Lecture Notes

Classroom Activity to Accompany Medical Terminology Systems, Sixth Edition

Barbara A. Gylys ∙ Mary Ellen Wedding

7Respiratory

System

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Structure•Upper respiratory tract•Nose, pharynx, larynx, trachea

•Lower respiratory tract•Bronchi, bronchioles, lungs, alveoli, breathing muscles

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Function•Respiration•External and Internal

•Other functions, with help of cardiovascular system• Provides oxygen to body cells•Eliminates the waste product carbon dioxide CO2

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Structure and Function ExerciseQ: Name the structures of the upper respiratory tract (URT)?A: Nose, pharynx, larynx, and trachea.Q: What are the structures of the lower respiratory tract ?A: Bronchi, bronchioles, alveoli, and the lungs.Q: What do abbreviations O2 and CO2 mean?

A: O2 means oxygen; CO2 means carbon dioxide.

Q: What is the main function of the respiratory system?A: Provides O2 and removes CO2 from body cells.

Q: What other body system helps the respiratory system transport O2 and remove CO2 from body cells?

A: CV system helps transport O2 and remove CO2 from body cells.

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Sleep ApneaSigns and Symptoms• Brief or prolonged absence of spontaneousrespirations.

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Sleep ApneaSigns and Symptoms (continued)• In obstructive sleep apnea, patients stop

breathing multiple times each night. Causes include airway obstruction that may be caused by soft palate, neck tissue, or tonsil enlargement.• In premature infants, the immature CNS

fails to maintain a consistent respiratory rate, and there are long pauses between regular breathing.

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Sleep ApneaSigns and Symptoms (continued)• Apnea is followed by a gasping breath that often awakens the person.• Occurs most often in middle-aged, obese men who snore excessively.

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Sleep ApneaTreatment• Tonsillectomy and adenoidectomy (T&A).• Uvulopalatopharyngoplasty (UPP). • CPAP apparatus to keep airway open in adults; home apnea monitor for infants.

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Clinically Related ExerciseQ: Mrs. J is diagnosed with sleep apnea and asks the nurse to explain this

disorder.A: The nurse explains it’s a temporary loss of breathing resulting in brief or

prolonged absence of spontaneous respiration.Q: Patient X presents for an excision of tonsils and adenoids as a treatment of

sleep apnea. The abbreviation for the surgical procedure to remove tonsils and adenoids is__________.

A: T&AQ: Mary is prescribed a CPAP machine for sleep apnea. The respiratory therapist

explains that this machine will help keep her airway open at night so she can breathe normally. The medical term to breathe normal is ___________.

A: eupneaQ: Mr. M presents with complaints of excessive snoring at night that awakens

him and also results in him gasping for breath. The physician explains that he has a common condition that occurs in middle-aged, obese men in which temporary cessation of breathing occurs. This condition is known as sleep (apnea, dyspnea, eupnea).

A: apnea

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Lung CancerSigns and Symptoms• Early-stage lung cancer usually produces

no symptoms and is difficult to detect.• When symptoms appear, they may include

smoker’s cough, wheezing, chest pain, dyspnea, and hemoptysis.• Risk factors include chemical exposure or

history of smoking or exposure to second-hand smoke.

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Lung CancerTreatment• Combination of surgery, radiation therapy,

and chemotherapy depending on whether the malignancy is localized or metastasized.• Chest x-ray, sputum cytology test, and

bronchoscopy with tissue biopsy are required for definitive diagnosis.

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Clinically Related ExerciseQ: Mr O works for a collision shop and sprays paint on cars. He is also a 2

pack/day smoker for 15 years. He is concerned about developing lung cancer and asks the nurse if it is preventable.

A: She explains that lung cancer is preventable if one avoids smoking and inhaling toxic substances.

Q: A 1 pack/day smoker for the past 8 years is diagnosed with lung cancer. She asks the doctor if her cancer will be cured if she stops smoking.

A: The doctor explains if smokers stop smoking during early precancerous cellular changes, damaged bronchial lining tissues often return to normal.

Q: The patient presents for a visual examination of his interior bronchi with biopsy to confirm a diagnosis of lung cancer. The physician documents the visual examination of the bronchi as a ____________________.

A: bronchoscopyQ: The patient is diagnosed with advanced lung cancer and asks why it was not

detected last year during her annual physical exam.A: The nurse explains that early-stage lung cancer usually produces no

symptoms and is difficult to detect. When symptoms appear, cancer often has metastasized to tissues such as the brain, liver, and bone.

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Upper Airway ObstructionSigns and Symptoms• Symptoms vary depending on the cause of obstruction, but some symptoms are common to all types of obstructions.• Cyanosis of the skin.• Difficulty breathing, choking, confusion, panic, unconsciousness.

