Chapter 11: The Respiratory System Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter Objectives Roles of oxygen and carbon dioxide and how each is carried in the blood. Respiratory tract and functions of each part. Breathing mechanism, the roles of the diaphragm and phrenic nerve. Word parts pertaining to the respiratory system. Major disorders of the respiratory system. Medical terms related to breathing & diseases of the respiratory system. 10 volumes & capacities commonly used to measure pulmonary function. Abbreviations commonly used with reference to the respiratory system. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Normal Structure and Function adenoids Lymphoid tissue located in the nasopharynx; the pharyngeal tonsils alveoli The tiny air sacs in the lungs through which gases are exchanged between the atmosphere and the blood in respiration (singular: alveolus). An alveolus, in general, is a small hollow or cavity; the term is also used to describe the bony socket for a tooth. bronchiole One of the smaller subdivisions of the bronchial tubes (root: bronchiol) bronchus One of the larger air passageways in the lungs. The bronchi begin as two branches of the trachea and then subdivide within the lungs (plural: bronchi) (root bronch). carbon dioxide (CO2) A gas produced by energy metabolism in cells and eliminated through the lungs carbonic acid An acid formed by carbon dioxide when it dissolves in water; H2CO3 compliance A measure of how easily the lungs expand under pressure. Compliance is reduced in many types of respiratory disorders. diaphragm The dome-shaped muscle under the lungs that flattens during inspiration (root: phren/o) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Normal Structure and Function (cont’d) epiglottis A leaf-shaped cartilage that covers the larynx during swallowing to prevent food from entering the trachea expectoration The act of coughing up material from the respiratory tract; also the material thus released; sputum expiration The act of breathing out or expelling air from the lungs; exhalation glottis The opening between the vocal cords hemoglobin The iron-containing pigment in red blood cells that transports oxygen inspiration The act of drawing air into the lungs; inhalation larynx The enlarged upper end of the trachea that contains the vocal cords (root: laryng/o) lung A cone-shaped spongy organ of respiration contained within the thorax (roots: pneum, pulm) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Normal Structure and Function (cont’d) mediastinum The space between the lungs together with the organs contained in this space nose The organ of the face used for breathing and for housing receptors for the sense of smell; includes an external portion and an internal nasal cavity (roots: nas/o, rhin/o) oxygen (O2) The gas needed by cells to release energy from food during metabolism palatine tonsils The paired masses of lymphoid tissue located on either side of the oropharynx; usually meant when the term tonsils is used alone pharynx The throat; a common passageway for food entering the esophagus and air entering the larynx (root: pharyng/o) phrenic nerve The nerve that activates the diaphragm (root: phrenic/o) pleura A double-layered membrane that lines the thoracic cavity (parietal pleura) and covers the lungs (visceral pleura) (root: pleur/o) pleural space The thin, fluid-filled space between the two layers of the pleura; pleural cavity Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Normal Structure and Function (cont’d) pulmonary ventilation The movement of air into and out of the lungs sinus A cavity or channel; the paranasal sinuses are located near the nose and drain into the nasal cavity. sputum The substance released by coughing or clearing the throat; expectoration. It may contain a variety of material from the respiratory tract. surfactant A substance that decreases surface tension within the alveoli and eases lung expansion. trachea The air passageway that extends from the larynx to the bronchi (root: trache/o) turbinate bones The bony projections in the nasal cavity that contain receptors for the sense of smell. Also called conchae (KON-kē). vocal cords Membranous folds on either side of the larynx that are important in speech production. Also called vocal folds. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders acidosis Abnormal acidity of body fluids. Respiratory acidosis is caused by abnormally high levels of carbon dioxide in the body. acute respiratory distress syndrome (ARDS) Pulmonary edema that can lead rapidly to fatal respiratory failure; causes include trauma, aspiration into the lungs, viral pneumonia, and drug reactions; shock lung acute rhinitis Inflammation of the nasal mucosa with sneezing, tearing, and profuse secretion of watery mucus, as seen in the common cold alkalosis Abnormal alkalinity of body fluids. Respiratory alkalosis is caused by abnormally low levels of carbon dioxide in the body. aspiration The accidental inhalation of food or other foreign material into the lungs. Also means the withdrawal of fluid from a cavity by suction. asthma A disease characterized by dyspnea and wheezing caused by spasm of the bronchial tubes or swelling of their mucous membranes atelectasis Incomplete expansion of a lung or part of a lung; lung collapse. May be present at birth (as in respiratory distress syndrome) or be caused by bronchial obstruction or compression of lung tissue (prefix atel/o means “imperfect”). Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders (cont’d) bronchiectasis Chronic dilatation of a bronchus or bronchi bronchitis Inflammation of a bronchus chronic Any of a group of chronic, progressive, and debilitating respiratory obstructive diseases, which includes emphysema, asthma, bronchitis, and pulmonary disease bronchiectasis (COPD) cyanosis Bluish discoloration of the skin caused by lack of oxygen in the blood (adjective: cyanotic) cystic fibrosis (CF) An inherited disease that affects the pancreas, respiratory system, and sweat glands. Characterized by mucus accumulation in the bronchi causing obstruction and leading to infection diphtheria Acute infectious disease, usually limited to the upper respiratory tract, characterized by the formation of a surface pseudomembrane composed of cells and coagulated material dyspnea Difficult or labored breathing, sometimes with pain; “air hunger” Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders (cont’d) emphysema A chronic pulmonary disease characterized by enlargement and destruction of the alveoli empyema Accumulation of pus in a body cavity, especially the pleural space; pyothorax hemoptysis The spitting of blood from the mouth or respiratory tract (ptysis means “spitting”) hemothorax Presence of blood in the pleural space hydrothorax Presence of fluid in the pleural space hyperventilation Increased rate and depth of breathing; increase in the amount of air entering the alveoli influenza An acute, contagious respiratory infection causing fever, chills, headache, and muscle pain; “flu” pertussis An acute, infectious disease characterized by a cough ending in a whooping inspiration; whooping cough Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders (cont’d) pleural effusion Accumulation of fluid in the pleural space. The fluid may contain blood (hemothorax) or pus (pyothorax or empyema). pleurisy Inflammation of the pleura; pleuritis. A symptom of pleurisy is sharp pain on breathing. pneumoconiosis Disease of the respiratory tract caused by inhalation of dust particles. Named more specifically by the type of dust inhaled, such as silicosis, anthracosis, asbestosis. pneumonia Inflammation of the lungs generally caused by infection. May involve the bronchioles and alveoli (bronchopneumonia) or one or more lobes of the lung (lobar pneumonia). pneumonitis Inflammation of the lungs; may follow infection or be caused by asthma, allergy, or inhalation of irritants Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders (cont’d) pneumothorax Accumulation of air or gas in the pleural space. May result from injury or disease or may be produced artificially to collapse a lung pyothorax Accumulation of pus in the pleural space; empyema respiratory distress syndrome (RDS) A respiratory disorder that affects premature infants born without enough surfactant in the lungs. It is treated with respiratory support and surfactant administration sudden infant death syndrome (SIDS) The sudden and unexplained death of an apparently healthy infant; crib death tuberculosis An infectious disease caused by the tubercle bacillus, Mycobacterium tuberculosis. Often involves the lungs but may involve other parts of the body as well. Miliary (MIL-ē-ar-ē) tuberculosis is an acute generalized form of the disease with formation of minute tubercles that resemble millet seeds Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Diagnosis arterial blood gases (ABGs) The concentrations of gases, specifically oxygen and carbon dioxide, in arterial blood. Reported as the partial pressure (P) of the gas in arterial (a) blood, such as PaO2 or PaCO2. These measurements are important in measuring acid-base balance bronchoscope An endoscope used to examine the tracheobronchial passageways. Also allows access for biopsy of tissue to removal of a foreign object lung scan Study based on the accumulation of radioactive isotope in lung tissue. A ventilation scan measures ventilation after inhalation of radioactive material. A perfusion scan measures blood supply to the lungs after injection of radioactive material. Also called a pulmonary scintiscan pulse oximetry Determination of the oxygen saturation of arterial blood by means of a photoelectric apparatus (oximeter), usually placed on the finger or the ear; reported as SpO2 in percent Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Diagnosis (cont’d) pulmonary function tests Tests done to assess breathing, usually by spirometry spirometer An apparatus used to measure breathing volumes and capacities; record of test is a spirogram thoracentesis Surgical puncture of the chest for removal of air or fluids, such as may accumulate after surgery or as a result of injury, infection, or cardiovascular problems. Also called thoracocentesis tuberculin test A skin test for tuberculosis. Tuberculin, the test