Restrictive Pulmonary Pathophysiology Flashcards
Where is EEV relative to vital capacity?
At the end of Tidal Volume – where the lungs don’t need any energy to remove air
The elastic recoil of the lungs creates what type of pull?
Inward
The elastic recoil of the chest wall connective tissue what type of pull?
Outward
How do changes in capillary oncotic and hydrostatic contribute to pulmonary edema?
Primarily an increase in hydrostatic pressure causes fluid to move into the interstitial space
Do changes in capillary oncotic and hydrostatic pressures predominantly affect ET, TT, or both?
Predominately Equilibrium Time
What is ARDS?
Pulmonary edema due to inflammation – “Adult Respiratory Distress Syndrome”
How does inflammation in the lungs interfere with gas exchange?
Leads to pulmonary edema and vasodilation
Does inflammation in the lungs alter ET, TT, or both?
Both
What measures can sometimes help to prevent pulmonary fibrosis?
Take precautions with particles; promote deep breaths
What are the mechanisms by which a thoracotomy causes pulmonary restriction?
Pain, Incision scars (disuse atrophy)
How can a thoracotomy impair pulmonary gas exchange?
Less deep breaths = decrease alveoli filling
What are the mechanisms by which obesity causes pulmonary restriction? How can this impair pulmonary gas exchange?
Increase WOB due to external load & diaphragm pushed upward which decreases lung volume.
What are some other MSK disorders that could reduce chest wall
Costochondritis, fractured rib, muscle weakness, ankylosis, rheumatoid arthritis
What measures can help to prevent loss of chest wall compliance?
Work on taking deep breaths; weight management; etc.
What are the accessory inspiratory muscles?
SCM, Scalenes, Pec Minor
What steps are necessary for a productive cough?
Step 1: Take deep breath
Step 2: Close Glottis
Step 3: Contract abdominals to increase intra-abdominal/thoracic pressure
(Step 4: open glottis)
Wich ventilatory (inspiratory and expiratory) muscles would have innervation in a patient with a complete SCI at: C6? T8? L2?
C6 Diaphragm only (maybe SCM?)
T8 Diaphragm and some Intercostals
L2 Diaphragm, Intercostals, Abdominals, Accessory Muscles
How would impaired ventilatory muscle function present in patients with progressive neuromuscular disorders?
Deterioration over time – won’t happen all at once. Pattern depends on condition
What is the type and location of the following space occupying disorder?
Hemothorax
Blood between pleural layers
What is the type and location of the following space occupying disorder?
Pleural effusion
Fluid between pleural layers
What is the type and location of the following space occupying disorder?
Pneuomothorax
Air between lung and pleural membranes
What is the type and location of the following space occupying disorder?
Adenocarcinoma tumor
Abnormal tissue in the lungs
What is the type and location of the following space occupying disorder?
Pulmonary edema
Fluid within the alveoli
What predisposes a patient to developing atelectasis?
Any condition that causes hypoventilation
How does surfactant act to prevent atelectasis?
Lines the alveoli to lower surface tension – makes it less likely to have alveoli collapse
↓ lung volume, ↓ CW compliance, ↓lung compliance, or ↓ muscle function: Lobectomy
↓ lung volume: The removal of a lobe of the lung decreases the total lung capacity and the functional residual capacity, resulting in reduced lung volume.
↓ lung volume, ↓ CW compliance, ↓lung compliance, or ↓ muscle function: Heart transplantation
↓ chest wall (CW) compliance: Following heart transplantation, especially if a sternotomy (opening of the chest) was performed, the thoracic cavity may experience stiffness due to surgical changes, healing processes, or alterations in the mechanics of the chest wall.
↓ lung volume, ↓ CW compliance, ↓lung compliance, or ↓ muscle function: Phrenic nerve injury
↓ muscle function
↓ lung volume, ↓ CW compliance, ↓lung compliance, or ↓ muscle function: 3rd-4th degree thorax burns
↓ chest wall (CW) compliance: Severe burns on the thorax can cause scarring and stiffness of the chest wall, limiting its ability to expand and contract during breathing.
↓ lung volume, ↓ CW compliance, ↓lung compliance, or ↓ muscle function: >90 degree scoliotic curves
↓ chest wall compliance
↓ lung volume, ↓ CW compliance, ↓lung compliance, or ↓ muscle function: Spinal muscle atrophy
↓ muscle function: This condition is characterized by the degeneration of motor neurons in the spinal cord, resulting in weakness and atrophy of the muscles, including those involved in breathing.
↓ lung volume, ↓ CW compliance, ↓lung compliance, or ↓ muscle function: Idiopathic lung fibrosis
↓ lung compliance: This condition is characterized by the thickening and stiffening of lung tissue due to fibrosis, which significantly reduces the lungs’ ability to expand, resulting in decreased lung compliance.
↓ lung volume, ↓ CW compliance, ↓lung compliance, or ↓ muscle function: Pulmonary edema
↓ lung compliance/volume: The accumulation of fluid in the alveoli and interstitial spaces of the lungs increases the stiffness of the lung tissue, reducing its ability to expand and thus leading to decreased lung compliance.
↓ lung volume, ↓ CW compliance, ↓lung compliance, or ↓ muscle function: Pulmonary emboli
↓ lung volume: The obstruction of blood flow in the pulmonary arteries due to a blood clot can cause areas of the lung to become non-ventilated or poorly ventilated, leading to decreased lung volumes.
What do diminished / absent breath sounds indicate?
Pneumothorax
Why is a cough often nonproductive in patients with restricted lung disease?
There are no secretions in the lung that needs to be removed – the things causing restrictive disease aren’t causing mucus production or are able to be coughed up
What causes a low tidal volume in patients with restricted lung disease?
Something is restricting movement of the lungs patients compensate by taking smaller breaths because it is more efficient for them
Why do many patients with restricted lung disease have low BMI?
It’s more difficult to eat with dyspnea – also WOB is harder so the metabolic demand is up
