Medical Terminology A Word-Building Approach Chapter 11
Respiratory System Jane Rice, RN, CMA-C
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Anatomy and Physiology Overview The respiratory system consists
of the nose, pharynx, larynx, trachea, bronchi, and lungs. Its
primary function is to furnish O 2 for use by individual tissue
cells and to take away CO 2. This process is accomplished by the
act of respiration, which has an internal and external
process.
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Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane
Rice
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Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane Rice
Figure 11.1 The respiratory system: nasal cavity, pharynx, larynx,
trachea, bronchus, and lung with expanded views of the trachea and
alveolar structure.
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The Nose The nose has five functions: Serves as an air
passageway. Warms and moistens inhaled air. Its cilia and mucous
membrane trap dust, pollen, bacteria, and other foreign matter.
Contains olfactory receptors, which sort out odors. Aids in
phonation and the quality of voice.
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The Nose The nose consists of internal and external portions:
External portion Internal portion
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The Nose External portion Triangle of cartilage and bone that
is covered with skin and lined with mucous membranes. The nostrils
or anterior nares are the external entrances to the nose.
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The Nose Internal Portion Septum Partition that separates the
nose into right and left chambers. Superior, middle, and inferior
conchae Three air passages of the nasal cavities. They lead to the
pharynx and are connected by openings with the paranasal sinuses,
the eustachian tubes, and the eyes.
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The Nose Internal Portion Paranasal sinuses four pairs that
drain into the nose. Frontal Maxillary Ethmoidal Sphenoidal
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The Pharynx Also known as the throat, it is a musculomembranous
tube that extends from the base of the skull, anterior to the
cervical vertebrae, and becomes continuous with the esophagus. The
functions of the pharynx are: Passageway for air. Passageway for
food. Aids in phonation by changing shape.
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The Pharynx It is divided into three portions Nasopharynx
Located behind the nose. Oropharynx Located behind the mouth.
Laryngopharynx Located behind the larynx.
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The Larynx Also called the voicebox; a muscular, cartilaginous
structure lined with mucous membrane. It is the enlarged upper end
of the trachea below the root of the tongue and hyoid bone.
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The Larynx Its function is the production of vocal sounds. High
notes are formed by short, tense cords. Low notes are produced by
long, relaxed vocal cords. The larynx is composed of nine
cartilages bound together by muscles and ligaments.
The Larynx The three unpaired cartilages: Thyroid cartilage
Epiglottic cartilage Cricoid cartilage
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The Larynx The three paired portions: Arytenoid cartilage
Cuneiform cartilage Corniculate cartilage
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The Larynx The cavity is divided into three regions: Vestibule
Ventricle Entrance to glottis
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The Trachea Also known as the windpipe; a cartilaginous tube
that is the air passageway extending from the pharynx and larynx to
the main bronchi. Its function is to provide an open passageway for
air to the lungs.
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The Trachea The trachea is composed of: Smooth muscle Is
reinforced at the front and side by C-shaped rings of cartilage.
Mucous membrane Lining that contains cilia, which sweep foreign
matter out of the passageway.
Slide 21
Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane Rice
Figure 11.2 Nose, nasal cavity, and pharynx: (A) nasal cartilages
and external structure; (B) meatus and positions of the entrance to
the ethmoid and maxillary sinuses; and (C) sagittal section of the
nasal cavity and pharynx.
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Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane Rice
Figure 11.2 (continued) Nose, nasal cavity, and pharynx: (A) nasal
cartilages and external structure; (B) meatus and positions of the
entrance to the ethmoid and maxillary sinuses; and (C) sagittal
section of the nasal cavity and pharynx.
Slide 23
Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane Rice
Figure 11.2 (continued) Nose, nasal cavity, and pharynx: (A) nasal
cartilages and external structure; (B) meatus and positions of the
entrance to the ethmoid and maxillary sinuses; and (C) sagittal
section of the nasal cavity and pharynx.
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The Bronchi Are the two main branches of the trachea. The
trachea divides into the right bronchus and the left bronchus. Each
bronchus enters the lung at a depression, the hilum. They then
subdivide into the bronchial tree composed of smaller bronchi,
bronchioles, and alveolar ducts.
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The Bronchi The bronchial tree terminates in the alveoli, which
are the tiny air sacs supporting a network of capillaries from
pulmonary blood vessels. The function of the bronchi is to provide
a passageway for air to and from the lungs.
