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Open Resources for Nursing (Open RN); Ernstmeyer K, Christman E, editors. Medical Terminology [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024.

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Medical Terminology [Internet]. 2nd edition.

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Chapter 4 Respiratory System Terminology

4.1. Respiratory System Introduction

Learning Objectives

• Apply the rules of medical language to build, analyze, spell, pronounce, abbreviate, and define terms as they relate to the respiratory system

• Identify meanings of key word components of the respiratory system

• Categorize diagnostic, therapeutic, procedural, or anatomic terms related to the respiratory system

• Use terms related to the respiratory system

• Use terms related to the diseases and disorders of the respiratory system

Introduction to the Respiratory System

The primary function of the respiratory system is to provide oxygen to body tissues and to remove carbon dioxide. This chapter will begin by reviewing common word components related to the respiratory system that can be used to build definitions of respiratory terminology. Other respiratory terms, whose definitions cannot be easily built from word components, will be described in context based on the anatomy and physiology of the respiratory system, as well as common respiratory diseases and disorders. Medical specialists, diagnostic tests, procedures, and equipment related to the respiratory system will also be discussed.

View Figure 4.1[1] for an illustration of major anatomic structures of the respiratory system.

References

1.
“2301 Major Respiratory Organs.jpg” by OpenStax College is licensed under CC BY 3.0 ↵.

4.2. Word Components Related to the Respiratory System

This section will describe common word components related to the respiratory system. These word components can be used to build definitions for many medical terms related to the respiratory system. Other common prefixes are described in Chapter 1.3, and common suffixes are described in Chapter 1.5.

Common Word Roots With A Combining Vowel Related to the Respiratory System

  • adenoid/o: Adenoids
  • alveol/o: Alveolus
  • atel/o: Imperfect, incomplete
  • bronch/o: Bronchus
  • bronchi/o: Bronchus
  • capn/o: Carbon dioxide
  • diaphragmat/o: Diaphragm
  • epiglott/o: Epiglottis
  • hem/o: Blood
  • hemat/o: Blood
  • laryng/o: Larynx
  • lob/o: Lobe
  • muc/o: Mucus
  • nas/o: Nose
  • orth/o: Straight
  • ox/i: Oxygen
  • pharyng/o: Pharynx
  • phon/o: Sound, voice
  • phren/o: Diaphragm
  • pleur/o: Pleura
  • pneum/o: Lung, air
  • pneumat/o: Lung
  • pneumon/o: Lung, air
  • pulmon/o: Lung
  • py/o: Pus
  • radi/o: X-rays, ionizing radiation
  • respir/o: Breath, breathing
  • rhin/o: Nose
  • sept/o: Septum
  • sinus/o: Sinus
  • somn/o: Sleep
  • son/o: Sound
  • spir/o: Breathe, breathing
  • thorac/o: Thorax, chest cavity
  • tom/o: To cut, section, slice
  • tonsill/o: Tonsil
  • trache/o: Trachea

4.3. Examples of Respiratory Terms Easily Defined By Their Word Components

Here are examples of respiratory medical terms that can be easily defined by breaking them down into word components.

Pulmonologist

1. Break down the medical term into word components: Pulmon/o/logist

2. Label the word parts: Pulmon = WR; o = CV; logist = S

3. Define the word components: Pulmon = lung; logist = specialist who studies and treats disorders

4. Create a final definition of the medical term: Specialist who treats diseases and disorders of the lungs

Adenoidectomy

1. Break down the medical term into word components: Adenoid/ectomy

2. Label the word parts: Adenoid = WR; ectomy = suffix

3. Define the word components: Adenoid = adenoid; ectomy = excision (cut out)

4. Create a final definition of the medical term: Excision of the adenoid

Bronchoscopy

1. Break down the medical term into word components: Bronch/o/scopy

2. Label the word parts: Bronch = WR; o = CV; scopy = suffix

3. Define the word components: Bronch = bronchus; scopy = visual examination

4. Create a final definition of the medical term: Visual examination of the bronchi

Interactive Learning Activity: Practice defining and pronouncing respiratory system medical terms by breaking them down into word parts.

Image ch4respiratory-Image001.jpg

You can also print this as a Chapter 4 Student Companion Worksheet and check your answers with this Answer Key.

4.4. Anatomy of the Respiratory System

This section will describe the major anatomic structures of the respiratory system, including the nose and adjacent structures, pharynx, larynx, trachea, bronchia, alveoli, and lungs. Common disorders affecting these structures will also be introduced.

Nose, Nasal Cavity, and Sinuses

See Figure 4.2[1] for an illustration of anatomic structures of the upper respiratory system. The upper respiratory system refers to the nose, nasal cavities, sinuses, pharynx, and larynx. An upper respiratory infection (ŬP-er RES-pĭr-ă-tō-rē ĭn-FEK-shun) (URI) refers to a viral infection of one or more of these structures.

Figure 4.2

Figure 4.2

The Upper Respiratory System

The entrance and exit for the respiratory system are through the nose. The nostrils are the opening to the nose, also referred to as nares. The nares and nasal cavities are lined with mucous membranes, containing sebaceous glands and hair follicles that serve to prevent the passage of large debris, such as dirt, through the nasal cavity. The word root for “nose” is rhin. For example, rhinorrhagia (rī-nō-RĀ-jē-ă) refers to bleeding from the nose, also called epistaxis (ĕp-ĭ-STĂK-sĭs). Rhinitis (rye-NYE-tis) refers to inflammation of the nasal mucosa. The nares open into the nasal cavity, which is separated into left and right sections by the nasal septum (SĔP-tŭm). The floor of the nasal cavity is composed of the hard palate and the soft palate. The nasal cavities are lined with mucous membranes that produce mucus (MŪ-kŭs), a substance created for lubrication and protection. Rhinorrhea (rye-noh-REE-uh), commonly referred to as a “runny nose,” is medical term for excess mucus production by the nasal cavity. Adjacent to the nasal cavity are the sinuses that serve to warm and humidify incoming air. There are four sinuses named for their adjacent bones: frontal sinus, maxillary sinus, sphenoidal sinus, and ethmoidal sinus. Sinusitis (sī-nŭ-SĪ-tĭs) refers to inflammation of the sinus cavities. Air moves from the nasal cavities and sinuses into the pharynx.[2]

The pharynx (FĂR-ĭngks), commonly known as the throat, is divided into three major regions: the nasopharynx, the oropharynx, and the laryngopharynx. See Figure 4.3[3] for an illustration of the regions of the pharynx.

Figure 4.3

Figure 4.3

Regions of the Pharynx

At the top of the nasopharynx is the pharyngeal tonsil, also called adenoid, which is collection of lymphatic tissue found at the back of the nasal cavity in the nasopharynx. The function of the pharyngeal tonsil or adenoid (ĂD-ĕ-noyd) is to trap and destroy invading pathogens that enter the airway during inhalation. Pharyngitis (fă-RĬN-JĪ-tĭs) is inflammation of the pharynx. Tonsillitis (tŏn-sĭl-Ī-tĭs) refers to inflammation of the tonsils. Adenoiditis (ad-ĕ-noyd-ĪT-is) refers to inflammation of the adenoids, a common medical condition in young children that can hinder speaking and breathing.[4]

The soft palate and a bulbous structure called the uvula swing upward during swallowing to close off the nasopharynx to prevent ingested materials from entering the nasal cavity. Eustachian tubes connect the middle ear cavities with the nasopharynx. This connection is why colds can sometimes cause ear infections in children.[5]

The oropharynx is bordered superiorly by the nasopharynx and anteriorly by the oral cavity. The oropharynx contains two distinct sets of tonsils called the palatine tonsils and lingual tonsils that also trap and destroy pathogens entering the body through the oral or nasal cavities.[6]

The laryngopharynx is located just below the oropharynx. It is the part of the pharynx (throat) located behind (posterior) the larynx. The laryngopharynx separates into the trachea (the tube going to the larynx) and the esophagus (the tube going into the stomach). The epiglottis prevents food and fluid and food from entering the trachea while swallowing.[7]

Larynx

The structure of the larynx (LĀR-ĭngks) is formed by several pieces of cartilage, as shown in Figure 4.4.[8] Three large cartilage pieces form the major structure of the larynx called thyroid cartilage (the larger piece of cartilage on the anterior side), epiglottis (at the top of the larynx), and cricoid cartilage (just inferior to the thyroid cartilage). Laryngitis (lă-rĭn-JĪ-tĭs) refers to inflammation of the larynx, specifically the vocal folds or cords, resulting in huskiness or loss of one’s voice and a cough.[9]

The epiglottis (ĕ-pĭ-GLŎT-ĭs) is a flap of tissue that covers the trachea during swallowing to prevent aspiration (ăs-pĭ-RĀ-shŭn), the inhalation of food or fluids into the trachea and lower respiratory tract. The act of swallowing causes the pharynx and larynx to lift upward, allowing the pharynx to expand and the epiglottis of the larynx to swing downward, closing the opening to the trachea.[10]

Vocal cords are white, membranous folds attached by muscle to the cartilages of the larynx on their outer edges. The inner edges of the vocal cords are free, allowing oscillation as air passes through to produce sound for speaking. See Figure 4.5[11] for an illustration of vocal cords. The word root phon refers to sound or voice, so the medical term dysphonia (dis-FŌ-nē-ă) refers to the medical condition of difficulty speaking (i.e., voice).[12]

Figure 4.5

Figure 4.5

Vocal Cords

The lower respiratory tract consists of the trachea, bronchi, alveoli, and lungs.

The trachea (trā-KĒ-ă) is formed by stacked, C-shaped pieces of cartilage that are connected by dense connective tissue. See Figure 4.6[13] for an illustration of the trachea. The trachea stretches and expands slightly during inhalation and exhalation, whereas the rings of cartilage provide structural support and prevent the trachea from collapsing. The trachea is lined with cilia and mucus-secreting cells to trap debris and move it towards the pharynx to be swallowed or spit out.[14]

Figure 4.6

Figure 4.6

Trachea

If the upper respiratory tract becomes blocked with mucus, inflammation, or a foreign object, no air can pass to the lungs, causing a life-threatening emergency. A tracheostomy (trā-kē-ŎS-tō-mē) is an incision created in the trachea to create an artificial opening to allow breathing when an obstruction is present.

Bronchi and Bronchioles

Bronchi (brŏng-kī) are the main air passageways of the lungs. The trachea branches into the right and left primary bronchi at the carina. The carina is a raised structure that contains specialized nervous system tissue that induces violent coughing if a foreign body, such as food, is present. Rings of cartilage, similar to those of the trachea, support the structure of the bronchi and prevent their collapse. The bronchi of each lung continue to branch up to 26 times creating the bronchial tree, which looks similar to the branching of an actual tree.[15]

Bronchioles (brŏng-kē-ŏlz) are the smallest branches of the bronchi that lead to the alveolar sacs. See Figure 4.7[16] for an illustration of the terminal (very last) bronchioles leading to the alveolar sacs. The muscular walls of these tiny bronchioles do not contain cartilage like those of the bronchi, so the muscular wall can change the size of the bronchia to increase or decrease airflow to the alveoli.[17]

Figure 4.7

Figure 4.7

Alveoli

The word root bronch refers to the bronchi. Bronchospasm (brŏng-kō-spăz-ăm) is a symptom of many respiratory conditions that refers to a sudden constriction of the muscles in the walls of the bronchi. Bronchitis (brŏng-KĪ-tĭs) refers to inflammation of the bronchi. Bronchoscopy (brŏng-KŎS-kŏ-pē) is a procedure in which a tube is inserted by a medical specialist to visually examine the bronchi.[18]

The trachea, bronchi, and bronchioles are lined with mucous membranes that create mucous secretions that can be expelled through the mouth, also referred to as sputum (SPŪT-ŭm).

Alveoli

Alveoli (ăl-VĒ-ŏ-lī) are small, grapelike sacs where gas exchange occurs. Alveoli have elastic walls that allow the alveolus to stretch during air intake, which greatly increases the surface area available for gas exchange. Alveoli secrete surfactant (SŬR-făk-tănt), a slippery substance that prevents the lungs from collapsing. Atelectasis (ă-tĕ-lĕk-TĀ-sĭs) is a medical term that refers to the collapse of alveoli and/or small passageways of the lungs that can result in a partially or completely collapsed lung.[19]

Alveol is the root word for alveolus, the singular form of alveoli. For example, the medical term alveolar (ăl-VĒ-ŏ-lăr) means pertaining to the alveolus. [footnote]This work is a derivative of Anatomy and Physiology by OpenStax licensed under CC BY 4.0. Access for free at https://openstax.org/books/anatomy-and-physiology/pages/1-introduction[/footnote]

Lungs

The lungs (lŭngz) are connected to the trachea by the main (primary) bronchi that branches to the right and left bronchi. See Figure 4.8[20] for an illustration of the lungs. On the inferior surface, the lungs are bordered by the diaphragm. The cardiac notch, a medial indentation found only on the left lung, allows space for the heart. The apex of the lung is the superior region, whereas the base is the distal region near the diaphragm.[21]

Each lung is composed of smaller units called lobes (lōbz). The right lung consists of three lobes: the superior, middle, and inferior lobes. The left lung is smaller and only contains two lobes, superior and inferior, as it shares space with the heart. Each lobe receives its own large bronchus that has multiple branches. A lobectomy (lō-BĔK-tŭ-mē) refers to surgical removal of a lobe of the lung.[22]

The word roots for lungs and/or air are pneum or pneumon. For example, the medical term pneumonia (noo-MŌN-yă) refers to a diseased state of the lung.[23]

There are two pleural membranes in the lungs. The visceral pleura is a thin membrane on the surface of the lungs. The parietal pleural lines the inside of the thoracic cavity. Between these two membranes is the pleural cavity that contains pleural fluid to reduce friction and also sticks to the lungs to keep them inflated. See Figure 4.9[24] for an illustration of the pleural membranes and the pleural cavity. Pleur is the word root for pleural membranes. For example, pleural effusion (PLOOR-ăl ĕ-FŪ-zhŭn) is a medical term that refers to excessive fluid between the pleural membranes caused by disease or trauma.[25]

Figure 4.9

Figure 4.9

Pleural Cavity

View the following YouTube video[26] to visually review the anatomy of the respiratory system: Respiratory System Anatomy (v2.0)

References

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“2305​_Divisions_of_the_Pharynx.jpg” by OpenStax College is licensed under CC BY 3.0 ↵.
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“2306_The_Larynx​.jpg” by OpenStax College is licensed under CC BY 3.0 ↵.
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“2307​_Cartilages_of_the_Larynx.jpg” by OpenStax College is licensed under CC BY 3.0 ↵.
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“2308a_The_Trachea​.jpg” by OpenStax Anatomy and Physiology is licensed under CC BY 4.0 ↵.
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“2309​_The_Respiratory_Zone.jpg” by OpenStax College is licensed under CC BY 3.0 ↵.
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“2312​_Gross_Anatomy_of_the_Lungs.jpg” by OpenStax College is licensed under CC BY 3.0 ↵.
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“2313​_The_Lung_Pleurea.jpg” by OpenStax College is licensed under CC BY 3.0 ↵.
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Forciea, B. (2015, May 13). Respiratory system anatomy (v2.0) [Video]. YouTube. All rights reserved. Video used with permission. https://youtu​.be/aqTwrdMS6CE ↵.

4.5. Physiology of the Respiratory System

The main function of the respiratory system is gas exchange (găs ĭk-SCHĀNJ), meaning providing a constant supply of oxygen to the body and removing carbon dioxide. To achieve gas exchange, the structures of the respiratory system create the mechanical movement of air into and out of the lungs called ventilation (vĕn-tĭ-LĀ-shŭn) (i.e., breathing).[1]

Ventilation and the Mechanics of Breathing

The lungs bring oxygen to the cells of our body through inhalation. Inhalation (i-hā-LĀ-shŭn), also called inspiration, is the act of breathing in. During inhalation, the diaphragm contracts and flattens, creating a larger lung cavity, which decreases the pressure in the lungs. At the same, the intercostal muscles (the muscles between the ribs) pull downward, also causing the thoracic cavity to expand. The thoracic cavity (thuh-RAS-ik KA-vah-tee) is the space inside the chest that contains the heart, lungs, and other organs. As the thoracic cavity expands, a negative pressure (i.e., vacuum) is created inside the chest cavity, causing air to rush into the lungs (because air always moves from high pressure to low pressure).

During exhalation (ĕks-hā-LĀ-shŭn), also called expiration, the act of breathing out, the diaphragm relaxes and the thoracic cavity springs back to its original position. This causes the volume of the thoracic cavity to decrease and pressure to increase, causing air to leave the lungs.[2] See Figure 4.10[3] for an illustration of inhalation and exhalation.

Figure 4.10

Figure 4.10

Inhalation and Exhalation

Health care professionals use an instrument called a stethoscope (STETH-ŏ-skōp) to listen to internal body sounds like lung sounds. Lung sounds are caused by the movement of air from the trachea to the bronchioles to the alveoli and can be impacted by the presence of sputum, bronchoconstriction, or fluid in the alveoli. These sounds are referred to as rhonchi (coarse crackles), rales (fine crackles), wheezes, stridor, and pleural rub[4]:

  • Rhonchi (rŏng-kahy), also referred to as coarse crackles, are low-pitched, continuous sounds heard on expiration that are a sign of turbulent airflow through mucus in the large airways.
  • Rales (rāylz), also called fine crackles, are popping or crackling sounds heard on inspiration. They are associated with medical conditions, such as heart failure or pneumonia, that cause fluid accumulation within the alveolar and interstitial spaces. The sound is similar to that produced by rubbing strands of hair together close to your ear.
  • Wheezes (wēz-ĕz) are whistling noises produced when air is forced through airways narrowed by bronchoconstriction or mucosal edema. For example, patients with asthma commonly have wheezing.
  • Stridor (strī-door) is heard only on inspiration. It is associated with obstruction of the trachea/upper airway.
  • Pleural rub (plur-uhl ruhb) sounds like the rubbing together of leather and can be heard on inspiration and expiration. It is caused by inflammation of the pleura membranes that results in friction as the surfaces rub against each other.

View the following YouTube video[5] to review the mechanics of breathing: Mechanics of Breathing AIDA Freediving

Forced breathing, also known as hyperpnea (hī-pĕrp-NĒ-ă), is a type of breathing that can occur during exercise or actions that require the active manipulation of breathing, such as singing. During forced breathing, muscle contractions of accessory muscles, in addition to the diaphragm, are used for inspiration and expiration. These additional muscle contractions during inspiration also occur during labored breathing (LĀ-bŏrd BRĒ-thĭng), a symptom of many respiratory disorders.[6]

The word root pnea refers to breathe. Therefore, tachypnea (tak-ip-NĒ-ă) refers to rapid breathing, bradypnea (brăd-ĬP-nē-ă) refers to slow breathing, hypopnea (hī-POP-ne-ă) refers to deficient breathing, and apnea (AP-nē-ă) refers to the absence of breathing. Dyspnea (disp-NĒ-ă) is a common symptom of respiratory disorders and refers to difficulty breathing.

Control of Breathing

Respiratory rate (RES-pĭr-ă-tō-rē rāt) is the number of breaths taken per minute. The normal respiratory rate for adults is 12-20 breaths per minute. A child under 1 year of age has a normal respiratory rate between 30 and 60 breaths per minute. By the time a child is about 10 years old, the normal rate is closer to 18 to 30. Respiratory rate can be an important indicator of a respiratory disorder because the rate may increase or decrease during illness or disease.[7]

The respiratory rate is controlled by the respiratory center located within the medulla oblongata and the pons in the brain stem, which responds primarily to changes in carbon dioxide, oxygen, and pH levels in the blood. These changes are sensed by central chemoreceptors, which are located in the brain, and peripheral chemoreceptors, which are located in the aortic arch and carotid arteries. The major factor that drives breathing is surprisingly not hypoxemia (hī-pŏk-SĒ-mē-ă), low levels of oxygen in the blood, rather the concentration of carbon dioxide. Carbon dioxide is a waste product of cellular respiration and is toxic at high levels in the blood, referred to as hypercapnia (hī-pĕr-KAP-nē-ă). As carbon dioxide levels in the blood increase, the central chemoreceptors stimulate the contraction of the diaphragm and intercostal muscles (i.e., the muscles between the ribs), and the rate and depth of respiration increase to help rid the body of carbon dioxide. Hyperventilation (hī-pĕr-vĕn-tĭ-LĀ-shŭn) refers to rapid and deep breathing. In contrast, low levels of carbon dioxide in the blood stimulate shallow, slow breathing to help the body retain carbon dioxide. Hypoventilation (hī-pō-vĕn-tĭ-LĀ-shŭn) refers to slow and shallow breathing.[8]

Gas Exchange

Ventilation (i.e., the mechanics of breathing) provides air to the alveoli in the lungs for gas exchange. Respiration (rĕs-pĭ-RĀ-shŏn) refers to the exchange of gases in the lungs between the alveoli and the pulmonary capillaries or in the tissues between the systemic capillaries and cells/tissues.[9]

Gas exchange refers to the exchange of oxygen and carbon dioxide through capillary walls of the alveoli and the pulmonary capillaries, called external respiration. During external respiration, oxygen from the air we breathe diffuses into the blood. Carbon dioxide (waste) diffuses out of the blood and into the alveoli where it can be exhaled. Throughout the rest of the body, gas exchange also occurs between the systemic capillaries and body cells/tissues, called internal respiration. During internal respiration, oxygen diffuses out of the systemic capillaries and into the surrounding cells and tissues, and carbon dioxide diffuses from the cells/tissues into the systemic capillaries where it is carried to the lungs. It is through this process that cells in the body are oxygenated and carbon dioxide, the waste product of cellular respiration, is removed from the body.[10]

Asphyxia (ăs-FIK-sē-ă) refers to deprivation of oxygen to the tissues, commonly referred to as suffocation.

Perfusion

In addition to adequate ventilation, the second important aspect of gas exchange is perfusion. Perfusion (pĕr-FYŪ-zhŭn) refers to the flow of blood. In the lungs, perfusion occurs in the pulmonary circulation (PŬL-mŭ-năr-ē sĕr-kyŏŏ-LĀ-shŭn), as it moves from the heart to the lungs and then back to the heart for distribution to the body. The pulmonary arteries (PŬL-mō-nĕ-rē ăr-tĕ-rēs) carry deoxygenated blood from the heart into the lungs, where they branch and eventually become the capillary network composed of pulmonary capillaries. These pulmonary capillaries create the respiratory membrane with the alveoli. As the blood is pumped through this capillary network, gas exchange occurs.[11]

Although a small amount of the oxygen is able to dissolve directly into the blood from the alveoli, most of the oxygen binds to hemoglobin (HĒ-mō-glō-bĭn) within red blood cells (erythrocytes). The more oxygen the hemoglobin in red blood cells carry, the brighter red the color of the blood. Oxygenated blood returns to the heart through the pulmonary veins to the left atrium and ventricle, where it is pumped out to the body via the aorta. The hemoglobin on the red blood cells transports the oxygen to the tissues throughout the body.[12]

Hypoxia

Diseases and disorders affecting the respiratory system can cause hypoxia (hī-PŎK-sē-ă), low levels of oxygen in the tissues. A patient’s oxygenation status is routinely assessed by health care professionals using pulse oximetry. Pulse oximetry (pŭls ŏk-SĬM-ĭ-trē) is an estimated oxygenation level based on the saturation of hemoglobin measured by a pulse oximeter. Because the majority of oxygen carried in the blood is attached to hemoglobin within the red blood cells, pulse oximetry estimates how much hemoglobin is “saturated” with oxygen. The normal range for pulse oximetry is 94-100%.[13]

Hypoxia can occur due to inadequate ventilation or impaired perfusion. For example, a medical condition called pulmonary edema (PŬL-mō-nĕ-rē ĕ-DĒ-mă) refers to fluid accumulation in alveoli, often caused by heart failure or kidney failure. As a result of the fluid, oxygen cannot move across the alveolar membrane into the blood, and carbon dioxide cannot be removed from the blood. As a result, hypoxia and hypercapnia (high levels of carbon dioxide) may occur, requiring urgent medical interventions to sustain life by decreasing carbon dioxide levels and increasing oxygen levels.[14]

View supplementary YouTube videos for additional review of the respiratory system:

Respiratory System[15]
Overview of the Respiratory System, Animation[16]
Respiratory System, Part 1: Crash Course A&P #31[17]

References

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“2316​_Inspiration_and_Expiration.jpg” by OpenStax College is licensed under CC BY 3.0 ↵.
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This work is a derivative of Open RN Nursing Skills 2e by Chippewa Valley Technical College with CC BY 4.0 licensing. ↵.
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Chandra, S. (2017, November 1). Mechanics of breathing AIDA freediving [Video]. YouTube. All rights reserved. https://youtu​.be/baYZ_dgGIWw?si​=_Vwrlr9J8vNSZuwA ↵.
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Amoeba Sisters. (2022, February 28). Respiratory system [Video]. YouTube. All rights reserved. https://www​.youtube.com​/watch?v=v_j-LD2YEqg ↵.
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Alila Medical Media. (2019, April 15). Overview of the respiratory system, animation [Video]. YouTube. All rights reserved. https://youtu​.be/03qvN5pjCTU?si​=LJRgMq6RwLiUhcXF ↵.
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CrashCourse. (2015, August 24). Respiratory system, Part 1: Crash Course Anatomy & Physiology #31 [Video]. YouTube. All rights reserved. https://youtu.be/bHZsvBdUC2I ↵.

4.6. Diseases and Disorders of the Respiratory System

This section provides an overview of common respiratory disorders and diseases.

Allergies

Allergies (ĂL-ĕr-jēz) occur when a person’s immune system reacts to a substance and makes antibodies that identify that substance as harmful. Substances identified as allergens can cause inflammation of the skin, sinuses, nasal passages, airways, or digestive system. The severity of allergies varies from person to person and can range from minor irritation to a potentially life-threatening emergency called anaphylaxis (ăn-ă-fĭ-LĂK-sĭs). While most allergies can’t be cured, allergy medications can help relieve symptoms.[1]

There are many types of allergies. Allergic rhinitis, commonly referred to as “hay fever,” can cause sneezing; pruritus (PRŪ-rī-tŭs), itching of the skin, as well as itching of the nose, eyes, or roof of the mouth; rhinorrhea; and watery, red, or swollen eyes. A food allergy can cause tingling in the mouth; swelling of the lips, tongue, face, or throat; hives; and anaphylaxis. Read more information about anaphylaxis in the following subsection. An insect sting allergy can cause swelling at the sting site, itching or hives all over the body, cough, chest tightness, wheezing, shortness of breath, and anaphylaxis. A drug allergy can cause hives, pruritus, rash, swelling in the respiratory tract, and anaphylaxis.

Anaphylaxis

Severe allergies, including allergies to foods, insect stings, medications, and blood transfusions, can trigger a severe reaction known as anaphylaxis. As a life-threatening medical emergency, anaphylaxis can cause a patient to go into anaphylactic shock, a potentially fatal condition. Signs and symptoms of anaphylaxis are as follows[2]:

  • Loss of consciousness
  • Drop in blood pressure
  • Severe shortness of breath
  • Skin rash
  • Light-headedness
  • Rapid, weak pulse
  • Nausea and vomiting

Treatment of anaphylaxis often requires injection of a medication called epinephrine to rapidly reduce the body’s allergic response and restore adequate respiratory status.

Asthma

Asthma (AZ-muh) is a common chronic respiratory condition that can affect all age groups. Asthma is characterized by episodes of inflammation and edema of the airways and bronchospasms that prevent air from entering the lungs. Excessive mucus secretion can also occur, which further contributes to blockage of the airway and shortness of breath. Bronchospasms can lead to asthma attacks (ĂZ-mă ă-TĂKS) that can range from mild to severe and can be life-threatening. An asthma attack may be triggered by environmental factors such as dust, pollen, pet hair, or dander; changes in the weather; mold; tobacco smoke; respiratory infections; or by exercise and stress.[3] Between episodes of asthma attacks, many individuals with asthma are asymptomatic.

See Figure 4.11[4] for an illustration of how asthma affects the airways.

Figure 4.11

Figure 4.11

How Asthma Affects the Airways

Symptoms of an asthma attack involve coughing, dyspnea (shortness of breath), wheezing, and tightness of the chest. Severe asthma attacks can be fatal and require immediate medical attention. Symptoms of a severe asthma attack include worsening dyspnea that can cause cyanotic (sī-ă-NŎT-ĭk) or blue lips or fingertips, worsening wheezing, confusion, drowsiness, a rapid pulse, sweating, and severe anxiety.[5]

Chronic asthma is typically diagnosed by health care providers by using pulmonary function tests. Read more about pulmonary function tests in the “Medical Specialists, Diagnostic Testing, and Procedures Related to the Respiratory System” section of this chapter. Individuals with asthma are often prescribed a peak flow meter (pēk flō mē-tĕr), a portable instrument used to measure air flow during forced exhalation, to help manage their symptoms.

Asthma is treated by respiratory medications given via an inhaler and/or nebulizer (NEB-yŭ-lī-zĕr). A nebulizer is a medical device that creates a mist for delivering respiratory medication. Inhalers may be referred to as dry powder inhalers (DPI) or metered dose inhalers (MDI). The severity of the condition, frequency of attacks, and identified triggers influence the type of medication that an individual may require. Long-term treatments for patients with severe asthma include oral and/or injectable medications.[6] See Figures 4.12,[7] 4.13,[8] and 4.14[9] for images of an albuterol inhaler, respiratory medication used in a nebulizer, and a nebulizer.

Figure 4.12

Figure 4.12

Albuterol Inhaler

Figure 4.13

Figure 4.13

Medication Used in a Nebulizer

Figure 4.14

Figure 4.14

Nebulizer

View the following YouTube video[10] for additional information about asthma: How Does Asthma Work? – Christopher E. Gaw

Bronchitis

Bronchitis is an inflammation of the lining of the bronchial tubes, which carry air to and from the lungs. People who have bronchitis often cough up thickened mucus, which can be discolored. Bronchitis may be either acute or chronic.

Often developing from a cold or other respiratory infection, acute bronchitis is very common. Acute bronchitis, also called a chest cold, usually improves within a week to ten days without lasting effects, although the cough may linger for weeks.

Chronic bronchitis (KRŎN-ĭk brŏng-KĪ-tĭs), a more serious condition, is a constant irritation or inflammation of the lining of the bronchial tubes, often due to smoking. Chronic bronchitis is one of the conditions included in chronic obstructive pulmonary disease (COPD).[11] Read more about COPD in the following subsection.

Symptoms for either acute bronchitis or chronic bronchitis may include the following:

  • Cough
  • Production of mucus (sputum), which can be clear, white, yellowish-gray, or green in color — rarely, it may be streaked with blood
  • Fatigue
  • Shortness of breath
  • Slight fever and chills
  • Chest discomfort

Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (KRŎN-ĭk ŏb-STRŬK-tĭv PŬL-mō-nĕ-rē dĭ-ZĒZ) (COPD) is an inflammatory lung disease that causes obstructed airflow out of the lungs. COPD is a chronic condition with most symptoms appearing in people in their middle 50s. COPD is most often caused by smoking but can also be caused by long-term exposure to irritating gases or dust. People with COPD are at increased risk of developing heart disease, lung cancer, and a variety of other conditions.

Emphysema and chronic bronchitis are the two types of COPD that often occur together. Emphysema (ĕm-fŭ-SĒ-mă) is a disorder affecting the alveoli where they become abnormally inflated, damaging their walls and making it harder to breathe. Chronic bronchitis is inflammation of the lining of the bronchial tubes and characterized by chronic cough and mucus (sputum) production. See Figure 4.15 for an illustration of normal lungs compared to lungs with COPD.[12]

Figure 4.15

Figure 4.15

Normal Lungs Compared to Lungs in a Person With COPD

COPD symptoms often don’t appear until significant lung damage has occurred, and they usually worsen over time, particularly if smoke exposure continues. Common signs and symptoms of COPD include the following:

  • Dyspnea (shortness of breath), especially during physical activities
  • Wheezing (HWĒ-zĭng) (breathing with a whistling or rattling sound in the chest)
  • Chronic cough
  • Excessive sputum (mucus from the respiratory tract) that may be clear, white, yellow, or greenish
  • Frequent respiratory infections
  • Lack of energy
  • Barrel chest (enlarged, rounded chest)
  • Unintended weight loss (in later stages)

Signs and symptoms of COPD worsen during exacerbations (ĕg-ză-sĕr-BĀ-shŭns) or flare-ups and can result in hospitalization. Symptoms of COPD exacerbation may include worsening dyspnea, green or brown mucus, fever, cyanosis (sī-ă-NŌ-sĭs) or blue lips or fingers caused by lack of oxygenation of tissues, and increased fatigue.

COPD is diagnosed by health care providers using spirometry. Spirometry is further described in pulmonary function tests in the “Medical Specialists, Diagnostic Testing, and Procedures Related to the Respiratory System” section of this chapter.

COPD is progressive disease that is treatable but not curable. Shortness of breath may be controlled with a medication called a bronchodilator (brŏng-kō-dī-LĀ-tŭr), a drug that relaxes and expands the bronchi. The best way to avoid exacerbations is to avoid triggers, avoid people who are sick, get the annual flu shot, and reduce exposure to cigarette smoke and pollution.[13] The majority of cases of COPD are caused by cigarette smoking, and the best way to prevent COPD is to never smoke or stop smoking.[14]

The Effects of Second-Hand Tobacco Smoke

The burning of a tobacco cigarette creates multiple chemical compounds that are released through mainstream smoke, which is inhaled by the smoker, and through sidestream smoke, which is the smoke that is given off by the burning cigarette. Second-hand smoke, which is a combination of sidestream smoke and the mainstream smoke that is exhaled by the smoker, has been demonstrated by numerous scientific studies to cause disease. At least 40 chemicals in sidestream smoke have been identified that negatively impact human health, leading to the development of COPD, cancer, or other conditions, such as immune system dysfunction, liver toxicity, cardiac arrhythmias, pulmonary edema, and neurological dysfunction. Furthermore, second-hand smoke has been found to harbor at least 250 compounds that are known to be toxic, carcinogenic, or both. Some major classes of carcinogens in second-hand smoke are polyaromatic hydrocarbons (PAHs), N-nitrosamines, aromatic amines, formaldehyde, and acetaldehyde.

Tobacco and second-hand smoke are considered to be carcinogenic. Exposure to second-hand smoke can cause lung cancer in individuals who are not tobacco users themselves. It is estimated that the risk of developing lung cancer is increased by up to 30 percent in nonsmokers who live with an individual who smokes in the house, as compared to nonsmokers who are not regularly exposed to second-hand smoke. Children are especially affected by second-hand smoke. Children who live with an individual who smokes inside the home have a larger number of lower respiratory infections, which are associated with hospitalizations, and higher risk of sudden infant death syndrome (SIDS). Second-hand smoke in the home has also been linked to a greater number of ear infections in children, as well as worsening symptoms of asthma.[15]

Common Cold

The common cold, also known as an upper respiratory infection (URI) is a viral infection of the upper respiratory tract. Many types of viruses can cause a common cold. Children younger than six are at greatest risk of colds, but healthy adults can also expect to have two or three colds annually. Most people recover from a common cold within a week to ten days. Symptoms might last longer in people who smoke.

Symptoms of a common cold usually appear one to three days after exposure to a cold-causing virus. Signs and symptoms, which can vary from person to person, are as follows[16]:

  • Runny or stuffy nose
  • Sore throat
  • Cough
  • Congestion
  • Slight body aches or a mild headache
  • Sneezing
  • Low-grade fever
  • Generally feeling unwell (malaise)

Coronavirus (COVID-19)

Influenza and COVID-19 are both highly contagious respiratory illnesses, but they are caused by different viruses. COVID-19 is caused by infection with a coronavirus named SARS-CoV-2. You cannot tell the difference between the common cold, influenza, and COVID-19 by symptoms alone because all have similar symptoms. Individuals with symptoms should get tested for both influenza and COVID-19 and take appropriate precautions to prevent the spread of infection.[17]

To read current information about COVID-19 symptoms and treatment, go to the Centers for Disease Control and Prevention (CDC) website on COVID-19.

Cystic Fibrosis

Cystic fibrosis (SĬS-tĭk fī-BRŌ-sĭs) is a genetic disease that causes problems with breathing and digestion. People with cystic fibrosis have thick, sticky mucus that builds up in the lungs and digestive tract and other areas of the body. This excessive mucus blocks airways, traps germs, makes respiratory infections more likely, and leads to lung damage. It also affects the pancreas, with the increased secretions preventing digestive enzymes from reaching the intestines, which decreases the body’s ability to absorb nutrients from food.[18]

Influenza

Influenza (in-floo-EN-ză), commonly referred to as the “flu,” is a highly contagious viral infection affecting the respiratory tract. Symptoms of influenza include fever, cough, sore throat, rhinorrhea (runny nose), muscle aches, headache, and fatigue (severe tiredness). Most people who get influenza will recover in less than two weeks, but some people develop complications (such as pneumonia) that can be life-threatening. Anyone can get influenza, even healthy people, and serious problems related to the flu can happen to anyone at any age, but some people are at higher risk of developing serious flu-related complications if they get sick. This includes people 65 years and older, people of any age with certain chronic medical conditions (such as asthma, diabetes, or heart disease), pregnant women, and children younger than five years old. Everyone aged six months and older should get an annual flu vaccine, ideally by the end of October, to prevent influenza and its potential complications.[19]

Lung Cancer

Cancer (KĂN-sŏr) is a disease in which cells in the body grow out of control. When cancer begins in the lungs, it is called lung cancer (lŭng KĂN-sŏr), although it may spread to lymph nodes or other organs in the body, such as the brain. Cancer from other organs also may spread to the lungs. When cancer cells spread from one organ to another, they are called metastases (mĕ-TĂS-tă-sēz).[20]

Cigarette smoking is the number one risk factor for lung cancer. In the United States, cigarette smoking is linked to about 80% to 90% of lung cancer deaths. People who quit smoking at any age have a lower risk of lung cancer than if they had continued to smoke, but their risk is higher than the risk for people who never smoked.[21]

After smoking, radon is the second leading cause of lung cancer in the United States. Radon is a naturally occurring gas that forms in rocks, soil, and water. It cannot be seen, tasted, or smelled. When radon gets into homes or buildings through cracks or holes, it can get trapped and build up in the air inside. People who live or work in these homes and buildings breathe in high radon levels. Over long periods of time, radon can cause lung cancer.[22]

Most people with lung cancer don’t have symptoms until the cancer is advanced and has metastasized. Lung cancer symptoms may include the following[23]:

  • Coughing that gets worse or doesn’t go away
  • Chest pain
  • Shortness of breath
  • Wheezing
  • Hemoptysis (hē-MŎP-tĭ-sĭs) (coughing up blood)
  • Fatigue (feeling very tired all the time)
  • Weight loss with no known cause
  • Repeated episodes of pneumonia
  • Swollen or enlarged lymph nodes inside the chest in the area between the lungs

Lung cancer may initially be suspected after routine tests like chest X-rays (chĕst ĕks-rās), also referred to as radiographs (RĀ-dē-ŏ-grăfs). Additional diagnostic testing is performed if lung cancer is suspected. Read more about diagnostic tests in the “Medical Specialists, Diagnostic Testing, and Procedures Related to the Respiratory System” section of this chapter.

Treatments for lung cancer may include surgery, chemotherapy, targeted therapy, immunotherapy, and radiation therapy.

Obstructive Sleep Apnea

Obstructive sleep apnea (ŏb-STRŬK-tĭv slēp ăp-NĒ-ă) is a chronic disorder that can occur in children and adults. It is characterized by periods of no breathing during sleep. These episodes may last for several seconds or several minutes and may differ in the frequency with which they are experienced. Sleep apnea leads to poor sleep. Symptoms of sleep apnea include fatigue, evening napping, irritability, memory problems, morning headaches, and excessive snoring. A diagnosis of sleep apnea is usually done during a sleep study, where the patient is monitored in a sleep laboratory or with home testing. Treatment of sleep apnea commonly includes the use of a device called a continuous positive airway pressure device (kŏn-TĬN-yū-ŭs POZ-ĭ-tĭv AIR-wā PRESS-ŭr dĭ-VĪS) (CPAP) during sleep. The CPAP machine has a mask that covers the nose, or the nose and mouth, and forces air into the airway at regular intervals. This pressurized air can help to gently force the airway to remain open, allowing for more normal ventilation to occur.[24] Read more about a CPAP device in the “Medical Specialists, Diagnostic Testing, and Procedures Related to the Respiratory System” section. See Figure 4.16[25] for an illustration of obstructive sleep apnea. As soft tissue falls to the back of the throat, it impedes the passage of air (blue arrows) through the trachea and is characterized by repeated episodes of complete or partial obstructions of the upper airway during sleep.

Figure 4.16

Figure 4.16

Obstructive Sleep Apnea

Pneumonia

Pneumonia is an infection of the alveoli of the lungs caused by microorganisms like bacteria, viruses, or fungi that can cause mild to severe illness in people of all ages.

Symptoms of pneumonia are as follows[26]:

  • Cough, which may produce greenish or yellow mucus (often called purulent sputum)
  • Fever and shaking chills
  • Dyspnea (shortness of breath)
  • Rapid, shallow breathing
  • Sharp or stabbing chest pain that gets worse when breathing deeply or coughing
  • Loss of appetite, low energy, and fatigue

See Figure 4.17[27] for an image of purulent sputum.

Figure 4.17

Figure 4.17

Purulent Sputum

Common diagnostic tests for pneumonia include sputum cultures and chest X-rays. Read more about these diagnostic tests in the “Medical Specialists, Diagnostic Testing, and Procedures Related to the Respiratory System” section of this chapter.

There are several categories of pneumonia that are treated with different types of antibiotics[28]:

  • Aspiration pneumonia: Pneumonia that occurs when food or liquid is breathed into the airways or lungs, instead of being swallowed.
  • Community-acquired pneumonia: Pneumonia that is diagnosed in someone in the community (not in a hospital).
  • Healthcare-associated pneumonia: Pneumonia that is diagnosed in someone during or following a stay in a health care setting.
  • Ventilator-associated pneumonia: Pneumonia that is diagnosed in someone who has been on a ventilator.

Incentive Spirometry

Patients who have undergone surgery are at risk for developing atelectasis and pneumonia. Atelectasis means the alveoli have become deflated, which can cause a partial or complete collapsed lung and/or lead to pneumonia. An incentive spirometer is a medical device often prescribed as a preventative measure after surgery or for patients with atelectasis. While sitting upright, the patient should breathe in slowly and deeply through the tubing with the goal of raising the piston to a specified level. See Figure 4.18[29] for an image of a patient using an incentive spirometer. The patient should attempt to hold their breath for five seconds, or as long as tolerated, and then rest for a few seconds. This technique should be repeated by the patient ten times every hour while awake.[16]

Figure 4.18

Figure 4.18

Using an Incentive Spirometer

Pulmonary Edema

Pulmonary edema is the accumulation of fluid in the alveoli causing decreased gas exchange, resulting in increased levels of carbon dioxide and decreased levels of oxygen in the blood. Pulmonary edema can be caused by several medical conditions, such as pneumonia, heart failure, kidney failure, and liver failure. It is treated with medications that help eliminate excess fluid from the body, called diuretics.

Pulmonary Embolism

A pulmonary embolism (PULL-muh-nair-ee EM-boh-liz-uhm) (PE) is a blood clot or other substance, such as fat or an air bubble, that has traveled through the bloodstream and lodged in a smaller vessel within the pulmonary circulation in the lungs and obstructed blood flow. This blockage causes lack of oxygen delivery to the tissues supplied by that blood vessel. A PE is medical emergency that requires rapid treatment to prevent severe damage to the lungs or heart and death. Symptoms of a PE may include sudden, severe dyspnea; sharp pain in the chest or arm; and pale, clammy skin. Treatment includes medications to dissolve the clot or procedures to remove the clot in order to quickly restore adequate pulmonary circulation.[30]

Respiratory Syncytial Virus

Respiratory syncytial virus (rĕs-pĭ-RĂ-tōr-ē SĬN-sĭ-shē-ăl VĪ-rŭs) (RSV) is a very common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be very serious in infants and older adults. RSV is a common cause of pneumonia and bronchiolitis. Bronchiolitis (brŏng-kē-ŎL-ĭ-tĭs) refers to inflammation of the small airways in the lung. Older adults and infants younger than six months of age with RSV may require hospitalization if they have problems breathing or become dehydrated. Severe cases may require endotracheal intubation and mechanical ventilation.[31]

Tuberculosis

Tuberculosis (tū-bĕr-kyŭ-LŌ-sĭs) (TB) is a serious infectious disease that affects the lungs. It is caused by bacteria that can be spread through the air from person to person. Symptoms include a chronic cough, hemoptysis (hē-MŎP-tĭ-sĭs) or coughing up blood, weight loss, night sweats, and fever. Patients with TB require a long course of treatment involving multiple antibiotics.[32]

View a supplementary YouTube video[33] on tuberculosis: CDC Tuberculosis (TB) Tansmission and Pathogenesis Video

References

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4.
“Asthma​_attack-illustration_NIH.jpg” by United States-National Institute of Health: National Heart, Lung, Blood Institute is in the Public Domain ↵.
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“Albuterol 2.jpg” by Mark Oniffrey is licensed under CC BY SA 4.0 ↵.
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TED-Ed. (2017, May 11). How does asthma work? - Christopher E. Gaw [Video]. YouTube. https://youtu​.be/PzfLDi-sL3w ↵.
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Centers for Disease Control and Prevention. (2023, June 30). What is COPD? https://www​.cdc.gov/copd/index.html ↵.
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Centers for Disease Control and Prevention. (n.d.). COVID-19. https://www​.cdc.gov/coronavirus​/2019-ncov/ ↵.
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Centers for Disease Control and Prevention. (2022, May 9). Cystic fibrosis. https://www​.cdc.gov/genomics​/disease/cystic_fibrosis.htm ↵.
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Centers for Disease Control and Prevention. (2022, October 3). Flu symptoms & complications. https://www​.cdc.gov/flu​/symptoms/symptoms.htm ↵.
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Centers for Disease Control and Prevention. (2023, July 31). What is lung cancer? https://www​.cdc.gov/cancer​/lung/basic_info​/what-is-lung-cancer.htm ↵.
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Centers for Disease Control and Prevention. (2023, July 31). What is lung cancer? https://www​.cdc.gov/cancer​/lung/basic_info​/what-is-lung-cancer.htm ↵.
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Centers for Disease Control and Prevention. (2023, July 31). What are the risk factors for lung cancer? https://www​.cdc.gov/cancer​/lung/basic_info/risk_factors.htm ↵.
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Centers for Disease Control and Prevention. (2023, July 31). What are the symptoms of lung cancer? https://www​.cdc.gov/cancer​/lung/basic_info/symptoms.htm ↵.
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Slowik, J. M., Sankari, A., & Collen, J. F. (2022). Obstructive sleep apnea. [Updated 2022 Dec 11]. In: StatPearls [Internet]. https://www​.ncbi.nlm​.nih.gov/books/NBK459252/ ↵.
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American Lung Association. (2023, August 3). Pneumonia symptoms and diagnosis. https://www​.lung.org​/lung-health-diseases​/lung-disease-lookup​/pneumonia/symptoms-and-diagnosis ↵.
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“Sputum​.JPG” by Zhangmoon618 is licensed under CC0 ↵.
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Centers for Disease Control and Prevention. (2022, September 30). Causes of pneumonia. https://www​.cdc.gov/pneumonia/causes​.html ↵.
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Centers for Disease Control and Prevention. (2023). Respiratory syncytial virus. https://www​.cdc.gov/rsv/about/symptoms​.html ↵.
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Centers for Disease Control and Prevention. (2023). Tuberculosis. https://www​.cdc.gov/tb/default.htm ↵.
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Centers for Disease Control and Prevention. (2020, May 6). CDC tuberculosis (TB) transmission and pathogenesis video [Video]. YouTube. All rights reserved. https://youtube​.com/watch?v=UKV8Zn7x0wM ↵.

4.7. Medical Specialists, Diagnostic Testing, and Procedures Related to the Respiratory System

Specialists

Pulmonologist

Respiratory medicine is concerned with the diagnosis and treatment of diseases related to the respiratory system. Respiratory medicine requires in-depth knowledge of internal medicine. A physician who specializes in diagnosing and treating respiratory system disease is called a pulmonologist (pŭl-mŏn-ŎL-ŏ-jĭst).[1]

Respiratory Therapist

Respiratory therapists (rĕ-spĭr-ă-tōr-ē THĔR-ă-pĭsts) (RTs) are health care professionals that monitor, assess, and treat people who are having problems breathing. RTs are licensed in the state in which they practice. RTs are trained in ventilation and airway management, cardiopulmonary resuscitation, and oxygen and aerosol therapy. They provide care for patients undergoing cardiac stress-testing, pulmonary function testing, smoking cessation, high-risk births, rehabilitation, and surgery. They also assist in treating patients with asthma, COPD, heart failure, and pneumonia.[2]

For more information, visit the American Association for Respiratory Care’s What is an RT? web page.

Thoracic Surgeon

A thoracic surgeon (thō-RĂS-ĭk SŬR-jŏn) refers to a surgeon who has specialized in either thoracic (chest) surgery or cardiothoracic (heart and chest) surgery. They perform surgery for patients with serious conditions of the heart, lungs, and other structures in the chest cavity.[3]

To learn more about thoracic surgeons, visit WebMD’s What is a Thoracic Surgeon? web page.

Diagnostic Testing and Procedures

Arterial Blood Gas

Arterial blood gas (ar-TĬR-ē-ăl blŭd găs) (ABG) is a measurement of dissolved oxygen and carbon dioxide levels in blood taken from an artery. ABG is often obtained for patients who have deteriorating or unstable respiratory status requiring urgent and/or emergency treatment. An ABG is typically drawn in the forearm from the radial artery by a respiratory therapist, emergency or critical care nurse, or other health care provider.

Bronchoscopy

A bronchoscopy (bron-KOS-kŏ-pē) is a procedure used to visualize the bronchi with a bronchoscope (BRŎNG-kŏ-skōp), a thin, flexible tube with a light and a lens or small video camera on the end. The tube is inserted into the patient’s nose or mouth, down the throat, into the trachea (windpipe), and into the airways (bronchi and bronchioles) of the lungs. It is typically performed by a physician. See Figure 4.19[4] for an image of a bronchoscopy.

Figure 4.19

Figure 4.19

Bronchoscopy

A bronchoscopy is performed to look for the causes of problems in the airways of the lungs or to further examine an abnormal area seen on an imaging test (such as a chest X-ray or CT scan).[5] Any abnormal areas in the airways that are seen with the bronchoscope can be biopsied to determine the cause of the abnormal finding. A biopsy is performed by passing long, thin instruments down the bronchoscope, such as small forceps (tweezers), needles, or brushes to collect the samples. Sterile salt water can also be flushed down the bronchoscope to rinse the airways and then suctioned up, which is referred to as a bronchial washing (BRŎNG-kē-ăl WŎSH-ing). The biopsy samples are visually examined under a microscope in a pathology lab.[6]

Chest X-Ray

As discussed earlier, a chest x-ray (CXR) is also referred to as a radiograph. Using a controlled beam of radiation, a CXR produces shadow-like images of organs and tissues like the bones, lungs, heart, and the diaphragm. After passing through the body, the beam hits a piece of film or a special detector. Tissues in the body absorb or block the radiation to varying degrees. Dense tissues, such as bones, block most radiation and appear white on the CXR. Soft tissues, like fat or muscle, block less radiation and show up in shades of gray. Organs that are mostly air (such as the lungs) appear black. Tumors are usually denser than the tissue around them, so they often show up as lighter shades of gray.[7] See Figure 4.20[8] for an image of a CXR. A CXR is used to diagnose a variety of respiratory conditions, such as pneumonia, pulmonary edema, and cancer.

Figure 4.20

Figure 4.20

Chest X-ray

Computed Tomography (CT) Scan

A computed tomography scan (kŏm-PYŌŌ-tĕd tŏ-mŎG-ră-fē skăn) (CT) uses X-rays to make detailed cross-sectional images of a person’s body. Instead of taking one or two pictures like a regular X-ray, a CT scanner takes many pictures and then a computer combines them to create detailed images in slices of the part of the body being studied. See Figure 4.21[9] for an image of a CT scanner.

Figure 4.21

Figure 4.21

CT Scanner

A CT scan is more likely to show lung tumors than routine chest X-rays. It can also show the size, shape, and position of any lung tumor and can help visualize enlarged lymph nodes that might contain cancer that has spread. A CT scan can also be used to look for masses in the liver, brain, and other organs that can occur if the cancer has metastasized.[10]

If a suspected area of cancer is deep within the body, a CT scan can be used to guide a biopsy needle into this area to obtain a tissue sample to biopsy for cancer. This procedure is referred to as a CT-guided needle biopsy (sē-tē GĪ-dĕd NĒ-dŭl BĪ-ŏp-sē).[11] See Figure 4.22[12] for an image of a CT-guided needle biopsy of the lung.

Figure 4.22

Figure 4.22

CT-Guided Needle Biopsy

Endotracheal Intubation

When a patient is experiencing respiratory failure or receiving general anesthesia during surgery, an endotracheal tube (ĕn-dō-TRĀ-kē-ăl tūb) (ET tube) is inserted to maintain a patent airway by health care professionals with advanced training, such as a respiratory therapist, paramedic, anesthesiologist, or physician. The ET tube is sealed within the trachea with an inflatable cuff, and oxygen is supplied via a bag valve mask or via mechanical ventilation. See Figure 4.23[13] for an image of a cuffed endotracheal tube.

Figure 4.23

Figure 4.23

An Endotracheal Tube

Magnetic Resonance Imaging (MRI)

Similar to CT scans, magnetic resonance imaging (măg-NĔT-ĭk rĕz-ŏ-năns ĬM-ă-jing) (MRI) scans show detailed images of soft tissues in the body. However, MRI scans use radio waves and strong magnets instead of radiation. MRI scans are used to diagnose many medical conditions, such as soft tissue abnormalities, tears in ligaments, joint abnormalities, and tumors. They are also used to evaluate for metastasis of cancer to other areas of the body, such as the brain, liver, lungs, and bones.[14]

Mechanical Ventilation

A mechanical ventilator (mĕ-kăn-Ĭ-kăl vĕn-tĬ-lā-tŏr) is a machine attached to an endotracheal tube to assist or replace spontaneous breathing. Mechanical ventilation is termed invasive because it requires placement of an endotracheal tube in the trachea. Mechanical ventilators are typically managed by respiratory therapists. See Figure 4.24[15] for an image of a simulated patient who is intubated with an endotracheal tube that is attached to a mechanical ventilator.

Figure 4.24

Figure 4.24

Simulated Intubated Patient on a Mechanical Ventilator

Needle Biopsy

During a needle biopsy (NĒ-dŭl BĪ-ŏp-sē), doctors use a needle to obtain a small sample of cells from a suspicious area (mass) to examine under a microscope. An advantage of needle biopsies is that they don’t require a surgical incision. There are a variety of types of needle biopsies. One type of needle biopsy is a fine needle aspiration biopsy (fīn NĒ-dŭl ăs-pĭ-RĀ-shŭn BĪ-ŏp-sē) (FNA). During this procedure, a syringe with a very thin, needle is used to aspirate (ĂS-pĭ-rāt) or withdraw cells and small fragments of tissue. An FNA biopsy is often used to check for cancer in lymph nodes.[16]

Positron Emission Tomography Scan

During a positron emission tomography scan (pŏz-Ĭ-trŏn ĭ-MĬSH-ən tŏ-mŏG-ră-fē skăn) (PET), a slightly radioactive substance is injected into the patient’s blood. If cancer cells are present in the body, they have a higher uptake of this radioactive substance and appear as a highlighted area on the scan. Often a PET scan is combined with a CT scan so the highlighted areas on the PET scan can be easily visualized with the corresponding image on the CT scan. PET/CT scans are useful to determine if cancer has spread to other parts of the body.[17] See Figure 4.25[18] for an image of a PET/CT scan showing a red highlighted area of radioactive substance, indicating cancer cells have spread to this area of the body.

Figure 4.25

Figure 4.25

PET-CT Scan

Pulmonary Function Tests

Pulmonary function tests (PŬL-mŏ-nā-rē fŭnk-shŭn tĕsts) (PFTs) allow physicians and respiratory therapists to evaluate the respiratory function of patients with various types of lung disease. PFTs do not provide a specific diagnosis, but the results are combined with other assessment data to reach a diagnosis. PFTs also help determine the severity of pulmonary disease, assess the patient’s response to treatment, and monitor for possible disease progression over time.[19]

Spirometry (spī-RŎM-ĕ-trē) is a common PFT that measures the patient’s ability to inhale and exhale air relative to time using a device called a spirometer. Spirometry is used for diagnosis and therapeutic management of common respiratory disorders, such as asthma and chronic obstructive pulmonary disease (COPD). The primary measurements during spirometry testing are forced vital capacity (FVC), forced expiratory volume exhaled in the first second (FEV1), and the FEV1/FVC ratio. The spirometry procedure has three phases that include maximal inspiration, a “blast” of exhalation, and a complete exhalation.[20] View an illustration of spirometry in Figure 4.26.[21]

Figure 4.26

Figure 4.26

Spirometry

View the following YouTube video[22] for more information about spirometry: How To Do a Spirometry Test and Interpret the Results

Sputum Culture

A sputum culture (SPYŌŌ-tŭm KŬL-chŭr) is a diagnostic test that evaluates the type and number of bacteria present in mucus from the respiratory tract. The patient is asked to cough deeply and spit any mucus that comes up into a sterile specimen container. Care must be taken to ensure the specimen only contains mucus and not saliva. The sample is sent to a lab where it is placed in a special dish and examined for two to three days or longer to see if bacteria or other disease-causing pathogens grow. See Figure 4.27[23] for an image of a sputum culture.

Figure 4.27

Figure 4.27

Sputum Culture

Thoracentesis

If fluid has collected in the pleural space around the lungs (called a pleural effusion), health care providers perform a procedure called a thoracentesis (thor-uh-sen-TEE-sis) to remove the fluid. Pleural effusion is typically caused by a medical condition, such as pneumonia, heart failure, infection, or lung cancer.

During a thoracentesis, the patient’s skin is numbed, and a needle is inserted between the ribs to aspirate (i.e., suction) the fluid for examination in the lab. If recurrent pleural effusions cause the patient to have trouble breathing, thoracentesis may be repeated to remove additional fluid to help the patient breathe better.[24] See Figure 4.28[25] for an illustration of removal of fluid during a thoracentesis.

Figure 4.28

Figure 4.28

Thoracentesis

Tracheostomy

A tracheostomy (trā-kē-ŎS-tŏ-mē) is a surgically created opening, called a stoma, that goes from the front of the patient’s neck into the trachea. A tracheostomy tube is placed through the stoma into the trachea to maintain a patent (open) airway and to administer oxygen. A tracheostomy may be an emergent procedure performed due to an airway obstruction or a planned procedure to manage a disease process. See Figure 4.29[26] for an illustration of a patient with a tracheostomy tube in place.

Figure 4.29

Figure 4.29

Patient With Tracheostomy Tube

Respiratory Equipment

There are various types of medical devices related to the respiratory system.

Continuous Positive Airway Pressure (CPAP)

A continuous positive airway pressure device (kŏn-TĬN-yū-ŭs POZ-ĭ-tĭv AIR-wā PRESS-ŭr dĭ-VĪS) (CPAP) is used for people who are able to breathe spontaneously on their own but need help in keeping their airway unobstructed, such as those with obstructive sleep apnea. The CPAP device consists of a special mask that covers the patient’s nose, or nose and mouth, and is attached to a machine that continuously applies mild air pressure to keep the patient’s airways from collapsing. See Figure 4.30[27] for an illustration of a patient wearing a CPAP device while sleeping.

Figure 4.30

Figure 4.30

CPAP Machine

Bilevel Positive Airway Pressure (BiPAP)

A bilevel positive airway pressure (BĪ-lĕv-ĕl PŎZ-ĭ-tĭv ĀR-wā PRĔSH-ŭr) (BiPAP) device is similar to a CPAP device in that it is used to prevent airways from collapsing, but BiPAP devices have two pressure settings. One setting occurs during inhalation, and a lower pressure setting is used during exhalation. Patients using BiPAP devices in their home environment for obstructive sleep apnea often find these two pressures more tolerable because they don’t have to exhale against continuous pressure. In acute care settings, BiPAP devices are also used for patients in acute respiratory distress as a noninvasive alternative to intubation and mechanical ventilation and are managed by respiratory therapists. See Figure 4.31[28] for an image of a simulated patient wearing a BiPAP mask in a hospital setting.

Figure 4.31

Figure 4.31

Simulated Patient Wearing a BiPAP Mask

Nasal Cannula

A nasal cannula (NĀ-zăl KĂN-yū-lă) is the simplest and most commonly used oxygenation device. It consists of oxygen tubing connected to two short prongs that are inserted into the patient’s nares (nostrils). See Figure 4.32[29] for an image of a nasal cannula. Nasal cannulas are used for short- and long-term therapy and are best used with stable patients who require low amounts of oxygen, such as patients with COPD.

Figure 4.32

Figure 4.32

Nasal Cannula

Read more information about additional oxygenation devices such as a high-flow nasal cannula, non-rebreather mask, partial rebreather mask, Venturi mask, oxymask, and oxymizer in the “Oxygenation Equipment” section of the “Oxygen Therapy” chapter of Open RN Nursing Skills, 2e.

Pulse Oximeter

A pulse oximeter (pŭls ŏk-SĬM-ĭ-tŏr) is a commonly used portable device used to obtain a patient’s oxygen saturation level, often referred to as a pulse oximetry reading. The pulse oximeter analyzes light produced by the probe as it passes through the finger to determine the saturation level of hemoglobin with oxygen while also analyzing the pulse rate See Figure 4.33[30] for an image of a portable pulse oximeter. The normal range for a pulse oximetry reading for an adult without an underlying respiratory condition is 94-100%.

Figure 4.33

Figure 4.33

Portable Pulse Oximeter

References

1.
American Lung Association. (2019, May 14). Know your providers - What does a pulmonologist do? https://www​.lung.org​/blog/know-your-providers-pulmonologist ↵.
2.
American Association for Respiratory Care. (n.d.). What is an RT? https://www​.aarc.org​/careers/what-is-an-rt/ ↵.
3.
WebMD. (2023, July 8). What is a thoracic surgeon? https://www​.webmd.com​/a-to-z-guides/what-is-a-thoracic-surgeon ↵.
4.
5.
6.
7.
8.
“Chest Xray PA 3-8-2010.png” by Stillwaterising is licensed under CC0 ↵.
9.
10.
11.
12.
13.
“Sondeintubation​.jpg” by bigomar2 is licensed under CC BY-SA 3.0 ↵.
14.
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16.
17.
18.
“Anterior​_Pancoast_tumor_PET.jpg” by Soichi Oka, Kenji Ono, Kenta Kajiyam, and Katsuma Yoshimatsu is licensed under CC BY-SA 4.0 ↵. [PMC free article: PMC7058854] [PubMed: 32145568]
19.
This work is a derivative of StatPearls by Ponce, Sankari, & Sharma and is licensed under CC BY 4.0 ↵.
20.
This work is a derivative of StatPearls by Ponce, Sankari, & Sharma and is licensed under CC BY 4.0 ↵.
21.
22.
BMJ Learning. (2020, July 1). How to do a spirometry test and interpret the results [Video]. YouTube. All rights reserved. https://youtu​.be/jSkwBoed6Tw?si​=AQxyjWNULZLAgC2t ↵.
23.
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29.
“Image00011.jpg” by British Columbia Institute of Technology is licensed under CC BY 4.0. Access for free at https://opentextbc​.ca​/clinicalskills/chapter​/5-5-oxygen-therapy-systems/ ↵.
30.
“OxyWatch​_C20_Pulse_Oximeter.png” by Thinkpaul is licensed under CC BY-SA 3.0 ↵.

4.8. Respiratory System Learning Activities

Interactive Learning Activity: Label the anatomy of the respiratory system using this drag and drop activity.

Image ch4respiratory-Image002.jpg

Interactive Learning Activity: Study terms discussed in this chapter using these flashcards.

Image ch4respiratory-Image003.jpg

Interactive Learning Activity: Test your comprehension of respiratory system terms and concepts.

Image ch4respiratory-Image004.jpg

Interactive Learning Activity: Using the sample documentation provided, drag the terms on the right to their appropriate spaces within the documentation.

Image ch4respiratory-Image005.jpg

Interactive Learning Activity: Using the sample documentation provided, drag the terms on the right to their appropriate spaces within the documentation.

Image ch4respiratory-Image006.jpg

Interactive Learning Activity: Using the sample documentation provided, drag the terms on the right to their appropriate spaces within the documentation.

Image ch4respiratory-Image007.jpg

Interactive Learning Activity: Practice identifying and defining word parts for terms discussed in this chapter:

Image ch4respiratory-Image008.jpg

You can also print this as a Chapter 4 Practice Worksheet and check your answers with this Answer Key PDF.

4.9. Glossary

Adenoid (ĂD-ĕ-noyd)

Lymphatic tissue between the back of the nasal cavity and the pharynx. (Chapter 4.4)

Adenoiditis (ad-ĕ-noyd-ĪT-is)

Inflammation of the adenoids. (Chapter 4.4)

Allergies (ĂL-ĕr-jēz)

A condition in which the immune system reacts abnormally to a foreign substance. (Chapter 4.6)

Alveolar (ăl-VĒ-ŏ-lăr)

Pertaining to the alveoli, the small air sacs in the lungs responsible for gas exchange​​. (Chapter 4.4)

Alveoli (ăl-VĒ-ō-lī)

Tiny air sacs in the lungs where the exchange of oxygen and carbon dioxide takes place. (Chapter 4.4)

Anaphylaxis (ăn-ă-fĭ-LĂK-sĭs)

A severe, potentially life-threatening allergic reaction. (Chapter 4.6)

Apnea (ĂP-nē-ă)

Absence of breathing. (Chapter 4.5)

Arterial blood gas (ar-TĬR-ē-ăl blŭd găs)

A test that measures the amounts of oxygen and carbon dioxide in the blood from an artery. It is used to check how well the lungs are able to move oxygen into the blood and remove carbon dioxide from the blood. (Chapter 4.7)

Asphyxia (ăs-FĬK-sē-ă)

A condition arising when the body is deprived of oxygen, causing unconsciousness or death; suffocation. (Chapter 4.5)

Aspirate (ĂS-pĭ-rāt)

To draw in or out using a sucking motion, typically refers to the process of drawing fluid or tissue samples from the body. (Chapter 4.7)

Aspiration (ăs-pĭ-RĀ-shŭn)

The inhalation of food, liquid, or other material into the respiratory tract. (Chapter 4.4)

Asthma (ĂZ-mă)

A condition in which a person’s airways become inflamed, narrow, and swell, producing extra mucus, which makes it difficult to breathe. (Chapter 4.6)

Asthma attacks (ĂZ-mă ă-TĂKS)

Episodes of severe asthma symptoms, such as coughing, wheezing, and shortness of breath. (Chapter 4.6)

Atelectasis (ăt-ĕ-lĔK-tă-sĭs)

The collapse of part or all of a lung, often caused by a blockage of the air passages or by pressure on the outside of the lung. (Chapter 4.4)

Bilevel positive airway pressure (BĪ-lĕv-ĕl PŎZ-ĭ-tĭv ĀR-wā PRĔSH-ŭr) (BiPAP)

A form of noninvasive ventilation that provides two levels of air pressure, one for inhalation and a lower one for exhalation, used in the treatment of sleep apnea and other respiratory problems. (Chapter 4.7)

Bradypnea (brăd-ĬP-nē-ă)

Abnormally slow breathing. (Chapter 4.5)

Bronchi (BRŎNG-kī)

The main passageways into the lungs. (Chapter 4.4)

Bronchial washing (BRŎNG-kē-ăl WŎSH-ing)

A procedure during bronchoscopy where saline is squirted into a part of the lung and then recollected for examination. It’s used to collect cells from the bronchial tubes. (Chapter 4.7)

Bronchioles (BRŎNG-kē-ōlz)

Small branches of the bronchi that lead to the alveoli in the lungs. (Chapter 4.4)

Bronchiolitis (brŏng-kē-ŎL-ĭ-tĭs)

An inflammation of the small airways in the lungs, known as bronchioles, usually due to a viral infection. It is most common in infants and young children, particularly during the winter months, and can cause symptoms like wheezing, coughing, and difficulty breathing. (Chapter 4.6)

