage your lungs.
What is another name for a pneumoconiosis?
occupational lung disease
Is lung scarring reversible?
NO
What are the types of interstitial lung disease?
Exposure related (drug induced/ occupational)
autoimmune related
idiopathic
