Chapter 2
Restrictive Resp. Disorders * Resulting from basically a collapsed lung - Alterations in lung parenchyma, pleura, chest wall, or neuromuscular function * Decrease in vital capacity (VC), lung capacity (TLC), functional residual capacity (FRC), residual volume (RV) * The greater the decrease in lung volume, greater the severity of disease

Fibrotic Interstitial Lung Disease * Immune reaction * Begins with injury to alveolar epithelial or capillary endothelial cells * Interstitial and alveolar wall thickening * Increased collagen bundles in interstitium * lung tissue becomes infiltrated * Persistent alveolitis leads to obliteration of alveolar capillaries, reorganization of lung parenchyma, irreversible fibrosis * Lead to large air-filled sacs (cysts) with dilated terminal and respiratory bronchioles * Occurs early, reversible * Triggering event leads to inflammatory response and increased inflammatory cells * Injury leads to increased membrane permeability and movement of fluid/debris into alveoli * Fibroblastic proliferation and deposition of large amount of collagen * Caused by increased mesenchymal cells and fibroblasts in interstitium * Alveolar walls become thickened with increased amounts of fibrous tissue * Progressive dyspnea with exercise with desaturation * Rapid-shallow breathing * Irritating, nonproductive cough * Clubbing of nail beds (40%-80%) * Bibasilar end-expiratory crackles (Velcro rales) * Cyanosis (late finding) * Anorexia, weight loss * Inability to increase cardiac output with exercise * Chest x-ray * PFT (decreased VC, TLC, diffusing capacity) * Open lung biopsy * Transbronchial biopsy * Gallium-67 scan * Bronchoalveolar lavage * Smoking cessation * Avoid environmental exposure to cause *