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8/3/2019 bianda axanditya

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The Differentiate Between The Two Broad Categories Of

Restrictive And Obstructive Lung Disease, Including The

Spirometric Abnormalities Associated With Each

Category

Bianda Axanditya( 22010110130181 )

I. Restrictive Lung Disease

a. General Explanation

Restrictive lung diseases (or restrictive ventilatory defects[1]) are a

category of extrapulmonary, pleural, or parenchymal respiratory diseases

that restrict lung expansion[2], resulting in a decreased lung volume, an

increased work of breathing, and inadequate ventilation and/or

oxygenation

People with restrictive lung disease cannot fully fill their lungs with air.Their lungs are restricted from fully expanding.

b. Patophysiology

In disorders that are intrinsic to the lung parenchyma, the underlyingprocess is usually pulmonary fibrosis (scarring of the lung).[3] As thedisease progresses, the normal lung tissue is gradually replaced by scartissue interspersed with pockets of air. This can lead to parts of the lunghaving a honeycomb-like appearance.

Restrictive lung disease most often results from a condition causingstiffness in the lungs themselves. In other cases, stiffness of the chest

wall, weak muscles, or damaged nerves may cause the restriction in lungexpansion

c. Causes

Some conditions causing restrictive lung disease are:

i. Interstitial lung disease, such as idiopathic pulmonary fibrosisii. Sarcoidosisiii. Obesity, including obesity hypoventilation syndrome

iv. Scoliosis
http://en.wikipedia.org/wiki/Restrictive_lung_disease#cite_note-0http://en.wikipedia.org/wiki/Respiratory_diseaseshttp://en.wikipedia.org/wiki/Restrictive_lung_disease#cite_note-emedicineRLD-1http://en.wikipedia.org/wiki/Pulmonary_fibrosishttp://en.wikipedia.org/wiki/Restrictive_lung_disease#cite_note-osborne-2http://www.webmd.com/lung/interstitial-lung-diseasehttp://www.webmd.com/diet/guide/what-is-obesityhttp://en.wikipedia.org/wiki/Respiratory_diseaseshttp://en.wikipedia.org/wiki/Restrictive_lung_disease#cite_note-emedicineRLD-1http://en.wikipedia.org/wiki/Pulmonary_fibrosishttp://en.wikipedia.org/wiki/Restrictive_lung_disease#cite_note-osborne-2http://www.webmd.com/lung/interstitial-lung-diseasehttp://www.webmd.com/diet/guide/what-is-obesityhttp://en.wikipedia.org/wiki/Restrictive_lung_disease#cite_note-0


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v. Neuromuscular disease, such as muscular dystrophy or amyotrophiclateral sclerosis (ALS)

But also can devided into two main causes,

Restrictive lung diseases may be due to specific causes which can beintrinsic to the parenchyma of the lung, or extrinsic to it.[5]

i. Intrinsic

Asbestosis caused by long-term exposure to asbestos dust. Radiation fibrosis, usually from the radiation given for cancertreatment. Certain drugs such as amiodarone, bleomycin and

methotrexate. As a consequence of another disease such as rheumatoidarthritis. Hypersensitivity pneumonitis due to an allergic reaction toinhaled particles. Acute respiratory distress syndrome (ARDS), a severe lungcondition occurring in response to a critical illness or injury. Infant respiratory distress syndrome due to a deficiency ofsurfactant in the lungs of a baby born prematurely.

Many cases of restrictive lung disease are idiopathic (have no knowncause). Still, there is generally pulmonary fibrosis.[3] Examples are:

Idiopathic pulmonary fibrosis Idiopathic interstitial pneumonia, of which there are severaltypes Sarcoidosis Eosinophilic pneumonia Lymphangioleiomyomatosis Pulmonary Langerhans' cell histiocytosis Pulmonary alveolar proteinosis

Conditions specifically affecting the interstitium are called interstitial lungdiseases.

ii.Extrinsic

Neuromuscular diseases, including Myasthenia gravis, andGuillain barre[6] Nonmuscular diseases of the chest wall, e.g. kyphosis andobesity.[7]

d. Diagnosis
http://www.webmd.com/parenting/understanding-muscular-dystrophy-basicshttp://www.webmd.com/brain/understanding-als-basicshttp://www.webmd.com/brain/understanding-als-basicshttp://en.wikipedia.org/wiki/Parenchymahttp://en.wikipedia.org/wiki/Asbestosishttp://en.wikipedia.org/w/index.php?title=Radiation_fibrosis&action=edit&redlink=1http://en.wikipedia.org/wiki/Amiodaronehttp://en.wikipedia.org/wiki/Bleomycinhttp://en.wikipedia.org/wiki/Methotrexatehttp://en.wikipedia.org/wiki/Rheumatoid_arthritishttp://en.wikipedia.org/wiki/Rheumatoid_arthritishttp://en.wikipedia.org/wiki/Hypersensitivity_pneumonitishttp://en.wikipedia.org/wiki/Acute_respiratory_distress_syndromehttp://en.wikipedia.org/wiki/Infant_respiratory_distress_syndromehttp://en.wikipedia.org/wiki/Surfactanthttp://en.wikipedia.org/wiki/Idiopathichttp://en.wikipedia.org/wiki/Pulmonary_fibrosishttp://en.wikipedia.org/wiki/Restrictive_lung_disease#cite_note-osborne-2http://en.wikipedia.org/wiki/Idiopathic_pulmonary_fibrosishttp://en.wikipedia.org/wiki/Idiopathic_interstitial_pneumoniahttp://en.wikipedia.org/wiki/Sarcoidosishttp://en.wikipedia.org/wiki/Eosinophilic_pneumoniahttp://en.wikipedia.org/wiki/Lymphangioleiomyomatosishttp://en.wikipedia.org/wiki/Langerhans'_cell_histiocytosishttp://en.wikipedia.org/wiki/Pulmonary_alveolar_proteinosishttp://en.wikipedia.org/wiki/Interstitial_lung_diseasehttp://en.wikipedia.org/wiki/Interstitial_lung_diseasehttp://en.wikipedia.org/wiki/Myasthenia_gravishttp://en.wikipedia.org/wiki/Guillain_barrehttp://en.wikipedia.org/wiki/Restrictive_lung_disease#cite_note-pmid2780083-5http://en.wikipedia.org/wiki/Restrictive_lung_disease#cite_note-pmid2780083-5http://en.wikipedia.org/wiki/Kyphosishttp://en.wikipedia.org/wiki/Obesityhttp://en.wikipedia.org/wiki/Restrictive_lung_disease#cite_note-6http://www.webmd.com/parenting/understanding-muscular-dystrophy-basicshttp://www.webmd.com/brain/understanding-als-basicshttp://www.webmd.com/brain/understanding-als-basicshttp://en.wikipedia.org/wiki/Parenchymahttp://en.wikipedia.org/wiki/Asbestosishttp://en.wikipedia.org/w/index.php?title=Radiation_fibrosis&action=edit&redlink=1http://en.wikipedia.org/wiki/Amiodaronehttp://en.wikipedia.org/wiki/Bleomycinhttp://en.wikipedia.org/wiki/Methotrexatehttp://en.wikipedia.org/wiki/Rheumatoid_arthritishttp://en.wikipedia.org/wiki/Rheumatoid_arthritishttp://en.wikipedia.org/wiki/Hypersensitivity_pneumonitishttp://en.wikipedia.org/wiki/Acute_respiratory_distress_syndromehttp://en.wikipedia.org/wiki/Infant_respiratory_distress_syndromehttp://en.wikipedia.org/wiki/Surfactanthttp://en.wikipedia.org/wiki/Idiopathichttp://en.wikipedia.org/wiki/Pulmonary_fibrosishttp://en.wikipedia.org/wiki/Restrictive_lung_disease#cite_note-osborne-2http://en.wikipedia.org/wiki/Idiopathic_pulmonary_fibrosishttp://en.wikipedia.org/wiki/Idiopathic_interstitial_pneumoniahttp://en.wikipedia.org/wiki/Sarcoidosishttp://en.wikipedia.org/wiki/Eosinophilic_pneumoniahttp://en.wikipedia.org/wiki/Lymphangioleiomyomatosishttp://en.wikipedia.org/wiki/Langerhans'_cell_histiocytosishttp://en.wikipedia.org/wiki/Pulmonary_alveolar_proteinosishttp://en.wikipedia.org/wiki/Interstitial_lung_diseasehttp://en.wikipedia.org/wiki/Interstitial_lung_diseasehttp://en.wikipedia.org/wiki/Myasthenia_gravishttp://en.wikipedia.org/wiki/Guillain_barrehttp://en.wikipedia.org/wiki/Restrictive_lung_disease#cite_note-pmid2780083-5http://en.wikipedia.org/wiki/Kyphosishttp://en.wikipedia.org/wiki/Obesityhttp://en.wikipedia.org/wiki/Restrictive_lung_disease#cite_note-6