Slide 26
Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane Rice
Figure 11.4 Larynx, trachea, bronchi, and lungs with an expanded
view showing the structures of an alveolus and the pulmonary blood
vessels.
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The Lungs Cone-shaped, spongy organs of respiration lying on
either side of the heart within the pleural cavity of the thorax.
They consist of elastic tissue filled with interlacing networks of
tubes and sacs that carry air and blood vessels carrying blood. The
main function of the lungs is to bring air into intimate contact
with blood so that O 2 and CO 2 can be exchanged in the
alveoli.
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The Lungs Pleura A serous membrane composed of six layers that
enclose the lungs. Costal Parietal Pericardiaca Phrenica Pulmonalis
Visceral
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The Lungs Pleural Cavity A space between parietal and visceral
pleura and contains serous fluid that lubricates and prevents
friction. The Diaphragm The musculomembranous wall that separates
the thoracic cavity from the abdominal cavity. Mediastinum The
central portion of the thoracic cavity, between the lungs, which
contains the heart and other structures.
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The Lungs Lung Base Broad inferior surface of the lung which
rests on the diaphragm. Lung Apex The pointed upper margin that
lies above the sternal end of the first rib. Lobes The divisions of
the lungs. Right lung has three lobes Left lung has two lobes
Cardiac depression Indentation for normal placement of the
heart.
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Respiration Volume The Vital Function of Respiration
Respiratory Rates
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Respiration Tidal volume (TV) Amount of air in a single
inspiration or expiration. Approximately 500 mL of air enters the
respiratory tract in an adult male during normal quiet breathing.
Supplemental air Amount of air that may be forcibly expired after a
normal quiet respiration. This is also the expiratory reserve
volume and amounts to approximately 1200 mL.
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Respiration Complemental air Amount of air that may be forcibly
inspired over and above a normal respiration; known as the
inspiratory reserve volume (IRV) and measures approximately 3600
mL. Residual volume Amount of air remaining in the lungs after
maximal expiration, approximately 1500 mL. Minimal air Small amount
of air that remains in the alveoli.
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Respiration Vital capacity (VC) Volume of air that can be
exhaled after a maximal inspiration. This amount equals the sum of
the tidal air, complemental air, and supplemental air. Functional
residual capacity Volume of air that remains in the lungs at the
end of a normal expiration. Total lung capacity Maximal volume of
air in the lungs after maximal inspiration.
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Respiration The process of respiration is interrelated with
other systems of the body. The medulla oblongata and the pons of
the CNS regulate and control respiration. Respiration, along with
temperature, pulse, and blood pressure, is a vital sign that aids
in determining an individuals state of health.
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Respiration Respiratory rates Regulated by the respiratory
center located in the medulla oblongata, the rate of respiration
varies with different age groups as follows: Newborn30 80/min 1st
year20 40/min 5th year20 25/min 15th year15 20/min Adult15
20/min
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Life Span Considerations: The Child At 12 weeks gestation, the
lungs of the fetus have a definite shape. At 20 weeks, the alveoli
of the lungs are complete. At 28 to 32 weeks, the alveoli begin to
produce surfactant, a substance in the lungs that regulates the
amount of surface tension of the fluid lining the alveoli. The lack
of surfactant in preterm infants contributes to respiratory
distress syndrome (RDS).
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Life Span Considerations: The Older Adult The respiratory
system is vulnerable to injuries. The mucous barriers break down,
cilia decrease in effectiveness, and the composition of the
connective tissue in the lungs changes. Diaphragmatic breathing is
predominant and it becomes difficult to breathe lying down.
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Life Span Considerations: The Older Adult Vital capacity
declines with age. There is a decline in the elastic recoil of the
lungs and an increase in the stiffness of the chest walls. Voice
may become gravelly and softer with a rise in pitch, making
communication more difficult, especially if there is impaired
hearing.
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Medical Words and Definitions with Word Parts These terms
(shown in black in the Building Your Medical Vocabulary feature)
can be analyzed and defined by dividing them into component parts.
