Restrictive Lung Diseases: Overview and Practice Questions

Restrictive lung diseases are respiratory disorders that make it difficult for patients to breathe. The most common symptom is shortness of breath, which can make everyday activities like walking or climbing stairs difficult or even impossible.

There are several different types, which have a few key differences and similarities.

In this article, we will provide an overview of the different restrictive lung diseases, including their symptoms, causes, and treatment methods. We included helpful practice questions for your benefit as well.

What is a Restrictive Lung Disease?

A restrictive lung disease is a type of disorder that restricts the lungs’ ability to expand. They are characterized by reduced lung volumes that can result from:

• Changes in lung parenchyma
• Pleural diseases
• Chest wall abnormalities
• Neuromuscular diseases

Restrictive lung diseases cause decreased lung compliance, which can result in impaired ventilatory function, reduced gas exchange, and respiratory failure in severe cases.

Signs and Symptoms

Each type of restrictive lung disease has its own unique signs and symptoms. However, one thing that all restrictive diseases have in common is that they decrease the ability of the lungs to expand.

This causes reduced lung volumes, which can result in hypoxemia, shortness of breath, and other breathing-related problems.

Treatment

There are several treatment methods that can be used to manage the symptoms of restrictive lung diseases, including the following:

• Lung expansion therapy
• Medications
• Smoking cessation
• Oxygen therapy
• Pulmonary rehabilitation
• Surgical procedures
• Noninvasive ventilation
• Mechanical ventilation (in severe cases)

The treatment methods will vary depending on the specific type of restrictive lung disease and the severity of the patient’s signs and symptoms.

Types of Restrictive Lung Diseases

There are several types of restrictive lung diseases, including the following:

• Pulmonary fibrosis
• Asbestosis
• Sarcoidosis
• Pleural effusion
• Pneumothorax
• Pleural Tumors
• Pulmonary edema
• Chest wall trauma
• Kyphoscoliosis
• Guillain-Barré syndrome
• Myasthenia gravis
• Scleroderma
• Morbid obesity

As you can see, there are various types of restrictive lung diseases. Each type has its own set of symptoms, causes, and treatment methods.

Pulmonary Fibrosis

Pulmonary fibrosis is a type of restrictive lung disease that is characterized by the development of scar tissue in the lungs. This makes it difficult for the lungs to expand, which results in difficulty breathing for the patient.

Asbestosis

Asbestosis is a lung condition that is caused by prolonged exposure to asbestos fibers in the air. This results in the development of inflammation and scar tissue in the lungs, which makes it difficult for the patient to breathe.

Sarcoidosis

Sarcoidosis is a restrictive lung disease characterized by the formation of granulomas in the lungs and lymph nodes. This can result in a dry cough, shortness of breath, wheezing, and chest pain.

Pleural Effusion

Pleural effusion is a respiratory condition characterized by an abnormal accumulation of fluid in the pleural space. When this build-up of fluid occurs, it puts pressure on the lungs and causes dyspnea and shortness of breath.

Pneumothorax

Pneumothorax is a condition that occurs when air leaks into the pleural space of the thorax, which results in a collapsed lung.

As air enters the pleural space, it alters the pressure that keeps the lungs inflated. This causes numerous signs and symptoms, such as hypoxemia, dyspnea, and chest tightness.

Pleural Tumors

Pleural tumors are growths that develop on the pleura, which is the lining of the lungs. These tumors can be either benign or malignant and can cause a variety of symptoms depending on their size and location.

They are listed as a type of restrictive lung disease because they can restrict expansion, which reduces lung volumes.

Pulmonary Edema

Pulmonary edema is a condition in which an excessive amount of fluid collects in the alveoli of the lungs. This accumulation of fluid decreases lung volumes and results in dyspnea and impaired gas exchange.

Chest Wall Trauma

Chest wall trauma is a term that refers to any type of injury or trauma to the chest wall. Some common examples in fractures to the ribs or sternum. This can result in a pneumothorax and have restrictive effects on the lungs.

Kyphoscoliosis

Kyphoscoliosis is a spinal deformity that results in an abnormal curvature of the spine. This irregular curvature can put pressure on the lungs and decrease expandability, which reduces lung volumes.

Guillain-Barré Syndrome

Guillain-Barré syndrome is a rapid-onset disease characterized by ascending paralysis in which the patient’s autoimmune system attacks and causes inflammation and deterioration of the peripheral nervous system.

As a result, the respiratory system is affected, which can lead to ventilatory failure.

Myasthenia Gravis

Myasthenia gravis is a chronic neuromuscular disease that leads to descending paralysis and muscular weakness in the face, throat, and respiratory system.

As the respiratory muscles are affected, it can lead to decreased lung expansion and ventilatory failure.

Scleroderma

Scleroderma is a connective tissue disorder that is characterized by the hardening and thickening of the skin. This can lead to pulmonary hypertension and interstitial lung disease.

Morbid Obesity

Morbid obesity is a condition in which a person is significantly overweight to the point that it puts their overall health at risk. As fat tissue builds up in the thoracic region, it limits the expandability of the lungs and chest wall.