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Upper Airway ObstructionTreatment• Depends on the cause of the blockage.• Objects lodged in the airway may be

removed with a laryngoscope or bronchoscope.• A tube may be inserted into the airway

(endotracheal tube or nasotracheal tube).• Opening is made directly into the airway

(tracheostomy) if needed.

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Clinically Related Exercise Q: Doctor X is concerned that Mrs. T has an airway blockage. The patient

asks if there a test to confirm a blockage.A: The doctor states tests may include bronchoscopy, laryngoscopy, and

radiography.Q: John’s x-ray shows a small foreign object lodged in his larynx. The

physician removes the object with an instrument called a ____________________.

A: laryngoscopeQ: The patient presents for an opening to be made into the trachea. This

surgical procedure is documented in the medical record as a ________________.

A: tracheostomyQ: The anesthesiologist inserts a tube directly into the patient’s trachea so

the patient will be able to breathe while under general anesthesia. This tube is known as an ___________________ _________________.

A: endotracheal tube

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Medical Vocabulary •acidosis•aerophagia•anosmia•anoxia•apnea•asphyxia•atelectasis•bradypnea

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Medical Vocabulary(continued)

• coryza• cyanosis• dysphonia• dyspnea• emphysema• epistaxis• eupnea• hypercapnia

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Medical Vocabulary(continued)

• influenza•mucoid• pertussis• pleurisy• pneumonia• pyothorax• respiration

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Medical Vocabulary(continued)• resuscitation• rhinoplasty• rhinorrhea• rhonchi• stridor• tachypnea• transnasally

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Diagnostic Procedures•Bronchoscopy• Tissue biopsy for cancer detection of lungs•Remove obstruction (tissue or other), or observe directly for pathological changes

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Diagnostic Procedures (continued) Thoracentesis• Remove fluid from

pleural space for diagnostic or therapeutic purposes

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Diagnostic Procedures (continued)• Arterial blood gas (ABG)• Magnetic resonance imaging (MRI)• Pulmonary function tests (PFTs)

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Word Building ExerciseQ: Visual examination of bronchi: __________________.A: bronchoscopyQ: Surgical puncture of chest: ______________________.A: thoracentesis or thoracocentesisQ: Forming an opening (mouth) in the trachea:___________.A: tracheostomyQ: Visual examination of larynx: ____________________.A: laryngoscopyQ: Instrument for measuring breathing: _________________.A: spirometerQ: Instrument for examining the larynx: _________________.A: laryngoscope

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Medical and Surgical Procedures

•Lavage• Irrigation of paranasal sinuses to remove mucopurulent material

•Postural drainage•Body is positioned so gravity helps remove secretions from the lung or bronchi. Coughing usually expels secretions from the trachea

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Medical and Surgical Procedures

(continued)

Tracheostomy• Upper airway

obstruction

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Clinically Related ExerciseQ: Mr. J has a history of smoking 2 packs/day for 30 years. He is

diagnosed with throat cancer and presents to the hospital for an excision of the larynx. What is this surgical procedure called?

A: laryngectomyQ: Mr. M has thick mucous secretions from a prolonged

respiratory infection. The nurse adjusts his bed upright to 90 degrees so he can easily cough up mucus. This type of therapeutic drainage is known as postural ______________.

A: drainageQ: Mrs. S presents to the ED with cyanosis caused by an

obstructed airway. The physician incises the trachea to open it below the blockage and restore breathing. An incision into the trachea is known as (tracheocentesis, tracheostenosis, tracheotomy).

A: tracheotomy

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Pharmacology•Bronchodilators•Drugs that dilate constricted airways via a metered-dose inhaler (MDI)

•Corticosteroids

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Pharmacology (continued)

• Metered-dose inhalers (MDIs)• Nebulized mist treatments (NMTs)•Administer meds directly into lungs via a nebulizer

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Clinically Related ExerciseQ: To reduce airway inflammation in an asthmatic patient, the

doctor prescribes a/an (antibiotic, corticosteroid, expectorant).A: corticosteroidQ: Ms. C presents with a chief complaint of shortness of breath

upon exertion. Medication is prescribed to expand the bronchial airways . It is known as a/an (bronchodilator, corticosteroid, expectorant).

A: bronchodilatorQ: Upon inhalation, a fine spray delivers medication into the

lungs. The device used is known as a/an (bronchoscope, intubator, nebulizer).

A: nebulizer Q: To reduce sputum thickness and ability to cough it up, the

physician prescribes a/an (antibiotic, corticosteroid, expectorant).

A: expectorant

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