Lecture Notes A PowerPoint Presentation 7 Respiratory System

Structure and Function Nose Pharynx Larynx Trachea (windpipe) Tube that extends from lower edge of the larynx downward into the thoracic cavity Rings of cartilage to help keep airways open Pedagogical Note: To tailor the slide presentation to your individual needs, simply delete or add slides and textual material. Numerous sources for illustrations and information are available on various websites. 2

Structure and Function (part 2) Bronchi Bronchial tree Lower part of the trachea that divides into the right and left bronchi, bronchioles, and alveoli Transport of air from the trachea over a wide area as quickly as possible Bronchioles Smaller divisions of the bronchi Walls composed of smooth muscle to allow contraction and expansion, thereby regulating airflow to the alveoli

Structure and Function (continued) Lungs Alveoli Tiny sacs located at the end of the alveolar ducts O2 and CO2 exchange between the alveolus and the capillary surrounding it Loss of alveolar wall elasticity from respiratory disease, making breathing difficult, especially when exhaling

Structure and Function (part 3) Respiration External Internal Other functions (with help of the cardiovascular system) Transport of O2 to body cells Removal of CO2, a waste product of cell metabolism 5

Structure and Function Exercise Name the main structures of the respiratory system. Name the smaller branches of the bronchi. Name the tiny air sacs in the lungs. Pedagogical Note: Questions only are presented on the first slide. Questions with answers (in red) are presented on the following slide. For testing purposes, you may wish to use only the question slides. 6 6

Structure and Function Exercise (part 4) Name the main structures of the respiratory system. Nose, pharynx, larynx, trachea, bronchi, and lungs Name the smaller branches of the bronchi. Bronchioles Name the tiny air sacs in the lungs. Alveoli 7

Structure and Function Exercise (part 5) What do the abbreviations O2 and CO2 mean? What body system helps the respiratory system transport O2 and remove CO2 from body cells? What does the abbreviation COPD mean? 8

Structure and Function Exercise (part 6) What do the abbreviations O2 and CO2 mean? O2 means oxygen; CO2 means carbon dioxide. What body system helps the respiratory system transport O2 and remove CO2 from body cells? Cardiovascular system What does the abbreviation COPD mean? Chronic obstructive pulmonary disease 9 9

Combining Forms Exercise List the CF(s) for: alveolus: larynx: nose: pleura: Pedagogical Note: Encourage your students to enhance and reinforce their study of word elements for this chapter by visiting the DavisPlus website and completing the flash-card activities.

Combining Forms Exercise (part 2) alveolus: alveol/o larynx: laryng/o nose: nas/o, rhin/o pleura: pleur/o

Combining Forms Exercise (part 3) pharynx: tonsils: trachea: lung:

Combining Forms Exercise (part 4) pharynx: pharyng/o tonsils: tonsill/o trachea: trache/o lung: pulmon/o, pneum/o, pneumon/o

Combining Forms Exercise (part 5) bronchus (plural, bronchi): bronchioles: chest: diaphragm:

Combining Forms Exercise (part 6) bronchus (plural, bronchi): bronch/o, bronchi/o bronchioles: bronchiol/o chest: thorac/o diaphragm: phren/o

Combining Forms Exercise (part 7) straight: mucus: blue:

Combining Forms Exercise (part 8) straight: orth/o mucus: muc/o blue: cyan/o

Complete the Medical Word Exercise resembling the adenoids: / paralysis of the larynx (voice box): /o/ expansion of the bronchi: / hernia of the trachea: /o/

Complete the Medical Word Exercise (part 2) resembling the adenoids: aden/oid paralysis of the larynx (voice box): laryng/o/plegia expansion of the bronchi: bronchi/ectasis hernia of the trachea: trache/o/cele 19

Complete the Medical Word Exercise (part 3) paralysis of the diaphragm: /o/ disease of the chest: /o/ rapid breathing: tachy/

Complete the Medical Word Exercise (part 4) paralysis of the diaphragm: phren/o/plegia disease of the chest: thorac/o/pathy rapid breathing: tachy/pnea 21

Build Medical Words Exercise inflammation of tonsils: resembling mucus: discharge from the nose: 22