material made from products of the tuberculosis organism, is injected below the skin or inoculated with a four-pronged device (tine test) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Normal Structure and Function carina A projection of the lowest tracheal cartilage that forms a ridge between the two bronchi. Used as a landmark for endoscopy. Any ridge or ridgelike structure (from a Latin word that means “keel”). hilum An anatomical depression in an organ where vessels and nerves enter nares The external openings of the nose; the nostrils (singular, naris) nasal septum The partition that divides the nasal cavity into two parts (root sept/o means “septum”) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Symptoms and Conditions anoxia Lack or absence of oxygen in the tissues; often used incorrectly to mean hypoxia asphyxia Condition caused by inadequate intake of oxygen; suffocation (literally “lack of pulse”) Biot respirations Deep, fast breathing interrupted by sudden pauses; seen in spinal meningitis and other disorders of the central nervous system bronchospasm Narrowing of the bronchi caused by smooth muscle spasms; common in cases of asthma and bronchitis Cheyne-Stokes respiration A repeating cycle of gradually increased and then decreased respiration followed by a period of apnea; caused by depression of the breathing centers in the brain stem; seen in cases of coma and in terminally ill patients cor pulmonale Enlargement of the heart's right ventricle caused by disease of the lungs or pulmonary blood vessels coryza Acute inflammation of the nasal passages with profuse nasal discharge; acute rhinitis Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Symptoms and Conditions (cont’d) croup A childhood disease usually caused by a viral infection that involves inflammation and obstruction of the upper airway. Croup is characterized by a barking cough, difficulty breathing, and laryngeal spasm deviated septum A shifted nasal septum; may require surgical correction epiglottitis Inflammation of the epiglottis that may lead to obstruction of the upper airway. Commonly seen in cases of croup (also spelled epiglottiditis) epistaxis Hemorrhage from the nose; nosebleed (Greek -staxis means “dripping”) fremitus A vibration, especially as felt through the chest wall on palpation Kussmaul respiration Rapid and deep gasping respiration without pause; characteristic of severe acidosis pleural friction rub A sound heard on auscultation that is produced by the rubbing together of the two pleural layers; a common sign of pleurisy Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Symptoms and Conditions (cont’d) rales Abnormal chest sounds heard when air enters small airways or alveoli containing fluid; usually heard during inspiration (singular:rale [rahl]). Also called crackles rhonchi Abnormal chest sounds produced in airways with accumulated fluids; more noticeable during expiration (singular: rhonchus) stridor A harsh, high-pitched sound caused by obstruction of an upper air passageway tussis A cough. An antitussive drug is one that relieves or prevents coughing wheeze A whistling or sighing sound caused by narrowing of a respiratory passageway Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Disorders byssinosis Obstructive airway disease caused by reaction to the dust in unprocessed plant fibers sleep apnea Intermittent periods of breathing cessation during sleep. Central sleep apnea arises from failure of the brain stem to stimulate breathing. Obstructive sleep apnea results from airway obstruction during deep sleep, as from obesity or enlarged tonsils small cell carcinoma A highly malignant type of bronchial tumor involving small, undifferentiated cells; “oat cell” carcinoma Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Diagnosis Mantoux test A test for tuberculosis in which PPD (tuberculin) is injected into the skin. The test does not differentiate active from inactive cases mediastinoscopy Examination of the mediastinum by means of an endoscope inserted through an incision above the sternum plethysmograph An instrument that measures changes in gas volume and pressure during respiration pneumotachometer A device for measuring air flow thoracoscopy Examination of the pleural cavity through an endoscope; pleuroscopy tine test A test for tuberculosis in which PPD (tuberculin) is introduced into the skin with a multi-pronged device. The test does not differentiate active from inactive cases Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Treatment aerosol therapy Treatment by inhalation of a drug or water in spray form continuous positive airway pressure (CPAP) Use of a mechanical respirator to maintain pressure throughout the respiratory cycle in a patient who is breathing spontaneously extubation Removal of a previously inserted tube intermittent positive pressure breathing (IPPB) Use of a ventilator to inflate the lungs at intervals under positive pressure during inhalation intermittent positive pressure ventilation (IPPV) Use of a mechanical ventilator to force air into the lungs while allowing for passive exhalation nasal cannula A two-pronged plastic device inserted