Patho - Exam 4 Restrictive Pulmonary Disorders

Front 1

What lung alterations take place with restrictive pulmonary disorders?

Back 1

-lung parenchyma, pleura, chest wall, neuromuscular apparatus

Front 2

What 4 capacities are decreased with restrictive pulmonary disorders?

Back 2

1. total lung capacity
2. vital capacity
3. functional residual capacity
4. residual volume

Front 3

List 4 pulmonary restrictive disorders:

Back 3

1. diffuse interstitial pulmonary fibrosis
2. Sarcoidosis
3. Hypersensitivity pneumonitis
4. Atelectasis

Front 4

pulmonary fibrosis:

Back 4

-not common
-can be autoimmune
-thickening of alveolar interstitum
-may be immune reaction
-survival rate is 4 yrs

Front 5

What effect does pulmonary fibrosis have on the body?

Back 5

-rapid, shallow breathing
-exertional dyspnea
-clubbing

Front 6

Dx of pulmonary fibrosis:

Back 6

-transbronchial biopsy
-xray (see honeycomb appearance with infiltrates and increased markings)
-decreased PF and O2

Front 7

Tx for pulmonary fibrosis:

Back 7

-corticosteroids
-lung transplantation

Front 8

sarcoidosis:

Back 8

-abnormal T-cells, similar to TB
-disease of unknown origin marked by formation of granulomatous lesions that appear especially in the liver, lungs, skin, and lymph nodes
-usually affects <40YO but can affect all ages

Front 9

What effect does sarcoidosis have on the body?

Back 9

-malaise, fever, dyspnea
-skin rashes, hepatoplenomegaly and lymphadenopathy
-pulmonary infiltration and fibrosis
-lacrimal and parotid involvement can be seen

Front 10

malaise:
mal-Aze'

Back 10

A vague feeling of bodily discomfort, as at the beginning of an illness

Front 11

Dx of sarcoidosis:

Back 11

-positive Kveim skin test
-trasnbronchial lung biopsy
-xray noting parenchymal involvement and hilar lymphadenopathy
-decreased PF

Front 12

Tx of sarcoidosis:

Back 12

-corticosteroids
-treatment of symptoms

Front 13

hypersensitivity pneumonitis:

Back 13

-extreme sensitivity to inflammation of lung tissue
-caused by inhalation of organic dusts

Front 14

What effects does hypersensitivity pneumonitis have on the body?

Back 14

-symptoms occur 4-6 hrs after exposure
-general and respiratory symptoms
-rales in lung bases
-fibrosis in a chronic form

Front 15

Dx of hypersensitivity pneumonitis:

Back 15

-infiltrates and increased markings on xray
-skin testing

Front 16

Tx of hypersensitivity pneumonitis:

Back 16

-to prevent further exposure
-possible corticosteroids

Front 17

atelectasis:

Back 17

-total or partial collapse of the lung
-congenital condition characterized by the incomplete expansion of the lungs at birth

Front 18

atelectasis vs. pneumothorax:

Back 18

atelectasis: internal, blockage in resp tree preventing air, ex: mucus, not manageable, Tx: PEEP

pneumothorax: external, compression to lungs, free air in chest cavity so lung collapses, ex: lung puncture, Tx: intubate

Front 19

3 Extrapulmonary restrictive disorders:

Back 19

1. diseases of the pleura
2. diseases of the chest wall
3. neuromuscular disorders

Front 20

2 Diseases of the pleura:

Back 20

1. pneumothorax
2. pleural effusion

Front 21

3 types of pneumothorax:

Back 21

1. spontaneous (males 20-40)
2. secondary (complication of a disease)
3. tension (from trauma)

Front 22

Tension pneumothorax:

Back 22

-emergency situation
-air enters during inspiration but cannot escape during expiration
-shifts lung due to pressure (mediastinal shift)
-decreases venous return and cardiac output

Front 23

What effect does pneumothorax have on the body?