Build Medical Words Exercise (part 2) inflammation of tonsils: tonsillitis resembling mucus: mucoid discharge from the nose: rhinorrhea 23

Build Medical Words Exercise (part 3) specialist in (treatment of) lungs: paralysis of the larynx: absence of breathing: 24

Build Medical Words Exercise (part 4) specialist in (treatment of) lungs: pulmonologist paralysis of the larynx: laryngoplegia absence of breathing: apnea 25

Diseases and Conditions Chronic obstructive pulmonary disease (COPD) Develops over a long time Produces partial blockage of air passages Stages range from at-risk (mild), where the patient is possibly unaware of the disease, to severe, with the possibility of respiratory or heart failure Pedagogical Note: To help you customize or add other disorders to your presentation, you can find numerous images in the image bank.

Diseases and Conditions (part 2) COPD (continued) Insidious because it is commonly first diagnosed after some lung capacity has been lost Includes emphysema, asthma, and chronic bronchitis

Clinically Related Exercise Mr. L. was recently prescribed a portable oxygen tank to ease his breathing discomfort. He was told that oxygen is commonly required in patients with COPD. He was aware of his diagnosis, but he did not know what this abbreviation meant. How would you respond? Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or website resources to tailor the Clinically Related Exercise sections to suit your course objectives.

Clinically Related Exercise (part 2) Mr. L. was recently prescribed a portable oxygen tank to ease his breathing discomfort. He was told that oxygen is commonly required in patients with COPD. He was aware of his diagnosis, but did not know what this abbreviation meant. How would you respond? COPD is the abbreviation for chronic obstructive pulmonary disease.

Clinically Related Exercise (part 3) Mrs. J. has not seen a physician in over 10 years. She is a heavy smoker, says she has no “lung problems,” and refuses to see a physician until “something develops.” Her daughter, a nursing student, has been studying COPD. What advice might she give her mother?

Clinically Related Exercise (part 4) Mrs. J. has not seen a physician in over 10 years. She is a heavy smoker, says she has no “lung problems,” and refuses to see a physician until “something develops.” Her daughter, a nursing student, has been studying COPD. What advice might she give her mother? Early-stage COPD, when treatment is most effective, is commonly not diagnosed because it is usually asymptomatic.

Diseases and Conditions (part 3) COPD-Emphysema Decreased alveolar elasticity Alveoli are able to expand (dilate) but unable to fully contract Commonly occurs with other lung disorders such as asthma, tuberculosis, and chronic bronchitis Emphysema

Diseases and Conditions (part 4) COPD-Emphysema (continued) Signs and symptoms Associated with long-term heavy smoking Characteristic “barrel chest” as a result of air trapped in the lungs Difficulty in breathing; shortness of breath Patients may find it easier to breathe while sitting upright or standing (orthopnea)

Diseases and Conditions (part 5) COPD-Emphysema (continued) Treatment Bronchodilators may help relax and widen air passages Inhaled steroids may be prescribed if the disease progresses Antibiotics prescribed if acute bronchitis or pneumonia develops Supplemental oxygen therapy

Clinically Related Exercise (part 5) Mr. Z. has had emphysema for 5 years. He tells his pulmonologist that lately he finds it harder to exhale than inhale and now struggles with breathing. She tells him that the disease causes a decrease in alveolar elasticity. Explain, in your own words, what this condition means.

Clinically Related Exercise (part 6) Mr. Z. has had emphysema for 5 years. He tells his pulmonologist that lately he finds it harder to exhale than inhale and now struggles with breathing. She tells him that the disease causes a decrease in alveolar elasticity. Explain, in your own words, what this condition means. Air sacs can open when inhaling, but they are unable to fully contract, trapping air in the lungs and causing difficulty in exhaling.

Clinically Related Exercise (part 7) Hospitalized with emphysema, Mr. L. asks the nurse “to put the bed up” as he prepares to go to sleep. His nurse explains that sitting upright or standing commonly helps people with emphysema breathe more easily. She tells him this procedure is called (orthopnea, eupnea, orthostasis).

Clinically Related Exercise (part 8) Hospitalized with emphysema, Mr. L. asks the nurse “to put the bed up” as he prepares to go to sleep. His nurse explains that sitting upright or standing commonly helps people with emphysema breathe more easily. She tells him this procedure is called orthopnea.

