The Respiratory System 12 The Respiratory System

Multimedia Directory Slide 27 Respiratory System Animation Slide 32 Sleep Apnea Video Slide 43 Asthma Animation Slide 46 Bronchitis Animation Slide 49 Pulmonary Diseases Video Slide 53 Cystic Fibrosis Video Slide 65 Pneumonia Animation Slide 71 Tuberculosis Video Slide 73 ARDS Animation Slide 75 Allergic Rhinitis Video Slide 94 Setting Up and Assisting with Intubation Video Slide 102 Nebulizer Video

Multimedia Directory (cont.) Slide 105 Pulse Oximetry Video Slide 114 Spirometry Video Slide 116 TB Testing & Analysis Video

Learning Objectives After completing this chapter, you will be able to: Define and spell the word parts used to create medical terms for the respiratory system Identify the organs of the respiratory system and describe their structure and function Define common medical terms used for the respiratory system

Learning Objectives (cont.) After completing this chapter, you will be able to: Break down and define common medical terms used for symptoms, diseases, disorders, procedures, treatments, and devices for the respiratory system

The Respiratory System Functions Brings oxygen to the bloodstream Removes waste product carbon dioxide from blood

Figure 12.1 The Upper Respiratory System

Figure 12.2 The Respiratory System

Prefixes a-, an- = without absence of dia- = through endo- = within epi- = upon, over, above, on top

Prefixes (cont.) eu- = normal, good in- = without neo- = new pan- = all, entire poly- = many

Combining Forms alveol/o = air sac, alveolus atel/o = incomplete bronch/i, bronch/o = airway, bronchus con/i = dust cyst/o = sac, bladder

Combining Forms (cont.) fibr/o = fiber glott/o = opening into the windpipe hem/o, hemat/o = blood laryng/o = voice box, larynx lob/o = a rounded part, lobe

Combining Forms (cont.) muc/o = mucus nas/o = nose orth/o = straight ox/i = oxygen pharyng/o = throat, pharynx

Combining Forms (cont.) phragm/o, phragmat/o = partition pleur/o = rib, pleura pneum/o, pneumon/o, pneumat/o = air, lung pulmon/o = lung

Combining Forms (cont.) py/o = pus rhin/o = nose sept/o = wall, partition sinus/o = cavity

Combining Forms (cont.) somn/o = sleep sphyx/o = pulse spir/o = to breathe sten/o = narrowness, constriction thorac/o = chest, thorax

Combining Forms (cont.) tonsill/o = almond, tonsil trache/o = windpipe, trachea tubercul/o = little mass or swelling

Suffixes -algia = pain -ar, -ary = pertaining to -capnia = condition of carbon dioxide -cele = hernia, swelling, protrusion -centesis = surgical puncture to aspirate fluids

Suffixes (cont.) -eal = pertaining to -ectasis = expansion, dilation -emia = condition of blood -metry = measurement -osis = condition of -otomy, -tomy = cutting into, incision

Suffixes (cont.) -oxia = condition of oxygen -pexy = surgical fixation, suspension -phonia = condition of sound or voice -plasm = something shaped -pnea = breathing -ptysis = to cough up

Suffixes (cont.) -rrhagia = bleeding, hemorrhage -rrhea = discharge (of fluid) -spasm = sudden, involuntary muscle contraction -staxis = dripping -stomy = surgical creation of an opening

Anatomy and Physiology Three steps of respiration Inspiration (inhalation) External respiration (gas exchange) Expiration (exhalation) Ventilation—inspiration and expiration together Diaphragm—most important respiratory muscle

Anatomy and Physiology (cont.) Conducting portion—chambers and tubes that conduct air to and from the lungs Upper respiratory tract Nose Pharynx Larynx Trachea

Anatomy and Physiology (cont.) Conducting portion—chambers and tubes that conduct air to and from the lungs Lower respiratory tract Bronchi Bronchial tree Bronchioles

Anatomy and Physiology (cont.) Respiratory portion—alveoli are sites of gas exchange with bloodstream Respiratory membrane Barrier between the alveolus and bloodstream Site of gas diffusion between lungs and blood Lung Visceral pleura—outer surface of lung Parietal pleura—outer membrane layer attached to inside wall of thorax

Figure 12.3 The bronchial tree and alveoli

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Word Roots alveol = air sac bronch = airway glott = opening into the windpipe laryng = voice box nas = nose

Word Roots (cont.) pharyng = throat phragm = partition pleur = rib spir = to breathe trache = windpipe

Symptoms and Signs Acapnia Anoxia Aphonia Absence of carbon dioxide Absence of oxygen Aphonia Absence of voice

Symptoms and Signs (cont.) Apnea Pause in breathing Bradypnea Slow breathing

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Symptoms and Signs (cont.) Bronchospasm Narrowing of the airway when smooth muscles contract in the walls of the bronchioles Cheyne-Stokes respiration Pattern of breathing marked by a gradual increase of deep breathing, followed by shallow breathing, that leads to apnea