Back 23

-decreased to almost absent breath sounds
-hyperresonance
-tension and large spontaneous are emergencies

Front 24

Dx of pneumothorax:

Back 24

-xray
-physical findings

Front 25

Tx of pneumothorax:

Back 25

< 15% treated with bedrest
> 15% treated with chest tube
-thoracotomy if the lung further collapses and large blebs are formed

Front 26

pleural effusion:

Back 26

-an abnormal collection of fluid in the pleural cavity

Front 27

5 types of pleural effusion:

Back 27

1. transudates
2. exudates
3. empyema (purulent drainage)
4. hemothorax
5. chylothorax

Front 28

transudate:

Back 28

-(thin) fluid substance passed thru a membrane or extruded from the blood
-common in CHF and nephrosis

Front 29

exudate:

Back 29

-(thick) fluid, cells, or other substances that have slowly escaped from blood vessels and have been deposited in tissues or on tissue surfaces
-high in protein content
-common in malignancies, infections, embolism, sarcoidosis

Front 30

What 2 forms are common with pleural effusions caused by trauma?

Back 30

hemothorax and chylothorax

Front 31

chylothorax:

Back 31

-can be caused by trauma or tuberculosis
-An accumulation of chyle in the thoracic cavity

Front 32

chyle:

Back 32

-a milky fluid consisting of lymph and emulsified fats
-formed in the small intestine during digestion of ingested fats

Front 33

What effects does pleural effusion have on the body?

Back 33

-pt are asymptomatic if condition is small
-symptoms formed from irritation or air occupying space

Front 34

What pressures are affected with a pleural effusion?

Back 34

hydrostatic
colloid
intrapleural

Front 35

Dx of pleural effusion:

Back 35

-fluid analysis
-cytology

Front 36

Tx of pleural effusion:

Back 36

-treat the underlying cause
-thoracentesis

Front 37

thoracentesis:

Back 37

-puncturing the chest wall so as to let out liquids contained in the cavity of the chest

Front 38

3 diseases of the chest wall:

Back 38

1. Kyphoscoliosis
2. Ankylosing spondylitis
3. Obesity

Front 39

Kyphoscoliosis:

Back 39

-backward and lateral curvature of the spine
-reduces chest capacity
-symptoms and treatment related to degree of severity

Front 40

Dx of pleural effusion:

Back 40

-fluid analysis
-cytology

Front 41

Ankylosing spondylitis:

Back 41

-progressive inflammation leading to immobility of vertebral joints and rib fixation
-fibrotic response resulting in joint calcification and ligament ossification
-can cause restrictive lung dysfunction

Front 42

Tx of pleural effusion:

Back 42

-treat the underlying cause
-thoracentesis

Front 43

Obesity as a disease of the chest wall:

Back 43

-increases abdominal size
-causes hypoventilation

Front 44

thoracentesis:

Back 44

-puncturing the chest wall so as to let out liquids contained in the cavity of the chest

Front 45

Tx for ankylosing spondylitis:

Back 45

-breathing and mobility exercise
-non-steroidal medication

Front 46

3 diseases of the chest wall:

Back 46

1. Kyphoscoliosis
2. Ankylosing spondylitis
3. Obesity

Front 47

5 neuromuscular disorders:

Back 47

1. Poliomyelitis
2. Amyotrophic lateral sclerosis
3. Muscular dystrophies
4. Myasthenia gravis
5. Guillain-Barre syndrome

Front 48

Kyphoscoliosis:

Back 48

-backward and lateral curvature of the spine
-reduces chest capacity
-symptoms and treatment related to degree of severity

Front 49

poliomyelitis:

Back 49

-aka infantile paralysis
-highly infectious viral disease that affects children & causes inflammation of motor neurons of the spinal cord and brainstem, leading to paralysis, muscular atrophy, and often deformity
-preventable through vaccination

Front 50

Ankylosing spondylitis:

Back 50

-progressive inflammation leading to immobility of vertebral joints and rib fixation
-fibrotic response resulting in joint calcification and ligament ossification
-can cause restrictive lung dysfunction

Front 51

amyotrophic lateral sclerosis:

Back 51

-aka Lou Gehrig's disease
-progressive weakness
-chronic, progressive disease marked by gradual degeneration of the nerve cells in the central nervous system that control voluntary muscle movement.
-causes muscle weakness and atrophy and usually results in death.

