Chapter 5 - Pulmonology

Respiratory System consists of…

air passages of the nose to the lungs

respiratory system functions

being oxygen into the body

expel waste product of carbon dioxide

major organs of the respiratory system

Nasal cavity

nostril

larynx

oral cavity

pharynx

trachea

lefts main (primary) bronchus

bronchi

alveoli

left lung diaphragm

parietal pleura

right lung

right main (primary) bronchus

Carina of trachea

nas/o

nose

sept/o

dividing wall

parts of the pharynx

nasopharynx

oropharynx

laryngopharynx

what is the larynx

your voice box

• first part of the lower respiratory tract

• remains open during speech and respiration to allow air into the trachea

• when swallowing the larynx pulls up to the epiglottis, forcing food into the esophagus

URI

Upper Respiratory Infection

• bacterial or viral infection

• example is the common cold

• antibiotics do not treat viral infections

• treated through supportive care

What is the trachea

• your windpipe

• passageway for inhaled and exhaled air

• has cartilaginous “rings” (actually c shaped so the esophagus around it can expand for swallowing food) to protect the windpipe

Bronchi

• trachea divides into right and left primary bronchi

• pathway that branches to the lungs

  • bronchi enter into the lungs and divide into smaller bronchioles

• bronchi supported by rings of cartilage similar to the trachea

bronchus

one major airway

bronchi

more than one bronchus

bronchiole

smaller airway branching from a bronchus

alveoli

• ends of bronchiolies

• where oxygen exchange happens with capillaries

• secrete surfacant that keeps their walls from collapsing

alveol/o

air sac or a small cavity/hollow

asthma

hyperactivity of the bronchi or bronchioles to an allergen or inhaled substances

• causes inflammation, excess mucus production, and bronchospasm

• latin term for breathe hard

• greek term for shortness of breath

-spasm

sudden involuntary muscle contraction

asthm/o

asthma

bronchitis

acute or chronic infection/inflammation of the bronchi

• chronic infection due to smoking or pollution

• acute due to an infection

-iectasis

condition of dilation, expansion or stretching

bronchiectasis

permanent enlargement and loss of elasticity in the bronchioles; allows secretions to accumulate

reactive airway disease

blanket term for conditions with reversible airway narrowing and wheezing

Lung Anatomy

• spongy aire filled structures

• right lung lobes

  • right upper lobe (RUL)

  • RML

  • RLL

• Left lung lobes

  • LUL

  • LLL

• top of lungs is the apex

• base rests on the diaphragm

BS

Abnormal breath sounds

• normal breathing sounds like soft wind through a tunnel

• pleural friction rub: creaking or grafting dur to inflammation of pleura

• crackles/rales: irregular crackling or bubbling due to fluid or infection in the alveoli

• Rhonchi: humming, whistling, or snoring due to mucus or foreign body obstruction (FBO)

• Stridor: high pitched crowing due to edema or obstruction

• Wheezes: high pitched whistling or squeaking due to asthma attack or reaction

FBO

foreign body obstruction

atel/o

incomplete

-ectasis

condition of dialation

atelectasis

collapse of all or part of the lung

COPD

Chronic Obstructive Pulmonary Disease

• group of chronic lung disease, including chronic bronchitis and emphysema

• happens due to chronic air pollution ot smoking

• characterized by chronic inflammation, severe coughing, SOB, and sputum production

• alveolar hyperinflation leads to b chest (barrel chest)

CF

Cystic Fibrosis

• inherited condition caused by recessive gene; causes problems in repiratory, digestive and sweat secretions

  • mucus secreted too thick and blocks alveoli

  • constant coughing an bronchiectasis occur

  • lung infections are frequent and lack of oxygen is chronic

fibr/o

fiber

em-

in

py/o

pus

-ema

condition

empyema

localized pockets of pus that have collected inside a body cavity of the lung due to a bacterial infection

Legionnaires’ disease

severe sometimes fatal bacterial infection

• starts as flulike symptoms and progresses to severe pneumonia and liver and kidney degradation

Occupational lung disease

group of lung diseases caused by constant workplace exposure to inhaled particles such as asbestosis

-coniosis

condition caused by dust

Lung Cancer

most common among smokers

• when tar deposits in the lungs become cancerous and spread

pneumonis

infection of lobes of the lungs; fluid, white blood cells, and microorganisma fill passages

Causes:

• bacterial

• viral

• aspiration (inhales material: vomit, food, saliva)

Double lung means it has affected both lungs

aspir/o

to breath in

pulmonary edema

build up of fluid in the alveoli

causes:

