1. MR250 MEDICAL TRANSCRIPTION I PULMONOLOGY CHAPTER 10 Week 7

2. Quick Spelling/Proofreading Quiz… Atalectasis Adventious sounds Bronchoiectasis Barrel chest Cheyne-Strokes respirations silia Crackles Extubated Intupation orthopnea

3. ANSWER KEY Atelectasis Adventitious sounds Bronchiectasis Barrel chest Cheyne-Stokes respirations Cilia Crackles Extubated Intubation Orthopnea

4. Respiratory Process The exchange of gases between blood in the systemic capillaries and the cells of the body is called internal respiration. Respiration occurs through 3 processes name and define them. 1.___________________________ 2.___________________________ 3.___________________________

5. ANSWER KEY 1. Diffusion, or gas movement through a semipermeable membrane from an area of greater concentration to one of lesser concentration. 2. Pulmonary effusion, which is blood flow from the right side of the heart, through the pulmonary circulation, into the left side of the heart. 3. Ventilation, which is gas distribution into and out of the lungs.

6. Respiratory Process Cont. Fill in the blanks… A patient who has _________, or difficulty breathing, may use the ________ of the neck and chest not normally associated with _________, called _________ muscles, to aid in bringing ___ into the ______.

7. ANSWER KEY A patient who has dyspnea, or difficulty breathing, may use the muscles of the neck and chest not normally associated with breathing, called accessory muscles, to aid in bringing air into the lungs.

8. Respiratory Process Cont. Orthopnea is discomfort in breathing except in an upright position. You may hear terms such as two- pillow orthopnea or three pillow orthopnea when transcribing what does that mean?

9. ANSWER KEY This describes a patient’s sleeping habits in which the patient requires two or three pillows, respectively, to breathe comfortably while sleeping.

10. Abbreviations –ABG –AFB –ARDS –DLCO –EBV –EGFRs –FEV1 –FiO2 –IMV –PCP –PEEP –PFTs –TLC

11. ANSWER KEY ABG= arterial blood gas AFB=acid-fast bacilli ARDS= acute respiratory distress syndrome DLCO= diffusing capacity for carbon monoxide EBV=Epstein-Barr virus EGFRs= epidermal growth factor receptors FEV1=forced expiratory volume measured in one second FiO2=fraction of inspired oxygen IMV=intermittent mandatory ventilation PCP=Pneumocystis carinii pneumonia PEEP=positive end-expiratory pressure PFTs=pulmonary function tests TLC=total lung capacity

12. Respiratory Process Cont. There are six common abnormal lung sound terms heard when transcribing medical reports list and define them below: 1._________________________________ 2._________________________________ 3._________________________________ 4._________________________________ 5._________________________________ 6._________________________________

13. ANSWER KEY 1. Rhonchi: loud, coarse, bubbling sounds occurring over the central airway during inspiration or expiration that sound like a whistle or a horn. 2. Wheezes: high-pitched, whistling-type sounds heard over the large bronchi. 3. Rales: friction sounds like pieces of sandpaper being rubbed together. 4. Grunting : refers to a grunting noises heard during expiration. 5. Stridor : a crowing sound heard on inspiration that is caused by air whistling as it passed through swollen upper airways.

14. Diagnostic Studies & Procedures Define the words below: –Pulmonary Function Tests –Spirometer/Spirogram –Tidal volume –Forced vital capacity –Forced expiratory volume –Pulse oximetry –Arterial Blood Gas Test –Peak Flow Monitoring –Ventilation Perfusion Scan

15. ANSWER KEY Pulmonary Function Tests : are a series of measurements that evaluate the lungs capacity to hold air, move air in and out, and to exchange oxygen and carbon dioxide. Spirometry/Spirogram/Spirometer : Spirometry is a test that provides measurable feedback about the function of the lungs. Spirogram is a tracing that shows the values of expiratory volumes and flow rates. Spirometer is a device that consists of a small plastic breathing tube hooked to a computerized console that records and prints the data it obtains.

16. ANSWER KEY Cont. Tidal volume : Indicates the amount of air inhaled or exhaled during normal breathing. Forced vital capacity: The volume of air that can be forcibly expired forcibly and quickly after the patient has taken in the deepest breath possible. Forced expiratory volume : The measurement taken when the patient takes the deepest breath possible and blows into the console's breathing tube, but only the first second of the forced exhalation is recorded.

17. ANSWER KEY Cont. Pulse oximetry : A noninvasive method of measuring oxygen saturation in the blood. Arterial Blood Gas Test : A test performed to determine the amounts of oxygen and carbon dioxide dissolved in the blood, and to ascertain the acid/base status of the blood. Peak Flow Monitoring : A test that measures the rate of air flow, or how fast air is able to pass through the airways. Ventilation Perfusion Scan : A scan used to assess distribution of blood flow and ventilation throughout both lungs.

18. Final Thoughts Well that’s all for tonight! Discussion Board this week. If you have any problems – send me an e-mail. Remember to get all of your assignments in on time! TATs are important! See you next week! Same time— same place!!