Chapter 7 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
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

Upper respiratory tract Nose, mouth, pharynx, epiglottis, larynx, and trachea Lower respiratory tract Bronchial tree and lungs Located within and protected by thoracic cavity

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 Mucous membranes 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 Olfactory receptors 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

Help protect body from infection entering through nose or mouth
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

Air-filled cavities lined with mucous membrane
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 Sphenoid 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 Ethmoid 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

Commonly known as throat Receives air and food Three divisions
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 (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

Located between pharynx and trachea
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

Commonly known as windpipe Transports air to and from lungs
Trachea 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 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

Right lung has three lobes Left lung has two lobes
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

Middle section of chest cavity Located between the lungs
Mediastinum 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

Pleural cavity (space)
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
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

(bronch: bronchus; -itis: inflammation)
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)

Croup Acute respiratory infection in children and infants Barking cough and stridor result from obstruction of larynx and swelling around vocal cords

Diphtheria Bacterial infection of throat and upper respiratory tract Toxins may damage heart muscle and peripheral nerves Immunization available

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

Pertussis Whooping cough Contagious bacterial infection Paroxysmal cough followed by breathlessness and noisy inspiration Immunization available

Rhinorrhea Watery flow of mucus from nose (rhin/o: nose; -rrhea: abnormal discharge) Sinusitis Inflammation of sinuses (sinus: sinus; -itis: inflammation)

Pharyngitis (pharyng: pharynx)
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 Dysphonia
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 Bronchiectasis
(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 Pleurodynia Inflammation of pleura
(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 Pyothorax Empyema
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 Pneumothorax
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

Acute respiratory distress syndrome
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 Pulmonary embolism Pneumorrhagia
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

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

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 Apnea 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)

Cheyne-Stokes respiration
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

Hyperpnea (hyper-: excessive)
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 Hemoptysis
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 Anoxia
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 Altitude 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 Cyanosis
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 Hypoxemia Respiratory failure
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

Bronchoscopy Visual examination of bronchi using bronchoscope (bronch/o: bronchus; -scopy: direct visual examination)

Chest X-ray Assists with diagnosing lung disorders Laryngoscopy Visual examination of larynx and vocal cords (laryng/o: larynx; -scopy: a direct visual examination)

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)

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)

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

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 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

Quick-relief (rescue medicines)
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

Endotracheal intubation
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 Laryngotomy
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)

Wedge resection Surgical removal of wedge-shaped piece of cancerous lung and margin of healthy tissue around the cancer

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)

Video-assisted thoracic surgery Uses thoracoscope to view inside the pleural cavity

Cystic Fibrosis Pancreatic enzymes Chest percussion
Aid digestive system Chest percussion Removal of excess mucus from the lungs Allows gravity to assist drainage of secretions

Diaphragmatic breathing CPAP machine
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 Ambu bag
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

Chapter 7 Respiratory System.

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