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In restrictive lung disease, forced expiratory volume in one second(FEV1) and forced vital capacity (FVC) are reduced so the FEV1/FVCratio is normal. In obstructive lung disease FEV1 is reduced while theFVC is normal thus the FEV1/FVC ratio is lower.

One definition requires a total lung capacity which is 80% or less of theexpected value.[4]

II. Obstructive Lung Disease

a. General Explanation

Obstructive lung disease is a category of respiratory disease

characterized by airway obstruction. It is generally characterized by

inflamed and easily collapsible airways, obstruction to airflow, and

frequent office visits and hospitalizations.

People with obstructive lung disease have difficulty exhaling all the airfrom the lungs. Because of damage to the lungs or narrowing of theairways inside the lungs, exhaled air comes out more slowly than normal.At the end of a full exhalation, an abnormally high amount of air may stilllinger in the lungs.

b. Causes

The most common causes of obstructive lung disease are:

Chronic obstructive pulmonary disease (COPD),which includes emphysema and chronic bronchitis Asthma Bronchiectasis Cystic fibrosis

Obstructive lung disease makes it harder to breathe, especially duringincreased activity or exertion. As the rate of breathing increases, there isless time to breathe all the air out before the next inhalation.

Condition Mainsite

Major changes Causes Symptoms
http://en.wikipedia.org/wiki/FEV1http://en.wikipedia.org/wiki/Forced_vital_capacityhttp://en.wikipedia.org/wiki/FEV1/FVC_ratiohttp://en.wikipedia.org/wiki/FEV1/FVC_ratiohttp://en.wikipedia.org/wiki/Total_lung_capacityhttp://en.wikipedia.org/wiki/Restrictive_lung_disease#cite_note-pmid11991875-3http://en.wikipedia.org/wiki/Respiratory_diseasehttp://en.wikipedia.org/wiki/Airway_obstructionhttp://www.webmd.com/lung/copd/default.htmhttp://www.webmd.com/lung/copd/what-is-emphysemahttp://en.wikipedia.org/wiki/FEV1http://en.wikipedia.org/wiki/Forced_vital_capacityhttp://en.wikipedia.org/wiki/FEV1/FVC_ratiohttp://en.wikipedia.org/wiki/FEV1/FVC_ratiohttp://en.wikipedia.org/wiki/Total_lung_capacityhttp://en.wikipedia.org/wiki/Restrictive_lung_disease#cite_note-pmid11991875-3http://en.wikipedia.org/wiki/Respiratory_diseasehttp://en.wikipedia.org/wiki/Airway_obstructionhttp://www.webmd.com/lung/copd/default.htmhttp://www.webmd.com/lung/copd/what-is-emphysema


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Chronicbronchitis

Bronchus

Hyperplasia andhypersecretion ofmucus glands

Tobaccosmoking andairpollutants

Productivecough

Bronchiectasis Bronchu

s

Dilation and

scarring of airways

Persistent

severeinfections

Cough,

purulentsputumand fever

Asthma Bronchus

Smoothmusclehyperplasia Excessivemucus

Inflammation

Immunologic oridiopathic

Episodicwheezing,cough anddyspnea

Emphysema Acinus Airspaceenlargement andwall destruction

Tobaccosmoking Dyspnea

Bronchiolitis(subgroup ofchronicbronchitis)

Bronchiole

Inflammatoryscarring andbronchioleobliteration

Tobaccosmoking andairpollutants

Cough,dyspnea

Unless else specified in boxes then reference is [3]

c. Diagnosis

Diagnosis of obstructive disease requires several factors depending onthe exact disease being diagnosed. However one commonalty betweenthem is a decreased FEV1/FVC ratio, which is the ability to exhale 70%of their breath within one second.

