Lecture Notes

1. 7 Respiratory System Lecture Notes Classroom Activity to Accompany Medical Terminology Systems, Sixth Edition Barbara A. Gylys ∙ Mary Ellen Wedding

2. 7 RESPIRATORY SYSTEM Structure • Upper respiratory tract • Nose, pharynx, larynx, trachea • Lower respiratory tract • Bronchi, bronchioles, lungs, alveoli, breathing muscles

3. 7 RESPIRATORY SYSTEM Function • Respiration • External and Internal • Other functions, with help of cardiovascular system • Provides oxygen to body cells • Eliminates the waste product carbon dioxide CO2

4. 7 RESPIRATORY SYSTEM Structure and Function Exercise Q: Name the structures of the upper respiratory tract (URT)? A: Nose, pharynx, larynx, and trachea. Q: What are the structures of the lower respiratory tract ? A: Bronchi, bronchioles, alveoli, and the lungs. Q: What do abbreviations O2 and CO2 mean? A: O2 means oxygen; CO2 means carbon dioxide. Q: What is the main function of the respiratory system? A: Provides O2 and removes CO2 from body cells. Q: What other body system helps the respiratory system transport O2 and remove CO2 from body cells? A: CV system helps transport O2 and remove CO2 from body cells.

5. 7 RESPIRATORY SYSTEM Sleep Apnea Signs and Symptoms • Brief or prolonged absence of spontaneousrespirations.

6. 7 RESPIRATORY SYSTEM Sleep Apnea Signs and Symptoms (continued) • In obstructive sleep apnea, patients stop breathing multiple times each night. Causes include airway obstruction that may be caused by soft palate, neck tissue, or tonsil enlargement. • In premature infants, the immature CNS fails to maintain a consistent respiratory rate, and there are long pauses between regular breathing.

7. 7 RESPIRATORY SYSTEM Sleep Apnea Signs and Symptoms (continued) • Apnea is followed by a gasping breath that often awakens the person. • Occurs most often in middle-aged, obese men who snore excessively.

8. 7 RESPIRATORY SYSTEM Sleep Apnea Treatment • Tonsillectomy and adenoidectomy (T&A). • Uvulopalatopharyngoplasty (UPP). • CPAP apparatus to keep airway open in adults; home apnea monitor for infants.

9. 7 RESPIRATORY SYSTEM Clinically Related Exercise Q: Mrs. J is diagnosed with sleep apnea and asks the nurse to explain this disorder. A: The nurse explains it’s a temporary loss of breathing resulting in brief or prolonged absence of spontaneous respiration. Q: Patient X presents for an excision of tonsils and adenoids as a treatment of sleep apnea. The abbreviation for the surgical procedure to remove tonsils and adenoids is__________. A: T&A Q: Mary is prescribed a CPAP machine for sleep apnea. The respiratory therapist explains that this machine will help keep her airway open at night so she can breathe normally. The medical term to breathe normal is ___________. A: eupnea Q: Mr. M presents with complaints of excessive snoring at night that awakens him and also results in him gasping for breath. The physician explains that he has a common condition that occurs in middle-aged, obese men in which temporary cessation of breathing occurs. This condition is known as sleep (apnea, dyspnea, eupnea). A: apnea

10. 7 RESPIRATORY SYSTEM Lung Cancer Signs and Symptoms • Early-stage lung cancer usually produces no symptoms and is difficult to detect. • When symptoms appear, they may include smoker’s cough, wheezing, chest pain, dyspnea, and hemoptysis. • Risk factors include chemical exposure or history of smoking or exposure to second-hand smoke.

11. 7 RESPIRATORY SYSTEM Lung Cancer Treatment • Combination of surgery, radiation therapy, and chemotherapy depending on whether the malignancy is localized or metastasized. • Chest x-ray, sputum cytology test, and bronchoscopy with tissue biopsy are required for definitive diagnosis.

12. 7 RESPIRATORY SYSTEM Clinically Related Exercise Q: Mr O works for a collision shop and sprays paint on cars. He is also a 2 pack/day smoker for 15 years. He is concerned about developing lung cancer and asks the nurse if it is preventable. A: She explains that lung cancer is preventable if one avoids smoking and inhaling toxic substances. Q: A 1 pack/day smoker for the past 8 years is diagnosed with lung cancer. She asks the doctor if her cancer will be cured if she stops smoking. A: The doctor explains if smokers stop smoking during early precancerous cellular changes, damaged bronchial lining tissues often return to normal. Q: The patient presents for a visual examination of his interior bronchi with biopsy to confirm a diagnosis of lung cancer. The physician documents the visual examination of the bronchi as a ____________________. A: bronchoscopy Q: The patient is diagnosed with advanced lung cancer and asks why it was not detected last year during her annual physical exam. A: The nurse explains that early-stage lung cancer usually produces no symptoms and is difficult to detect. When symptoms appear, cancer often has metastasized to tissues such as the brain, liver, and bone.

13. 7 RESPIRATORY SYSTEM Upper Airway Obstruction Signs and Symptoms • Symptoms vary depending on the cause of obstruction, but some symptoms are common to all types of obstructions. • Cyanosis of the skin. • Difficulty breathing, choking, confusion, panic, unconsciousness.