Diseases and Conditions (part 6) COPD-Asthma Produces spasms of smooth muscles in bronchial passages Attacks may be sudden and violent (paroxysms) “Triggers” include allergens, irritants, and sometimes exercise, cold, and stress Asthma.

Diseases and Conditions (part 7) COPD-Asthma (continued) Signs and symptoms Wheezing Dyspnea Coughing with large amounts of mucous secretions

Diseases and Conditions (part 8) COPD-Asthma (continued) Treatment Avoidance of “triggers” Mucolytics to loosen mucus Bronchodilators to relax smooth muscles For uncontrolled bronchospasms, a life-threatening condition (status asthmaticus), hospitalization may be necessary

Clinically Related Exercise (part 9) Mr. K., a cross-country runner, develops exertion asthma during competition. He carries a “puffer” that delivers a medication that helps “relax” the smooth muscles of the alveoli. This medication is a(n) (mucolytic, antibiotic, bronchodilator).

Clinically Related Exercise (part 10) Mr. K., a cross-country runner, develops exertion asthma during competition. He carries a “puffer” that delivers a medication that helps “relax” the smooth muscles of the alveoli. This medication is a bronchodilator.

Clinically Related Exercise (part 11) Ms. L. was at a friend’s home and began playing with her friend’s cat; she then experienced an allergic reaction. Without warning, her eyes became red and puffy, and she began wheezing and struggling to breathe. A violent and sudden attack of asthma is called a (spastic, paroxysmal, convulsive) attack.

Clinically Related Exercise (part 12) Ms. L. was at a friend’s home and began playing with her friend’s cat; she then experienced an allergic reaction. Without warning, her eyes became red and puffy, and she began wheezing and struggling to breathe. A violent and sudden attack of asthma is called a paroxysmal attack.

Diseases and Conditions (part 9) COPD-Chronic bronchitis Inflammation of the bronchial passages Most commonly caused by constant irritation (tobacco smoke, pollution, and dust and chemical exposure) Other causes are viral and bacterial infections Chronic bronchitis.

Diseases and Conditions (part 10) COPD-Chronic bronchitis (continued) Signs and symptoms Productive cough Chest discomfort Morning “smoker’s” cough

Diseases and Conditions (part 11) COPD-Chronic bronchitis (continued) Treatment Smokers must refrain from tobacco use Antibiotics for bacterial causes of bronchitis Inhalers with various medications depending on the cause of bronchitis Respiratory therapy to learn various breathing techniques

Clinically Related Exercise (part 13) Mr. B. has chronic bronchitis. Recently, he also received a Dx of acute bacterial bronchitis. During his office visit, the pulmonologist prescribed (antibiotics, antihistamines, antitussives) to treat the acute infection.

Clinically Related Exercise (part 14) Mr. B. has chronic bronchitis. Recently, he also received a Dx of acute bacterial bronchitis. During his office visit, the pulmonologist prescribed antibiotics to treat the acute infection.

Clinically Related Exercise (part 15) Mrs. P., a 20-year smoker, complains of a hacking morning cough that started several months ago. It takes her about an hour to “settle down.” Her probable Dx is (asthma, acute bronchitis, chronic bronchitis).

Clinically Related Exercise (part 16) Mrs. P., a 20-year smoker, complains of a hacking morning cough that started several months ago. It takes her about an hour to “settle down.” Her probable Dx is chronic bronchitis.

Diseases and Conditions (part 12) Pulmonary embolism Foreign object that travels through the bloodstream Possibly a blood clot, air, or fat Usually a blood clot that has traveled into a pulmonary artery (see illustration) Pulmonary embolism.