Symptoms and Signs (cont.) Dysphonia Hoarseness of the voice Dyspnea Difficulty breathing Epistaxis A nosebleed Eupnea Normal breathing

Symptoms and Signs (cont.) Hemoptysis Coughing up and spitting out blood that originates from the lungs Hemothorax Blood in the pleural cavity Hypercapnia Excessive carbon dioxide in the blood

Symptoms and Signs (cont.) Hyperpnea Deep breathing Hyperventilation Excessive movement of air in and out of the lungs Hypocapnia Deficient levels of carbon dioxide in the blood Can result in apnea

Symptoms and Signs (cont.) Hypopnea Shallow breathing Hypoventilation Breathing rhythm that fails to meet the body’s gas-exchange demands Hypoxemia Deficient levels of oxygen in the blood

Symptoms and Signs (cont.) Hypoxia Deficient levels of oxygen in tissues throughout the body Laryngospasm Spasmodic closure of the glottis Orthopnea Ability to breathe is limited to an upright position

Symptoms and Signs (cont.) Paroxysm Episodes of severe coughing Rhinorrhagia Rapid flow of blood from the nose Also called epistaxis

Symptoms and Signs (cont.) Rhinorrhea Fluid discharge from the nose Sputum Expectorated matter; usually contains mucus and sometimes pus Tachypnea Rapid breathing Thoracalgia Pain in the chest region

Diseases and Disorders Asphyxia Suffocation Asthma Characterized by widespread narrowing of the bronchioles formation of mucous plugs Symptoms—wheezing, shortness of breath, coughing

Figure 12.4 Asthma

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Diseases and Disorders (cont.) Atelectasis Absence of gas in the lungs Also called collapsed lung Bronchiectasis Dilation of the bronchi Patient: has chronic respiratory infections often produces a lot of purulent sputum

Diseases and Disorders (cont.) Bronchitis Inflammation of the bronchi Bronchogenic carcinoma Cancer that originates in the bronchi

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Figure 12.5 Bronchogenic carcinoma

Diseases and Disorders (cont.) Bronchopneumonia Acute inflammation of the smaller bronchial tubes, bronchioles, and alveoli Chronic obstructive pulmonary disease A group of disorders associated with obstruction of bronchial airflow Usually a result of inhaling tobacco products for many years Abbreviated COPD

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Diseases and Disorders (cont.) Coccidioidomycosis Fungal infection of upper respiratory tract and lungs that often spreads to other organs Also known as valley fever Cor pulmonale Disease of the right side of the heart that is caused by a chronic lung disease, such as emphysema

Diseases and Disorders (cont.) Coryza Common viral head cold Croup Respiratory condition of infants and young children “Barking” cough

Diseases and Disorders (cont.) Cystic fibrosis Hereditary disease characterized by excess mucus production in the respiratory tract and elsewhere Abbreviated CF

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Diseases and Disorders (cont.) Deviated septum Nasal septum is not median, creating one nasal cavity that is larger than the other Diaphragmatocele Protrusion of the stomach and/or intestine through the diaphragm Can interfere with breathing

Diseases and Disorders (cont.) Emphysema Chronic lung disease characterized by enlarged alveoli damaged respiratory membrane Symptoms include apnea a barrel chest due to labored breathing gradual deterioration due to chronic hypoxemia

Figure 12.6 Emphysema

Figure 12.6 (continued) This patient shows characteristics of emphysema

Diseases and Disorders (cont.) Epiglottitis Inflammation of the epiglottis Insomnia Inability to sleep Laryngitis Inflammation of the larynx

Diseases and Disorders (cont.) Laryngotracheobronchitis Chronic inflammation of the larynx, trachea, and bronchi Acute form that strikes infants and children is called croup Legionellosis Form of pneumonia caused by the bacterium Legionella pneumophila Also called Legionnaire’s disease

Diseases and Disorders (cont.) Nasopharyngitis Inflammation of the nose and pharynx Obstructive sleep apnea Collapse of the pharynx during sleep Pansinusitis Inflammation of all paranasal sinuses on one or both sides of the face

Diseases and Disorders (cont.) Pertussis Acute infectious disease Inflammation of the larynx, trachea, and bronchi Spasmodic coughing Also called whooping cough Pharyngitis Inflammation of the pharynx

Diseases and Disorders (cont.) Pleural effusion Escape of fluid into the pleural cavity during inflammation Pleuritis Inflammation of the pleurae Also called pleurisy Pneumatocele Hernia of the lung, in which the lung protrudes through an opening in the chest

Diseases and Disorders (cont.) Pneumoconiosis Inflammation of the lungs caused by the chronic inhalation of fine particles Includes: asbestosis silicosis

