Transcript Diagnostic Procedures of Respiratory System

Chapter 7
Respiratory
System
Related Combining Forms
Structure
Related Combining Forms
Nose
nas/o
Sinuses
sinus/o
Pharynx
pharyng/o
Larynx
laryng/o
Epiglottis
epiglott/o
Trachea
trache/o
Bronchi
bronch/o, bronchi/o
Alveoli
alveol/o
Lungs
pneum/o, pneumon/o,
pulmon/o
Functions of Respiratory System
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Delivers air to the lungs
Conveys oxygen from inhaled air to blood
Expels waste products through exhalation
Produces airflow through larynx making
speech possible
Structures of Respiratory System
Structures of Respiratory System
• Upper respiratory tract
– Nose, mouth, pharynx, epiglottis, larynx, and
trachea
• Lower respiratory tract
– Bronchial tree and lungs
• Located within and protected by thoracic cavity
Structures of Respiratory System
Nose
• Air enters through nose, and passes through
nasal cavity
• Nostrils
– External openings of nose
• Nasal septum
– Wall of cartilage dividing the nose into two
equal sections
Nose
• Cilia
– Thin hair located inside nostrils
– Filter incoming air to remove debris
• Mucous membranes
– Specialized tissues lining parts of the
respiratory, digestive, reproductive, and
urinary systems
Nose
• Mucus
– Secretion produced by mucous membranes
– Helps moisten, warm, and filter air entering
the nose
• Olfactory receptors
– Nerve endings acting as receptors for sense
of smell
– Also important also for sense of taste
Tonsils
• Help protect body from infection entering
through nose or mouth
• Palatine tonsils
– Located at back of the mouth
• Nasopharyngeal tonsils
– Located behind the nose and roof of the
mouth
– Adenoids
Paranasal Sinuses
• (para-: near; nas: nose; -al: pertaining to)
• Air-filled cavities lined with mucous
membrane
• Located in bones of the skull
• Three functions
– Make bones of skull lighter
– Give resonance to the voice
– Secrete mucus to lubricate nasal cavity
Paranasal Sinuses
• Four pairs
– Frontal sinuses
• Located in frontal bone just above eyebrows
• Infection causes pain in this area
– Sphenoid sinuses
• Located in sphenoid bone behind eye and under
the pituitary gland
• Near the optic nerves
• Infection may damage vision
Paranasal Sinuses
– Maxillary sinuses
• Located in maxillary bones under the eyes
• Infection causes pain in posterior maxillary teeth
– Ethmoid sinuses
• Located in ethmoid bone between nose and eyes
• Separated from orbital cavity by thin layer of bone
Pharynx
• Commonly known as throat
• Receives air and food
• Three divisions
– Nasopharynx
• (nas/o: nose; -pharynx: throat)
• Posterior to nasal cavity; continues downward
toward the mouth
• Transports air only
• Opens into the oropharynx
Pharynx
– Oropharynx
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•
(or/o: mouth; -pharynx: throat)
Visible when looking into the mouth
Shared by respiratory and digestive systems
Transports air, food, and fluids to the
laryngopharynx
Pharynx
– Laryngopharynx
• (laryng/o: larynx; -pharynx: throat)
• Shared by respiratory and digestive systems
• Air, food, and fluids continue to the opening of
esophagus and trachea; air enters trachea; food
and fluids enter esophagus
Larynx
• Also known as voice box
• Located between pharynx and trachea
• Supported by nine cartilages; largest is
thyroid cartilage (Adam's apple)
• Contains vocal cords that
– Separate to allow passage of air
– Close to assist with sound production
Protective Swallowing Mechanisms
• Two mechanisms prevent entrance of food or
water into trachea
– Soft palate moves up and backward to close
off the nasopharynx
• Prevents food from entering the nose
– Epiglottis swings downward and closes off the
laryngopharynx
• Prevents food from entering the trachea and lungs
Trachea
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Commonly known as windpipe
Transports air to and from lungs
Located in front of the esophagus
Held open by flexible C-shaped cartilage
rings
– Allow food to pass down the esophagus
Trachea
Bronchi
• Primary bronchi branch from trachea to
convey air into the two lungs
• Each bronchus divides and subdivides into
increasingly smaller bronchioles
Alveoli
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Also known as air sacs
Located at the end of each bronchiole
Site of gas exchange