Diseases and Conditions (part 13) Pulmonary embolism (continued) Signs and symptoms Shortness of breath Chest pain Hemoptysis Edema Acrocyanosis Finger clubbing

Diseases and Conditions (part 14) Pulmonary embolism (continued) Treatment Anticoagulant therapy Thrombolytics (clot busters) Insertion of small filters to remove the embolism from the bloodstream Surgical embolectomy (possibly required in life-threatening cases)

Clinically Related Exercise (part 17) Mr. P. arrives at the ER with chest pain and blood in the sputum. A CT angiogram confirms a diagnosis of pulmonary embolism lodged in the vessels of his lung. This type of clot (embolus) travels from distant veins, usually in the (arms, legs, or abdomen). 56 56 56

Clinically Related Exercise (part 18) Mr. P. arrives at the ER with chest pain and blood in the sputum. A CT angiogram confirms a diagnosis of pulmonary embolism lodged in the vessels of his lung. This type of clot (embolus) travels from distant veins, usually in the legs. 57 57 57

Clinically Related Exercise (part 19) Mr. L. undergoes knee replacement. He is advised that a complication of this surgery is the development of blood clots that may break loose and travel to the lungs. This is a serious condition known as a pulmonary (aneurysm, edema, embolism). 58 58 58

Clinically Related Exercise (part 20) Mr. L. undergoes knee replacement. He is advised that a complication of this surgery is the development of blood clots that may break loose and travel to the lungs. This is a serious condition known as a pulmonary embolism. 59 59 59

Diseases and Conditions (part 15) Sleep apnea Breathing at night stops and starts repeatedly Serious symptom, especially in patients with other life-threatening conditions Accompanied by snoring loud enough to disturb others

Diseases and Conditions (part 16) Sleep apnea (continued) More common in males and older adults Three forms: Obstructive, in which throat muscles relax as a result of obstruction of the airway (by the soft palate or obesity of the neck) Central, in which the brain does not send the proper signals to the muscles that control breathing Complex, a combination of obstructive and central

Diseases and Conditions (part 17) Sleep apnea (continued) Signs and symptoms In premature infants, failure of the immature CNS to maintain a consistent respiratory rate, causing long pauses between periods of regular breathing In adults, commonly found in middle-aged, obese patients who snore excessively Commonly caused by the soft palate blocking the airway or obesity of the neck, leading to gasping respirations that commonly awaken the patient

Diseases and Conditions (part 18) Sleep apnea (continued) Treatment Tonsillectomy and adenoidectomy (T&A) Uvulopalatopharyngoplasty (UPP) Continuous positive airway pressure (CPAP) apparatus to keep airway open in adults Apnea monitor in the hospital and at home for infants

Clinically Related Exercise (part 21) Mrs. S. is diagnosed with sleep apnea and asks the nurse to explain this disorder Ms. M. presents for an excision of tonsils and adenoids as a treatment for sleep apnea. The abbreviation for excision of the tonsils and adenoids is . 64

Clinically Related Exercise (part 22) Mrs. S. is diagnosed with sleep apnea and asks the nurse to explain this disorder. She explains that this condition occurs when an individual’s breathing at night stops and starts repeatedly. Ms. M. presents for an excision of tonsils and adenoids as a treatment for sleep apnea. The abbreviation for excision of the tonsils and adenoids is T&A. 65

Clinically Related Exercise (part 23) Mr. A. complains of excessive snoring at night that awakens him and causes him to gasp for breath. The physician explains that he has a common condition for middle-aged, obese men in which temporary cessation of breathing occurs. This condition is known as sleep (apnea, dyspnea, eupnea). 66

Clinically Related Exercise (part 24) Mr. A. complains of excessive snoring at night that awakens him and causes him to gasp for breath. The physician explains that he has a common condition for middle-aged, obese men in which temporary cessation of breathing occurs. This condition is known as sleep apnea. 67

Diseases and Conditions (part 19) Lung cancer (bronchogenic carcinoma) Includes various malignant neoplasms in the trachea, bronchi, or air sacs of the lungs Leading cancer killer in men and women Initial stages of the disease are commonly asymptomatic Commonly metastasize to surrounding tissue

Diseases and Conditions (part 20) Lung cancer (continued) Signs and symptoms Chronic cough and wheezing Chest pain, dyspnea Hemoptysis Risk factors Chemical exposure History of smoking or exposure to second-hand smoke

Diseases and Conditions (part 21) Lung cancer (continued) Treatment Depends on the type of malignancy Surgery, radiation therapy, chemotherapy, or a combination of these modalities

