Respiratory System

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Respiratory System

• HST I

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Includes

• Nasal cavity
• Sinuses
• Pharynx
• Larynx
• Epiglottis
• Trachea

• Bronchi
• Bronchioles
• Alveoli
• Lungs
• Pleura
• Mediastinum

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Main organs involved in the respiratory system

• Nose/mouth
• Pharynx
• Larynx
• Trachea
• Bronchi
• Alveoli (within lungs)
• Lungs

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Nasal Cavity

• Anterior Nares nostrils
• Nasal Septum cartilage which divides nasal
  cavities into right and left sides
• Turbinates are bones that protrude into the nasal
  cavity they increase the surface area for
  filtering dust and dirt particles by the mucous
  membranes
• Cilia the hairs in the nose trap larger dirt
  particles

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Sinuses

• Cavities in the skull, ducts connect them to the
  nasal cavity, lined with mucous membranes to warm
  and moisten air
• Frontal
• Maxillary
• Ethmoid
• Sphenoid
• Sinuses give resonance to the voice.

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Pharynx

• The throat
• Common passageway for air and food
• 5 long
• Divided into
• Nasopharynx
• Oropharynx
• Laryngopharynx

When food is swallowed, the epiglottis closes
over the opening to the larynx, preventing food
from entering the lungs.
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Larynx

• Voice box
• Triangular chamber below the pharynx
• Within the larynx are vocal cords (glottis)
• Adams Apple

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Trachea

• Windpipe
• 4 ½ long
• Walls are alternate bands of membrane and C
  shaped rings of hyaline cartilage to keep
  trachea open
• Lined with ciliated mucous membranes
• Coughing and expectoration gets rid of dust-laden
  mucous

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Bronchi and bronchioles

• Lower end of trachea divides into R and L
  bronchus
• As they enter lungs, subdivide into bronchial
  tubes and bronchioles
• Bronchi similar to trachea with ciliated mucous
  membrane and hyaline cartilage

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• Bronchial tubes cartilaginous plates (instead
  of C-shaped rings)
• Bronchioles thinner walls of smooth muscle,
  lined with ciliated epithelium
• At the end, alveolar ducts and cluster of alveoli

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Alveoli

• Composed of a single layer of epithelial tissue
• Inner surfaces covered with surfactant to keep
  alveoli from collapsing
• Each alveolus surrounded by capillaries
• O2 and CO2 exchange takes place between the
  alveoli and capillaries (diffusion)

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Lungs

• Fill thoracic cavity
• Separated by mediastinum and heart
• Upper part apex
• Lower part base
• Base fits snugly over diaphragm
• Lung tissue porous and spongy it floats
• R lung larger and shorter (displaced by the
  liver) and has 3 lobes
• L lung smaller (displaced by heart) and has 2
  lobes

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Diaphragm

• Large dome-shaped muscle that contracts
  rhythmically, continually, and most of the time,
  involuntarily.

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Pleura

• Thin, moist slippery membrane that covers the
  lungs
• Double-walled sac
• Space is pleural cavity filled with pleural
  fluid to prevent friction

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Mediastinum

• Interpleural space
• Contains
• Thymus gland
• Heart (and aorta)
• Pulmonary arteries and veins
• Superior and inferior vena cava
• Esophagus
• Trachea
• Thoracic duct
• Lymph nodes and vessels

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Functions of the Respiratory System

1. External, internal, and cellular respiration
2. Production of sound (vocal cords)

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• Oxygen is the MOST critical substance needed by
  the body for survival.
• We can only live about 4-6 minutes without
  oxygen.
• Arterial blood 21 O2
• Venous blood 16 (5 loss per cycle)

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• Clinical death the moment breathing and
  heartbeat stop
• Biological death when brain cells die,
  irreversible after 6 10 minutes

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• Constant removal of carbon dioxide is just as
  important for survival maintains homeostasis

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Pulmonary Ventilation (Breathing)

• Inspiration
• Intercostal muscles lift ribs outward, sternum
  rises and the diaphragm contracts and moves
  downward this increases the volume of the lungs
  and air rushes in
• Expiration
• Opposite action takes place
• Exhalation is a passive process

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Respiratory Movements

• 1 inspiration 1 expiration 1 respiration
• Normal adult 14 20 respirations / min
• Age dependent - newborn 40 60 / min
• Increases with exercise, body temperature,
  certain diseases
• Sleep respirations ?
• Emotion can ? or ?

