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Respiratory System

Respiratory System. Medical Terminology. Key terms:. Carbon dioxide: product of cellular metabolism Granuloma Mucosa: epithelial layer lining cavities and lumens Mucus Naris: nostril Oxygen pH. Key Terms. Respiratory failure Vs. respiratory distress Septum Sputum

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Respiratory System

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  1. Respiratory System Medical Terminology

  2. Key terms: • Carbon dioxide: product of cellular metabolism • Granuloma • Mucosa: epithelial layer lining cavities and lumens • Mucus • Naris: nostril • Oxygen • pH

  3. Key Terms • Respiratory failure • Vs. respiratory distress • Septum • Sputum • Status asthmaticus • Critical extreme of asthma symptoms • Surfactant: lipoprotein that reduces surface tension of alveoli and allows their patency

  4. Anatomy • Upper respiratory tract: • Nasal cavity • Cilia, nasal septum, olfactory neurons • Nasopharynx • Adenoids, tonsils (palatine) • Oropharynx • Laryngopharynx • Larynx (phonation), epiglottis, trachea

  5. Anatomy • Lower respiratory tract: • Trachea • Right & Left mainstem bronchi • Lungs • Within lungs: • Bronchioles • Alveoli • Pulmonary capillaries

  6. Anatomy • Other thoracic structures: • Intercostal muscles (between ribs) • Mediastinum • Heart, aorta, esophagus,bronchi • Pleural cavities • Pleura (visceral & parietal) • Diaphragm • Separates abdomen from thorax • Initiate the mechanics of ventilation • Begins inspiration • expiration

  7. Respiration • Process by which: • Oxygen is absorbed from inhaled air • Oxygen is then transported to cells for their metabolic processes • Cellular waste products of metabolism (carbon dioxide & water) are brought back to the lung • Lungs return CO2 and water to environment.

  8. Respiration: Processes • Ventilation: the mechanics • External respiration • Exchange of gases between alveoli & pulmonary capillaries • Transportation of respiratory gases through CV system to cells and back • Internal respiration • Exchange of gases between tissues & systemic capillaries

  9. Ventilation • Involves • Involuntary movement of air in and out of respiratory tract • Inspiration & expiration • Stimulus for this is oxygen & carbon dioxide levels in the blood • Autonomic NS stimulates diaphragm and intercostal muscles

  10. Combining Forms • Naso- or rhino- (nose) (rhinoplasty) • Septo- (septum) septal hematoma • Sinuso- (sinus) • Adenoido- (adenoids) (adenoidal hypertrophy) • Tonsillo- (tonsillectomy) • Pharyngo- (Pharyngeal) • Epiglotto- (epiglottitis)

  11. Combining Forms • Laryngo- (laryngomalacia) • Tracheo- (tracheostomy) • Bronchio- or broncho- (bronchiectasis) • Bronchiolo- (bronchioloconstriction) • Alveolo- (alveolar) • Pneumo-, pneumono- or pulmono- (lungs) • Pleuro- (pleurocentesis)

  12. Combining Forms • Anthraco- (coal) anthracosis • Atelo- inperfect/incomplete (atelectasis) • Conio- (dust) (pneumoconioses) • Cyano- • Lobo- (lobe) lobectomy • Ortho- (straight) (orthopnea) • Oxo- or oxi- (oxygen) oximeter

  13. Combining Forms • Pectoro-, stetho-, thoraco- (chest) • Phreno- (diaphragm) phrenic nerve • Spiro- (breathe) spirometry

  14. Suffixes: • -capnia (CO2) (hypercapnia) • -osmia (smell) (anosmia) • -phonia (voice) (dysphonia) • -pnea (breathing) (apnea, tachypnea) • -ptysis (spitting) (hemoptysis) • -thorax (chest) (hemothorax, chylothorax)

  15. Chronic Obstructive Pulmonary Disease (COPD) • Includes three major disease components: • Asthma, chronic bronchitis, emphysema • Major etiology in US: smoking • Risk factor for pulmonary infections & CA • Major symptoms and signs: dyspnea, labored respirations, chronic cough, hypoxia, hypercarbia, cyanosis

  16. Asthma • Three major disease components: • Bronchospasm, increased mucus production, airway inflammation • Reversible bronchospasm • Increased risk of asthma during URI or pulmonary infections, allergen contact, aspirin-sensitivity, with exercise.