Clinically Related Exercise (part 25) Mr. O. works at a body shop and sprays paint on cars. He admits that he often does not wear a face mask during his work hours. Although he is somewhat obese and has a history of cigarette use (two packs per day for over 15 years), he is in good physical health. What are his two risk factors for developing lung cancer? 71

Clinically Related Exercise (part 26) Mr. O. works at a body shop and sprays paint on cars. He admits he often does not wear a face mask during his work hours. Although he is somewhat obese, and has a history of cigarette use (two packs per day for over 15 years) he is in good physical health. What are his two risk factors for developing lung cancer? His risk factors are cigarette smoking and exposure to toxic chemicals. 72

Clinically Related Exercise (part 27) Ms. B. has smoked one pack of cigarettes per day for the past 3 years and is concerned about developing lung cancer. How can she reduce her chances of developing this disease? 73 73

Clinically Related Exercise (part 28) Ms. B. has smoked one pack of cigarettes per day for the past 3 years and is concerned about developing lung cancer. How can she reduce her chances of developing this disease? Early precancerous cellular changes and damaged lining in bronchial tissues commonly return to normal when there has not been a long history of cigarette smoking. 74 74

Clinically Related Exercise (part 29) Ms. T. is diagnosed with advanced lung cancer and asks why it was not detected last year during her annual physical examination. How should the nurse respond? 75 75

Clinically Related Exercise (part 30) Ms. T. is diagnosed with advanced lung cancer and asks why it was not detected last year during her annual physical examination. How should the nurse respond? Early-stage lung cancer usually produces no symptoms and is difficult to detect. When symptoms appear, cancer commonly has metastasized to tissues, such as the brain, liver, and bone. 76 76

Vocabulary Challenge Exercise atelectasis: consolidation: coryza: Pedagogical Note: To customize the medical vocabulary, simply add or delete the terms on the slide. Also, numerous images are available from the image bank and/or other resources if you want to add illustrations.   77

Vocabulary Challenge Exercise (part 2) atelectasis: collapsed or airless condition of the lung(s) consolidation: process of becoming solid (used to describing an engorged lung) coryza: acute inflammation of the nasal mucosa accompanied by profuse nasal discharge; also called rhinitis or a cold   78

Vocabulary Challenge Exercise (part 3) epistaxis: rhonchi: stridor:

Vocabulary Challenge Exercise (part 4) epistaxis: bleeding from the nose; also called nosebleed, nasal hemorrhage, or rhinorrhagia rhonchi: abnormal respiratory sound resembling snoring, caused by blockage in the larger airways stridor: high-pitched sound heard on inspiration that may indicate a serious airway obstruction

Endotracheal intubation. Procedures Endotracheal intubation Tube placed through the mouth into the pharynx, larynx, and trachea Used to establish an open airway Administration of medications In an anesthetized patient to facilitate breathing Pedagogical Note: You may want to bring a few diagnostic instruments or laboratory setups for students to examine. Various images of medical instruments are available on the web if you do not have the actual instruments. In addition, other procedures can be included to suit individual classroom needs. Endotracheal intubation.

Procedures (part 2) Tracheostomy Surgical creation of an opening into the trachea through the neck Performed to bypass an obstruction, clean and remove secretions, deliver oxygen to the lungs, and treat some breathing disorders Tracheostomy. (A) Lateral view. (B) Frontal view. 82

Procedures (part 3) Lavage Postural drainage Irrigation of paranasal sinuses to remove mucopurulent material Postural drainage Body positioned so gravity helps remove secretions from the lung or bronchi followed by coughing, which will usually expel secretions from the trachea 83

Clinically Related Exercise (part 31) Upon awakening from general anesthetic for an abdominal hernia repair, Mr. B. complains of a sore throat. The nurse responds that it was caused by the passage of a tube into the trachea. The tube ensured that the air passages would remain open during the surgery. What is the name for this procedure?

Clinically Related Exercise (part 32) Upon awakening from general anesthetic for an abdominal hernia repair, Mr. B. complains of a sore throat. The nurse responds that it was caused by the passage of a tube into the trachea. The tube ensured that the air passages would remain open during the surgery. What is the name for this procedure? Endotracheal intubation

Procedures (part 4) Polysomnography Tests sleep cycles in patients with sleeping disorders Records brain waves (EEGs), electrical activity of muscles, eye movements, respiratory rate, blood pressure, oxygen saturation of the blood, and heart rhythm Polysomnography.

