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.
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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.
There are several treatment methods that can be used to manage the symptoms of restrictive lung diseases, including the following:
- Lung expansion therapy
- 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
- Pleural effusion
- Pleural Tumors
- Pulmonary edema
- Chest wall trauma
- Guillain-Barré syndrome
- Myasthenia gravis
- 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 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 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 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 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 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 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 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 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 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 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 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 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?
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
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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?
29. Is asthma an obstructive or restrictive lung disease?
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?
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?
40. Is COPD an obstructive or restrictive lung disease?
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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?
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?
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?
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.
Medical Disclaimer: This content is for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please consult with a physician with any questions that you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you read in this article. We strive for 100% accuracy, but errors may occur, and medications, protocols, and treatment methods may change over time.
The following are the sources that were used while doing research for this article:
- Egan’s Fundamentals of Respiratory Care. 12th ed., Mosby, 2020. [Link]
- Clinical Manifestations and Assessment of Respiratory Disease. 8th ed., Mosby, 2019. [Link]
- Martinez-Pitre, Pedro J., et al. “Restrictive Lung Disease.” National Library of Medicine, www.ncbi.nlm.nih.gov/books/NBK560880.
- Caronia, Jonathan D. Robert. “Restrictive Lung Disease: Background, Pathophysiology, Etiology.” Medscape, 11 Jan. 2022, emedicine.medscape.com/article/301760-overview
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Medical Disclaimer: The information provided by Respiratory Therapy Zone is for educational and informational purposes only. It should not be used as a substitute for professional medical advice, diagnosis, or treatment. Please consult with a physician with any questions that you may have regarding a medical condition.