14. 7 RESPIRATORY SYSTEM Upper Airway Obstruction Treatment • Depends on the cause of the blockage. • Objects lodged in the airway may be removed with a laryngoscope or bronchoscope. • A tube may be inserted into the airway (endotracheal tube or nasotracheal tube). • Opening is made directly into the airway (tracheostomy) if needed.

15. 7 RESPIRATORY SYSTEM Clinically Related Exercise Q: Doctor X is concerned that Mrs. T has an airway blockage. The patient asks if there a test to confirm a blockage. A: The doctor states tests may include bronchoscopy, laryngoscopy, and radiography. Q: John’s x-ray shows a small foreign object lodged in his larynx. The physician removes the object with an instrument called a ____________________. A: laryngoscope Q: The patient presents for an opening to be made into the trachea. This surgical procedure is documented in the medical record as a ________________. A: tracheostomy Q: The anesthesiologist inserts a tube directly into the patient’s trachea so the patient will be able to breathe while under general anesthesia. This tube is known as an ___________________ _________________. A: endotracheal tube

16. 7 RESPIRATORY SYSTEM Medical Vocabulary • acidosis • aerophagia • anosmia • anoxia • apnea • asphyxia • atelectasis • bradypnea

17. 7 RESPIRATORY SYSTEM Medical Vocabulary (continued) • coryza • cyanosis • dysphonia • dyspnea • emphysema • epistaxis • eupnea • hypercapnia

18. 7 RESPIRATORY SYSTEM Medical Vocabulary (continued) • influenza • mucoid • pertussis • pleurisy • pneumonia • pyothorax • respiration

19. 7 RESPIRATORY SYSTEM Medical Vocabulary (continued) • resuscitation • rhinoplasty • rhinorrhea • rhonchi • stridor • tachypnea • transnasally

20. 7 RESPIRATORY SYSTEM Diagnostic Procedures • Bronchoscopy • Tissue biopsy for cancer detection of lungs • Remove obstruction (tissue or other), or observe directly for pathological changes

21. 7 RESPIRATORY SYSTEM Diagnostic Procedures (continued) Thoracentesis • Remove fluid from pleural space for diagnostic or therapeutic purposes

22. 7 RESPIRATORY SYSTEM Diagnostic Procedures (continued) • Arterial blood gas (ABG) • Magnetic resonance imaging (MRI) • Pulmonary function tests (PFTs)

23. 7 RESPIRATORY SYSTEM Word Building Exercise Q: Visual examination of bronchi: __________________. A: bronchoscopy Q: Surgical puncture of chest: ______________________. A: thoracentesis or thoracocentesis Q: Forming an opening (mouth) in the trachea:___________. A: tracheostomy Q: Visual examination of larynx: ____________________. A: laryngoscopy Q: Instrument for measuring breathing: _________________. A: spirometer Q: Instrument for examining the larynx: _________________. A: laryngoscope

24. 7 RESPIRATORY SYSTEM Medical and Surgical Procedures • Lavage • Irrigation of paranasal sinuses to remove mucopurulent material • Postural drainage • Body is positioned so gravity helps remove secretions from the lung or bronchi. Coughing usually expels secretions from the trachea

25. 7 RESPIRATORY SYSTEM Medical and Surgical Procedures (continued) Tracheostomy • Upper airway obstruction

26. 7 RESPIRATORY SYSTEM Clinically Related Exercise Q: Mr. J has a history of smoking 2 packs/day for 30 years. He is diagnosed with throat cancer and presents to the hospital for an excision of the larynx. What is this surgical procedure called? A: laryngectomy Q: Mr. M has thick mucous secretions from a prolonged respiratory infection. The nurse adjusts his bed upright to 90 degrees so he can easily cough up mucus. This type of therapeutic drainage is known as postural ______________. A: drainage Q: Mrs. S presents to 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). A: tracheotomy

27. 7 RESPIRATORY SYSTEM Pharmacology • Bronchodilators • Drugs that dilate constricted airways via a metered-dose inhaler (MDI) • Corticosteroids

28. 7 RESPIRATORY SYSTEM Pharmacology (continued) • Metered-dose inhalers (MDIs) • Nebulized mist treatments (NMTs) • Administer meds directly into lungs via a nebulizer

29. 7 RESPIRATORY SYSTEM Clinically Related Exercise Q: To reduce airway inflammation in an asthmatic patient, the doctor prescribes a/an (antibiotic, corticosteroid, expectorant). A: corticosteroid Q: Ms. C presents with a chief complaint of shortness of breath upon exertion. Medication is prescribed to expand the bronchial airways . It is known as a/an (bronchodilator, corticosteroid, expectorant). A: bronchodilator Q: Upon inhalation, a fine spray delivers medication into the lungs. The device used is known as a/an (bronchoscope, intubator, nebulizer). A: nebulizer Q: To reduce sputum thickness and ability to cough it up, the physician prescribes a/an (antibiotic, corticosteroid, expectorant). A: expectorant