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Cardiopulmonary PT > Restrictive pulmonary disorders > Flashcards

Restrictive pulmonary disorders Flashcards

1
Q

Restrictive disorders characterized by

A
  • affects lung parenchyma, pleura or thoracic pump
  • inspiration difficulty
  • decreased lung or thoracic compliance
  • diagnostic measure via decreased volumes or capacities related to reduction in ventilation, decreased lung volume or diminished expansion
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2
Q

Changes in lung volumes with restrictive pulmonary disorders

A
  • TLV is reduced and all other volumes are reduced
  • ratios are normal
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3
Q

Restricitive pulmonary disorders

common characteristics

A
  • tachypnea/dyspnea
  • hypoexmia
  • diminished lung sounds often with dry inspiratory crackles
  • decreased diffusing capacity
  • decreasedlung volumes/capacity
  • cough–usually dry and non-productive
  • weight loss/muscle wasting
  • pulmonary HTN, RV hypertrophy, COR PULMONARE
  • increased work of breathing
  • abnomral chest X-ray
  • can be a portion of the lung
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4
Q

Restricitive pulmonary disorders

Supportive measures

A
  • corrective measure related to the root of problem
  • supplemental O2
  • nutritional support
  • interventions to promote appropriate physical activity
  • interventions to prevent accumulation of secretions/infections
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5
Q

Restricitive pulmonary disorders

Interventions to promote appropriate physical activity and ventilation

A
  • posture (can be a RPD –scoliosis, kypohsis)
  • soft tissue mobilization
  • deep breathing/respiratory muscule training
  • incentive spirometer
  • airway clearance
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6
Q

Restricitive pulmonary disorders

Interventions to prevent accumulation of secretions/infection

A
  • airway clearance - postural drainage, percussion, vibration and cough
  • antibiotic therapy
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7
Q

Restricitive pulmonary disorders

Extrinsic factors

A
  • obesity/pregnancy
  • ascites
  • surgery/chemo/radiation
  • trauma, surger
  • flail chest
  • pleural-pneumothorax/pleural effusion
  • conntective tissue diseases
  • neuromuscular dysfunction
  • musculoskeletal dysfunction
  • pharmaceutical causes
  • radiation therapy
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8
Q

Restricitive pulmonary disorders

Flail chest

A
  • FX of 2+ ribs with 2 fx on each
  • one segment is floating
  • move in a peridoxal manner - suck in
  • medical emergency
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9
Q

Restricitive pulmonary disorders

pharmaceutical causes of restrictive disorders

A
  • drug supresses drive to breathe
  • radiation for cancer can cause scar tissues
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10
Q

Restricitive pulmonary disorders

Inrinsic factors

A
  • atelectasis
  • pulmonary edema (cardiogenic/noncardiogenic/adult respiratory distress disorder
  • maturational causes: abnormalities of fetal development - infant respiratory distress disorder/aging
  • idiopathic pulmonary fibrosis
  • environmental or occupational fibrosis
  • infection –pneumonia
  • cancers
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11
Q

Restricitive pulmonary disorders

trauma causes of restrictive disorders

A
  • crush injuries: results in rib fx, flail chest lung contusions
  • penetrating wounds: pneumothorax, hemothorax, pulmonary laceration
  • Theramal trauma: burns to thorac/inhalation burns
  • surgery: anesthesia, incision, pain

*pneumothorax: penetrate pleural space = air rushes in

air changes the pressure

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12
Q

Restricitive pulmonary disorders

Respiratory changes with aging: changes in the chest wall

A
  • decrease strength of respiratory muscles and chest compliance
  • decreased MVV, and increased O2 consumption in respiratory muscles
  • increased minute ventilation and work of breathing
  • increased respiratory muscle fatigue
  • Results in decreased pulmonary efficiency
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13
Q

Restricitive pulmonary disorders

respiratory changes with aging: changes in the lung

A
  • increased alveolar compliance and decreased pulmonary capillary bed
  • increase RV, increased physiological deadspace
  • decreased VC/decrese V/Q matching
  • decreased flow rates and PaO2
  • look at picture in powerpoint
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14
Q

abnormalities in fetal development–infant respiratory distress syndrome

A
  • immature lungs and decreased surfacant
  • can impact them as they are older due to their development
  • infants born less than 36 weeks are at higher risk fo RDS related to immature lungs
  • dysplagis/fibrotic changes can occur
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15
Q