Produce surfactant that reduces surface
tension of the fluid in the lungs preventing
collapse during exhalation
Lungs
• Right lung has three lobes
– Upper (superior), middle, lower (inferior)
• Left lung has two lobes
– Upper (superior), lower (inferior)
– Space is restricted due to location of the heart
Lungs
Mediastinum
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Middle section of chest cavity
Located between the lungs
Contains connective tissue
Contains organs
– Heart and its veins/arteries, esophagus,
trachea, bronchi, thymus gland, lymph nodes
Pleura
• Moist membrane covering outer surface of
lungs and lining inner surface of thoracic
cavity
• Parietal pleura
– Outer layer
– Attached to chest wall
– Lines thoracic cavity, covers diaphragm, and
forms sac containing each lung
Pleura
• Visceral pleura
– Inner layer
– Attached directly to each lung
• Pleural cavity (space)
– Fluid-filled space between parietal and
visceral pleural membranes
– Fluid acts as a lubricant
Diaphragm
• Muscle separating thoracic cavity from the
abdomen
• Breathing occurs as diaphragm contracts and
relaxes
• Contraction stimulated by phrenic nerves
Diaphragm
Respiration
• Exchange of oxygen for carbon dioxide
• 1 inhalation + 1 exhalation = 1 respiration
Inhalation and Exhalation
• Inhalation
– Breathing in
– Diaphragm contracts, and pulls downward;
thoracic cavity expands causing vacuum
drawing air into lungs
• Exhalation
– Breathing out
– Diaphragm relaxes, and moves upward;
thoracic cavity narrows forcing air out of lungs
Inhalation and Exhalation
External Respiration
• With inhalation of air into alveoli, oxygen is
passed into capillaries and carried by
erythrocytes to body cells
• Carbon dioxide, as a waste product, is
passed into bloodstream and transported into
air spaces for exhalation
Internal Respiration
• Exchange of gases within cells of blood and
tissues
• Oxygen passes into cells; carbon dioxide
passes into bloodstream where it is
transported to the lungs, and expelled during
exhalation
Medical Specialties Related to Respiratory System
• Otolaryngologist
– Specializes in diagnosing/treating
diseases/disorders of head and neck
• (ot/o: ear; laryng/o: larynx; -ologist: specialist)
• Pulmonologist
– Specializes in diagnosing/treating
diseases/disorders of respiratory system
• (pulmon: lung)
Medical Specialties Related to Respiratory System
• Thoracic surgeon
– Performs surgery on organs inside thorax, or
chest including heart, lungs, and esophagus
Pathology of Respiratory System
• Chronic obstructive pulmonary disease
(COPD)
– Group of lung diseases
– Obstructed bronchial airflow causes difficult
exhalation
– Common cause: smoking
Chronic Bronchitis
• (bronch: bronchus; -itis: inflammation)
– Inflammation of airways due to recurrent
exposure to inhaled irritant (such as cigarette
smoke)
– Mucus-producing cells increase in size and
number resulting in excessive mucus
production and thickening of walls of air
passages
Emphysema
• Progressive loss of lung function
• Characterized by decrease in number of
alveoli, enlargement of remaining alveoli, and
destruction of their walls
• Lungs overinflate, remain partially expanded
resulting in a barrel chest appearance
• Common cause: smoking
Asthma
• Chronic inflammatory disease of bronchial
tubes
• May be triggered by allergic reaction
• Partial obstruction of airway results in
wheezing
• May be induced by exercise
Upper Respiratory Diseases
• Upper respiratory infection and acute
nasopharyngitis
– Describe the common cold
– Usually due to human rhinovirus
• Allergic rhinitis
– Allergic reaction to airborne allergens
resulting in increased mucus flow
• (rhin: nose; -itis: inflammation)
Upper Respiratory Diseases
• Croup
– Acute respiratory infection in children and
infants
– Barking cough and stridor result from
obstruction of larynx and swelling around
vocal cords
Upper Respiratory Diseases
• Diphtheria
– Bacterial infection of throat and upper
respiratory tract
– Toxins may damage heart muscle and
peripheral nerves
– Immunization available
Upper Respiratory Diseases
• Epistaxis
– Nosebleed
– May be caused by dry air, injury, medication,
or hypertension
• Influenza
– Acute, highly contagious viral infection
– Spread by respiratory droplets
– Many strains; some may be prevented by
