Respiratory System

What are the 2 primary functions of the respiratory system?

Ventilation and respiration

How does respiration help the body?

By supplying oxygen to organs, tissues, and cells, allowing for the removal of carbon dioxide

What does the respiratory system do to blood and how does that connect with the cardiovascular system?

Oxygenates the blood and removes carbon dioxide while the cardiovascular system transports these gases

What are the major structures of the respiratory system?

Thorax, lungs, conducting airways

What is the respiratory epithelium?

Entire lining of the respiratory tract, coated with a mucus film and numerous hairlike projections called cilia that project from the pharynx and trachea

How does air travel throughout the respiratory system (in order)?

Nasal cavity, oral cavity, pharynx, larynx, trachea, bronchi, bronchioles, alveoli

What are trachea and bronchi and how are they kept open?

From the larynx into the lungs, trachea branches off into bronchi which further divides into bronchioles, trachea and bronchi are kept open by tracheal cartilage

What are bronchioles?

Smaller tubules which lack cartilaginous

What are Alveoli?

Sac like cavities at the end of bronchioles, site where gas exchange occurs from alveoli —> capillaries

What is the diaphragm?

Muscular dome shaped partition, attaches to the lower ribs and separates thoracic cavity from abdominal cavity

What is pleura?

Double layered serous membrane that surrounds the lungs and wraps around chest cavity

What is visceral pleura?

Encases the lungs

What is parietal pleura?

Lines the inside of the chest cavity

What is the pleural cavity?

Located between visceral and parietal pleura, contains pleural fluid, prevents friction between layers during breathing

What is the mediastinum?

Gap between lungs, esophagus, heart, trachea, lymph nodes, and great vessels

What is inspiration?

Aka inhalation, diaphragm contracts downwards, air is sucked into the lungs, active process

What is expiration?

Aka exhalation, diaphragm relaxes, pushes upward, forces air out of lungs, passive process relying on recoil

What is Pulse Oximetry?

Measure blood oxygen level, normal is greater than 90% and lower value indicates decrease in lung function

What are Arterial Blood Gases?

Aka ABGs, used to evaluate O2, CO2, and blood pH, key indicators of respiratory function

What is sputum analysis?

Aka phlegm, helpful in diagnosing respiratory diseases

What is a bronchoscopy?

Visual exam of air passages leading to lungs

What is a laryngoscopy?

Visual examination of back of the threat

What are the 3 main imaging techniques used to help confirm diagnosis?

Xray, CT, MRI

What is resonance?

Low pitched sound, heard over normal lungs

What is hyperresonance?

Louder, lower pitched than normal resonance, heard over hyperinflated lungs

What is tympany?

Drum like, loud, empty quality sound, abnormal indicating excessive air in chest

What is a dull sound?

Heard over dense structures such as heart or liver

What is dullness?

Replaces resonance when fluid is present or solid tissue replaces air containing lung tissue

What is Respiratory Failure?

When the lungs can’t oxygenate blood or remove carbon dioxide, leading to hypoxia or hypercapnia and impairing organ function

What are the causes of respiratory failure?

Inability to ventilate, resulting in buildup of carbon dioxide, impairment of alveolar-arterial gas exchange, resulting in decreased oxygen in blood

What diseases can induce respiratory failure?

Infections, tumors, and immune diseases

What physical or neurological problems can induce respiratory failure?

Trauma, central nervous system damage, and congenital defects

What other disorders or conditions can induce respiratory failures?

Circulatory disorders, inflammatory disturbances, and environmental conditions

What are the main symptoms of respiratory failure?

Chest pain, dyspnea, cough, hemoptysis, chills, fever, wheezing, fatigue

What is hemoptysis?

Coughing or spitting up blood from the respiratory tract

What are the signs and symptoms of hemoptysis?

Can be massive indicating serious underlying condition, bright or dark red blood streaked sputum, dark red clots from pulmonary bleeding in severe lung infections, respiratory malignancy, or erosion of pulmonary vessels

What is the etiology of hemoptysis?

Pulmonary arterial hypertension, pulmonary venous hypertension, trauma, vessel erosion, tumors, inflammatory conditions

What is the prognosis for hemoptysis?

In 75% of cases not a sign of serious infection, prognosis good with treatment

What is the diagnosis for hemoptysis?

Determine source of bleeding by visual exam and radiography, coagulation studies, PDF skin test for tuberculosis, lung and CT scan

What is the diagnosis for hemoptysis if others are inconclusive?

Pulmonary angiogram

General treatment for hemoptysis?

Treat source of bleeding

Treatment for severe hemoptysis?

Ligation, surgical removal, or repair of vessel

What is the treatment for minor hemoptysis?

Antibiotics, cough suppressant therapy if cause uncertain

Prevention for hemoptysis?

Considered a symptom usually so no direct prevention

What is atelectasis?

Airless or collapsed state of pulmonary tissue

Respiratory symptoms for atelectasis?

Dyspnea, cyanosis, diminished breath sounds over affected area

Physical signs of atelectasis?

Substernal retractions, mediastinal shift toward collapsed side, diaphoresis

Other signs and symptoms of atelectasis?

Anxiety, tachycardia, fever

Etiology of atelectasis?

Incomplete expansion of lobules or segments due to partial or complete collapse, can happen at birth or via bronchial tree obstructions

What is complete atelectasis?

