Chapter 7: The Respiratory System Flashcards
Key function of the respiratory system:
Exchange of oxygen (O2) and carbon dioxide (CO2), a waste product.
Define breathing (ventilation)
Also known as pulmonary respiration. Process in which lungs carry oxygen-rich air from the atmosphere to the body, and waste CO2 from the lungs to the atmosphere.
Define carbon dioxide (CO2)
Tasteless, colorless, odorless gas produced by body cells during metabolism.
Define cartilage
Tough, elastic connective tissue that’s more rigid than ligaments but less dense than bone.
Define cilia
Minute hair-like structures that extend from the surface of the cell. Cilia in the trachea move particles upward to the pharynx, a mechanism called the cilia escalator.
Cilia escalator
Process of cilia in the trachea moving particles upward to the pharynx; destroyed by habitual smoking.
Define diffuse
To move or spread out a substance at random, rather than by chemical reaction or application of external forces.
Define oxygen (O2)
Tasteless, colorless, odorless gas that’s essential for human respiration.
Define pH
Symbol that indicates the degree of acidity or alkalinity of a substance; acidic < 7 < alkaline, where 7 is neutral.
Define serous membrane
Thin layer of tissue that covers internal body cavities and secretes fluid that keeps the membrane moist; also called serosa.
Nasal cavity
Where air is drawn in to begin inhalation; lined with mucus membranes and cilia. Here air is filtered, heated, and moistened to prepare it for the lungs.
Nasal septum
Vertical portion of cartilage that divides the nasal cavity into right and left halves.
Olfactory neurons
Receptors for sense of smell that are covered with a layer of mucus and located deep in the nasal cavity.
Pharynx
Muscular tube that serves as a passageway for food and air. Consists of the nasopharynx, oropharynx, and laryngopharynx.
Nasopharynx
Posterior to the nose and contains a collection of lymphoid tissue known as adenoids.
Adenoids
Pharyngeal tonsils that protect the respiratory tract from microscopic organisms.
Oropharynx
Posterior to the mouth and contains a collection of lymphoid tissue known as palatine tonsils or tonsils.
Palatine tonsils (tonsils)
Protect the respiratory tract from microscopic organisms.
Laryngopharynx
Superior to the larynx
Larynx
Also known as the “voice box” and contains structures to make vocal sounds possible; joins the pharynx with the trachea.
Epiglottis
Leaf-shaped structure on top of the larynx that seals off the air passage to the lungs during swallowing.
Trachea
Also known as the windpipe; composed of smooth muscle embedded with C-shaped rings of cartilage, which provides rigidity to keep the air passage open.
Bronchi (singular bronchus)
2 branches that stem from the trachea; one leads to the right lung and the other leads to the left lung. Contain C-shaped rings of cartilage.
Mucus membrane (mucosa)
Line the inner walls of the trachea and bronchi and are imbedded with cilia.
Bronchioles
Smaller and smaller branches that stem from the right and left bronchi.
Alveoli
Singular alveolus, tiny air sacs at the end of the bronchioles that expand/contract with the inflow and outflow of air.
Pulmonary capillaries
Lie next to the alveoli. CO2/O2 exchange takes place between these and the alveoli.
How many lobes are in the lungs?
5, 3 on the right, 2 on the left.
Mediastinum
Space between the 2 lungs that contains the aorta, esophagus, heart, and bronchi.
Pleura
Serous membrane that covers the lobes of the lungs and folds over to line the walls of the thoracic cavity. There’s the visceral pleura, parietal pleura, and pleural cavity.
Visceral pleura
Serous membrane that lies closest to the lung.
Parietal pleura
Serous membrane that lines the thoracic cavity.
Pleural cavity
Space between the visceral and parietal pleura that contains a small amount of lubricating fluid.
Diaphragm
Large, muscular partition that separates the thoracic and abdominal cavities and assists in changing the volume of the thoracic cavity to produce the pressure differential needed for ventilation.
Inspiration
When the diaphragm contracts, it partially descends into the abdominal cavity, which decreases pressure in the chest and draws air into the lungs.
Expiration
When the diaphragm relaxes, it slowly returns to the thoracic cavity increasing pressure in the chest, which forces air out of the lungs.
What are the 4 separate processes of pulmonary respiration?
Pulmonary ventilation (breathing), external respiration, transport of respiratory gases, and internal respiration.
Pulmonary ventilation (breathing)
Large, involuntary action that moves air into/out of the lungs in response to changes in blood O2 and CO2 levels and nervous stimulation of the diaphragm and intercostal muscles.
External respiration
Exchange of O2 and CO2 between the alveoli and pulmonary capillaries.
Transport of respiratory gases
Movement of O2 to the body cells and CO2 to the lungs via the cardiovascular system.
Internal respiration
Exchange of O2 and CO2 between the body cells and blood in the systemic capillaries.
nas/o
rhin/o
nose
nas/al: pertaining to the nose.
rhin/o/plasty: surgical repair of the nose
sept/o
septum
sinus/o
sinus, cavity
pharyng/o
pharynx (throat)
adenoid/o
adenoids
tonsill/o
tonsills
epiglott/o
epiglottis
laryng/o
larynx (voice box)
laryng/o/plegia: paralysis of the voice box
trache/o
trachea (windpipe)
bronchi/o
bronch/o
bronchi (singular bronchus)
bronchi/ectasis: dilation of the bronchi
bronchiol/o
bronchiole
alveol/o
alveoli (singular alveolus); air sac
pleur/o
pleura(e)
pneum/o
pneumon/o
air; lung
pneum/o/lith: stone in the lung
pulmon/o
lung
anthrac/o
coal; coal dust
atel/o
incomplete; imperfect
atel/ectasis: incomplete dilation
coni/o
dust
pneum/o/coni/osis: abnormal condition of dust in the lungs.
cyan/o
blue
lob/o
lobe
orth/o
straight
orth/o/pnea: breathing straight; patients with orthopnea have an easier time breathing when sitting upright or standing erect.
pector/o
steth/o
thorac/o
chest
phren/o
diaphragm; mind
spir/o
breathe
-capnia
carbon dioxide (CO2)
hyper/capnia: excessive CO2
-osmia
smell
an/osmia: without smell.
-phonia
voice
-pnea
breathing
-ptysis
spitting
-thorax
chest
brady-
slow
dys-
painful; difficult
eu-
good; normal
tachy-
fast; rapid
Common signs and sx of respiratory disorders:
Cough (dry or productive), thoracodynia, altered breathing patterns, SOB, fever, cyanosis, exercise intolerance.
Chronic Obstructive Pulmonary Disorder (COPD)
Includes respiratory disorders that produce a chronic partial obstruction of the air passages. Insidious in onset, leads to dyspnea, and is commonly not diagnosed until after the patient has already lost some lung capacity.
3 major disorders of COPD:
Asthma
Chronic Bronchitis
Emphysema
Asthma
Produces bronchospasms and is caused by exposure to allergens/irritants, stress, cold, and exercise. Sx include a productive cough. Tx includes mucolytics and bronchodilators
Define exacerbations
Flare ups of respiratory diseases
Mucolytics
Agents that loosen and break down mucus.
Bronchodilators
Agents that expand the bronchi by relaxing their smooth muscles.
Status asthmaticus
Life-threatening condition that occurs when treatment does not reverse bronchospasms in an asthma exacerbation; requires hospitalization.
Chronic bronchitis
Inflammation of the bronchi that may be caused by smoking, air pollution, viruses, or bacteria. Sx include swelling of the mucosa, thoracodynia and a heavy, productive cough. Tx includes bronchodilators, expectorants, and steroids.
Expectorants
Medications that aid in the removal of mucus to help widen air passages.
Emphysema
Characterized by the decrease in elasticity of the alveoli; they will expand, but are unable to contract back to their original size, which makes it difficult to exhale. Patients with this may have a characteristic “barrel-chested” appearance. People at high risk for this are long-term smokers and those with other respiratory disorders. Sx include orthopnea and tx is similar to that of bronchitis.
orthopnea
Easier breathing when sitting upright or standing erect.
Pneumonia
Inflammatory condition that affects the lungs, primarily the alveoli. As inflammatory fluids collect in the alveoli, they lose their spongy texture and become consolidated, which make O2 exchange difficult. Causes include bacterial, viral, or fungal infections, and chemicals or other inhaled substances. Sx are thoracodynia, dyspnea, hemoptysis, and mucopurulent sputum.
Define consolidated
Swollen and engorged.
What is mucopurulent sputum?
Sputum that contains WBCs.
Lobar pneumonia
Bacterial in origin, also called primary pneumonia; usually affects a large portion of one lobe of the lungs. Typically occurs in young, healthy adults and tx includes antibiotic therapy.
Bronchopneumonia
Caused by a wide variety of organisms, also called secondary pneumonia; centered in the bronchi and surrounding alveoli. Tends to occur in infants, the elderly, and those with illnesses, such as cancer, heart failure, and immune disorders.
Pneumocystitis pneumonia (PCP)
Closely associated with AIDS. Caused by normal flora becoming opportunistic when an organisms immune system begins to fail.
Define normal flora
an organism that resides in/on most people and causes no harm to a healthy individual.
Define opportunistic
Descriptive term for an organism that has the potential to cause disease.
Acute Respiratory Distress Syndrome (ARDS)
Condition in which the lungs no longer function effectively and threaten the life of the patient. Alveoli fill with edema from inflammation and cause them to collapse. Mechanical ventilation is usually required to save the patient’s life.
Neonatal Respiratory Distress Syndrome (NRDS)
Form of respiratory distress syndrome seen in preterm infants or infants born to diabetic mothers. Caused by insufficient surfactant, which causes the alveoli to collapse and breathing to become labored. Signs/sx include cyanosis of the extremities, flared nares, tachypnea, and a characteristic grunt heard on expiration. Radiography shows a hyaline membrane, bilateral decrease in lung volume, and alveolar consolidation; also known as Hyaline Membrane Disease (HMD).
Define surfactant
phospholipid substance that keeps the alveoli open.
Cyanosis
Clinical blueness of a body tissue.
Nares
nostrils
tachypnea
rapid breathing
Hyaline membrane
Membrane that has a ground-glass appearance.
Lung cancer
Also known as bronchogenic carcinoma; is a malignancy that arises from the epithelium of the bronchi. Masses that form eventually block the alveoli and their passages. Metastasizes in a short time and is usually caused by smoking, high pollution, radiation, and asbestos. Few lung cancers are found in the early stages when cure rate is high, and prognosis for these patients is usually poor. Tx may include surgery, chemotherapy, radiation, or a combination.
Abnormal breath sounds
Abnormal noises hear over the lungs and airways, commonly leading to the diagnosis or a respiratory or cardiac condition; also called adventitious breath sounds. Most common are crackles, rhonchi, stridor, and wheezes.
Crackle
Intermittent sounds caused by exudates, spasms, hyperplasia, or when air enters moisture-filled alveoli; also called rales.
Rhonchus
A continuous sound heard during inspiration and expiration caused by secretions in larger airways and commonly resembles snoring.
Stridor
High-pitched, harsh sound caused by swelling/spasm of the larynx or obstruction of the upper airway. May be life-threatening and may need immediate intervention.
Wheeze
Whistling or sighing that results from narrowing of the lumen of the respiratory passageway. Sign of asthma, croup, hay fever, obstructive emphysema, and other respiratory conditions.
Acidosis
Excessive acidity in body fluids. Commonly associated with pulmonary insufficiency and consequently CO2 retention.
Anosmia
Absence of the sense of smell. Usually a temporary side effect of a URI or a condition that causes intranasal swelling.
Apnea
Disorder in which breathing stops repeatedly during sleep, resulting in blood deoxygenation, causing the patient to awaken gasping for air; also called sleep apnea. May occur as often as 5 min-1 hr between episodes.
Central sleep apnea (CSA)
Form of sleep apnea that occurs when the brain fails to stimulate breathing muscles, causing Cheyne-Stokes respirations.
Cheyne-Stokes respirations
Periodic pauses in breathing, commonly associated with heart failure.
Obstructive Sleep Apnea (OSA)
Most common form of sleep apnea caused by an upper airway blockage that prevents air from getting to the lungs. Causes include enlarged adenoids/tonsils or decreased muscle tone of the soft palate. Continuous positive airway pressure (CPAP) is a ventilatory support used to keep the airways open.
Mixed sleep apnea
Type of sleep apnea that occurs when CSA and OSA occur simultaneously.
Atelectasis
Collapsed or airless state of the lung, may be acute or chronic, and affects all or part of the lung. Potential surgical complication, especially those of the chest due to shallow breathing to avoid pain during surgery.
Coryza
Acute inflammation of the membranes of the nose; also called rhinitis. Causes include bacteria viruses, irritants, or allergens.
Croup
Common childhood condition caused by inflammation of the larynx, trachea, and bronchial passages and sometimes involve the lungs. Signs and sx include a resonant, barking cough with suffocative, difficult breathing, laryngeal spasms, and sometimes narrowing of the top of the air passages.
Cystic fibrosis
Life-threatening genetic disease causing mucus to become unusually thick and sticky, which plugs tubes and ducts, especially in the lungs and pancreas. No cure known, tx consists of supportive measures that help a patient live a normal life to the extent possible and that prevent pulmonary infection.
Deviated nasal septum
Displacement of the cartilage dividing the nostrils that causes reduced airflow and sometimes epistaxis.
Epiglottitis
Severe, life-threatening infection of the epiglottis and supraglottic structures; occurs most commonly in kids ages 2-12 years old. Signs and sx include fever, dysphagia, inspiratory stridor, and respiratory distress. Intubation or tracheostomy may be required to open the airway.
Epistaxis
Nasal hemorrhage, also called a nosebleed.
Hypoxemia
O2 deficiency in arterial blood, usually a sign of respiratory impairment, and commonly causes hypoxia.
Hypoxia
O2 deficiency in the body or section of the body that commonly causes cyanosis.
Influenza
Acute, contagious viral disorder of the respiratory tract, characterized by weakness, fever, chills, and myalgia; especially in the back, arms, and legs. Also called the flu. This virus is constantly changing and new strains continue to be discovered. A flu vaccine is recommended every flu season since flu can cause serious complications; pneumonia, bronchitis, sinusitis, and asthma flare-ups.
Pertussis
Acute infectious disease characterized by a cough that has a characteristic “whoop” sound; also called “whooping cough”. Immunization is received as an infant as part of the TDP vaccine (tetanus-diphtheria, and pertussis).
Pleural effusion
Abnormal accumulation of fluid in the pleural cavity that impairs breathing by limiting expansion of the lungs.
Exudate
A pleural effusion that is high in protein and immune cells.
Transudate
A pleural effusion that resembles a serum and doesn’t contain inflammatory cells.
Empyema
Exudative pleural effusion characterized by a collection of pus in the pleural cavity; commonly a result of bacterial pneumonia that spreads from the lungs. Also called pyothorax.
Pneumothorax
Presence of air in the pleural cavity, commonly caused by blunt or penetrating chest injury, or a result of thoracic surgery. Commonly causes atelectasis.
Pleurisy
Inflammation of the pleural membrane characterized by a stabbing pain exacerbated by coughing or deep breathing; also called pleuritis.
Pulmonary edema
Accumulation of extravascular fluid in the lung tissues and alveoli, most commonly caused by heart failure. Induces coughing and dyspnea.
Pulmonary embolism
Blockage in an artery of the lungs caused by a mass of undissolved matter (blood clot, tissue, air bubble, or bacteria) that has traveled to the lungs from another part of the body. Commonly caused by a DVT that travels from the leg to the lungs.
Sudden Infant Death Syndrome (SIDS)
Completely unexpected and unexplained death of an apparently normal, healthy infant; usually less than 12 months old; also known as crib death. Occurrence has decreased 30% since parents have been instructed to place infants on their back to sleep.
Tuberculosis (TB)
Potentially contagious or fatal disease spread through respiratory droplets affecting any organ of the body, but primarily the lungs. Causes chest pain, hemoptysis, fatigue, and night sweats. Many strains of TB are resistant to treatment. Therefore, patients with TB require administration of multiple antibiotics taken for several months to eradicate the organism.
Mantoux test
TB screening test in which an injection of tuberculin purified protein derivative (PPD) is placed just beneath the surface of the skin to identify previous exposure to TB. Positive skin test is indicated by a hard, red, swollen lump at the injection site after 2 days. Positive test is followed up with a CXR to confirm if the patient has active TB.
Oximetry
Non-invasive method of monitoring the percentage of hemoglobin (Hb) saturated with O2; also called pulse oximetry. Probe is attached to the patient’s finger (or earlobe) and links to a computer that displays the percent of Hb saturated with O2.
Polysomnography
Test of sleep cycles and stages using electroencephalograms (EEGs), as well as electrical activity of the muscles, eye movement, respiratory rate, blood pressure, blood O2 saturation, heart rhythm, and sometimes direct observation of the person during sleep using a video camera.
Electroencephalogram (EEG)
A continuous recording of brain waves.
Pulmonary Function Tests (PFTs)
Series of tests to aid in the diagnosis of lung diseases and to help evaluate the effectiveness of treatments. Also help evaluate patients with SOB and evaluates lung function before surgery.
Spirometry
PFT that measures how quickly and how much air moves in/out of the lungs. Spirometer produces a graphic record of spirometry results for the patient’s chart.
Bronchoscopy
Visual examination of the bronchi using an endoscope inserted through the mouth and trachea for viewing of the structures and for projection on a monitor. Attachments on the bronchoscope help suction mucus, remove foreign bodies, collect sputum, and perform biopsy.
Laryngoscopy
Visual examination of the larynx using an endoscope to detect tumor, foreign bodies, nerve/structural injury, or other abnormalities.
Mediastinoscopy
Visual examination of the mediastinal structures including the heart, trachea, bronchi, esophagus, thymus, and lymph nodes. Scope is inserted through a small incision made above the sternum. Additional incisions may be made to remove nodes or perform other diagnostic/therapeutic procedures.
Arterial blood gas (ABG)
Test that measures dissolved O2 and CO2 in arterial blood. Evaluates acid-base state and how well O2 is being carried to body tissues.
Sputum culture
Microbial test to identify disease-causing organisms of the lower respiratory tract, especially those that cause pneumonias.
Sweat test
Measurement of how much salt (NaCl) is in sweat. Used almost exclusively in children to confirm cystic fibrosis and is commonly the gold standard in diagnosis.
Throat culture
Test used to identify pathogens, especially group A streptococci. Untreated streptococcal infections may lead to serious complications, including kidney and heart disease.
Chest x-ray (CXR)
Radiographic test that aids in identifying lung conditions such as pneumonia, lung cancer, COPD, and pneumothorax. Other imaging tests are performed when CXR results are inconclusive.
Computed Tomography Pulmonary Angiography (CTPA)
Minimally invasive imaging technique that combines CT with angiography to produce images of the pulmonary arteries. Highly sensitive and specifically used for diagnosing PEs.
Ventilation-Perfusion (V-Q Scan)
Nuclear test scan that evaluates airflow (ventilation) in the lungs for evidence of blood clot in the lungs; also called a V-Q lung scan.
Pleurectomy
Excision of part of the pleura, usually the parietal pleura. Helps reduce pain caused by a tumor mass or prevent the occurrence of pleural effusion, but is generally ineffective in the treatment of a malignancy of the pleura.
Pneumonectomy
Excision of a lung or portion of a lung, common treatment for cancer. There are wedge resection, segmental resection, lobectomy, and pneumonectomy.
Septoplasty
Surgical repair of a deviated nasal septum, usually performed when the septum encroaches on breathing passages or nasal structures. Common complications of a deviated septum include interference with bleeding and predisposition to sinus infections.
Thoracentesis
Surgical puncture and drainage of the pleural cavity; also called pleurocentesis or thoracocentesis. Diagnostic procedure used to find the cause or nature of an effusion. Therapeutic procedure used to relieve discomfort caused by an effusion.
Tracheostomy
Surgical procedure in which an opening is made in the neck and into the trachea, into which a breathing tube may be inserted.
Aerosol therapy
Lung treatment using various techniques to deliver medications in mist form directly into the lungs or air passageways. Includes nebulizer mist treatments (NMTs), metered-dose inhalers (MDIs), and dry powder inhalers (DPIs).
Antral lavage
Washing/irrigating of the paranasal sinuses to remove mucopurulent material in an immunosuppressed patient or one with known sinusitis that has failed to respond to medical management.
Endotracheal intubation
Plastic tube is inserted into the trachea to maintain an open airway. Commonly performed before surgery when the patient is first placed under sedation or in emergency situations to facilitate ventilation if necessary.
Postural drainage
Method of positioning the patient so gravity aids in the drainage of secretions from the bronchi and lobes of the lungs to make breathing easier.
Antibiotics
Destroy/inhibit growth of bacteria by disrupting their membrane or 1 or more of their metabolic processes.
Antihistamines
Block histamines from binding to histamine receptor sites in tissues. Histamines can cause sneezing itchiness, runny nose, and rashes. Commonly combined with decongestants, antitussives, or analgesics for cold and flu sx relief.
Antitussives
Relieve/suppress cough reflex in the medulla of the brain. Help alleviate dry, non-productive cough and shouldn’t be used with productive coughs.
Bronchodilators
Stimulate bronchial muscles to relax, thereby expanding air passages, resulting in increased airflow. Help treat chronic sx and prevent acute attacks of respiratory diseases, such as asthma and COPD. Commonly used with corticosteroids.
Corticosteroids
Act on the immune system by blocking production of substances that trigger allergic and inflammatory reactions. Available as nasal sprays, inhalers, and oral forms to treat chronic lung conditions, such as asthma and COPD.
Decongestants
Restrict blood vessels of nasal passageways and limit blood flow, which causes swollen tissue to shrink so air can pass more freely. Commonly prescribed for allergies and colds, usually combined with antihistamines and cold remedies.
Expectorants
Liquefy respiratory secretions so they’re more easily dislodged during coughing episodes. Prescribed for productive coughs.
ABG
arterial blood gas(es)
AIDS
Acquired Immune Deficiency Syndrome
ARDS
Acute Respiratory Distress Syndrome
CF
cystic fibrosis
CO2
carbon dioxide
COPD
Chronic Obstructive Pulmonary Disease
CPAP
Continuous Positive Airway Pressure
CT
computed tomography
CTPA
computed tomography pulmonary angiography
CXR
chest x-ray
DPI
dry powder inhaler
DPT
diphtheria-pertussis-tetanus
DVT
deep vein thrombosis
EEG
electroencephalogram
Hb, Hgb
hemoglobin
HMD
Hyaline Membrane Disease
MDI
metered-dose inhaler
NMT
nebulized mist treatment
O2
oxygen
OSA
obstructive sleep apnea
Pco2
partial pressure of carbon dioxide
PCP
pneumocystitis pneumonia; primary care physician
PFT
pulmonary function test
pH
degree of acidity or alkalinity
Po2
partial pressure of oxygen
PPD
purified protein derivative
SIDS
Sudden Infant Death Syndrome
SOB
shortness of breath
TB
Tuberculosis
URI
upper respiratory infection