annual immunization
Upper Respiratory Diseases
• Pertussis
– Whooping cough
– Contagious bacterial infection
– Paroxysmal cough followed by breathlessness
and noisy inspiration
– Immunization available
Upper Respiratory Diseases
• Rhinorrhea
– Watery flow of mucus from nose
• (rhin/o: nose; -rrhea: abnormal discharge)
• Sinusitis
– Inflammation of sinuses
• (sinus: sinus; -itis: inflammation)
Pharynx and Larynx
• Pharyngitis (pharyng: pharynx)
– Sore throat
– Inflammation of pharynx
• Laryngospasm
• (laryng/o: larynx; -spasm: a sudden involuntary
contraction)
– Sudden spasmotic closure of larynx
Voice Disorders
• Aphonia
– Loss of ability of larynx to produce normal
speech sounds
• (a-: without; phon: sound or voice: -ia: abnormal
condition)
• Dysphonia
– Difficulty in speaking
• (dys-: bad)
Voice Disorders
• Laryngitis
– Inflammation of larynx
– Often results in loss of voice
• (laryng: larynx; -itis: inflammation)
Trachea and Bronchi
• Tracheorrhagia
• (trache/o: trachea; -rrhagia: bleeding)
– Bleeding from mucous membranes of trachea
• Bronchiectasis
• (bronch/i: bronchus; -ectasis: stretching or
enlargement)
– Permanent dilation of bronchi due to chronic
infection/inflammation
Trachea and Bronchi
• Bronchorrhea
• (bronch/o: bronchus; -rrhea: abnormal flow)
– Excessive discharge of mucus from bronchi
Pleural Cavity
• Pleurisy
• (pleur: pleura; -isy: a noun ending)
– Inflammation of pleura
• Pleurodynia
• (pleur/o: pleura; -dynia: pain)
– Sharp pain occurring when inflamed
membranes rub together during inhalation
Pleural Cavity
• Pleural effusion
– Excess accumulation of fluid in pleural space
• Pyothorax
– Presence of pus in pleural cavity between
layers of pleural membrane
• (py/o: pus; -thorax: chest)
• Empyema
– Collection of pus in a body cavity
Pleural Cavity
• Hemothorax
– Collection of blood in pleural cavity
• (hem/o: blood)
• Pneumothorax
• (pneum/o: lung or air)
– Accumulation of air in pleural cavity
– Causes pressure imbalance preventing full
expansion or partial collapse of lung
Lungs
• Acute respiratory distress syndrome
– Decreased oxygen levels in blood because of
life-threatening inflammation in lungs and fluid
in alveoli
• Atelectasis
– Incomplete expansion of a part or all of a lung
– Due to obstruction or pneumothorax
• (atel: incomplete; -ectasis: stretching or
enlargement)
Lungs
• Pulmonary edema
– Accumulation of fluid in lung tissues
• Pulmonary embolism
– Blockage of pulmonary artery by foreign
matter or an embolus
• Pneumorrhagia
– Bleeding from the lungs
• (pneum/o: lungs; -rrhagia: bleeding)
Tuberculosis
• Infectious disease caused by Mycobacterium
tuberculosis
• Usually attacks lungs, but may affect other
body organs
• Multidrug-resistant tuberculosis may occur if
prescribed regimen of medications is not
strictly followed
Pneumonia Named for the Affected Lung Tissue
• Two types of bacterial pneumonia
– Bronchopneumonia
• (bronch/o: bronchial tubes; pneumon: lung; -ia:
abnormal condition)
• Affects bronchioles
– Lobar pneumonia
• Affects one or more lobes of a lung
• Double pneumonia involves both lungs
Pneumonia Named for the Causative Agent
• Aspiration pneumonia
– Due to inhaling foreign substance into lungs
• Bacterial pneumonia
– Commonly caused by Streptococcus
pneumoniae
• Community-acquired pneumonia
– Results from contagious infection outside
hospital/clinic
Pneumonia Named for the Causative Agent
• Hospital-acquired pneumonia
– Acquired during a stay in hospital
• Mycoplasma pneumonia
– Milder, longer lasting form caused by
Mycoplasma pneumoniae
– Also known as walking pneumonia since the
patient is often not bedridden
Pneumonia Named for the Causative Agent
• Pneumocystis pneumonia
– Opportunistic infection caused by
Pneumocystis carinii
• Viral pneumonia
– Caused by viruses
Interstitial Lung Disease
• Group of disorders causing inflammation and
scarring of alveoli and their supporting
structures
• Pulmonary fibrosis
– Progressive formation of scar tissue in the
lung causing decreased lung capacity and
difficulty in breathing
• (fibros: fibrous connective tissue; -is: noun ending)
Environmental/Occupational Interstitial Lung Diseases
• Pneumoconiosis
– Fibrosis of lung tissue due to dust inhalation
• (pneum/o: lung; coni: dust; -osis: abnormal
condition or disease)
• Asbestosis