1.Prefixes (P) 2.Roots (R) 3.Combining Forms (CF) 4.Suffixes (S)
Building Your Medical Vocabulary
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Medical Words and Definitions without Word Parts These terms
(shown in pink in the Building Your Medical Vocabulary feature) are
not usually analyzed and defined by dividing them into component
parts. Building Your Medical Vocabulary
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Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane Rice
Figure 11.5 Acute exacerbations of asthma can require management in
the emergency department. The child is placed in a semisitting
position to facilitate respiratory effort.
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Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane Rice
Figure 11.6 Use of a bronchoscope during a bronchoscopy.
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Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane Rice
Figure 11.7 Two important changes occur in the upper airway in
croup: The epiglottis swells, thereby occluding the airway, and the
trachea swells against the cricoid cartilage, causing
restriction.
Slide 46
Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane Rice
Figure 11.8 Evaluation of a child for cystic fibrosis with a sweat
chloride test. Sweat is being collected under the wrappings for
later analysis of the amount of sodium and chloride.
Slide 47
Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane Rice
Figure 11.9 Normal lung and one with emphysema.
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Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane Rice
Figure 11.10 Administeration of abdominal thrusts (the Heimlich
maneuver) to (A) a conscious victim and (B) an unconscious
victim.
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Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane Rice
Figure 11.11 Paranasal sinuses are part of the upper respiratory
system. From here, infections can spread via the nasopharynx to the
middle ear or bronchi. Note locations of laryngitis, pharyngitis,
sinusitis, and tonsillitis.
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Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane Rice
Figure 11.12 (A) Bronchopneumonia with localized pattern. (B) Lobar
pneumonia with a diffuse pattern within the lung lobe. (C)
Interstitial pneumonia is typically diffuse and bilateral.
Slide 51
Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane Rice
Figure 11.13 Sucking chest wound (pneumothorax).
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Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane Rice
Figure 11.14 Thoracocentesis (thoracentesis).
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Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane Rice
Figure 11.15 Tracheostomy tube in place.
Slide 54
Cystic Fibrosis Video Click here to view a video on the topic
of cystic fibrosis.here Back to Directory
Slide 55
Drug Highlights Antihistamines Act to counter the effects of
histamine by blocking histamine 1 (H1) receptors. Decongestants Act
to constrict dilated arterioles in the nasal mucosa.
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Drug Highlights Antitussives May be classified as: Non-narcotic
agents - Anesthetize the stretch receptors located in the
respiratory passages, lungs, and pleura by dampening their activity
and thereby reducing the cough reflex at its source. Narcotic
agents - Depress the cough center located in the medulla, thereby
raising its threshold for incoming cough impulses. Expectorants
Promote and facilitate the removal of mucus from the lower
respiratory tract.
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Drug Highlights Mucolytics Break chemical bonds in mucus,
thereby lowering its thickness. Bronchodilators Used to improve
pulmonary airflow by dilating air passages.
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Drug Highlights Inhalational glucocorticoids Used in the
treatment of bronchial asthma and in seasonal or perennial allergic
conditions when other forms of treatment are not effective.
Antituberculosis agents Used in long-term treatment of TB. Often
used in combination of two or more drugs.
Slide 59
Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane Rice
Figure 11.16 Drugs used to treat respiratory disorders.
Slide 60
Diagnostic and Lab Tests Acid-Fast Bacilli (AFB) Test performed
on sputum to detect the presence of Mycobacterium tuberculosis, an
acid-fast bacillus. Positive test results indicate tuberculosis.
Antistreptolysis O (ASO) Test performed on blood serum to detect
the presence of streptolysin enzyme O, which is secreted by
beta-hemolytic streptococcus. Positive results indicate
streptococcal infection.
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Diagnostic and Lab Tests Arterial Blood Gases (ABGs) Series of
test performed on arterial blood to establish acid-base balance.
Important in determining respiratory acidosis, and/or alkalosis,
metabolic acidosis and/or alkalosis. Bronchoscopy Visual
examination of the larynx, trachea, and bronchi with a flexible
bronchoscope. With the use of biopsy forceps, tissue and secretions
can be removed for analysis.
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Diagnostic and Lab Tests Culture, Sputum Examination of the
sputum to determine the presence of microorganisms. Abnormal
results may indicate tuberculosis, bronchitis, pneumonia,
bronchiectasis, and other infectious respiratory diseases (RD).
Culture, Throat Test to identify the presence of microorganisms in
the throat, especially beta-hemolytic streptococci. Laryngoscopy
Visual examination of the larynx via a laryngoscope.
