Extrinsic Causes of Restrictive Lung Disease

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  • 0:01 Extrinsic Restrictive…
  • 0:57 The Skeleton and…
  • 2:08 Obesity and Breathing
  • 3:24 Muscular Disorders and…
  • 4:31 The Pleural Space and…
  • 7:13 Lesson Summary
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Lesson Transcript
Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

Did you know that air can actually cause you problems breathing? It's true. Find out in this lesson how air, fluid, fat, and all sorts of other stuff causes difficulty breathing.

Extrinsic Restrictive Lung Disease

Take your finger and stick it between your ribs. But be gentle; I don't want you to get a bruise. There are different things that you can feel as you do this. There's your skin, some fat underneath that, and beneath that are muscles. There are muscles between your ribs. They're there to help you breathe. Just like your diaphragm, a muscle located underneath your lungs that helps you breathe, these muscles between your ribs help you breathe as well.

Sometimes, either the innervation to respiratory muscles, the respiratory muscles themselves, or even the bones that surround your lungs are affected in a negative way, to the point of actually causing difficulties breathing. These types of conditions are grouped together under extrinsic causes of restrictive lung disease - in other words, conditions that cause difficulty breathing as a result of problems outside of the lungs themselves.

The Skeleton and Breathing Difficulties

In the case of the latter, if the skeletal structures surrounding your lungs are affected, this can result in breathing difficulties.

One such condition is known as ankylosing spondylitis. This is an inflammatory condition that results in the fusion of the spine. If the spine freezes in place, usually in a hunchback appearance, then your chest squeezes down on itself, resulting in breathing difficulties. Go ahead and try it yourself. Sit up straight and breathe in deeply. Exhale. Now slouch over like Quasimodo. Just try and breathe in the same volume of air as before. It won't happen.

This type of forward curvature of the thoracic spine is known as kyphosis. A more severe form of spinal issues that causes breathing difficulties is known as kyphoscoliosis, a condition affecting the spine as a result of a combination of kyphosis and scoliosis, where 'scoliosis' refers to a lateral curvature of the spine - that is to say, a side-to-side curve.

Obesity and Breathing

While primary skeletal issues can cause problems breathing in, things that occur outside of the chest itself but still impinge on the chest's ability to help the lungs breathe can also result in restrictive breathing difficulties - again, that is to say, breathing difficulties that make it hard to breathe inwards.

One of the most famous causes of this is obesity. I do not believe it's hard to imagine why. If there is extra weight upon your chest, then the muscles that help you breathe have to work that much harder in order to help you breathe inwards, resulting in breathing difficulties. If you really want to try this (with some supervision), then put a small iron workout plate on your chest as you are lying down. It's going to be more difficult to breath in as a result.

Therefore, obesity can lead to something known as obesity hypoventilation syndrome, sometimes called Pickwickian syndrome. This is a condition whereby improper and diminished breathing as a result of obesity leads to low levels of oxygen and high levels of carbon dioxide in the blood. This condition can lead most people to also develop sleep apnea, which refers to diminished or temporarily suspended breathing during sleep.

Muscular Disorders and Breathing

One of the reasons, besides the weight itself, that individuals with obesity have trouble breathing is because the muscles that help you breathe get tired. Just like your muscles get tired after lifting heavy weights for a long period of time, so do the respiratory muscles between your ribs and your diaphragm get tired from working against excess weight.

These same muscles can also suffer from neuromuscular disorders such as myasthenia gravis or Guillain-Barré syndrome, both of which can lead to respiratory paralysis and failure.

Here the muscles fail not so much as a result of having to work against a heavier load but because the signal for their function is diminished or lost. If an electrical signal to any of your favorite gadgets is lost, it will stop working as well, even if the parts that make up the gadget are in perfect working order. Well, if the signal to your muscles is lost as a result of nervous system destruction, then those muscles cannot work to help you breathe even if the muscles are perfectly healthy.

The Pleural Space and Breathing

Finally, for this lesson, the last set of extrinsic causes of restrictive lung disease I want to go over include those that affect the pleural space. This is the space between your lungs and your chest wall. If anything affects this space in an abnormal way, then it will decrease the lungs' ability to expand, resulting in restrictive lung disease.

Let's look at some of the things that can happen by imagining a balloon suspended inside of a glass box. The balloon represents our lungs and the glass box represents our chest wall.

Normally, you'll be able to inflate that balloon just fine, until the very edges of the glass box, meaning you'll be able to take a nice deep breath.

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