into the nostrils for delivery of oxygen Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Treatment (cont’d) orthopneic position An upright or semiupright position that aids breathing positive endexpiratory pressure (PEEP) Use of a mechanical ventilator to increase the volume of gas in the lungs at the end of exhalation, thus improving gas exchange postural drainage Use of body position to drain secretions from the lungs by gravity. The patient is placed so that secretions will move passively into the larger airways for elimination thoracic gas volume (TGV, VTG) The volume of gas in the thoracic cavity calculated from measurements made with a body plethysmograph Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Surgery adenoidectomy Surgical removal of the adenoids intubation Insertion of a tube into a hollow organ, such as into the larynx or trachea for entrance of air. Patients may be intubated during surgery for administration of anesthesia or to maintain an airway. Endotracheal intubation may be used as an emergency measure when airways are blocked lobectomy Surgical removal of a lobe of the lung or of another organ pneumoplasty Plastic surgery of the lung. In reduction pneumoplasty, nonfunctional portions of the lung are removed, as in cases of advanced emphysema tracheotomy Incision of the trachea through the neck, usually to establish an airway in cases of tracheal obstruction tracheostomy Surgical creation of an opening into the trachea to form an airway or to prepare for the insertion of a tube for ventilation, also the opening thus created Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Drugs antihistamine Agent that prevents responses mediated by histamine, such as allergic and inflammatory reactions antitussive Drug that prevents or relieves coughing asthma maintenance drug Agent used to prevent asthma attacks and for chronic treatment of asthma bronchodilator Drug that relieves bronchial spasm and widens the bronchi corticosteroid Hormone from the adrenal cortex; used to reduce inflammation decongestant Agent that reduces congestion or swelling expectorant Agent that aids in removal of bronchopulmonary secretions isoniazid (INH) Drug used to treat tuberculosis leukotriene antagonist Drug that prevents or reduces inflammation by inhibiting leukotrienes, substances made in white blood cells that promote inflammation; they also constrict the bronchi and increase mucus production; used in asthma treatment mucolytic Agent that loosens mucus to aid in its removal Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Abbreviations ABG(s) Arterial blood gas(es) AFB Acid-fast bacillus (usually Mycobacterium tuberculosis) ARDS Acute respiratory distress syndrome; shock lung ARF Acute respiratory failure BCG Bacillus Calmette-Guérin (tuberculosis vaccine) BS Breath sounds C Compliance CF Cystic fibrosis CO2 Carbon dioxide COLD Chronic obstructive lung disease COPD Chronic obstructive pulmonary disease Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Abbreviations (cont’d) CPAP Continuous positive airway pressure CXR Chest radiograph, chest x-ray DTaP Diphtheris, tetanus, acellular pertussis (vaccine) ERV Expiratory reserve volume FEV Forced expiratory volume FRC Functional residual capacity FVC Forced vital capacity HPS Hantavirus pulmonary syndrome IC Inspiratory capacity INH Isoniazid IPPB Intermittent positive pressure breathing Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Abbreviations (cont’d) IPPV Intermittent positive pressure ventilation IRV Inspiratory reserve volume LLL Left lower lobe (of lung) LUL Left upper lobe (of lung) MEFR Maximal expiratory flow rate MMFR Maximum midexpiratory flow rate O2 Oxygen PaCO2 Arterial partial pressure of carbon dioxide PaO2 Arterial partial pressure of oxygen PCP Pneumocystis pneumonia Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Abbreviations (cont’d) PEEP Positive end-expiratory pressure PEFR Peak expiratory flow rate PFT Pulmonary function test(s) PIP Peak inspiratory pressure PND Paroxysmal nocturnal dyspnea PPD Purified protein derivative (tuberculin) R Respiration RDS Respiratory distress syndrome RLL Right lower lobe (of lung) RML Right middle lobe (of lung) RSV Respiratory syncytial virus Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Abbreviations (cont’d) RUL Right upper lobe (of lung) RV Residual volume SARS Severe acute respiratory syndrome SIDS Sudden infant death syndrome SpO2 Oxygen percent saturation T&A Tonsils and adenoids; tonsillectomy and adenoidectomy TB Tuberculosis TGV Thoracic gas volume Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Abbreviations (cont’d) TLC Total lung capacity TV Tidal volume URI Upper respiratory infection VC Vital capacity VTG Thoracic gas volume Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Respiratory System • Main functions: – Provide oxygen to cells – Eliminate carbon dioxide • Works closely with cardiovascular system to accomplish gas exchange • External gas exchange occurs between atmosphere and blood • Internal gas exchange occurs between blood and tissues Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Respiratory System Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Upper