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Diagnostic and Lab Tests Nasopharyngography X-ray examination
of the nasopharynx. Pulmonary function test Series of tests
performed to determine the diffusion of O 2 and CO 2 across the
cell membrane in the lungs. Tests are done on all phases of
respiration, with abnormal results indicating various respiratory
diseases and conditions. Rhinoscopy Visual examination of the nasal
passages.
Slide 64
Spirometry Video Click here to view a video on the topic of
spirometry.here Back to Directory
Slide 65
Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane
Rice
Slide 66
Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane
Rice
Slide 67
Apnea A temporary cessation of breathing. Sleep apnea is the
cessation of breathing during sleep. The types of sleep apnea are:
Obstructive apnea Central apnea
Slide 68
Apnea Video Click here to view a video on the topic of
apnea.here Back to Directory
Slide 69
Asthma An inflammatory disease of the bronchi characterized by
wheezing, dyspnea, and a feeling of constriction in the chest.
Inflammation of the airways causes airflow into and out of the
lungs to be restricted. When an asthma attack occurs, the muscles
of the bronchial tree become tight and the lining of the air
passage swells, reducing airflow and producing the characteristic
wheezing sound.
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Asthma Treatment is aimed at avoiding known allergens and
respiratory irritants and controlling symptoms and airway
inflammation through medication. There are two basic types of
medications for the treatment of asthma: Long-term control
medications such as inhaled glucocorticoids. Quick-relief
medications such as short-acting bronchodilators.
Slide 71
Asthma Animation Click here to view an animation on the topic
of asthma.here Back to Directory
Slide 72
Asthma Video Click here to view a video on the topic of
asthma.here Back to Directory
Slide 73
Passive Smoke Exposure Video Click here to view a video on the
topic of passive smoke exposure.here Back to Directory
Slide 74
Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane Rice
Figure 11.17 Changes in bronchioles during an asthma attack: (A)
normal bronchiole and (B) in asthma attack.
Slide 75
Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane Rice
Figure 11.18 This educational piece from the American Lung
Association explains what triggers an asthmatic episode. The
required lifestyle changes for the affected individual and family
are significant. Culture sometimes plays a significant part in
exposure to lifestyle triggers. (Reprinted with permission 2006
American Lung Association.) For more information about the American
Lung Association or to support the work it does, call
1-800-LUNG-USA (1-800-586-4872) or log on to www.lungusa.org.
Slide 76
Pneumonia An inflammation of the lung (or lungs). It is caused
by many different organisms such as: Bacteria (which produce most
serious pneumonia) Viruses Fungi Chemical irritants
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Pneumonia Symptoms include: Cough with greenish mucus, or
puslike sputum Chills Fever Fatigue Chest pain Muscle aches
Slide 78
Pneumonia Pneumonia is diagnosed through: Auscultation Chest
x-ray Sputum culture Treatment of pneumonia is cause-
dependent.
Slide 79
Tuberculosis A contagious disease caused by the bacillus
Mycobacterium tuberculosis, which is carried in droplets. Symptoms
depend on where in the body the TB bacteria are growing. The
disease is characterized by the development of granulomas in the
infected tissues.
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Tuberculosis TB bacteria usually grow in the lungs, and
symptoms include a chronic cough, hemoptysis, whitish or
grayish-yellow frothy sputum, fatigue, low-grade fever, night
sweats, weakness, chills, anorexia, and weight loss. Diagnosis is
made by auscultation, presence of enlarged lymph nodes and/or
pleural effusion, chest x-ray, sputum culture, tuberculin skin
test, and bronchoscopy.
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Tuberculosis Treatment requires long-term drug therapy.
Multidrug-resistant tuberculosis (MDR TB) occurs when the TB
bacteria become resistant to two of the drugs that are used to
treat tuberculosis.
Slide 82
Tuberculosis Video Click here to view a video on the topic of
tuberculosis.here Back to Directory
Slide 83
Tuberculosis Testing Video Click here to view a video on the
topic of tuberculosis testing.here Back to Directory
Slide 84
Copyright 2008 by Pearson Education, Inc. Pearson Prentice Hall
Upper Saddle River, NJ 07458 Medical Terminology, 6e By Jane Rice
Figure 11.19 Lobar pneumonia. (Source: Photo Researchers,
Inc.)
