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Respiratory System 1 Objectives After studying this chapter, you will be able to: •Name the parts of the respiratory system and discuss the function of each part. •Define combining forms used in building words that relate to the respiratory system and its parts. •Identify the meaning of related abbreviations. 2 Objectives Part 2 •Name the common diagnoses, clinical procedures, and laboratory tests used in treating disorders of the respiratory system. •List and define the major pathological conditions of the respiratory system. •Explain the meaning of the surgical terms related to the respiratory system. 3 Structure and Function The respiratory system performs two major tasks: •Exchanging air between the body and the outside environment known as external respiration •Bringing oxygen to the cells and removing carbon dioxide from them referred to as internal respiration 4 External Respiration External Respiration Air from the outside environment enters the nose or mouth during inspiration (inhalation). The Nose •Also called external nares •Divided into two halves by the nasal septum •Contains the paranasal sinuses where air is warmed •Contains cilia which is responsible for filtering out foreign bodies 5 Pharynx Pharynx Also known as the throat is a passageway for both air and food Three Sections of the Pharynx Nasopharynx -contains the pharyngeal tonsils (adenoids) which aid in the body’s immune defense Oropharynx -back portion of the mouth that contains the palatine tonsils which aid in the body’s immune defense Laryngopharynx -bottom section of the pharynx where the respiratory tract 6 divides into the esophagus and the larynx Epiglottis The epiglottis, a movable flap of cartilage that covers the opening to the larynx (voice box) prevents food from entering the larynx during swallowing. Occasionally, a person may swallow and inhale at the same time so some food may enter the larynx and choking occurs. A technique called the Heimlich maneuver has saved many people from choking to death. 7 Larynx Larynx Serves as a passageway to the trachea and the area where sounds are produced Vocal Cords Size and thickness determine the pitch of sound •Short and thin = high pitch •Thick and long = low pitch Posterior Portion of Tongue False Vocal Cords Glottis True Vocal Cords 8 Trachea larynx Trachea trachea •Also known as the windpipe •Connects the larynx to the right and left bronchi •Point at which it divides into the right and left bronchi is called the mediastinum bronchi 9 Internal Respiration Internal Respiration Air from the bronchi travels to the bronchioles then to the tiny air sacs (alveoli) which connect to lung capillaries. Oxygen and carbon dioxide are exchanged and oxygen is delivered to the body cells. alveolus capillaries 10 Lungs Lungs •Consist of a right and left lobe •Covered by a double layer of membrane that makes movement in the thoracic cavity easier. The outer layer is the parietal pleura and the inner layer is the visceral pleura •The space between the two pleurae is called the pleural cavity •Consist of an apex (top section), hilum (middle section) and base (lower section) 11 Inhale/Exhale The passage of air from the external environment to the lung capillaries, bloodstream and out consists of one inhalation and one exhalation. 12 Muscles for Breathing Muscles for Breathing The major Bronchioles muscles that Alveoli contract to enlarge the thoracic cavity during inspiration Lungs are the: Pharynx Larynx Trachea (windpipe) Right and left bronchi •Diaphragm •Intercostal muscles Note: The diaphragm lowers itself when it contracts during inhalation 13 Combining Forms & Combining Form Meaning Abbreviations [adenoid(o)] adenoid (o) adenoid; gland alveol (o) alveolus bronch (o) bronchus bronchiol (o) bronchiole capn (o) carbon dioxide epiglott (o) epiglottis laryng (o) larynx 14 Combining Forms & Combining Form Meaning Abbreviations [lob(o)] lob (o) lobe of the lung mediastin (o) mediastinum nas (o) nose or (o) mouth ox (o) oxygen pharyng (o) pharynx phon (o) voice, sound 15 Combining FormsMeaning & Abbreviations [phren(o)] phren(o) diaphragm Combining Form pleur(o) pleura pneum (o) air rhin (o) nose spir (o) breathing steth (o) chest thorac (o) thorax 16 Combining Forms & Abbreviation Meaning Abbreviations [ABG] ABG arterial blood gas AFB acid-fast bacillus A&P auscultation and percussion AP anteroposterior ARD acute respiratory disease ARDS ARF adult respiratory distress syndrome acute respiratory failure17 Combining Forms & Abbreviation Meaning Abbreviations [BS] BS breath sounds COLD chronic obstructive lung disease COPD chronic obstructive pulmonary disease CPR cardiopulmonary resuscitation CTA clear to auscultation CXR chest x-ray DOE dyspnea on exertion 18 Combining Forms & Abbreviation Meaning Abbreviations [DPT] DPT diptheria,pertussis, tetanus ENT ear, nose and throat ET tube endotracheal intubation tube FEF forced expiratory flow FEV forced expiratory volume FVC forced vital capacity HBOT hyperbaric oxygen therapy 19 Combining Forms & Meaning Abbreviations [IMV] intermittent mandatory Abbreviation IMV IPPB IRDS ventilation intermittent positive pressure breathing infant respiratory distress syndrome IRV inspiratory reserve volume LLL left lower lobe LUL left upper lobe MBC maximal breathing capacity 20 Combining Forms & Abbreviation Meaning Abbreviations [MDI] MDI metered dose inhaler PA posteroanterior PCP pneumocystis carinii pneumonia PEEP positive end expiratory pressure PFT pulmonary function tests PND paroxysmal nocturnal dyspnea; postnasal drip RD respiratory disease 21 Combining Forms & Meaning Abbreviations [RDS] respiratory distress syndrome Abbreviation RDS RLL right lower lobe RUL right upper lobe SIDS sudden infant death syndrome SOB shortness of breath T&A tonsillectomy and adenoidectomy TB tuberculosis 22 Combining Forms & Meaning Abbreviations [TLC] total lung capacity Abbreviation TLC TPR temperature, pulse, and respirations URI upper respiratory infection VC vital capacity V/Q scan ventilation/perfusion scan 23 Diagnostic, Procedural & Laboratory Tests Methods Used to Diagnose Respiratory Disorders: •Auscultation •Assessing respiratory rate •Percussion •Sputum analysis Normal Adult respiratory rate is 15 to 20 respirations per minute. 