Chapter 7 Respiratory System Related Combining Forms Structure

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

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 • • (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 • • 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

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 • • 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 • Bi. PAP 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