Diseases and Disorders (cont.) Pneumocystis carinii pneumonia Pneumonia caused by the fungus P. carinii A common opportunistic disease in patients with AIDS Pneumonia Inflammation of lung tissue Alveoli accumulate fluid and sometimes pus Causes may be bacterial, viral, fungal, or noninfectious, such as smoke inhalation

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Diseases and Disorders (cont.) Pneumonitis Inflammation of the lungs, independent of a particular cause Pneumothorax Presence of air or gas in the pleural space, causing lung to collapse Causes include fractured rib, puncture wounds to chest, ruptured air sac (as with emphysema)

Figure 12.7 Pneumothorax and atelectasis

Diseases and Disorders (cont.) Pulmonary edema Accumulation of fluid in the alveoli and bronchioles Pulmonary embolism Blockage in the pulmonary circulation caused by a moving blood clot Pulmonary neoplasm Tumor of the lung

Diseases and Disorders (cont.) Pulmonary tuberculosis Lung infection Includes tubercle formation, inflammation, and necrotic lesions Abbreviated TB Pyothorax A condition of pus in the pleural cavity Also called empyema

Figure 12.8 Pulmonary tuberculosis

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Diseases and Disorders (cont.) Respiratory distress syndrome Respiratory failure characterized by atelectasis Two forms Neonatal (or infant) respiratory distress syndrome Adult (or acute) respiratory distress syndrome

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Diseases and Disorders (cont.) Rhinitis Inflammation of the nasal mucous membrane Rhinomycosis Fungal infection of the nasal mucous membrane

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Diseases and Disorders (cont.) Severe acute respiratory syndrome Rapid-onset viral infection Abbreviated SARS Sinusitis Inflammation of the sinus mucous membranes

Diseases and Disorders (cont.) Tonsillitis Inflammation of a tonsil, usually a palatine tonsil Tracheitis Inflammation of the trachea

Diseases and Disorders (cont.) Tracheostenosis Narrowing of the trachea Upper respiratory infection Infection of the upper respiratory tract Usually the result of a virus Abbreviated URI

Treatments, Procedures, and Devices Acid-fast bacilli smear Clinical test performed on sputum to identify the presence of bacteria that react to acid Adenoidectomy Excision of a swollen pharyngeal tonsil, known as an adenoid

Treatments, Procedures, and Devices (cont.) Antihistamine Therapeutic drug that inhibits the effects of histamines (compounds released by cells that cause bronchial constriction and blood-vessel dilation) Arterial blood gases Clinical test on arterial blood to identify levels of oxygen and carbon dioxide Abbreviated ABGs

Treatments, Procedures, and Devices (cont.) Aspiration Removal of fluid with suction Auscultation Physical examination, often with the aid of a stethoscope, for listening to sounds within the body

Figure 12.9 Auscultation

Treatments, Procedures, and Devices (cont.) Bronchodilation Use of a bronchodilating agent to allow easier breathing Bronchogram X-ray image of the bronchi

Treatments, Procedures, and Devices (cont.) Bronchography Procedure for obtaining an x-ray of the bronchi Bronchoplasty Surgical repair of a bronchus Bronchoscopy Bronchi are examined with a bronchoscope

Figure 12.10 Bronchoscopy

Treatments, Procedures, and Devices (cont.) Chest CT scan Diagnostic 3-D imaging of the chest Used to diagnose: respiratory tumors pleural effusion pleurisy other diseases

Figure 12.11 Chest CT scan Source: Getty Images Inc.-Stone Allstock

Treatments, Procedures, and Devices (cont.) Chest x-ray X-ray photograph of the thoracic cavity Used to diagnose: tuberculosis tumors other lung conditions Abbreviated CXR Also called a chest radiograph

Figure 12.12 Chest x-ray Source: Bachman/Photo Researchers Inc.

Figure 12.12 (continued) Chest x-ray Source: Bachman/Photo Researchers Inc.

Treatments, Procedures, and Devices (cont.) Ear, nose, and throat specialist Physician who specializes in the treatment of diseases of the ear, nose, and throat Abbreviated ENT

Treatments, Procedures, and Devices (cont.) Endoscopy Visual examination of a body space with an endoscope A noninvasive technique for diagnostic and treatment purposes

Treatments, Procedures, and Devices (cont.) Endotracheal intubation Insertion of a tube into the trachea via the nose or mouth to open the airway Expectorant Drug that breaks up mucus and promotes coughing to remove it

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Treatments, Procedures, and Devices (cont.) Incentive spirometry Breathing therapy in which patient uses a portable spirometer to assist in deep breathing exercises Laryngectomy Surgical removal or excision of the larynx