– Result of inhalation of asbestos particles
• (asbest: asbestos)
Environmental/Occupational Interstitial Lung Diseases
• Silicosis
– Result of inhalation of silica dust
• (silic: glass; - osis: abnormal condition or disease)
Cystic Fibrosis
• Life-threatening genetic disorder
• Large quantities of abnormally thick mucus
collect in lungs and pancreas
• Results in damage to lungs, poor growth, and
nutritional deficiencies
Lung Cancer
• Leading cause of cancer death in the United
States
• Cancer cells form in lung tissues
• Common causes are smoking and inhaling
secondhand smoke
Lung Cancer
Breathing Disorders
• Eupnea
– Easy or normal breathing
• (eu-: good; -pnea: breathing)
• Apnea
– Temporary absence of spontaneous
respiration
• (a-: without; -pnea: breathing)
Breathing Disorders
• Bradypnea
– Less than 10 breaths/minute
• (brady-: slow; -pnea: breathing)
Breathing Disorders
• Cheyne-Stokes respiration
– Irregular pattern of alternating rapid or shallow
respiration followed by slower respiration or
apnea
• Tachypnea (tachy-: rapid)
– More than 20 breaths/minute
• Dyspnea (dys-: painful)
– Difficult or labored breathing
Breathing Disorders
• Hyperpnea (hyper-: excessive)
– Deeper and more rapid than normal
breathing, commonly associated with exertion
• Hypopnea (hypo-: decreased)
– Shallow or slow respiration
• Hyperventilation
– Rapid rate of deep respiration, commonly
associated with anxiety
Sleep-Related Breathing Disorders
• Sleep apnea
– Potentially serious
– Breathing repeatedly stops and starts during
sleep
– May cause decrease in blood oxygen levels
• Snoring
– Noisy breathing caused by vibration of soft
palate
Coughing
• Expectoration
– Act of coughing up and spitting out saliva,
mucus, or other body fluid
• (expector: cough up; -ation: state or action)
• Hemoptysis
– Expectoration of blood/blood-stained sputum
derived from the lungs or bronchial tubes
• (-ptysis: spitting)
Lack of Oxygen
• Airway obstruction
– Food or foreign object partially or completely
blocks airway preventing air from entering or
leaving the lungs
• Anoxia
– Absence of oxygen from body tissues/organs
even though the flow of blood is adequate
Lack of Oxygen
• Hypoxia
– Deficient oxygen levels in body tissues/organs
– Less severe than anoxia
• (hyp-: deficient; ox: oxygen: -ia: abnormal
condition)
• Altitude hypoxia
– Due to decreased oxygen in the air at higher
altitudes, especially above 8,000 feet
Lack of Oxygen
• Asphyxia
– Lack of oxygen leading to loss of
consciousness
• Cyanosis
– Bluish discoloration of skin/mucous
membranes due to inadequate oxygen supply
• (cyan: blue; -osis: abnormal condition or disease)
Lack of Oxygen
• Hypercapnia
– Buildup of carbon dioxide in the blood
• (capn: carbon dioxide)
• Hypoxemia
– Decreased oxygen levels in the blood
• Respiratory failure
– Medical emergency consisting of either
hypoxemia or hypercapnia
Lack of Oxygen
• Smoke inhalation
– Particles from fire coat alveoli, preventing
normal exchange of gases
Sudden Infant Death Syndrome
• Sudden, unexplainable death of apparently
healthy sleeping infant
• May occur between 2 and 6 months of age
• Also known as crib death
Diagnostic Procedures of Respiratory System
• Respiratory rate
– Counting of number of breaths/minute
• Respiratory sounds
– Evaluation of sounds heard upon auscultation
of lungs
Diagnostic Procedures of Respiratory System
• Bronchoscopy
– Visual examination of bronchi using
bronchoscope
• (bronch/o: bronchus; -scopy: direct visual
examination)
Diagnostic Procedures of Respiratory System
• Chest X-ray
– Assists with diagnosing lung disorders
• Laryngoscopy
– Visual examination of larynx and vocal cords
• (laryng/o: larynx; -scopy: a direct visual
examination)
Diagnostic Procedures of Respiratory System
• Peak flow meter
– Measures air flow out of the lungs
• Polysomnography
– Measures physiological activity during sleep
• (poly-: many; somn/o: sleep; -graphy: the process
of recording)
Diagnostic Procedures of Respiratory System
• Pulmonary function tests
– Group of tests measuring volume/flow of air
into and out of the lungs
• Spirometer
– Measures volume of air inhaled/exhaled and
length of time required for each breath
• (spir/o: to breathe; -meter: to measure)
Diagnostic Procedures of Respiratory System
• Pulse oximeter
– External monitor placed on fingertip or ear
