HSC 4555 Lecture Notes - Lecture 11: Pulmonary Function Testing, Granuloma, Kyphoscoliosis
Copstead-Kirkhorn: Pathophysiology, 4th Edition
Chapter 23: Restrictive Pulmonary Disorders
KEY POINTS
LUNG PARENCHYMA DISORDERS
FIBROTIC INTERSTITIAL LUNG DISEASES
Diffuse Interstitial Lung Disease, Sarcoidosis, and Hypersensitivity Pneumonitis
•Diffuse interstitial pulmonary fibrosis is a restrictive disorder characterized by thickening of
the alveolar interstitium. The disorder is an immune-mediated disorder that follows an initial
lung injury.
•Lung tissues are characteristically infiltrated by immune cells (macrophages and
lymphocytes). Excess fibrin deposition results in stiff, noncompliant lungs. Vital capacity, tidal
volume, FRC, and diffusion capacity are generally reduced. Respiratory rate increases to
compensate for the small tidal volume.
•Treatment centers on administration of drugs to depress immune system activity, such as
corticosteroids.
•Sarcoidosis is a restrictive disorder associated with abnormal protein deposits (granulomas)
in the lung. Granulomas are fibrotic and are associated with immune cells (histiocytes). The
cause is unknown.
•Symptoms include progressive dyspnea, fever, enlarged lymph nodes, and generalized
symptoms of inflammation. Pulmonary lymph nodes may be primarily affected, with
progression to parenchymal involvement. Pulmonary function test results are consistent with a
restrictive disorder, demonstrating reduced lung volumes and increased respiratory rate.
•Treatment centers on alleviation or relief of the symptoms. Corticosteroids may be used to
reduce inflammation.
•Hypersensitivity pneumonitis includes a group of inflammatory lung disorders associated
with inhalation of organic particles. Antibodies are produced in response to the inhaled
particles; then antigen-antibody complexes deposit in the lung, initiating inflammation and
granuloma production.
•Hypersensitivity pneumonitis is characterized by general symptoms of inflammation (e.g.,
fever, chills, malaise), dyspnea, dry cough, and tachypnea. Chronic exposure leads to
progressive fibrosis and pulmonary dysfunction characteristic of restrictive parenchymal
disease.
Occupational Lung Diseases
•Occupational lung diseases result from chronic inhalation of gases and inert particles.
Commonly identified particles include coal, silica, and asbestos. Smoking and environmental
pollutants may be contributing factors because they depress the ciliary function necessary to
remove inhaled particles.
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Document Summary
Diffuse interstitial lung disease, sarcoidosis, and hypersensitivity pneumonitis. Diffuse interstitial pulmonary fibrosis is a restrictive disorder characterized by thickening of the alveolar interstitium. The disorder is an immune-mediated disorder that follows an initial lung injury. Lung tissues are characteristically infiltrated by immune cells (macrophages and lymphocytes). Excess fibrin deposition results in stiff, noncompliant lungs. Vital capacity, tidal volume, frc, and diffusion capacity are generally reduced. Respiratory rate increases to compensate for the small tidal volume. Treatment centers on administration of drugs to depress immune system activity, such as corticosteroids. Sarcoidosis is a restrictive disorder associated with abnormal protein deposits (granulomas) in the lung. Granulomas are fibrotic and are associated with immune cells (histiocytes). Symptoms include progressive dyspnea, fever, enlarged lymph nodes, and generalized symptoms of inflammation. Pulmonary lymph nodes may be primarily affected, with progression to parenchymal involvement. Pulmonary function test results are consistent with a restrictive disorder, demonstrating reduced lung volumes and increased respiratory rate.