III.Spirometry Test
http://en.wikipedia.org/wiki/Chronic_bronchitishttp://en.wikipedia.org/wiki/Chronic_bronchitishttp://en.wikipedia.org/wiki/Bronchushttp://en.wikipedia.org/wiki/Bronchushttp://en.wikipedia.org/wiki/Tobacco_smokinghttp://en.wikipedia.org/wiki/Tobacco_smokinghttp://en.wikipedia.org/wiki/Productive_coughhttp://en.wikipedia.org/wiki/Productive_coughhttp://en.wikipedia.org/wiki/Bronchiectasishttp://en.wikipedia.org/wiki/Asthmahttp://en.wikipedia.org/wiki/Idiopathichttp://en.wikipedia.org/wiki/Emphysemahttp://en.wikipedia.org/wiki/Bronchiolitishttp://en.wikipedia.org/wiki/Obstructive_lung_disease#cite_note-Kumar13-2-2http://en.wikipedia.org/wiki/FEV1/FVC_ratiohttp://en.wikipedia.org/wiki/Chronic_bronchitishttp://en.wikipedia.org/wiki/Chronic_bronchitishttp://en.wikipedia.org/wiki/Bronchushttp://en.wikipedia.org/wiki/Bronchushttp://en.wikipedia.org/wiki/Tobacco_smokinghttp://en.wikipedia.org/wiki/Tobacco_smokinghttp://en.wikipedia.org/wiki/Productive_coughhttp://en.wikipedia.org/wiki/Productive_coughhttp://en.wikipedia.org/wiki/Bronchiectasishttp://en.wikipedia.org/wiki/Asthmahttp://en.wikipedia.org/wiki/Idiopathichttp://en.wikipedia.org/wiki/Emphysemahttp://en.wikipedia.org/wiki/Bronchiolitishttp://en.wikipedia.org/wiki/Obstructive_lung_disease#cite_note-Kumar13-2-2http://en.wikipedia.org/wiki/FEV1/FVC_ratio


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Sources

http://www.webmd.com/lung/obstructive-and-restrictive-lung-disease?

page=2

http://en.wikipedia.org/wiki/Restrictive_lung_disease

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1237217/pdf/westjmed0027

6-0040.pdf

http://www.boom-outahere.com/SWood/Pulmonary

%20Lectures/Handouts/Mechanics%204%20-%20Assessing%20pulmonary

%20function.pdf
http://www.webmd.com/lung/obstructive-and-restrictive-lung-disease?page=2http://www.webmd.com/lung/obstructive-and-restrictive-lung-disease?page=2http://en.wikipedia.org/wiki/Restrictive_lung_diseasehttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC1237217/pdf/westjmed00276-0040.pdfhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC1237217/pdf/westjmed00276-0040.pdfhttp://www.boom-outahere.com/SWood/Pulmonary%20Lectures/Handouts/Mechanics%204%20-%20Assessing%20pulmonary%20function.pdfhttp://www.boom-outahere.com/SWood/Pulmonary%20Lectures/Handouts/Mechanics%204%20-%20Assessing%20pulmonary%20function.pdfhttp://www.boom-outahere.com/SWood/Pulmonary%20Lectures/Handouts/Mechanics%204%20-%20Assessing%20pulmonary%20function.pdfhttp://www.webmd.com/lung/obstructive-and-restrictive-lung-disease?page=2http://www.webmd.com/lung/obstructive-and-restrictive-lung-disease?page=2http://en.wikipedia.org/wiki/Restrictive_lung_diseasehttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC1237217/pdf/westjmed00276-0040.pdfhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC1237217/pdf/westjmed00276-0040.pdfhttp://www.boom-outahere.com/SWood/Pulmonary%20Lectures/Handouts/Mechanics%204%20-%20Assessing%20pulmonary%20function.pdfhttp://www.boom-outahere.com/SWood/Pulmonary%20Lectures/Handouts/Mechanics%204%20-%20Assessing%20pulmonary%20function.pdfhttp://www.boom-outahere.com/SWood/Pulmonary%20Lectures/Handouts/Mechanics%204%20-%20Assessing%20pulmonary%20function.pdf


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