Restrictive lung disease final

Small group presentation which was done during our physiology days under the guidance of Prof. Sampath Gunawardena senior lecturer in department of Physiology, Faculty of Medicine University of Ruhuna.

1. Restrictive Lung Disease Deegala S.A. Deemanthi M.N. Dias P.G.N.J. Dilanka I.W.G.M. Dinuraji K.S.H.

2. What are the main types of lung diseases? Characteristic of the restrictive lung disease Different causes for restrictive lung disease Identification of restrictive lung disease by lung function test Comparison between obstructive airway disease and restrictive lung disease Objectives

3. Restrictive lung disease Intrinsic factors Diseases of lung parenchyma (lung fibrosis) Inflammation or scarring of lung tissue Extrinsic factors Extra parenchymal disease Thoracic cage disorders (Scoliosis, Kyphosis ) Disorders affecting pleura (Pleural thickening, Pneumothorax ) Neuromuscular disorders (Respiratory muscle paralysis)

4. Occupational and environmental factors silica dust - silicosis asbestos fibers - asbestosis Radiation treatment Smoking Factors that affect lung tissue

5. Medications chemotherapy drugs - methotrexate antiarrhythmic drug - amiodarone Medical conditions Pneumonia Tuberculosis Rheumatoid arthritis Factors that affect lung tissue contd.

6. Pulmonary fibrosis occurs when lung tissue becomes damaged and scarred. This thickened, stiff tissue makes it more difficult for lungs to expand Because of lung fibrosis elasticity compliance Intrinsic factors

7. Lung compliance in pulmonary fibrosis

8. Signs and symptoms of pulmonary fibrosis Shortness of breath (dyspnea) Dry cough Fatigue Unexplained weight loss Aching muscles and joints Pulmonary fibrosis

9. Complications Pulmonary hypertension Right heart failure Respiratory failure Lung cancer Pulmonary fibrosis contd.

10. Difficulty in expansion of lungs reduces the ventilation Reduces gas exchange Pco 2 increases in blood while Po 2 decreases Hypercapnoea and Hypoxia lead to elevation of blood H + and reduces the blood pH Changes in blood gas levels in pulmonary fibrosis

11. Diagnosis Chest X-ray Lung function test CT scan Echocardiogram Lung biopsy

12. A spirometer will measure how much air can be exhaled after a maximal inspiration Lung function test

13. Restricted lung expansion effectively reduce Total lung capacity (TLC) Vital capacity (VC ) Forced vital capacity (FVC) Forced expiratory volume in 1 second ( FEV1) Lung function test in lung fibrosis

14. But FEV1/FVC ratio remains normal because FEV1 and FVC both reduced proportionately or ratio may be high Peak expiratory flow rate will be reduced in severe restrictive lung diseases Lung function test in lung fibrosis contd..

15. Lung function test in lung fibrosis contd..

16. Obstructive air way disease Restrictive lung disease FEV1 FVC FEV1/FVC normal compliance elasticity FEV1 FVC normal or reduced FEV1/FVC

17. Lung function test in lung fibrosis contd..

18. Pulmonary fibrosis cannot be reversed Some treatments reduce the symptoms and slow the progress of the disease Treatments and drugs for lung fibrosis

19. Treatment Initially treated with a corticosteroid Sometimes in combination with other drugs that suppress the immune system e.g. - cyclosporine Oxygen therapy (not very effective if the pulmonary ventilation is significantly reduced) Treatments and drugs for lung fibrosis contd.

20. Ganong’s Review of Medical Physiology 24 th Edition Hutchison’s clinical methods 23 rd Edition Kumar & Clarks Clinical Medicine Guyton and Hall Textbook of Medical Physiology http://www.mayoclinic.org/diseases-conditions http://www.nlm.nih.gov/pubs/factsheets/pubmed.html References

21. Special thanks to Dr. Sampath Gunawardena Senior Lecturer Department of Physiology

22. Thank you