Respiratory Passageways • Air enters through nose, past sinus cavities • Air then passes through pharynx • Pharynx divided into three regions: – Nasopharynx (upper) – Oropharynx (middle) – Laryngeal (lower) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Lower Respiratory Passageways and Lungs • Larynx contains vocal cords (allows speech) • Trachea is tube with C-shaped cartilage rings (divides into bronchus) • Bronchial System consists of bronchus, bronchioles, alveoli Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Lower Respiratory Passageways and Lungs (cont’d) • Lungs – Right is larger and has 3 lobes – Left has 2 lobes – Covered by pleura • Parietal (outer) • Visceral (inner) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Suffixes for Respiration Suffix -pnea Meaning breathing Example orthopnea -oxia* level of oxygen hypoxia -capnia* level of carbon dioxide voice hypercapnia -phonia dysphonia Definition of Example breathing difficulty that is relieved by assuming an upright (ortho-) position decreased amount of oxygen in the tissues increased carbon dioxide in the tissues difficulty in speaking *When referring to levels of oxygen and carbon dioxide in the blood, the suffix -emia is used, as in hypoxemia, hypercapnemia. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Roots for Respiratory Passageways Root nas/o Meaning nose Example intranasal Definition of Example within the nose rhin/o nose rhinoplasty plastic repair of the nose pharyng/o pharynx pharyngospasm laryng/o* larynx laryngeal spasm (sudden contraction) of the pharynx pertaining to the larynx trache/o trachea tracheotome bronch/o, bronch/i bronchiol bronchus bronchogenic instrument used to incise the trachea originating in a bronchus bronchiole bronchiolectasis dilatation of the bronchioles *Note addition of e before adjective ending -al. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins The Larynx Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Breathing • Ventilation made up of: – Inspiration • Phrenic nerve stimulates diaphragm to contract and flatten • Chest cavity enlarges • Change in pressure causes air to be pulled in – Expiration • Breathing muscles relax • Lungs return to original size • Air forced out Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Roots for the Lungs and Breathing Root phren/o Meaning diaphragm Example phrenic Definition of Example pertaining to the diaphragm phrenic/o phrenic nerve phrenicectomy pleur/o pleura pleurodesis partial excision of the phrenic nerve fusion of the pleura pulm/o, pulmon/o pneumon/o lungs extrapulmonary outside the lungs lung pneumonitis pneum/o, pneumat/o spir/o air, gas; also pneumothorax respiration, lung breathing spirometer inflammation of the lung; pneumonia presence of air in the thorax (pleural space) instrument for measuring breathing volumes Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pulmonary Ventilation Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Gas Transport • Oxygen in blood – Attached to hemoglobin in red blood cells – Released to cells as needed • Carbon dioxide mostly as carbonic acid – Amount formed regulates blood pH Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Clinical Aspects of Respiration • Pulmonary function affected by conditions that: – Cause resistance to air flow – Limit proper expansion of chest • Conditions directly affecting respiratory system: – Infection – Injury – Allergy – Aspiration – Cancer Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Clinical Aspects of Respiration (cont’d) • Changes in ventilation affect pH of blood – Alkalosis = too much carbon dioxide exhaled by hyperventilation (blood too alkaline) – Acidosis = too little carbon dioxide exhaled by hypoventilation (blood too acidic) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Infections • Pneumonia – Caused by several different microorganisms – Types: bronchopneumonia, lobar pneumonia – Leading cause of death in debilitated patients • Tuberculosis – Caused by Mycobacterium tuberculosis – Symptoms: fever, weight loss, weakness, cough, Hemoptysis (sputum with blood) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Infections (cont’d) • Influenza – Viral disease of respiratory tract – Symptoms: chills, fever, headaches and muscular aches • Common cold – Types: rhinovirus, adenovirus, coronavirus Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Emphysema • Overexpansion and destruction of alveoli • Causes: – Exposure to cigarette smoke or pollution – Chronic infection • Classified under chronic obstructive pulmonary disease (COPD) heading Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Asthma • Narrowing of bronchial tubes • Main factor may be irritation caused by allergy • Symptom of wheezing indicated by: – Constriction of bronchial tubes – Edema of bronchial linings – Accumulation of mucus • Extreme “attacks” may result in: – Dyspnea – Cyanosis Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pneumoconiosis • Chronic irritation and inflammation – Caused by inhalation of dust particles • Occupational hazard of mining and stonework • Different forms named for specific dusts: – Silicosis (silica or quartz) – Anthracosis (coal) – Asbestosis (asbestos fibers) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Lung Cancer • Leading cause of cancer related deaths in men and women • Cigarette smoking is major factor • Cannot be detected early, metastasizes rapidly • Overall survival rate is low • Diagnosed by: – Radiographic studies – CT scans – Sputum examination – Bronchoscope Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Respiratory Distress Syndrome • Occurs in premature infants • Results from lack of surfactant in lungs • Acute respiratory distress syndrome – May result from: • Trauma • Allergic reactions • Infection • Other causes – Involves edema that can cause respiratory failure Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Cystic Fibrosis • Hereditary disease caused by flawed gene • Affects glandular secretions by altering chloride transport • Bronchial secretions thicken leading to: – Infection – Other respiratory disorders • Diagnosed by increased amounts of sodium and chloride in sweat • No cure currently available Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Sudden Infant Death Syndrome • Unexplained death of infant under age of 1 • Death usually caused during sleep • To reduce occurrence: – Place baby on back when sleeping – Keep baby in smoke-free environment – Use firm, flat baby mattress – Don’t overheat the baby Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pleura Disorders • Pleurisy = inflammation of pleura, usually with infection – Main symptom is pain which causes rapid, shallow breathing • Accumulation of substances between layers of pleura lead to other conditions: – Pneumothorax – Empyema – Hemothorax – Hydrothorax Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pleura Disorders (cont’d) • Fluids removed by thoracentesis Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Diagnosis of Respiratory Disorders • Methods for diagnosing respiratory disorders: – Radiographs – CT scans – MRI scans – Lung scans – Bronchoscopy – Tests of pleural fluid removed with thoracentesis Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Diagnosis (cont’d) • Methods for diagnosing respiratory disorders: – Examination of arterial blood gases • Evaluate gas exchange • Measures: • Carbon dioxide • Oxygen • Bicarbonate • Blood pH Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Diagnosis (cont’d) – Pulse oximetry • Measure oxygen saturation of arterial blood – Pulmonary function tests • Spirometer measures volume of air moved with varying degrees of effort Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 1. The gas that is supplied to tissues by the respiratory system is: (a) oxygen (b) neon (c) sulfur (d) carbon dioxide Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 1. The gas that is supplied to tissues by the respiratory system is: (a) oxygen (b) neon (c) sulfur (d) carbon dioxide Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 2. The gas that is eliminated by the respiratory system is: (a) chlorine (b) carbon dioxide (c) hydrogen (d) fluoride Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 2. The gas that is eliminated by the respiratory system is: (a) chlorine (b) carbon dioxide (c) hydrogen (d) fluoride Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 3. The air sacs through which gases are exchanged in the lungs are the: (a) trachea (b) alveoli (c) bursae (d) bronchi Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 3. The air sacs through which gases are exchanged in the lungs are the: (a) trachea (b) alveoli (c) bursae (d) bronchi Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 4. The structure that holds the vocal cords is the: (a) larynx (b) tongue (c) uvula (d) tonsils Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 4. The structure that holds the vocal cords is the: (a) larynx (b) tongue (c) uvula (d) tonsils Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 5. The tubes that carry air from the trachea into the lungs are the: (a) arteries (b) nares (c) veins (d) bronchi Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 5. The tubes that carry air from the trachea into the lungs are the: (a) arteries (b) nares (c) veins (d) bronchi Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 6. The dome-shaped muscle under the lungs is the: (a) palate (b) diaphragm (c) hiatus (d) esophagus Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 6. The dome-shaped muscle under the lungs is the: (a) palate (b) diaphragm (c) hiatus (d) esophagus Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 7. The membrane around the lungs is the: (a) peritoneum (b) mucosa (c) pleura (d) mediastinum Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 7. The membrane around the lungs is the: (a) peritoneum (b) mucosa (c) pleura (d) mediastinum Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 8. A term for inflammation of the lungs is: (a) pneumonia (b) bronchitis (c) pleuritis (d) laryngitis Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 8. A term for inflammation of the lungs is: (a) pneumonia (b) bronchitis (c) pleuritis (d) laryngitis Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins