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Respiratory System
- Consist of an upper and lower respiratory system
- Functions:
- Supply oxygen to body cells and tissues
- Eliminate carbon dioxide from the body
- Provide airflow between the upper and lower respiratory tracts through the larynx and vocal cords, making human vocal sounds possible
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Cilia
- Hairlike projections on the mucus membranes inside the nose
- Filter out foreign bodies, warm and moisten air
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Nasal septum
Divides right and left nasal cavities
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Paranasal sinuses
- Air-filled cavities in the bones of the face connecting to the nasal cavity
- Produce mucus, produce sound
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Pharynx (throat)
- Space behind the mouth
- Air enters the nose and passes through the nasal cavity, reaching the pharynx
- Three divisions: nasopharynx, oropharynx, and laryngopharynx
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Nasopharynx
- Contains pharyngeal tonsils (adenoids) which are collections of lymphatic tissue
- More prominent in children
- When enlarged can obstruct airway
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Oropharynx
Location for the palatine tonsils (two rounded masses of lymphatic tissue)
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Laryngopharynx
- Serves as passageway for air from the nose and mouth to the larynx
- Divides into two branches: larynx (voice box) and esophagus
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Epiglottis
Prevents choking by closing over the upper region of larynx during swallowing
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Larynx
Air passageway btw the pharynx and trachea
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Glottis
- Vocal cords
- Vocal structure of the larynx
- Vocal cords vibrate to produce sound in response to expelled air
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Trachea
- Air passage from the larynx into the thorax
- In the mediastinum, the trachea divides into two branches called bronchial tubes or bronchi
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Bronchi
- Two subdivisions of the trachea serving to convey air to and from the lungs
- Each bronchus (singular) leads to a separate lung
- Bronchus divides into smaller tubes called bronchioles
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Alveoli
Saclike cavities where gas is exchanged btw the lungs and blood
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Bronchioles
- Finer subdivisions of the bronchi located in the lungs
- Each terminal bronchiole end in alveoli
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Lungs
Spongy organs of respiration in which blood is aerated
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Lobes
Subdivisions of the lungs
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Pleura
Double folded membrane surrounding the lungs and lining the pleural cavity
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Parietal pleura
Outer layer nearest to the ribs
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Visceral pleura
Inner layer closest to the ribs
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Pleural cavity
Space btw the layers (parietal and visceral) of the pleura
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Diaphragm
Muscular partition btw the abdominal and thoracic cavities
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Thorax
- Anatomic region of the body extending from the neck to the diaphragm; formed by:
- The sternum
- The thoracic vertebrae
- The ribs
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Mediastinum
- Area of the thoracic cavity btw the lungs
- Contains the:
- Heart
- Aorta
- Esophagus
- Trachea and Thymus
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Path of Air
- •Air passes from the larynx to the trachea
- (windpipe).
- •In the mediastinum, the trachea divides
- into two branches called bronchial tubes or bronchi.
- •Each bronchus (singular) leads to a
- separate lung.
- Bronchus
- divides into smaller tubes called bronchioles.
- Each terminal bronchiole end in alveoli.
- •Alveolus is lined with a single layer of
- epithelium which permits exchange of gas between the alveolus and the capillary
- that surrounds it.
- •Blood in capillary accepts oxygen from
- the alveolus while releasing carbon dioxide into alveolus.
- •Erythrocytes carry oxygen to the body and
- carbon dioxide to lungs to be exhaled.
- •Each lung is covered by pleura, the outer
- layer is the parietal pleura and the inner layer is the visceral pleura. The
- lungs extend from the collarbone to the diaphragm.
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External Respiration
Process of inspiration and expiration
Expiration (exhalation) - breathing out
Inspiration (inhalation) - breathing in
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Internal Respiration
Exchange of gases between blood and cells
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Ventilation
Distribution of gas into and out of the lungs
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Dyspnea
Labored or difficult breathing
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Apnea
Temporary absence of breathing
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Orthopnea
Difficulty breathing while lying down
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Eupnea
Normal respirations (12-16 breaths/min)
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Bradypnea
Slow respirations
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Tachypnea
Rapid respirations (>25 breaths/min)
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Hyperpnea
Breathing that is deeper than normal
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Hyperventilation
Increased aeration of the lungs
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Hypoxia
Less than normal oxygen
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Alveol/o
Alveolus, air sac
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Bronchi/o, Bronch/o
Bronchus, bronchial tube
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Bronchiol/o
Bronchiole, small bronchus
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Laryng/o
Larynx, voice box
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Pneum/o, Pneumon/o
Lung, air
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Trache/o
Trachea, windpipe
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-thorax
Pleural cavity, chest
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Rales (crackles)
Popping or clicking sounds, indicates fluid in alveoli
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Rhonchi
- Rumbling sounds, bronchi obstructed by sputum
- Sputum: material expelled from bronchi, lungs or upper respiratory tract
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Pleural Rub
Friction sounds in the lungs when pleural surfaces rub against one another
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Stridor
Whistling sound heard on inspiration, obstruction in pharynx or larynx (i.e. allergic reaction)
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Wheeze
Airy, whistling-type sound, caused by narrowed airway (i.e. asthma)
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Croup
Acute viral infection in infants & children, characterized by obstruction of larynx (cough and stridor)
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Pertussis (whooping cough)
Acute infectious inflammation of the larynx, trachea, and bronchi caused by the bacterium Bordetella pertussis
Highly contagious; is a vaccine preventable disease
Coughing that ends in loud ‘whooping’ inspiration
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Asthma (Bronchial disorders)
Chronic severe breathing disorder characterized by attacks of wheezing due to inflammation and narrowing of the airways
Signs and symptoms- Dyspnea, wheezing, cough
Cause- Allergy, infection
Treatment- Inhaled anti-inflammatory agents, bronchodilators, avoid triggers
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Cystic Fibrosis (Bronchial disorders)
Inherited disorder of exocrine glands
Blood test to detect gene
Affects cells that produce mucus, sweat and digestive juices
Instead of acting as a lubricant, secretions plug up tubes, ducts and passageways, Especially in lungs and pancreas
- Treatment- Treat infections and pulmonary
- obstruction, lung transplantation
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Emphysema
- Known as chronic obstructive pulmonary
- disease (COPD)
Air sacs in lungs are gradually destroyed, making you progressively more short of breath
Leads to increase in pulmonary artery pressure
Smoking is leading cause of emphysema
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Lung Cancer
Uncontrolled growth of abnormal cells in one or both lungs; begins with a mutation in a cell’s DNA
Caused by normal aging process or environmental factors such as cigarette smoke, breathing in asbestos fibers, and to exposure to radon gas
Two types of lung cancer:
Non-small cell
Small cell
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Pneumonia
- Bacterial infection and inflammation within the lobes of the lungs- Alveolar
- membrane can become damaged
- Exudate
- (fluid, blood cells, debris) compromises the ability of the alveoli to exchange
- air
- •Infiltrate is a fluid-filled area within the lungs that can be visualized on a chest X-ray
- or CT scan
- Bacterial pneumonia- pneumonia caused by a bacterial infection
Pneumococcal pneumonia - form of pneumonia caused by the bacterial species Streptococcus pneumoniae
•Bronchopneumonia- infection of the smaller bronchial tubes of the lungs
•Common in infants and the elderly
• Lobar pneumonia- infection of the alveoli caused by fluid and pus filling an entire lobe of the lung
Nosocomial (hospital acquired)
Aspiration
- Caused by material such as food or
- vomitus- Lodges in bronchi or lungs
- Elderly, Alzheimer patients, stroke
- victims and people with dysphagia are at risk
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Pulmonary abcess
Collection of pus in the lungs- bacterial infection
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Pulmonary edema
Air sacs and bronchioles fill with fluid
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Pulmonary embolism
Clot or other material lodges in the lung, usually travels from veins in the leg causing a pulmonary infarction
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Atelectasis
Collapsed lung - Bronchioles and alveoli resemble a collapsed balloon
Causes include blockage (i.e., tumor, secretions) of bronchus or smaller bronchial tube
As a result air, fluid, blood, etc. accumulates in pleural cavity
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Tuberculosis (TB)
Infection caused by Mycobacterium tuberculosis, a bacterium that attacks the lungs and is spread through the air from one person to another
Bacilli produce small tubules
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Mesothelioma
Malignant tumor in the pleura, caused by asbestos exposure
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Pneumothorax
Air in the pleural space, may follow trauma, perforation of the chest wall
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Hypoxemia
Decreased level of oxygen in the blood
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Hypoxia
Decreased levels of oxygen in the tissue
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Acid-fast Bacilli (ABF) Smear
Test performed on sputum for the presence of the bacteria that cause tubercolosis
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Arterial Blood Gases (ABG)
Test performed on arterial blood to determine the level of oxygen and carbon dioxide; is used to check how well your lungs are able to move oxygen into the blood and remove carbon dioxide from the blood
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Tuberculin Test
Uses purified protein derivative (PPD); skin test used to determine if a patient has developed an immune response to the bacteria that cause tuberculosis
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Chest Radiography (CXR)
Radiographic image of the chest used to evaluate the lungs and heart
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Ventilation-perfusion (V/Q) scan
Test used to access distribution of blood flow and ventilation through both lungs
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Positron Emission Tomography
Radioactive glucose is injected; tumors have higher metabolic activity
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Bronchoscopy
Endoscopic examination of the larynx and airways using fiberoptic endoscope
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Peak flow monitoring
- Peak flow meter is a portable, easy-to-use device that measures the rate of air flow through the airways and is a measure of how well your lungs are working
- Helps manage asthma symptoms and prevent asthma attack
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Polysomnography
- Monitoring and recording normal and abnormal activity during sleep
- Sleep apnea- breathing blocked or partly blocked during sleep
- May happen from 5 to more than 50 times an hour.
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Pulse Oximetry
Measurement of oxygen saturation in the blood
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Pulmonary function tests (PFTs)
Group of tests that measure how well the lungs take in and release air and how well they move gases such as oxygen from the atmosphere into the body's circulation
Spirometry - measures air flow and volume of air inspired and expired by the lungs using a spirometer
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Thorascopy
Endoscopic examination of the thorax done through a small opening in the chest wall
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Video-assisted thoracoscopic surgery (VATS)
Thoracic surgery performed using endoscopic cameras, optical systems, display screens, and surgical instruments; enables surgeons to view the inside of the chest cavity and remove tissue to test for disease
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Adenoidectomy
Excision of the adenoids
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Laryngectomy
Excision of the larynx
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Lobectomy
Excision of a lobe (of the lung)
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Pneumonectomy
Excision of the lung
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Tonsillectomy
Excision of one or both tonsils
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Bronchoplasty
Surgical repair of the bronchus
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Rhinoplasty
Surgical repair of the nose
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Septoplasty
Surgical repair of the sinus
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Tracheoplasty
Surgical repair of the trachea
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Laryngotracheotomy
Incision of the larynx and trachea
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Sinusotomy
Incision of the sinus
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Thoracentesis
Surgical puncture to aspirate fluid from the chest cavity
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Thoracotomy
Incision into the chest cavity
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Tracheostomy
Creation of an artificial opening in the trachea
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Tracheotomy
Incision of the trachea
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Aspiration
Removal of accumulated fluid by suction
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Cardiopulmonary resuscitation (CPR)
Medical procedure to ventilate the lungs and artificially circulate the blood
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Continuous positive airway pressure (CPAP) therapy
Breathing apparatus that pumps constant pressurized air through the nasal passages via a mask
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Endotracheal intubation
Tube inserted in the larynx ad trachea to establish an airway for breathing purposes
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Hyperbaric Medicine
Medicinal use of high barometric pressure to increase oxygen content of blood and tissues
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Mechanical ventilation
Use of an automatic mechanical device to perform all or part of the work of breathing
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Incentive spirometry
Used to encourage patients to breathe deeply by using a spirometer that gives visual feedback as the patient inhales forcefully
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Otorhinolaryngology
Medical specialty concerned with diagnosis and treatment of diseases in the ear, nose and throat
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Pulmonology
Medical specialty concerned with diseases of the lungs and the respiratory tract
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