Figure 12.13 Incentive spirometer

Treatments, Procedures, and Devices (cont.) Laryngocentesis Surgical puncture and aspiration of fluid from the larynx Laryngoplasty Surgical repair of the larynx Laryngoscopy Procedure that examines the larynx with a laryngoscope

Treatments, Procedures, and Devices (cont.) Laryngostomy Surgical creation of a permanent opening into the larynx Laryngotracheotomy Incision into the larynx and trachea Lobectomy Excision of a section or lobe of a lung Usually a treatment for lung cancer

Treatments, Procedures, and Devices (cont.) Magnetic resonance imaging Noninvasive diagnostic imaging that uses magnetic fields and computer imaging equipment Abbreviated MRI

Treatments, Procedures, and Devices (cont.) Mechanical ventilation Assisted breathing using a ventilator, which pushes air into the patient’s airway Nebulizer Device used to convert a liquid medication to a mist and deliver it to the lungs with the aid of a deep inhalation

Figure 12.14 Mechanical ventilation

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Treatments, Procedures, and Devices (cont.) Oximetry Measurement of oxygen levels in the blood using an oximeter A pulse oximeter is a noninvasive procedure with an oximeter that is pressed against the fingertip

Figure 12.15 Pulse oximetry

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Treatments, Procedures, and Devices (cont.) Pleurocentesis Surgical puncture and aspiration of fluid from the pleural cavity Pneumobronchotomy Incision of the lung and bronchus

Treatments, Procedures, and Devices (cont.) Pneumonectomy Excision of an entire lung Usually performed as a treatment for lung cancer Pulmonary angiography X-ray of the blood vessels of the lungs following injection of a contrast medium

Treatments, Procedures, and Devices (cont.) Pulmonary function tests Diagnostic tests performed to determine cause of lung disease by evaluating lung capacity through the use of spirometry Tests include: tidal volume (TV) vital capacity (VC)

Figure 12.16 Pulmonary Function Test

Treatments, Procedures, and Devices (cont.) Pulmonary specialist Physician who specializes in the treatment of lung disease Respiratory specialist Medical health professional who specializes in the treatment of breathing disorders

Treatments, Procedures, and Devices (cont.) Resuscitation To revive, to bring back to life or consciousness Most common form is cardiopulmonary resuscitation (CPR)

Treatments, Procedures, and Devices (cont.) Rhinoplasty Surgical repair of the nose, often for cosmetic reasons Septoplasty Surgical repair of the nasal septum Septotomy Incision of the nasal septum

Treatments, Procedures, and Devices (cont.) Sinusotomy Incision of a paranasal sinus Spirometer Instrument used to measure breathing volume Spirometry Procedure that uses a spirometer to measure breathing volumes

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Treatments, Procedures, and Devices (cont.) Stethoscope Diagnostic instrument used to hear sounds in the body, such as breathing TB skin test Test to determine the presence of a TB infection Also called PPD skin test or Mantoux skin test

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Figure 12.17 TB skin test

Figure 12.17 (continued) TB skin test

Figure 12.17 (continued) TB skin test

Treatments, Procedures, and Devices (cont.) Thoracocentesis Surgical puncture into the chest cavity to aspirate fluid Also called thoracentesis Thoracoscopy Examination of the thoracic cavity using a thoracoscope

Treatments, Procedures, and Devices (cont.) Thoracostomy Surgical puncture into the chest cavity, usually for the insertion of a tube Thoracotomy Incision into the chest

Treatments, Procedures, and Devices (cont.) Tonsillectomy Excision of one or more tonsils, usually palatine tonsils in the back of the throat Tracheoplasty Surgical repair of the trachea Tracheostomy Surgical creation of an opening into the trachea, usually for the insertion of a tube as a long-term treatment

Figure 12.18 Tracheostomy Source: (Ansell Horn/Phototake NYC)

Figure 12.18 (continued) Tracheostomy Source: (Ansell Horn/Phototake NYC)

Treatments, Procedures, and Devices (cont.) Tracheotomy Incision into the trachea Ventilation-perfusion scanning Diagnostic tool of nuclear medicine used to evaluate pulmonary function Can identify pulmonary embolism and pulmonary edema Abbreviated VPS Also called lung scan and V/Q scan

Figure 12.19 Ventilation-perfusion scanning Source: Science Photo Library/Photo Researchers, Inc.

Figure 12.19 Ventilation-perfusion scanning Source: Science Photo Library/Photo Researchers, Inc.

Pharmaceuticals Antibiotics Antihistamines Antitussives Bronchodilators Corticosteroids Decongestants Expectorants

Abbreviations ABGs AFB ARDS CF COPD CPR

Abbreviations (cont.) CXR flu HMD IRDS LLL LTB LUL

Abbreviations (cont.) MRI NRDS OSA PCP PE PFT

Abbreviations (cont.) PPD RDS RLL RUL SARS

Abbreviations (cont.) TB TV URI VC VPS or V/Q scan