24 Pulmonary Function Tests Pulmonary function tests measure the mechanics of breathing. Peak flow meter •measures the capacity for breathing Spirometer •a pulmonary function testing machine that measures the lungs volume and capacity Forced Vital Capacity Forced Expiratory Volume Highest breathing capacity following the deepest breath Shows breathing capacity at different parts of the respiratory cycle 25 Abnormalities/Masses Abnormalities such as masses and restricted blood flow within the lungs can be detected via: •Chest x-rays •MRI •Lung scans Structures of the respiratory system can be observed via: •Endoscopy •Bronchoscopy 26 Laboratory Tests Laboratory Tests •Throat Cultures •Sputum Sample •Arterial Blood Gases •Sweat Test 27 Pathology adenoiditis epiglottitis bronchitis Inflammatory laryngitis Conditions rhinitis pharyngitis pneumonitis sinusitis tonsillitis laryngotracheobronchitis 28 eupnea Breathing Patterns Breathing Patterns hyperpnea bradypnea dyspnea tachypnea apnea hypopnea Other Conditions orthopnea •Cheyne Stokes Respiration •Hyperventilation •Hypoxemia 29 Upper Respiratory Infection Upper respiratory infection is a term that covers an infection of some or all of the respiratory tract. Other Conditions: •Croup •Diptheria •Epistaxis •Rhinorrhea •Pertussis 30 Chronic Obstructive Pulmonary Chronic Obstructive Disease Pulmonary Disease (COPD) is a term for any disease with chronic obstruction of the bronchial tubes and lungs such as: •Emphysema •Chronic Bronchitis Asthma causes narrowing of the bronchi leading to dyspnea, wheezing and coughing. Normal bronchiole Asthmatic bronchiole, showing constriction 31 Hemoptysis Hemoptysis Lung or bronchial hemorrhage that results in the spitting of blood. Cystic Fibrosis Disease of the exocrine glands that causes secretion of abnormally thick mucus which leads to chronic obstruction. Atelectasis Collapsed alveoli leading to collapse of a lung or part of a lung. Pneumonia Acute infection of the alveoli. 32 Environmental Conditions Conditions caused by environmental agents Pneumoconiosis •Caused by dust in the lungs Anthracosis •Caused by coal dust Asbestosis •Caused by asbestos particles released during construction of ships and buildings Silicosis •Caused by the silica dust from grinding rocks or glass 33 Disorders of the Pleura Disorders of the Pleura Pneumothorax •Accumulation of air or gas in the pleural cavity. Empyema •Pus in the pleural cavity. Hemothorax •Blood in the pleural cavity. Pleural Effusion •Escape of fluid into the pleural cavity. 34 Otorhinolaryngologists Otorhinolaryngologists are physicians that specialize in disorders of the upper respiratory tract. Surgical Removal Conditions •Tonsillectomy •Laryngectomy •Adenoidectomy •Pneumonectomy •Lobectomy 35 bronchoplasty Surgical Repair laryngoplasty Surgical Repair rhinoplasty septoplasty tracheoplasty 36 Surgical Incisions Surgical Incisions •Laryngotracheotomy •Sinusotomy •Thoracotomy •Tracheotomy Tracheostomy tube •Endotracheal intubation is the insertion of a tube through the nose or mouth, pharynx, larynx and into the trachea to establish an 37 airway. Pharmacology Antibiotics, antihistamines and anticoagulants are used for respiratory disorders just as with other system disorders. Medications specific to Respiratory Conditions: Bronchodilators •Dilate the bronchial walls Expectorants •Promote coughing and expulsion of mucus 38 Mechanical Devices Mechanical Devices that aid in Respiration Ventilators •Actually serve as a breathing substitute for patients who can not breathe on their own. Nebulizers •Deliver medication through the mouth or nose to ease breathing problems 39 Agents to Treat Respiratory Agents Used to Treat Respiratory Conditions Conditions Antitussive Expectorants (relieves coughing) Decongestants (decreases and prevents mucus buildup) (promotes coughing and expelling of mucus) 40 Apply Your Knowledge Identify the following respiratory structures: A. Trachea B. Bronchi C. Alveolus 41 Apply Your Knowledge Part 2 An obstruction in which of the following would be MOST fatal? A. BRONCHIOLE B. TRACHEA C. BRONCHI Answer: B. Trachea 42 Apply Your Knowledge Part 3 Mr. Davis has had hoarseness for the past six months. He recently went to his physician and received a diagnosis of cancer of his voice box. Which of the following procedures might be indicated for Mr. Davis? A. Pharyngectomy B. Pneumonectomy C. Laryngectomy Answer: C. Laryngectomy 43 Apply Your Knowledge Part 4 Melissa has very thick respiratory secretions. She visits a local pharmacy looking for something to help her with her dry cough. Which of the following types of medication should Melissa consider taking? A. Expectorant B. Antitussive C. Antibiotic Answer: A. Expectorant 44