Occurs when a tumour exerts external pressure on the lung preventing air entry

What are the risk factors for atelectasis?

Obesity, upper abdominal or chest surgery, neuromuscular weakness, existing pulmonary disease

Prognosis for atelectasis?

Mild cases resolve spontaneously, severe cases are highly prone to complications such as pneumonia

Diagnosis for atelectasis?

Radiography, physical exam, CT scans, auscultation, bronchoscopy

Treatment for for atelectasis?

Early post op ambulation, deep breathing, periodic coughing, airway suctioning, analgesics, antibiotics, and surgical drainage of pleural effusions

Prevention for atelectasis?

Early ambulation, good ventilation therapy after surgery or prolonged immobility, cessation of smoking

What is a pulmonary embolism?

Blood clot or other material lodges and occludes an artery in pulmonary circulation

Signs and symptoms of acute pulmonary embolism?

Sudden onset dyspnea, apprehension, anxiety, sounds of rales, pleural rub

Signs and symptoms of small uncomplicated cases of pulmonary embolism?

Cough, chest pain, low grade fever

Signs and symptoms of extensive pulmonary embolism?

Dyspnea, tachypnea, chest pain, hemoptysis

Signs and symptoms of massive pulmonary embolism?

Sudden onset cyanosis, shock, death

Etiology of pulmonary embolism?

Most emboli are thrombi that break loos from a deep vein in the lungs or pelvis and travel through venous circulation into pulmonary circulation

What are the risk factors for pulmonary embolism?

Immobility, injury, predisposition to clot formation, pregnancy, diabetes mellitus, myocardial infarction, oral contraceptives high in estrogen

What is the prognosis for pulmonary embolism?

Mild has a positive outcome with treatment, massive has a high mortality

Diagnosis for pulmonary embolism?

Lung scan, CT and pulmonary angiography, auscultation, ABGs showing reduced oxygen and CO2, studies to locate residual thrombi in veins of lower extremities

Goals of treatment for pulmonary embolism?

Prevent fatal episode, maintain cardiopulmonary integrity, maintain adequate ventilation and perfusion

Treatment for pulmonary embolism?

Oxygen therapy, anticoagulants, thrombolytic drugs

Prevention for pulmonary embolism?

Prophylactic therapy, early ambulation, compression of stockings, management of long term immobility

What is an upper respiratory tract infection?

Aka common cold, acute inflammatory process that affects mucous membranes lining the upper respiratory tract

Signs and symptoms of URTI?

Nasal congestion and discharge, sneezing, watery eyes, sore and hoarse throat, coughing, headache, slight fever

Etiology of URTI?

Can be caused by more than 200 viruses, rhinoviruses are most common

Diagnosis for URTI?

Based on physical exam and symptoms

Treatment for URTI?

No cure, pain relief meds, decongestants, antihistamines

Prevention for URTI?

Proper hand washing, avoid contact with sick people

What is allergic rhinitis?

Inflammation of mucous membranes of nose caused by allergic reaction to airborne substances

Risk factors for allergic rhinitis?

Family history, having allergies, exposure to allergens

Symptoms of allergic rhinitis?

Runny nose, water eyes, congestion, sneezing

Etiology of allergic rhinitis?

Immunoglobulin E binds to mast cells and induces them to release histamine and other chemicals

Diagnosis for allergic rhinitis?

Physical exam, medical history, allergy testing

What is sinusitis?

Inflammation of mucous membrane lining of sinuses

Risk factors for sinusitis?

Upper respiratory infection, allergies, obstruction of nose, weakened immune system

Signs and symptoms of sinusitis?

Facial pain and pressure, nasal stuffiness and discharge, loss of smell, cough, congestion

Etiology of sinusitis?

Usually viral infection, often common cold

Diagnosis for sinusitis?

Medical history, physical exam, nasal endoscopy, imaging tests, nasal and sinus cultures, allergy testing

Treatment for sinusitis?

Saline nasal spray, nasal corticosteroids, decongestants, pain relievers

What is a deviated septum?

Crooked nasal septum

Signs and symptoms of deviated septum?

Narrowing and obstruction of air passage making breathing difficult, slightly increased tendency to develop sinusitis, no significant symptoms

Etiology for deviated septum?

Congenital anomaly for minor deviation, trauma for substantial deviation

Prognosis for deviated septum?

Good prognosis, fairly common

Diagnosis for deviated septum?

Nose can look normal, deviation visible during nasal speculum exam

General treatment for deviated septum?

Usually not necessary unless there is compression of air passage

When may surgery be used for a deviated septum and what does it involve?

To repair obstruction, for cosmetic reasons, straightening involves removing cartilage, reshaping it, and positioning it back

Prevention for deviated septum?

Cannot avoid genetic anomalies, avoid trauma to nose

What is anosmia?

Impairment or loss of smell

Signs and symptoms of anosmia?

Loss of smell without obvious caused, lost or impaired ability to taste

Common causes of anosmia?

Nasal polyps, allergic rhinitis

Temporary cause of anosmia?

Intranasal swelling accompanying upper respiratory infection

Other causes for anosmia?

Phobia for particular odor as a psychological basis, damage to olfactory nerve

Prognosis for anosmia?

Temporary when related to upper respiratory infection

Diagnosis for anosmia?

Physical exam, neurological diagnostic tests

Treatment for anosmia?

Underlying cause, remove polyps, allergen injections for allergic rhinitis, nerve damage may not be correctable