lobe to measure oxygen saturation level in the
blood
• (ox/i: oxygen: -meter: to measure)
• Sputum
– Phlegm ejected through mouth
– Sputum cytology examines the phlegm to
detect cancer cells
Diagnostic Procedures of Respiratory System
• Phlegm
– Thick mucus
– Secreted by tissues lining respiratory
passages
Tuberculosis Testing
• Mantoux PPD skin test
– Injection of small amount of PPD tuberculin
under the top layer of skin on forearm
– Site is checked for reaction after 48-72 hours
• Positive result from skin or blood test
indicates possibility of exposure to TB
– Chest X-ray and sputum cytology for
confirmation
Treatment Procedures of Respiratory System
• Antitussive
– Prevents or relieves coughing
• (anti-: against; tuss: cough; -ive: performs)
• Bronchodilator
– Inhaled medication that relaxes/expands
bronchial passages
Treatment Procedures of Respiratory System
• Metered-dose inhaler
– Administers medication in aerosol form
• Nebulizer
– Allows for inhalation of a medicated mist via
face mask or mouthpiece
Asthma Treatment
• Controller medicines
– Daily inhalation of corticosteroids
• Quick-relief (rescue medicines)
– Taken at first sign of an attack
– Dilate airways
• Avoid substances that trigger symptoms
Nose, Throat, and Larynx
• Endotracheal intubation
– Establishing open airway by passage of tube
through mouth into the trachea
• (endo-: within; trache: trachea; -al: pertaining to)
• Functional endoscopic sinus surgery
– Treating chronic sinusitis by enlarging
opening between nose and sinus
Nose, Throat, and Larynx
• Laryngectomy
– Surgical removal of the larynx
• (laryng: larynx; -ectomy: surgical removal)
• Laryngotomy
– Surgical incision into larynx to relieve upper
airway obstruction
• (laryng: larynx; -otomy: surgical incision)
Nose, Throat, and Larynx
• Septoplasty
– Surgical repair or alteration of parts of the
nasal septum
• (sept/o: septum; -plasty: surgical repair)
Trachea
• Tracheostomy
– Surgical creation of stoma into trachea for
insertion of temporary or permanent tube to
facilitate breathing
• (trache: trachea; -ostomy: surgically creating an
opening)
Trachea
• Tracheotomy
– Incision into trachea to gain access to the
airway below the blockage
• (trache: trachea; -otomy: surgical incision)
Lungs, Pleura, and Thorax
• Pneumonectomy
– Surgical removal of all or part of a lung
• (pneumon: lung; -ectomy: surgical removal)
• Lobectomy
– Surgical removal of a lobe of an organ
• (lob: lobe)
Lungs, Pleura, and Thorax
• Wedge resection
– Surgical removal of wedge-shaped piece of
cancerous lung and margin of healthy tissue
around the cancer
Lungs, Pleura, and Thorax
• Thoracentesis
– Surgical puncture of chest wall for removal of
fluid from pleural cavity
• (thor/a: thorax or chest; -centesis: surgical
puncture to remove fluid)
• Thoracotomy
– Surgical incision into chest walls for biopsy or
for treatment
• (thorac: chest; -otomy: surgical incision)
Lungs, Pleura, and Thorax
• Video-assisted thoracic surgery
– Uses thoracoscope to view inside the pleural
cavity
Cystic Fibrosis
• Pancreatic enzymes
– Aid digestive system
• Chest percussion
– Removal of excess mucus from the lungs
– Allows gravity to assist drainage of secretions
Respiratory Therapy
• Diaphragmatic breathing
– Relaxation technique for relief of anxiety
• CPAP machine
– Noninvasive ventilation device
– Used in treatment of sleep apnea
– Reduces snoring and prevents dangerous
apnea disturbances
Respiratory Therapy
• BiPAP machine
– Similar to CPAP, but can be set at higher
pressures for inhaling and lower pressures for
exhaling
• Ambu bag
– Emergency resuscitator to assist ventilation
Respiratory Therapy
• Ventilator
– Mechanical device for artificial respiration
– Supplements natural breathing function
– Forces air into the lungs
– Exhalation is passive as lungs contract
Supplemental Oxygen Therapy
• Nasal cannula
– Small tube divided into two nasal prongs
• Rebreather mask
– Exhaled breath is partially reused, delivering
up to 60% oxygen
• Nonrebreather mask
– Higher levels of oxygen added to the air taken
in by the patient
Supplemental Oxygen Therapy
• Hyperbaric oxygen therapy
– Special chamber for delivering pure oxygen
– Lungs and bloodstream absorb more oxygen
resulting in promotion of healing and
assistance with fighting infection