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Lung Capacity and Volume

• Spirometer device that measures lung capacity
• Tidal Volume amount of air that moves in and
  out of lungs with each breath.
• Normal 500 mL
• Residual Volume amount of air left in lungs
  that cannot be voluntarily expelled

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• Hyperventilation
• Rapid breathing causes body to lose CO2 too
  quickly, blood CO2 decreases which leads to
  alkalosis
• Symptoms dizziness and possible fainting
• Rx have person breathe into a paper bag

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Maintaining Transmission-Based Isolation
Precautions

• A communicable disease is caused by a pathogenic
  organism that can be easily transmitted to others
• An epidemic occurs when the communicable disease
  spreads rapidly from person to person and affects
  a large number of people at the same time
• A pandemic exists when the outbreak of disease
  occurs over a wide geographic area and affects a
  high proportion of the population

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Maintaining Transmission-Based Isolation
Precautions

• Transmission-based isolation precautions are
  methods or techniques of caring for patients who
  have communicable diseases
• Examples of communicable diseases include
• Tuberculosis
• Wound infections
• Pertussis (whooping cough)

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Transmission-Based Isolation Precautions

• The type of transmission-based isolation depends
  on the causative organism of the disease, the way
  the organism is transmitted and whether the
  pathogen is antibiotic resistant.
• Personal protective equipment (PPE) is used to
  provide protection from the pathogen.
• Some transmission-based isolation require the use
  of gowns, gloves, face shields and masks, while
  others only require the use of a mask.

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Whats the difference between standard
precautions and isolation precautions?

• Standard precautions are used on all patients,
  while transmission-based isolation techniques are
  used to provide extra protection against specific
  diseases or pathogens to prevent their
  spread Vs.

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Airborne Precautions

• Used for patients known or suspected to be
  infected with pathogens transmitted by airborne
  droplet nuclei, where the droplets contain
  microorganisms and remain suspended in the air.
• Examples of diseases requiring isolation include
  rubella (measles), varicella (chicken pox),
  tuberculosis, and shingles (herpes zoster).

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Airborne Precautions (cont.)

• The patient must be placed in a private room, and
  the door must be kept closed.
• Air in the room must be discharged to outdoor air
  or filtered before being circulated to other
  areas.
• Each person must wear a mask that contains
  special filter to prevent the entrance of small
  airborne pathogens.
• If at all possible, the patient should not be
  moved from the room. If transport is essential,
  the patient should wear a surgical mask during
  transport to minimize the release of droplets
  into the air.

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Droplet Precautions

• Must be followed for a patient known or suspected
  to be infected with pathogens transmitted by
  large droplets expelled during coughing,
  sneezing, talking or laughing.
• Examples of diseases requiring these isolation
  precautions include diphtheria, pertussis,
  adenovirus, mumps and severe cases of viral
  influenza, meningitis and pneumonia.

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Droplet Precautions (cont.)

• The patient should be placed in a private room.
  If a private room is not available, the patient
  can be placed in a room with another patient who
  has the same infection at least 3 feet away from
  other patients or visitors.
• Masks must be worn when working within 3 feet of
  the patient.
• If the patients has to be transported, they must
  wear a surgical mask.

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Contact Precautions

• Must be followed for any patients known or
  suspected to be infected with epidemiologically
  microorganisms that can be transmitted by either
  direct or indirect contact.
• Examples of diseases requiring this type of
  isolation include any gastrointestinal,
  respiratory, skin, or wound infections caused by
  multidurg-resistant organisms any highly
  contagious skin infection and viral or
  hemorrhagic conjunctivitis or fevers.

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Contact Precautions (cont.)

• The patient should be placed in a private room.
• Gloves must be worn when entering the room.
• Gloves must be changed after having contact with
  material that may contain high concentrations of
  the microorganisms, such as wound drainage or
  fecal material.
• Gloves must be removed before leaving the room,
  and the hands must be wash with an antimicrobial
  agent.
• A gown must be worn in the room if there is any
  chance of contact with the patient, environmental
  surfaces or items in the room. The gown must be
  removed before leaving the room and care must be
  taken to ensure that clothing is not contaminated
  after gown removal.