Adult respiratory distress syndrome

A
  • increased permeability at the alveoli/capilary membrane
  • related to barriers between capilary and alveoli
  • noncardiogeneic - failure of microvascular endothelum (increased permability)
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16
Q

abnormalities in fetal development

A
  • Hypoplasia/Aplasia refers to decrease or lack of organ development. Reduces amounts of lung parenchyma
  • Infant Respiratory Distress Syndrome (hyaline membrane disease)-insufficient maturation of lung tissue/insufficient surfactant development leads to alveolar collapse. Infants born at ˂36 weeks are at high risk forIRDS. Incidence of this is 75% for infants born 26-28 weeks
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17
Q

What does pulmonary edema impact

A
  • alveoli expansion in early stages due to fluid in interstitial space
  • then progresses to fluid within alveoli
  • OVERALL restricts ventilation
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18
Q

acute respiratory distress syndrome/acute lung injury

A
  • serious clinical syndrome caused by acute lung injury (trauma, sepsis, drug overdose, inhaled toxins, massive blood transfusion, pneumonia)
  • characterized by increased permeability at alveoli/endothelial interface, leading to severe hypoxemia, pulmonary edema, and atelectasis
  • Damage occurs to the alveolar cells and the vascular endothelium
  • Patient develops edema, narrowing of airways, increasedfluid production into alveoli, decreased surfactant production

Sameas adult respiratory distress syndrome

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19
Q

Triggers of ARDS

A
  • pneumonia
  • inhalation injury (smoke/toxins)
  • aspiration injury
  • chest trauma
  • near drowning (fluid within alveoli)
  • sepsis
  • major trauma
  • burns
  • hypovolemia
  • transfusion-related acute injury
20
Q

Pulmonary Fibrosis disrders:

discrption

A
  • idiopathic, environmental, occupation, viral, genetic causes
  • changes within alveoli and between alveoli
  • scarring/destruction of lung architecture characterizes the condition
  • irreversibly enlarged damged bronchioles and disotred alveoli
  • “honeycombing” clustered cystic air spaces
  • greatly decreases gas exchange, reducing oxygen transfered into blood
21
Q

Environmental or occupational lung disease (fibrosis): hypersensitivity pneumonitis

A
  • farmers lung
  • baggassosis
  • humidifier/air conditioner lung
  • bird breeder’s lung
  • cheese worker’s lung
  • malt worker’s lung
  • paprike splitter’s lung
  • mollusk shell hypersensitivity
  • chemical worker’s lung
  • wheat weevil
22
Q

Environmental or occupational lung disease (fibrosis) : pneumoconiosis

A
  • asbestosis
  • berylliosis
  • silicossis
  • coal worker’s lung
  • byssinosis
  • baritosis
  • chalicosis
23
Q

Lung cancer

A
  • leading cause of cancer death
  • metatsiszes quickly to pleura, lymph, bone, brain, kidney and liver
24
Q

Types of lung cancer

A
  • small cell lung cancer
  • non-small cell lung cancer
  • if a cancer has characteristics of both types it is called a mixed small cell/large cell cancer - uncommon
25
Q

Lung cancer signs and symptoms

A
  • Cough that does not go away or gets wrose
  • coughing up blood or rust colored sputum
  • chest pain that is often worse with deep breathing, coughing, laughing
  • hoarseness
  • SOB
  • infections such as bronchitis, pneumonia that dont go away or keep coming back
  • new onset of wheezing
  • loss of appetite
  • unexplained weight loss
  • feeling tired or weak
26
Q

Pneumonia: pathophysiology

A
  • infection to the lung
  • inflammatory response
  • alveolar edema and exudate formation (mucus with cellular debris)
  • alveoli and respiratory bronchioles fill with serous exudate, blood cells, fibrin, bacteria
  • consolidation of lung tissues
27
Q

Types of pneumonia

A
  • community acquired
  • nosocomical: hospital acquired
  • immunocompromised
  • aspiration
28
Q

Community-acquired pneumonia

A
  • pneumococcus
  • H. influenzae
  • moraxella catarrhalis
  • staph aureus
  • mycoplasma
  • ligionella
  • chlamydophila
  • gram negative bacteria
  • virsus
  • unknown
29
Q

Nosocomical pneumonia

A
  • gram (-) bacteria
  • klebsiella
  • escherichia coli
  • pseudomonas
  • MRSA
  • polymicrobial
  • unknown
30
Q

Immunocompromised pneumonia

A
  • cytomegalovirus
  • pneumocystis jiroveci
  • mycobacterium avium
  • aspergillosis
  • candidiasis
  • others
31
Q

Aspiration pneumonia

A
  • anaerobic oral flora
  • aerobic - pneumococcus, staoh, haemophilus influenzar, pseudomonas aeruginosa
32
Q

RSV

Respiratory syncytial virus

A
  • spread via respirtory droples
  • can be spread via airbrone or direct contacct
  • intiates in the upper respiratory tract
  • seasional virus that is realtively common
  • complication of pneumonia occurs when it spreads to the lower respiratory tract
33
Q

RSV s

signs and symptoms

A
  • mild -flu like symptoms
  • upper respiratory congestion
  • mild headache
  • mild cough
  • mild fever
  • sore throat
  • V/Q mismatch

Severe symptoms

  • cyanosis
  • dyspnea
  • tachpnea
  • wheezing
  • severe cough
  • fever
34
Q

what is coronavirus

A
  • primarily cause respiratory symptoms but occasionall enteric, hepatic, and neurological symptoms are seen
  • mostly mild symptoms
  • can be zoonotic, animal to human
  • new type jumped from animal species and then spread
  • spread via large and small droplets (airborne)
35
Q

What makes up COVID

A
  • RNA
  • nucleoproteins: give virus its structure and enable replication
  • Viral envelope: protects the virsu when it is outside host cell
  • Spike proteins: allow it to grab onto things like hooks
36
Q

ACE2 and COVID

A
  • a glycoprotein that resides on the cell surface serves as a receptor site for COVID
  • broadly distributed throughout the human body including the kidney, intestine, lung, CV system
  • possible endothelial cell dysfucntion
  • allows virsl entry and ACE2 normal function is blocked
37
Q

ACE-2 receptor is the site of cell entry for

A
  • matrix products
  • antithrombotic factors
  • procoagulant factors
  • growth factors
  • vasoconstricting factors
  • vasodilator factors
  • inflammatory mediateors
  • lipid metabolism
38
Q

Post-acute COVID/chronic covid

A
  • originally post-covid was thought to be the short period after ilness
  • considered impact of being hospitalized
  • Post intensive care syndrome or hospital acquired waekness
  • in July 2021 is was recognized as long COVID
  • post-covid conditions are a wide range of new, returning, or ongoing health problems that people experience for 4 or more weeks after first being infected with the virus
39
Q

Long haul COVID

A
  • can be vaired but may appear to have symtposm similar to myalgic encephalitis/chronic fatigue syndreom (MECFS) and postural tachycardiac syndroem (POTS)
40
Q

Myalgic encephalomyelitis/chronic fatigue syndrome

A
  • long term illness that affects many systems
  • etiology unclear
  • people with ME/CFS are often not able to do usual activites
  • sleep issues. significant fatigue, post-exertional fatigue
  • sometimes confusion dizziness, pain
41
Q

Postural Orthostatic tacycardia syndrome

What is it, common symptoms and a diagnoistic test

A
  • POTS
  • autonmic dysfunction
  • abnormally large increases in HR with standing - lightheadedness
  • difficulty thinking and concentrating
  • fatigue
  • intolerance of exercise
  • headache
  • blurry vision
  • palpitations
  • tremor and nausea
  • standing toerance test is diagnotic
  • UNRELATED TO ORTHOSTATIC HYPOTENSION
42
Q

Post exertional malaise

A
  • PEM
  • symtpoms that exacerbate after physical, mental or emtional effort
43
Q

Post exertional symptom exacerbation

A
  • PESE
  • worsening of symptoms 24-72 hours following exertion
  • exertion refers to cognitive, emotional, or social acitvity and is often minimal or at a threshold previously tolerated
44
Q

energy envelope

A
  • used with PEM,PESE
  • the area that one can consistently function without symptoms
45
Q

Pacing

A
  • strategies that reduce spikes in exertion
  • avoid push followed by crash (PEM,PESE)

Cardiopulmonary PT (25 decks)

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