Procedures (part 5) Polysomnography (continued) Helps differentiate the various sleep disorders, including: Sleep apnea Sleep walking Teeth grinding (bruxism) Hypersomnia Polysomnography.

Procedures (part 6) Pneumonectomy Surgical procedure to remove a lung or a portion of a lung Four types (see illustration) Wedge resection Removal of a small wedge-shaped section of a lobe of the lung Performed for biopsy or for small tumors Pneumonectomies.

Procedures (part 7) Pneumonectomy(continued) Four types (continued) Segmental resection Removal of a larger portion of the lobe but not the entire lobe Lobectomy Removal of an entire lobe of the lung Called bilobectomy with removal of two lobes Pneumonectomies.

Procedures (part 8) Pneumonectomy(continued) Four types (continued) Removal of an entire lung Performed as an open chest procedure (thoracotomy) Pneumonectomies.

Procedures (part 9) Septoplasty Correction of a deviated nasal septum, the dividing partition separating the right and left nostrils Difficulty breathing caused by deviation of septum that may impede airflow through the nose Removal of cartilage or bone usually required to restore normal nasal breathing 91

Clinically Related Exercise (part 33) Mr. W. fell off his bike, which resulted in facial lacerations and a nasal fracture. His septum now completely blocks his right nostril. The surgeon will perform a surgical repair of the septum, which is known as . 92

Clinically Related Exercise (part 34) Mr. W. fell off his bike, which resulted in facial lacerations and a nasal fracture. His septum now completely blocks his right nostril. The surgeon will perform a surgical repair of the septum, which is known as septoplasty. 93 93

Procedures (part 10) Laryngectomy Removal of all or part of the larynx Results in the separation of the airway from the mouth, nose, and esophagus Patient breathes through an opening in the neck Laryngectomy. (A) Airflow before laryngectomy. (B) Airflow after laryngectomy.

Clinically Related Exercise (part 35) Mr. J. has a history of smoking two packs per day for 30 years. He is diagnosed with throat cancer and arrives at the hospital for an excision of the larynx. What is this surgical procedure called? 95

Clinically Related Exercise (part 36) Mr. J. has a history of smoking two packs per day for 30 years. He is diagnosed with throat cancer and arrives at the hospital for an excision of the larynx. What is this surgical procedure called? Laryngectomy 96 96

Clinically Related Exercise (part 37) Mr. M. has accumulated thick mucus in his lungs as a result of a prolonged respiratory infection. As part of his treatment, his head must be positioned below the affected lung area. The use of body positioning to facilitate removal of mucus is called postural . 97 97

Clinically Related Exercise (part 38) Mr. M. has accumulated thick mucus in his lungs as a result of a prolonged respiratory infection. As part of his treatment, his head must be positioned below the affected lung area. The use of body positioning to facilitate removal of mucus is called postural drainage. 98 98

Clinically Related Exercise (part 39) Mrs. S. arrives at the ED with cyanosis caused by an obstructed airway. The physician incises the trachea to open it below the blockage and restore breathing. An incision into the trachea is known as (tracheocentesis, tracheostenosis, tracheotomy). 99 99

Clinically Related Exercise (part 40) Mrs. S. arrives at the ED with cyanosis caused by an obstructed airway. The physician incises the trachea to open it below the blockage and restore breathing. An incision into the trachea is known as tracheotomy. 100 100

Clinically Related Exercise (part 41) Once in the recovery room following her T&A, Mrs. Q. wears a small finger monitor that provides information regarding her oxygen saturation in the blood. This finger- clip device is known as a(n) (aspirator, oximeter, spirometer). 101

Clinically Related Exercise (part 42) Once in the recovery room following her T&A, Mrs. Q. wears a small finger monitor that provides information regarding her oxygen saturation in the blood. This finger- clip device is known as an oximeter. 102