  17. Asthma • Usual symptoms and signs: • Dyspnea, frequent cough, audible wheezing, trouble sleeping, decreased exercise tolerance • Status asthmaticus • Life-threatening exacerbation of asthma

  18. Chronic Bronchitis • Ongoing inflammation of epithelial (mm) lining of airways • Chronic cough and mucus production • Acute bronchitis: • Active infection • May be bacterial or viral • Change in cough and sputum pattern

  19. Emphysema • Alveolar walls are destroyed • Have fewer, much larger, less absorptive alveoli with more fragile walls • Air trapping occurs, barrel chest appearance, chronically low blood O2 and chronically high CO2 blood levels

  20. Influenza • Viral respiratory disease (Types A, B, C) • Pandemics (Type A) • Local geographical outbreaks (Type B) • S/S: myalgias, fever, chills, HA, anorexia, may have cough and nasal congestion, secondary bacterial pneumonias due to immunecompromise, 5 day course usually

  21. Pleural Effusions • Any abnormal fluid collection between the parietal and visceral pleura • Examples are: hydrothorax, hemothorax, chylothorax, empyema (pneumothorax is abnormal collection of air or collapsed lung) • Etiologies of effusions: CHF, any hypervolemic condition, CA, infections, trauma • Diagnosis: ascultation/percussion, thoracentesis, CXR.

  22. Tuberculosis • Systemic infection due to the tuberculosis mycobacterium • Slower growing than usual bacteria • Treatment for months-years • Increase in multiple-drug resistance over the years • Recent increase in TB in immunocompromised pts and immigrants

  23. Tuberculosis • Aerosolized transmission • S/S: chronic cough (months or years), night sweats, hemoptysis, weight loss, febrile episodes • Primary tuberculosis (lungs) • Tubercle is a focal granuloma

  24. Pneumonia • Inflammation in lungs, may cause consolidation • May be infectious or due to contact with chemicals • Infectious agents: viruses, bacteria, fungi • Some categories of pneumonia: • Aspiration, lobar, bronchopneumonia (more diffuse), opportunistic

  25. Cystic Fibrosis • Hereditary exocrine disorder • Exocrine glands secrete especially viscous mucus that obstructs ducts of pancreas, GI tract, sweat glands and bronchioles in lungs • Risk for infection and autoimmunity • Sweat test (+ for CF if elevated Cl in sweat) • Fatal illness, survival approx 30 YOA

  26. Respiratory Distress Syndrome • Diseases of reduced lung compliance (elasticity) due to surfactant deficiency or other factors • IRDS (hyaline membrane disease) • Premature infants, diabetic mothers, ground glass appearance on CXR, hypoxia, cyanosis • ARDS • Etiology varies, “white out” appearance of lungs on CXR, hypoxia, often capillary leak

  27. Oncology • Primary lung cancer • Bronchogenic CA • Most common CA in lungs • Cigarette smoking is risk • Basal cells of epithelium are origin • Commonly metastasizes to other areas of lungs • Best px: early stages (resection) • Usually very poor px, rarely found early

  28. Related Terms • Acidosis • Increased acid (H + ions) in blood • May be respiratory or metabolic in origin • Asphyxia • Insufficient oxygen intake • Atelectasis • Cheyne-Stokes respirations • Abnormal respiration pattern, deep regular breaths • May be a sign of respiratory, neurological, toxicological, or metabolic diseases

  29. Related Terms: • Compliance: ease of ventilation of lung tissue that reflects tissue elasticity • Coryza • Croup: viral upper airway infection • Deviated nasal septum • Epiglottitis: obstructive bacterial infection of the airway • Epistaxis: nosebleed

  30. Related Terms • Finger clubbing: distal phylangeal enlargement due to chronic hypoxia • Hypoxemia (in blood) • Hypoxia (in tissues) • Pertussis: whooping cough, long duration bacterial infection • Pleurisy: symptom of pleural inflammation, pleuritic pain (worse with inspiration)

  31. Related Terms • Pneumoconiosis: dust inhalation diseases • Pulmonary edema: excessive fluid in lungs • Pulmonary embolus: clot lodged in lungs • Rales: incontinuous sound (crackles) • Rhonchus: more sonorous sound • Stridor: inspiratory sound, airway obstruction • SIDS (sudden infant death syndrome) • Wheeze: whistling sound of air movement through narrowed airway.

  32. Diagnostics • Mantoux test: intradermal TB test • Oximetry • Pulmonary function testing: dynamic testing and depiction of various lung volumes • Spirometry: the technique for PFT’s • Bronchoscopy • Laryngoscopy

  33. Diagnostics • Arterial blood gases (ABG’s) • Sputum culture • Sweat test • Throat culture: usually looking for Strep A • CXR • Chest CT • Ventilation/perfusion scan: nuclear scan

  34. Therapeutics • Aerosol therapy (nebulizer) • For treatment of wheezing in asthma & COPD • Lavage (usually diagnostic) • Postural drainage • Rhinoplasty/ septoplasty • Pneumonectomy/lobectomy • Thoracentesis • Thoracostomy (Tube or open) (Chest tube)

  35. Pharmacology • Antihistamines (Benadryl, Allegra, etc) • Antitussives (codeine) • Bronchodilators (albuterol) • Corticosteroids (prednisone) • Decongestants (pseudoephedrine) • Expectorants (guaifenesin) • Antibiotics

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