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Contact Precautions (cont.)

• Movement and transport of the patient from the
  room should be for essential purposes only.
• The room and items in it must receive daily
  cleaning and disinfection as needed.
• If possible, patient-care equipment (bedside
  commode, stethoscope, thermometer) should be left
  in the room and used only for this patient. If
  not, all equipment must be cleaned and
  disinfected before being used on another patient.

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Reverse Isolation Precautions

• Used to protect patients from organisms present
  in the environment.
• Examples of patients requiring this isolation
  include patients whose immune systems have been
  depressed prior to receiving transplants,
  severely burned patients, patients receiving
  chemotherapy or radiation treatments, or patients
  whose immune systems have failed.

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Pulse Oximetry

• A noninvasive tool
• Monitors a patients oxygen status
• Infrared light source measures light
• Measures peripheral oxygen saturation of Hgb
  (SaO2)

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Normal levels

• Hgb is the oxygen carrier in the blood
• Normal saturation is 97-99

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LEV ELS

• At 92 96 the pt needs O2
• At 86-91 the pt is experiencing hypoxemia
• Below 85 the pt needs ET intubation
• Below 70 is life threatening

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False readings

• Abnormal hemogoblin
• Vasoconstriction
• Hypothermia
• Cardiac dysrhythmias

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Sensor locations

• Forehead
• Nasal
• Ear clip
• Fingers

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Types of sensors

• Reusable
• Single use

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Diseases and Abnormal Conditions

• Asthma- a respiratory disorder usually caused by
  a sensitivity to an allergen such as dust,
  pollen, an animal, medications or a type of food

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Diseases and Abnormal Conditions

• Bronchitis- an inflammation of the bronchi and
  bronchial tubes

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Diseases and Abnormal Conditions

• Chronic Obstructive Pulmonary Disease (COPD)- any
  chronic lung disease that results in obstruction
  of the airways

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Diseases and Abnormal Conditions

• Emphysema- a noninfectious, chronic respiratory
  condition that occurs when the walls of the
  alveoli deteriorate and lose their elasticity.

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Diseases and Abnormal Conditions

• Epistaxis- also known as a nosebleed, occurs when
  capillaries in the nose become congested and bleed

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Diseases and Abnormal Conditions

• Influenza (flu)- a highly contagious viral
  infection of the upper respiratory system

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Diseases and Abnormal Conditions

• Laryngitis- an inflammation of the larynx and
  vocal cords

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Diseases and Abnormal Conditions

• Lung Cancer- is the leading cause of cancer
  death in both men and women.
• It is a preventable disease because the main
  cause is exposure to carcinogens in tobacco,
  either through smoking or through exposure to
  second-hand smoke

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Diseases and Abnormal Conditions

• Pleurisy- an inflammation of the pleura, or
  membranes, of the lungs
• Usually occurs with pneumonia or other lung
  infections

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Diseases and Abnormal Conditions

• Pneumonia- an inflammation or infection of the
  lungs characterized by exudate ( a buildup of
  fluid) in the alveoli.

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Diseases and Abnormal Conditions

• Rhinitis- an inflammation of the nasal mucous
  membrane, resulting in a runny nose, watery eyes,
  sneezing, soreness and congestion.

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Diseases and Abnormal Conditions

• Sinusitis- an inflammation of the mucous membrane
  lining the sinuses

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Diseases and Abnormal Conditions

• Sleep Apnea- a condition in which an individual
  stops breathing while asleep, causing a
  measurable decrease in blood oxygen levels
• Two types of Sleep Apnea
• Obstructive Sleep Apnea
• Central Sleep Apnea

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Diseases and Abnormal Conditions

• Tuberculosis (TB)- an infectious lung disease
  caused by the bacterium Mycobacterium tuberculosis

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Diseases and Abnormal Conditions

• Upper Respiratory Infection (URI)- or common
  cold, is an inflammation of the mucous membrane
  lining the upper respiratory tract

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Related Health Careers

• Internist
• Otolaryngologist
• Perfusionist
• Pulmonologist
• Respiratory Therapist
• Respiratory Therapy Technician
• Thoracic Surgeon