Front 52

Obesity as a disease of the chest wall:

Back 52

-increases abdominal size
-causes hypoventilation

Front 53

Tx for ankylosing spondylitis:

Back 53

-breathing and mobility exercise
-non-steroidal medication

Front 54

5 neuromuscular disorders:

Back 54

1. Poliomyelitis
2. Amyotrophic lateral sclerosis
3. Muscular dystrophies
4. Myasthenia gravis
5. Guillain-Barre syndrome

Front 55

chylothorax:

Back 55

-can be caused by trauma or tuberculosis
-An accumulation of chyle in the thoracic cavity

Front 56

chyle:

Back 56

-a milky fluid consisting of lymph and emulsified fats
-formed in the small intestine during digestion of ingested fats

Front 57

What effects does pleural effusion have on the body?

Back 57

-pt are asymptomatic if condition is small
-symptoms formed from irritation or air occupying space

Front 58

What pressures are affected with a pleural effusion?

Back 58

hydrostatic
colloid
intrapleural

Front 59

Dx of pleural effusion:

Back 59

-fluid analysis
-cytology

Front 60

Tx of pleural effusion:

Back 60

-treat the underlying cause
-thoracentesis

Front 61

thoracentesis:

Back 61

-puncturing the chest wall so as to let out liquids contained in the cavity of the chest

Front 62

3 diseases of the chest wall:

Back 62

1. Kyphoscoliosis
2. Ankylosing spondylitis
3. Obesity

Front 63

Kyphoscoliosis:

Back 63

-backward and lateral curvature of the spine
-reduces chest capacity
-symptoms and treatment related to degree of severity

Front 64

3 Extrapulmonary restrictive disorders:

Back 64

1. diseases of the pleura
2. diseases of the chest wall
3. neuromuscular disorders

Front 65

2 Diseases of the pleura:

Back 65

1. pneumothorax
2. pleural effusion

Front 66

3 types of pneumothorax:

Back 66

1. spontaneous (males 20-40)
2. secondary (complication of a disease)
3. tension (from trauma)

Front 67

Tension pneumothorax:

Back 67

-emergency situation
-air enters during inspiration but cannot escape during expiration
-shifts lung due to pressure (mediastinal shift)
-decreases venous return and cardiac output

Front 68

What effect does pneumothorax have on the body?

Back 68

-decreased to almost absent breath sounds
-hyperresonance
-tension and large spontaneous are emergencies

Front 69

Dx of pneumothorax:

Back 69

-xray
-physical findings

Front 70

Tx of pneumothorax:

Back 70

< 15% treated with bedrest
> 15% treated with chest tube
-thoracotomy if the lung further collapses and large blebs are formed

Front 71

pleural effusion:

Back 71

-an abnormal collection of fluid in the pleural cavity

Front 72

5 types of pleural effusion:

Back 72

1. transudates
2. exudates
3. empyema (purulent drainage)
4. hemothorax
5. chylothorax

Front 73

transudate:

Back 73

-(thin) fluid substance passed thru a membrane or extruded from the blood
-common in CHF and nephrosis

Front 74

exudate:

Back 74

-(thick) fluid, cells, or other substances that have slowly escaped from blood vessels and have been deposited in tissues or on tissue surfaces
-high in protein content
-common in malignancies, infections, embolism, sarcoidosis

Front 75

What 2 forms are common with pleural effusions caused by trauma?

Back 75

hemothorax and chylothorax

Front 76

muscular dystrophy:

Back 76

-group of progressive muscle disorders caused by a defect in one or more genes that control muscle function and characterized by gradual irreversible wasting of skeletal muscle

Front 77

myasthenia gravis:

Back 77

-aka Goldflam disease
-disease characterized by progressive fatigue and generalized weakness of the skeletal muscles, especially those of the face, neck, arms, and legs, caused by impaired transmission of nerve impulses following an autoimmune attack on acetylcholine receptors.

Front 78

Guillain-Barre syndrome:

Back 78

-ascending pattern of weakness
-temporary inflammation of the nerves, causing pain, weakness, and paralysis in the extremities and often progressing to the chest and face
-typically occurs after recovery from a viral infection or, in rare cases, following immunization for influenza