• left sided heart failure

• chest wall trauma

• pneumonia

Severe acute respiratory syndrome (SARS)

severe, communicable viral illness that can be fatal

• spreads through close contact

pulmonary embolism

a traveling clot or fat globule lodges in the lung

• blocks blood flow and causes SOB

• often occurs in patients who are on bedrest

SOB

shortness of breath

embolus

something traveling through the blood stream

TB

Tuberculosis

• communicable disease that is caused by Mycobacterium tuberculosis

• Causes nodules/tubercles in the lungs

• waxy coating makes the bacterium resistant

• requires a 9-month-long course of drugs as treatment

tubercul/o

tubercle

tubercle

small nodule

bronchiole

Small passages that end in alveoli

Anatomy of the Thorax

The bony cage between the neck and diaphragm

• Sternum ribs and spine protect the lungs and thoracic cavity

  • lungs fill most of the thoracic cavity

• Mediastinum

  • lies between the lungs

• diaphragm

  • makes up the inferior border of thoracic cavity

hemothorax

blood in the thoracic cavity, typically due to trauma

Pleural effusion

accumulation of excess fluid in the pleural space due to inflammation or infection

-thorax

thorax, chest

effus/o

flowing out

Pleurisy

inflammation/infection of the pleura that cause the two pleural layers to rub against one another and create pleural friction rub

pleur/o

lung membrane

-isy

condition of infection or inflammation

pneumothorax

air in the pleural space that causes the lung to collapse; typically caused bby the result of a penetrating trauma

AKA collapsed lung

pneum/o

air, lung

Mechanics of breathing

• Inspiration

  • thoracic volume increases, pressure goes down, air moves in

• Expiration

  • thoracic volume decreases, pressure goes up, air moves out

Apnea

absense of spontaneous respiration due to respiratory failure or arrest

• in infants, it may be due to immature CNS (central nervous system)

• in middle aged adults may be caused due to obstructive sleep apnea

a-

without

pne/o

breathing

bradypnea

abnormally slow rate of breathing due to brain damage or chemical imbalance in the blood

dyspnea

abnormal, difficult, laboured or painful breathing

• dyspnea on exertion occurs during activity in patients with lung disease

orthopnea

difficulty breathing when lying supine; patient sleeps sitting up or semi-upright

orth/o

straight

tachypnea

abnormally fast breathing due to lung disease

cough

protective mechanism to forcefully expel things from the lungs

expectoration

coughing up sputum

ex-

away from

pector/o

chest

-ation

process

hemoptysis

coughing suptum that contains blood

-pytsis

condition of coughing up

gas exchange

O2 given into the bloodstream

blood cell drops CO2 to be exhaled

anoxia

complete lack or severely decreased level of oxygen in srterial blood and body tissue. caused by choking suffocation or drowning

ox/o

oxygen

asphyxia

abnormally high level of CO2 and an abnormally low level of O2 in the blood

• signs may be tachycardia and cyanosis

sphyx/o

pulse

hypercapnia

very high level of CO2 in arterial blood

hypoxemia

very low level of O2 in arterial blood

capn/o

carbon dioxide

ABGs

Arterial Blood Gasses

• blood test to measure O2 and CO2 and acidity in a sample of arterial blood

• important to assess lung and kidney function

Corboxyhemoglobin

blood test to measure the levels of carbon monoxide in blood. typically done for patients exposed to fire or fumes

carbox/y

carbon monoxide

glob/o

comprehensive; shaped like a globe (think hemoglobin)

-in

substance

Oximetry

non invasive test to measure oxygen saturation of the blood; oximeter emits light waves that reflect off hemoglobin

PFT

Pulmonary Function Test

• breathing test to measure the volume of air that can be forcefully inhaled or exhaled

Sleep Study

procedure to determine whether a patient has obstructive sleep apnea; uses sensores to measure movement, breathing, and O2 level

Sputum C&S

Lab test to identify which bacterium is causing lung infection

sputum placed in a culture dish with disks of antibiotic drugs to see which drug the bacterium is sensitive to

Tuberculosis test

test that shows whether a person has been exposed to TB

CXR

chest radiography/X-Ray

CT and MRI scans

Tomography scans that take many images in small slices to provide detailed picture of lung structure

• CT: uses xrays

• MRI: Uses Magnetic Field

tom/o

cut; layer; slice

Lung Scan

procedure in which radioactive air is breathed in and a radioactive drug is injected to identify areas of poor gas uptake and poor perfusion in the lungs

• ventilation: radioactive tracer is inhaled

• perfusion: radioactive tracer is injected

per-

through, throughout

fus/o

pouring