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Medical Terminology

• Root Word(s)
• Rhin(o)- denotes the nose
• Rhinorrhea runny nose
• Rhinodynia- pain in the nose
• Rhinolith- stone or rock in the nose
• Rhinorrhagia- excessive discharge of blood in the
  nose
• Rhinitis- inflammation of the nose
• Rhinomycosis- disease condition of fungus in the
  nose

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Medical Terminology

• Root Word(s)
• Pneumon(o) pneum(ato) pneum(a)- denotes the
  lung
• Pneumonitis- inflammation in the lung
• Pneumonography- to record the lung
• Pneumoconiosis- disease condition of dust in the
  lung
• Pneumothorax- chest cavity in the lung
• Pneumocentesis- surgical puncture in the lung

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Medical Terminology

• Root Word(s)
• Trache(o)- denotes the trachea
• Tracheotomy- surgical removal of the trachea
• Tracheoplasty- surgical repair of the trachea
• Tracheopathy- disease condition in the trachea
• Tracheorrhaphy- to suture the trachea
• Tracheitis- inflammation in the trachea

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Medical Terminology

• Root Word(s)
• Laryngeal- pertaining to the larynx
• Laryngostenosis- abnormal hardening of the larynx
• Laryngoscope- visual examination of the larynx
• Laryngocentesis- surgical puncture of the larynx

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Medical Terminology

• Root Word(s)
• Thorac(o)- denotes the thorax
• Thoracodynia- pain in the thorax
• Thoracentesis- surgical puncture of the thorax
• Thoracoscopy- visual examination of the thorax
• Thoracoplasty- surgical repair of the thorax
• Thoracotomy- surgical removal of the thorax

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Medical Terminology

• Root Word(s)
• pnea- denotes breathing
• Eupnea- normal breathing
• Dyspnea- difficult breathing
• Orthopnea- straight breathing
• Hyperpnea- excessive/above breathing
• Tachypnea- fast breathing
• Apnea- without breathing

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Medical Terminology

• Root Word(s)
• Bronch(o)- denotes bronchi
• Bronchiectasis- dilation of the bronchi
• Bronchitis- inflammation in the bronchi
• Bronchoscopy- visual examination of the bronchi
• Bronchoplegia- paralysis of the bronchi
• Bronchopneumonitis- inflammation of the lung and
  bronchi

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Medical Terminology

• Root Word(s)
• Pleur(o)- denotes the membrane lining the chest
  cavity and covering the lungs
• Pleuralgia- pain in the membrane lining the chest
  cavity and covering the
  lungs
• Pleuroclysis- washing out in the membrane lining
  the chest cavity and
  covering the lungs
• Pleuritis- inflammation in the membrane lining
  the chest cavity and covering the lungs
• Pleurotomy- surgical incision in the membrane
  lining
  the chest cavity and covering the lungs
• Pleurocentesis- surgical puncture of the membrane
  lining the chest cavity and
  covering the lungs

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Medical Terminology

• Root Word(s)
• Pharyng(o)- denotes the pharynx
• Pharyngonasal- pertaining to the nose of the
  pharynx
• Pharyngitis- inflammation of the pharynx
• Pharyngoscope- visual examination of the pharynx
• Pharyngostenosis- abnormal hardening of the
  pharynx
• Pharyngoxerosis- dry condition of the pharynx

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Abbreviations (G-H)

• Gallbladder
• Gastrointestinal
• Gallon
• Gram
• Gastric Analysis
• Grain
• Glucose Tolerance Test
• Gynecology

• GB
• GI
• gal
• Gm
• GA
• gr
• GTT
• Gyn

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Abbreviations (G-H)

• H
• H2O
• H2O2
• HBV
• HCI
• hct
• HDL
• Hg
• Hgb
• HHA

• Hydrogen
• Water
• Peroxide
• Hepatitis B Virus
• Hydrochloric Acid
• Hematocrit
• High-Density Lipoprotein
• Mercury
• Hemoglobin
• Home Health Assistant

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Abbreviations (G-H)

• HMO
• HOB
• HOH
• Hr, hr, hrs
• Ht
• Hx
• hypo
• hyper
• hyst

• Health Maintenance Organization
• Head of Bed
• Hard of Hearing
• Hour, hours
• Height
• History
• Hypodermic, or under
• Above, high
• hysterectomy