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Cardiopulmonary Exam II > Restrictive Lung Disease > Flashcards

Restrictive Lung Disease Flashcards

1
Q

What is RLD?

A

Restrictive lug dysfunction- abnormal reduction in pulmonary ventilation
-volume of air moving in and out is reduced

**is not a disease- can result from many different diseases, trauma, or drugs

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2
Q

Lung compliance with RLD

A

-chest wall and/or lung compliance decreased
-lungs stiff and difficult to expand
-resistance to lung expansion increased

**lung volumes and capacities are decreased

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3
Q

Work of breathing

A

The work of breathing must increase due to a greater need for transpulmonary pressure (difference between alveolar pressure and intrapleural pressure in lungs)

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4
Q

Overall S/S of RLD

A

Signs:
-tachypnea
-hypoxemia
-decreases breath sounds
-decreases lung volumes and capacities
-R sided HF
-decreases gas exchange

Symptoms:
-dyspnea*
-cough*
-weight loss

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5
Q

Examples of abnormalities in fetal lung development that may cause RLD

A
  1. Agenesis: absence of bronchus and lung parenchyma
  2. Aplasia: rudimentary bronchus w/o normal pung parenchyma
  3. Hypoplasia: incomplete development- lungs function by not normally (most common)
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6
Q

What is restrictive distress syndrome?

A

A disorder of prematurity or lack of complete lung maturation- a hyaline membrane disease
-caused by abnormalities in surfactant system and inadequate surfactant production

**a possible cause of RLD

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7
Q

What is the treatment of respiratory distress syndrome?

A

Surfactant replacement therapy within 2 hours of birth- given as aerosol via endotracheal intubation

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8
Q

Signs and symptoms of respiratory distress syndrome

A

Signs:
-increased RR
-decreased lung compliance
-decreases lung volumes
-increased work of breathing
-decreased oxygen concentration & increased carbon dioxide

Symptoms:
-nasal flaring
-grunting
-crying (decreased in volume and strength)
-cyanotic

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9
Q

T/F normal aging is considered another cause of RLD?

A

True- compliance of lungs decreases at about 20 yrs, pts has been exposed to numerous environmental factors, decalcification of ribs and arthritic changes (decreases chest wall compliances)

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10
Q

What are the maturational causes of RLD?

A
  1. abnormalities in fetal lung development
  2. respiratory stress syndrome
  3. normal aging
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11
Q

Treatment for normal aging that causes RLD

A

No specific treatment required
-keep aerobically exercising and strength training

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12
Q

What are the pulmonary causes of RLD?

A
  1. Idiopathic pulmonary fibrosis
  2. Coal worker’s Pneumoconiosis (black lung diseass)
  3. Asbestosis
  4. Bronchopulmonary dysplasia
  5. Bronchiolitis Obliterans
  6. Atelectasis
  7. Pneumonia
  8. Adult respiratory distress syndrome
  9. bronchogenic carcinoma
  10. Pleural effusions
  11. Sarcoidosis
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13
Q

What are the cardiovascular causes of RLD?

A
  1. Pulmonary edema
  2. Pulmonary emboli
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14
Q

What are the neuromuscular causes of RLD?

A
  1. SCI
  2. ALS
  3. Guillain-Barre Syndrome
  4. Myasthenia Gravis
  5. Tetanus
  6. Duchenne Muscular Dystrophy
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15
Q

MSK causes of RLD

A
  1. Diaphragmatic Paralysis or Paresis
  2. Kyphoscoliosis
  3. Ankylosing Spondylitis
  4. Pectus Excavatum (sternal depression)
  5. Pectus Carinatum ( sternum protruding anteriorly)
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16
Q

Connective tissue causes of RLD

A
  1. RA
  2. Scleroderma (armored skin)
17
Q

T/F pregnancy can cause RLD

A

True- during the third trimester ventilation to dependent regions of the lungs is impaired due to the fetus and there is a decrease in chest wall compliance due to decreases downward excursion of diaphragm

18
Q

Nutritional and Metabolic caused of RLD

A
  1. Obesity
  2. DM
19
Q

Traumatic causes of RLD

A
  1. crash injuries/blunt trauma
  2. lung contusion
  3. penetrating wounds (shooting or stabbing)
  4. thermal trauma
20
Q

Therapeutic causes of RLD

A
  1. surgical therapy
  2. lung transplantation
21
Q

Pharmaceutical causes of RLD

A
  1. cardiovascular drugs
  2. chemotherapeutics
  3. poisons
  4. anesthetics
  5. muscle relaxants
  6. illicit
22
Q

What is the overall treatment approaches for RLD?

A
  1. If the cause is permanent: treatment consists of supportive measures
  2. If the cause is reversible: treatment consists of corrective and supportive measures
23
Q

What is idiopathic pulmonary fibrosis?

A

Inflammatory process of alveolar wall

Treatment: corticosteroids, oxygenation/ventilation, good nutrition, smoking cessation, lung transplant

24
Q

What is Coal Worker’s Pneumoconiosis?

A

Interstitial lung disease caused by inhalation of coal dust

Treatment: cessation of exposure to coal dust, good nutrition, adequate oxygenation/ventilation, progressive exercise

25
Q

What is asbestosis?

A

Diffuse interstitial pulmonary fibrotic disease caused by asbestos exposure

Treatment: no cure! symptomatic support

26
Q

What is bronchopulmonary dysplasia?

A

Chronic pulmonary syndrome in neonates who have been ventilated and received high concentrations of O2- survivors of RDS

27
Q

What is bronchiolitis Obliterans

A

Fibrotic lung disease that affects small airways- produces restrictive and obstructive lung dysfunction due to necrosis of respiratory epithelium
-peds: viral infection
-adults: toxic fume inhalation

Treatment:
-peds: corticosteroids
-adults: oxygen, fluid balance, corticosteroids

28
Q

What is Atelectasis?

A

Incomplete expansion of lung or loss of volume (partial or complete collapse of lung)

Treatment: deep breathing, incentive spirometry, coughing

29
Q

What is Pneumonia?

A

Inflammatory process of the lung parenchyma that begins as an infection in the lower respiratory tract

Treatment: drug therapy, oxygen, mechanical ventilation, postural drainage, airway clearance

30
Q

What is adult respiratory distress syndrome?

A

Severe hypoxemia caused by acute lung injury (trauma, aspiration, inhaled toxins, drugs, metabolic pneumonias)

Treatment: treat due to cause, support adequate gas exchange and tissue oxygenation, nutrition and fluid balance

31
Q

What is a bronchogenic carcinoma?

A

malignant growth of abnormal cells in the bronchus

Treatment: surgery, radiation, chemo

32
Q

What are pleural effusions?

A

Accumulation of fluid within the pleural space

Treatment: target underlying cause

33
Q

What is sarcoidosis?

A

A mysterious multisystem disease characterized by the presence of non-necrotic epithelioid granulomas in many organs

Treatment: corticosteroids

34
Q

What is pulmonary edema?

A

Increased amount of fluid within the lung

Treatment: aimed at decreasing cardiac preload and maintaining oxygenation

35
Q

What is a pulmonary emboli?

A

A complication of venous thrombosis- the thrombi travels from systemic veins to the pulmonary circulation

Cardiopulmonary Exam II (11 decks)

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