Procedures (part 11) Bronchoscopy Use of a specialized endoscope (bronchoscope) inserted through the mouth or nose Enables examination of the larynx, trachea, bronchi, and bronchioles for pathological changes Bronchoscopy. 103 103

Procedures (part 12) Bronchoscopy (continued) Enables tissue biopsy and removal of obstruction (tissue or other) Aids in other diagnostic and therapeutic procedures Bronchoscopy. 104 104

Procedures (part 13) Continuous positive airway pressure (CPAP) Consists of a pump that forces air through a mask into air passages to keep them open, especially in sleep apnea CPAP device. 105 105

Procedures (part 14) Throat culture Thoracentesis Identifies the microbe (bacterium or fungus) causing a throat infection, with results usually available within 2 days Thoracentesis Removal of fluid from the pleural space for diagnostic or therapeutic purposes (see illustration) Thoracentesis. 106 106

Metered-dose inhaler (MDI). Procedures (part 15) Aerosol therapy Metered-dose inhalers (MDIs) deliver a specific amount of aerosolized medication when activated (see illustration) Most common delivery system for treating COPD Metered-dose inhaler (MDI). 107

Procedures (part 16) Aerosol therapy (continued) Nebulized mist treatments (NMTs) deliver medications as a fine mist directly into the lungs when the patient inhales (see illustration) Effective in delivering medication to infants, small children, and those who cannot use other inhalers Nebulizer. 108

Clinically Related Exercise (part 43) Upon inhalation, a fine spray delivers medication into the lungs. The device used for this treatment is a(n) (bronchoscope, intubator, nebulizer). The most common method of treating COPD is the delivery of medications or mists directly into the lungs, a procedure called (aerosol therapy, chemotherapy, infusion therapy). 109

Clinically Related Exercise (part 44) Upon inhalation, a fine spray delivers medication into the lungs. The device used for this treatment is a nebulizer. The most common method of treating COPD is the delivery of medications or mists directly into the lungs, a procedure called aerosol therapy. 110

Procedures (part 17) Arterial blood gas (ABG) Magnetic resonance imaging MRI) Pulmonary function tests (PFTs) Sweat test 111 111

Build Medical Words Exercise (part 5) visual examination of the bronchi: surgical puncture of the chest: forming an opening (mouth) in the trachea: 112 112

Build Medical Words Exercise (part 6) visual examination of the bronchi: bronch/o/scopy surgical puncture of the chest: thor/a/centesis or thorac/o/centesis forming an opening (mouth) in the trachea: trache/o/stomy 113 113

Build a Medical Word Exercise visual examination of the larynx: instrument for examining the larynx: incision of the trachea: 114 114

Build a Medical Word Exercise (part 7) visual examination of the larynx: laryng/o/scopy instrument for examining the larynx: laryng/o/scope incision of the trachea: trache/o/tomy 115 115

Build a Medical Word Exercise (part 8) process of recording radiation or an x-ray: act of measuring oxygen: act of measuring breath (breathing): 116 116

Build a Medical Word Exercise (part 9) process of recording radiation or an x-ray: radi/o/graphy act of measuring oxygen: ox/i/metry act of measuring breath (breathing): spir/o/metry 117 117

Pharmacology Bronchodilators Corticosteroids Drugs used to increase airflow by dilating constricted airways of the bronchioles and bronchi Corticosteroids Act on the immune system by blocking substances that trigger allergic and inflammatory actions

Pharmacology (continued) Decongestants Constrict blood vessels of the nasal passages, causing swollen tissues to shrink Antitussives Relieve or suppress coughing by blocking the cough reflex in the medulla of the brain

Clinically Related Exercise (part 45) To reduce airway inflammation in an asthmatic patient, the doctor prescribes a(n) (antibiotic, corticosteroid, expectorant). Ms. C. presents with a chief complaint of shortness of breath upon exertion. Medication is prescribed to expand the bronchial airways via an MDI. This medication is known as a(n) (antihistamine, bronchodilator, expectorant).

Clinically Related Exercise (part 46) To reduce airway inflammation in an asthmatic patient, the doctor prescribes a corticosteroid. Ms. C. presents with a chief complaint of shortness of breath upon exertion. Medication is prescribed to expand the bronchial airways via an MDI. This medication is known as a bronchodilator.

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