Restrictive Lung Diseases Practice Questions:

1. What is the general problem of restrictive lung diseases?
They restrict the expansion of the lungs.

2. How are lung volumes affected by restrictive lung diseases?
They are decreased

3. How is the FEV1/FVC ratio affected by restrictive lung diseases?
It increases

4. What are the causes of restrictive lung diseases?
Chest wall disorders, poor muscular effort to breathe, and interstitial lung diseases

5. What chest wall disorders can cause restrictive lung disease?
Scoliosis, kyphosis, and obesity

6. What are the clinical findings of restrictive lung diseases?
Dry cough, dyspnea on exertion, late inspiratory crackles, cor pulmonale, decreased lung volumes, and an increased FEV1/FVC ratio

7. What type of disease is characterized by decreased lung compliance, increased inspiratory effort, and smaller static and dynamic lung volumes?
Restrictive lung disease

8. What are the two types of restrictive lung diseases?
Extrapulmonary and parenchymal

9. What causes extrapulmonary restrictive lung disease?
Conditions that limit the inspiratory movement of the chest wall

10. What conditions cause chest wall deformities?
Muscular dystrophy, kyphoscoliosis, and obesity

11. What is another term for parenchymal restrictive lung disease?
Interstitial lung disease

12. What does a restrictive pattern demonstrate in pulmonary function testing?
Decreased total lung capacity and a normal or increased FEV1/FVC ratio

13. What is the definition of restrictive lung disease?
A type of disease that causes a reduction in lung volumes

14. What volume readings are affected in restrictive lung disease?
Vital capacity and total lung capacity

15. What are the two types of restrictive lung disease?
Intrinsic and extrinsic

16. What is affected by an intrinsic restrictive lung disease?
The lung parenchyma

17. What is affected by an extrinsic restrictive lung disease?
The pleura or chest wall

18. What is the definition of intrinsic restrictive lung disease?
A disease that causes inflammation or scarring of the lung tissue

19. What is the definition of extrinsic restrictive lung disease?
A disease of the chest wall, pleura, or respiratory muscles

20. What are the types of intrinsic restrictive lung diseases?
Sarcoidosis, idiopathic pulmonary fibrosis, interstitial lung disease, ARDS, and IRDS

21. What are the types of extrinsic restrictive lung diseases?
Myasthenia gravis, Guillain-barre syndrome, kyphosis, and diseases that restrict the lower thoracic region

22. What spirometry tests are used to diagnose a restrictive lung disease?
Functional residual capacity (FRC)

23. What is sarcoidosis?
A multi-system inflammatory disease of unknown etiology characterized by granulomas in lungs and intrathoracic lymph nodes

24. What is idiopathic pulmonary fibrosis?
A type of chronic progressive interstitial scarring that disrupts alveolar epithelial cells and causes diffuse epithelial cell disorganization

25. What can cause interstitial lung disease?
Asbestosis, silicosis, pneumoconiosis, medications, radiation, hypersensitivity pneumonitis, rheumatoid arthritis, lupus, and scleroderma

26. What part of the lung does ILD affect?
The pulmonary interstitium

27. What do normal lungs allow?
Space for efficient gas exchange to occur

28. What does an increase in interstitial tissue cause?
Decreased perfusion

29. Is asthma an obstructive or restrictive lung disease?
Obstructive

30. How serious is restrictive lung disease?
Restrictive lung diseases can lead to a variety of signs and symptoms and can be life-threatening in severe cases.

31. What is the difference between a restrictive and obstructive lung disease?
Obstructive lung disease are characterized by decreased flows. Restrictive lung diseases are characterized by decreased lung volumes.

32. Why is pneumonia a restrictive lung disease?
Because is lung consolidation and decreased lung volumes

33. What is typical of restrictive lung diseases?
Decreased lung expansion

34. What test would you use to determine if a patient has a restrictive lung disease?
Spirometry

35. What is a mixed obstructive and restrictive lung disease?
A disease that results in both obstruction and restriction of the lungs

36. What is a common symptom of restrictive lung diseases?
Shortness of breath

37. How is a restrictive lung disease diagnosed?
By assessing a patient’s PFT results

38. How does a restrictive lung disease affect ventilation?
The lungs are not able to expand, which results in decreased ventilation

39. Is a pneumothorax an obstructive or restrictive lung disease?
Restrictive

40. Is COPD an obstructive or restrictive lung disease?
Obstructive

41. How to improve lung volume with restrictive disease?
Perform lung expansion therapy

42. Why does the ERV decrease in restrictive lung diseases?
The patient’s lung volumes are decreased, which results in a decreased expired volume

43. How to treat a restrictive lung disease?
Lung expansion therapy, medications, and oxygen therapy

44. What is decreased in restrictive lung diseases?
Lung volumes

45. What is the best indicator for a restrictive lung disease?
A decreased vital capacity

46. A patient with a decreased FEV1 and normal FEV1/FVC ratio has what type of disease?
Restrictive lung disease

47. What does a flow-volume loop look like in a restrictive lung disease?
The loop will appear tall and skinny.

48. How much are lung volumes decreased in a restrictive lung disease?
20%

49. A patient with decreased flows and volumes has what type of lung disease?
Both obstructive and restrictive

50. What happens to the residual volume in a restrictive lung disease?
It decreases

Final Thoughts

Restrictive lung diseases have impacted millions of people around the world and will continue to do so for years to come. This is why it’s important for respiratory therapists to be well-informed about the different types, including their causes, symptoms, and treatment methods.

If you enjoyed this guide, we have a similar article on obstructive lung diseases that I think you’ll find helpful. Thank you so much for reading and, as always, breathe easy, my friend.