Restritive Lung Disese (RLD) Flashcards
What does restrictive lung disease mean?
- Reduced lung volume in air fields
*decrease in lung compliance and function
*alteration in lung parenchyma (intrinsic)
*disease of the pleura or of the chest wall (extrinsic)
*disease of the neuromuscular system
What does reduced lung volume lead to? And how is it characterized?
Leads to restrictive pattern on spirometry characterized by
1. Reduced total lung capacity
2. Reduced vital capacity
3. Reduced resting lung volume
4. Expiratory airflow are persevered and airway resistance is normal
What will patients with RLD need to do?
- Need to produce a greater effort and more energy in order to simply inflate the lung fields (dyspnea)
*effort to breath is harder
How is RLD characterized by?
- Reduced distensibility of the lungs
- Compromised lung expansion
- Reduced lung volumes, reduced lung capacity
- Diverse, known or unknown etiology
What will be present in RLD
- Stiffened parenchyma
- Increased elastic recoil
- Decreased compliance
*prevents lungs form expanding fully - Presence of fibrotic tissue
*decreased FVC, desired volumes
*no obstruction, normal FEV1
What is the etiology of RLD
PAINT
P = pleural
A = Alveolar
I = interstitial
N = neuromuscular
T = thoracic cage
What is the etiology of the RLD (intrinsic)
Directly affects the lung parenchyma
1. Inflammation, scarring of the lung tissue (interstitial lungs diseases)
2. Filling of the air spaces with exudate and debris (pneumonitis)
3. Reduced gas transfer
What is the etiology of RLD (extrinsic)
Restriction by the chest wall, pleura, or respiratory muscles
1. Neuromuscular diseases, pleural disorders, obesity, fusion of Costovertebral or thoracic vertebra
What is the etiology of RLD (acute restrictive pulmonary diseases)
Acute Lung injury
1. Acute hypersensitivity pneumonitis (interstitial pneumonias)
2. EVALI
3. Acute respiratory distress syndrome (ARDS)
What is the etiology of RLD (chronic restrictive pulmonary diseases)
Diffuse interstitial lung disease
1. Idiopathic pulmonary fibrosis
2. Sarcoidosis
3. Connective tissue disease
4. Drug-induced lung disease
What do all the intrinsic causes of RLD cause?
Affects the lung parenchyma (gas exchange units)
1. Alveolitis - obliteration - reorganization - fibrosis
*once fibrosis is present irreversible, non-functioning
2. Highly variable
*has common presentation, PE, chest radiographs
*single biopsy specimen: sporadic, normal/abnormal alveoli
What are the intrinsic causes of RLD
- Idiopathic pulmonary fibrosis (IPF)
- Environmental pneumoconioses/occupational pneumoconioses
- Hypersensitivity pneumonitis
- Medication SE
- Sarcoidosis
What are the extrinsic causes of RLD ?
- Kyphoscoliosis
- Pleural conditions
- Obesity
- Nureomusclar disorders
- Ascites
What are the signs and symptoms of RLD
- Insidious onset progressive dyspnea
- Non productive cough
- Tachypnea
- Bidbasilar dry rales
- Digital clubbing
- R HF symptoms and signs
What will be the PFT changes for RLD
- Restrictive changes
- Total lung capacity and volume are decreased
*useful in monitoring the progression of disease and prognosis
