Obstructive vs Restrictive Pulmonary Disease - Pathology - ATOT

Topic: Obstructive vs Restrictive Pulmonary Disease
Faculty: Pathology
Course: ATOT 2nd year

1. Obstructive vs Restrictive Pulmonary Disease Dr. Salman Ansari(MBBS) Tutor, Dept. of Pathology Kanachur Institute of Medical Sciences

2. Obstructive lung diseases Restrictive lung diseases Obstructive vs restrictive lung diseases

3. Obstructive lung diseases Increase in resistance to airflow Due to partial or complete obstruction at any level from the trachea to the bronchioles Examples of obstructive airway diseases: Emphysema Chronic Bronchitis Bronchial asthma Bronchiectasis

4. Restrictive pulmonary diseases Reduced expansion of lung parenchyma and decreased total lung capacity X-ray shows ground-glass shadows

5. Types of restrictive lung disease Restriction due to disorders of chest wall : Diseases which restrict expansion of the chest wall due to problems with chest wall/pleura/muscles E.g: kyphoscoliosis Poliomyelitis Pleural diseases Severe obesity Interstitial and infiltrative diseases : Diffuse involvement of parenchyma of the lung E.g: Pneumoconiosis Interstitial fibrosis

6. Spirometry: basic definitions FVC TLC FEV1

7. FVC Forced Vital Capacity the amount of air that can be forcefully exhaled from your lungs after breathing in as deeply as possible Normal: >80% But there is still some air left behind in the lungs - this is called Residual Volume(RV)

8. TLC Total lung capacity volume of air in the lungs upon the maximum effort of inspiration Normal: 6 liters TLC = FVC + RV

9. FEV1 forced expiratory volume in 1 second (FEV1) the maximum amount of air that the subject can forcibly expel during the first second following maximal inhalation Normal: >80%

10. What happens in obstructive lung diseases? To FEV1? To FVC? To TLC?

11. Obstructive FEV1 : ↓↓ Very low FVC : ↓ low/almost normal FEV1/FVC ratio : ↓↓ Very low TLC : high

12. What happens in restrictive lung diseases? To FEV1? To FVC? To TLC?

13. Restrictive FEV1 : ↓ low FVC : ↓ low FEV1/FVC ratio : normal(since both are low) TLC : low

14. Obstructive Restrictive FEV1 ↓ ↓ ↓ FVC ↓ /Normal ↓ FEV1/FVC ratio ↓ Normal TLC ↑ ↓

15. Feature Obstructive pulmonary disease Restrictive pulmonary disease Nature of airway disease Obstruction at any level from trachea to bronchiole Reduced expansion of lung parenchyma Pulmonary function test TLC: ↑ FEV1/FVC: ↓ TLC: ↓ FEV1/FVC ratio: Normal Chest X-ray Depends on cause B/l infiltrates showing ground glass shadows Examples Chronic bronchitis Emphysema Bronchial asthma Bronchiectasis Chest wall disorders : kyphoscoliosis, poliomyelitis Interstitial lung diseases : pneumoconioses

16. For notes, scan: References: Ramadas Nayak - Textbook of Pathology for Allied Health Sciences Questions: [email protected] For PPT, scan: