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RCA Test 2 > Restrictive lung diseases > Flashcards

Restrictive lung diseases Flashcards

(45 cards)

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1
Q

Parenchymal lung disease

A

Alveolitis-extrinsic and intrinsic
interstitial lung disease
pulmonary fibrosis

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2
Q

chest wall diseases

A

Pleural
skeletal deformities
obesity
neuromuscular

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3
Q

Skeletal abnormalities

A 
kyphoscoliosis 
scoliosis 
ankylosing spondylitis
pectus excavatum
pectus carinatum
diaphragmatic paralysis 
obesity
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4
Q

chest wall diseases (physiological abnormalities)

A

increase WOB, restricted lung volumes, exercise limitations, VQ mismatch, hypoventilation

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5
Q

Kyphoscoliosis

A

twisting of spine, distortion of thoracic cage
idiopathic is the most common form
adolescence
poliomyelitis was most common cause

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6
Q

kyphosis

A

little effect on lung function

diaphragm and rib movement uniform

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7
Q

Kyphoscoliosis (physiological abnormalities)

A 
gradual resp failure 
carbon dioxide accumulation 
chronic resp acidosis 
hypoxia 
corpulmonale
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8
Q

Kyphoscoliosis (general)

A 
reduction in TLC and VC
NO obstruction of airflow
V/Q mismatch
Hypoxemia, Corpulmonale 
Decrease chem drive to breath
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9
Q

Scoliosis (general)

A

lateral deviation of the spine

attention to good posture may be effective in preventing the disorder in children + adults

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10
Q

Scoliosis (etiology)

A

congenital - spina bifida

aquired

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11
Q

Scoliosis (types)

A

idiopathic - most common type (adolescence)
functional (postural) - develops temp, correctable
structural - changes in spine structure (by arthritis)
paralytic- develops by neurological disease, polio

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12
Q

Scoliosis (pathology)

A

localized/whole areas of the spinal column
curves are S or C shaped
Cardiac or pulmonary restrict possible
effects gait

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13
Q

Scoliosis (clinical)

A

slight, mild, severe
early deformity not obvious sometimes
clothing not fitting correctly.
no pain usually

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14
Q

Scoliosis (Postural/early)

A

amenable to exercise or exercise combined with traction - Cotrel’s traction
less than 40 degrees
milwaukee brace, risser cast or halofemoral or halopelvic traction

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15
Q

Scoliosis (management)

A 
corrective surgery when curve exceeds 40 degrees and bracing fails 
Harrington rod instrumentation 
Dwyer instrumentation- 
Luque instrumentation 
Cotrel-Dubosset
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16
Q

Harrington rod instrumentation

A

series of rods and hooks that apply compression to the posterior spinal elements

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17
Q

Dwyer instrumentation

A

titanium cables passed though heads of titanium screws embedded in the vertebral bodies

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18
Q

Luque instrumentation

A

two L shaped rodes and a series of sublaminar wires that apply transverse traction to the vertebral bodies
used with Harrington rod instrumentation

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19
Q

Cotrel-Dubosset instrumentation

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A

de-rotates the spine

20
Q

Scoliosis (degree of severity mild)

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A

asymptomatic >35 deg rotation

no vent required

21
Q

Scoliosis (degree of severity moderate-mild)

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A

Restrictive >70 deg rotation

22
Q

Scoliosis (degree of severity Severe)

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A

RLD and cardio-respiratory failure

>120 deg

23
Q

Ankylosing Spondylitis (General)

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A 
Occurs mainly in men
fusion of  vertebral bodies+costovertebral joints
GOOD DIAPHRAGMATIC MOVEMENT
VC and TLC slightly reduced 
Thoracic wall compliance low
MINOR ventilation effect, Reg ABG
24
Q

Ankylosing Spondylitis (Patho)

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A 
inflammation of the spine 
bones of spine fuse (ankylose)
begins @ sacroiliac joint, obliterate cartilage
new bony growths 
progress up spine-complete fusion
25
Ankylosing Spondylitis (clinical manifestations)
low back pain, swelling of the hips, knees, shoulder mild fever, loss of appetite low back pain flares+subsides intermittently decrease motion of back takes 10 to 20 years to fuse spine
26
Ankylosing Spondylitis (Clinical manifestationsl)
Poker back with possible kyphosis | knees flexed as person attemps to move head upright
27
Ankylosing Spondylitis (diagnostic test)
Presence in serum of HLA-B27
28
Ankylosing Spondylitis (diagnostic test)
xray films showing bony growths called syndesmorphytes that bridge adjacent vertebrae to give the spine a bamboo appearance
29
Ankylosing Spondylitis (medical management)
``` relieve pain (rest, heat) achieve/maintain alignment of spine strengthen paraspinal muscles prone lying 3 to 4 times a day 15-30 anti inflammatory analgesics ```
30
Ankylosing Spondylitis (medical management)
spinal osteotomy or hip arthroplasty for person with severe symptoms
31
Pectus Excavatum
congenital depression of the sternum, no effect on lung function
32
Pectus Carinatum
Pigeon chest, no effect on ventilation
33
Diaphragmatic paralysis (general)
Unilateral paralysis may not be detected Bilateral paralysis less common easily recognized lung volumes reduced 25% increase A-aDo2
34
Diaphragmatic paralysis (causes)
invasive lesions of mediastinum trauma, post surgical dissection rarely herpes zoster
35
Diaphragmatic paralysis (breathing pattern)
rapid shallow breathing due to higher position of paralysed muscle reduce lung vol, hypercapnia, vent failure, hypoxia
36
Diaphragmatic paralysis (symptom)
orthopnea prominent in this condition reduced chest wall compliance lowered FRC
37
Diaphragmatic paralysis (causes)
The cause may be central hypo ventilation worse at night, REM high spinal cord lesion, invasive lesions to mediastinum, polyneuropathies, trauma
38
Diaphragmatic paralysis (diagnosis)
transdiaphragmatic pressure mesurements fluoroscopy, phrenic nerve conduction time MRI of cervical spine
39
Obesity (general)
Normal lungs develop severe resp failure reduced chem drive to breath upper airway obstruction during sleep
40
Obesity (general)
Adipose neck tissue encroach on pharynx thoracic cage compliance is reduced FRC + ERV reduced RV and TLC is normal
41
Normal BMI
19-24
42
Overweight
25-34
43
Borderline obesity
35-39
44
Morbid obesity
>40
45
Obesity rate
42% normal weight 55% overweight 23% morbidly obese

RCA Test 2 (4 decks)

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