Bronchitis (brŏng-KĪ-tĭs)

Inflammation of the bronchial tubes, often resulting from infection or environmental factors like smoking. (Chapter 4.4)

Bronchodilator (brŏng-kō-DĪ-lā-tŏr)

A drug that relaxes bronchial muscle resulting in expansion of the bronchial air passages, used in conditions like asthma. (Chapter 4.6)

Bronchoscope (BRŎNG-kŏ-skōp)

A medical instrument with a light and camera used for examining the inside of the trachea, bronchi, and lungs. (Chapter 4.7)

Bronchoscopy (brŏng-KŎS-kŏ-pē)

A procedure that allows a doctor to look at the airway through a thin viewing instrument called a bronchoscope. (Chapter 4.4)

Bronchospasm (BRŎNG-kō-spăz-ŭm)

The sudden constriction of the muscles in the bronchial walls. (Chapter 4.4)

Cancer (KĂN-sŏr)

A disease in which abnormal cells divide uncontrollably and destroy body tissue. (Chapter 4.6)

Chest X-rays (chĕst ĕks-rāz) (CXR)

An imaging test that uses small amounts of radiation to produce pictures of the organs, bones, and tissues in the chest area; also called radiographs. (Chapter 4.6)

Chronic bronchitis (KRŎN-ĭk brŏng-KĪ-tĭs)

A form of bronchitis characterized by chronic cough and mucus production for at least three months in two consecutive years. (Chapter 4.6)

Chronic obstructive pulmonary disease (KRŎN-ĭk ŏb-STRŬK-tĭv PŬL-mō-nĕ-rē dĭ-ZĒZ) (COPD)

A group of lung diseases that block airflow and make it difficult to breathe. (Chapter 4.6)

Computed tomography scan (kŏm-PYŌŌ-tĕd tŏ-mŎG-ră-fē skăn) (CT)

A medical imaging technique used to create detailed images of internal body structures, particularly useful for diagnosing diseases or conditions in the lungs and other thoracic structures. (Chapter 4.7)

Continuous positive airway pressure device (kŏn-TĬN-yū-ŭs POZ-ĭ-tĭv AIR-wā PRESS-ŭr dĭ-VĪS) (CPAP)

A type of therapy used in sleep apnea, in which air is supplied through a mask to keep airways open during sleep. (Chapter 4.6)

CT-guided needle biopsy (sē-tē GĪ-dĕd NĒ-dŭl BĪ-ŏp-sē)

A procedure where a needle biopsy is performed with the guidance of computed tomography (CT) imaging to obtain a tissue sample from the lung or other internal organs. (Chapter 4.7)

Cyanosis (sī-ă-NŌ-sĭs)

A bluish discoloration of the skin and mucous membranes resulting from poor circulation or inadequate oxygenation of the blood. (Chapter 4.6)

Cyanotic (sī-ă-NŎT-ĭk)

Pertaining to cyanosis; a bluish or purplish discoloration of the skin due to deficient oxygenation of the blood. (Chapter 4.6)

Cystic fibrosis (SĬS-tĭk fī-BRŌ-sĭs)

A genetic disorder affecting the lungs and digestive system, characterized by thick, sticky mucus that can clog airways and lead to respiratory and digestive problems. (Chapter 4.6)

Dysphonia (dis-FŌ-nē-ă)

Difficulty in speaking due to a problem with the voice. (Chapter 4.4)

Dyspnea (dĭs-PNĒ-ă)

Difficulty or discomfort in breathing; shortness of breath. (Chapter 4.5)

Emphysema (ĕm-fĭ-ZĒ-mă)

A chronic respiratory disease where there is overinflation of the air sacs (alveoli) in the lungs, leading to a decrease in lung function and breathlessness. (Chapter 4.6)

Endotracheal tube (ĕn-dō-TRĀ-kē-ăl tūb) (ET tube)

A flexible plastic tube that is put in the mouth and then down into the trachea to help a patient breathe. (Chapter 4.7)

Epiglottis (ĕ-pĭ-GLŎT-ĭs)

A flap of tissue that covers the trachea during swallowing to prevent aspiration. (Chapter 4.4)

Epistaxis (ĕp-ĭ-STĂK-sĭs)

Bleeding from the nose; also called rhinorrhagia. (Chapter 4.4)

Exacerbations (ĕg-ză-sĕr-BĀ-shŭns)

Episodes where symptoms of a disease become worse or more severe. (Chapter 4.6)

Exhalation (ĕks-hă-LĀ-shŭn)

The process of breathing out air. (Chapter 4.5)

Fine needle aspiration biopsy (fīn NĒ-dŭl ăs-pĭ-RĀ-shŭn BĪ-ŏp-sē) (FNA)

A diagnostic procedure used to investigate lumps or masses. In this technique, a thin needle is used to extract sample cells from the body. (Chapter 4.7)

Gas exchange (găs ĭk-SCHĀNJ)

The process in the lungs where oxygen is taken up by the blood and carbon dioxide is released from the blood. (Chapter 4.5)

Hemoglobin (HĒ-mō-glō-bĭn)

A protein in red blood cells that carries oxygen from the lungs to the rest of the body and returns carbon dioxide from the body to the lungs. (Chapter 4.5)

Hemoptysis (hē-MŎP-tĭ-sĭs)

Coughing up blood from the respiratory tract. (Chapter 4.6)

Hypercapnia (hī-pĕr-KĂP-nē-ă)

Excess carbon dioxide in the bloodstream, typically caused by inadequate respiration. (Chapter 4.5)

Hyperpnea (hī-PŬR-pnē-ă)

Excessively deep or rapid breathing; forced breathing. (Chapter 4.5)

Hyperventilation (hī-pĕr-vĕn-tĭ-LĀ-shŭn)

Breathing that is deeper and more rapid than normal. (Chapter 4.5)

Hypopnea (hī-pŎP-nē-ă)

Deficient shallow or slow breathing. (Chapter 4.5)

Hypoventilation (hī-pō-vĕn-tĭ-LĀ-shŭn)

Reduced rate and/or depth of air movement into the lungs, leading to increased carbon dioxide levels in the blood. (Chapter 4.5)

Hypoxemia (hī-pŏk-SĒ-mē-ă)

Low levels of oxygen in the blood. (Chapter 4.5)

Hypoxia (hī-PŎK-sē-ă)

A condition in which the body or a region of the body is deprived of adequate oxygen supply at the tissue level. (Chapter 4.5)

Influenza (ĭn-flōō-ĕn-ză)

A highly contagious viral infection affecting the respiratory tract, commonly referred to as the flu, with symptoms like fever, cough, sore throat, and muscle aches. (Chapter 4.6)

Inhalation (ĭn-hă-lĀ-shŭn)

The process of breathing in air. (Chapter 4.5)

Labored breathing (LĀ-bŏrd BRĒ-thĭng)

Breathing that requires more effort than normal; often a sign of distress or illness. (Chapter 4.5)

Laryngitis (lă-rĭn-JĪ-tĭs)

Inflammation of the larynx, typically resulting in huskiness or loss of voice. (Chapter 4.4)

Larynx (LĀR-ĭngks)

The organ forming an air passage to the lungs and holding the vocal cords; the voice box. (Chapter 4.4)

Lobectomy (lō-BĔK-tŏ-mē)

Surgical removal of a lobe of an organ, such as a lobe of the lung. (Chapter 4.4)

Lobes (lōbz)

Divisions of the lungs; the right lung has three lobes, and the left lung has two. (Chapter 4.4)

Lung cancer (lŭng KĂN-sŏr)

A type of cancer that begins in the lungs and may spread to lymph nodes or other organs in the body. (Chapter 4.6)

Lungs (lŭngz)

The main organs of the respiratory system, responsible for the exchange of oxygen and carbon dioxide. (Chapter 4.4)

Magnetic resonance imaging (măg-NĔT-ĭk rĕz-ŏ-năns ĬM-ă-jing) (MRI)

A medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. (Chapter 4.7)

Mechanical ventilator (mĕ-kăn-Ĭ-kăl vĕn-tĬ-lā-tŏr)

A machine that provides respiratory support for patients who are unable to breathe effectively on their own. (Chapter 4.7)

Metastases (mĕ-TĂS-tă-sēz)

The spread of cancer from one part of the body to another. (Chapter 4.6)

Mucus (MŪ-kŭs)

A slippery secretion produced by, and covering, mucous membranes for lubrication and protection. (Chapter 4.4)

Nasal cannula (NĀ-zăl KĂN-yū-lă)

A device used to deliver supplemental oxygen or increased airflow to a patient in need of respiratory help. (Chapter 4.7)

Nebulizer (NĒB-yū-lī-zĕr)

A device for converting a drug into mist and delivering it to the lungs, often used in treating asthma and other respiratory conditions. (Chapter 4.6)

Needle biopsy (NĒ-dŭl BĪ-ŏp-sē)

A procedure to obtain a sample of cells from the body for laboratory testing, often used to diagnose diseases such as cancer. (Chapter 4.7)

Obstructive sleep apnea (ŏb-STRŬK-tĭv slēp ăp-NĒ-ă) (OSA)

A sleep disorder characterized by pauses in breathing or periods of shallow breathing during sleep. (Chapter 4.6)

Peak flow meter (pēk flō mē-tĕr)

A small, hand-held device used to measure the ability to push air out of the lungs. (Chapter 4.6)

Perfusion (pĕr-FYŪ-zhŭn)

The passage of fluid through the circulatory system or lymphatic system to an organ or a tissue. (Chapter 4.5)

Pharyngitis (fă-RĬN-JĪ-tĭs)

Inflammation of the pharynx, often resulting in a sore throat. (Chapter 4.4)

Pharynx (FĂR-ĭngks)

Commonly known as the throat; a part of the neck and throat that is situated posteriorly to the mouth and nasal cavity and cranially to the esophagus and larynx. (Chapter 4.4)

Pleural effusion (PLŪR-ăl ĕ-FYŪ-zhŭn)

A condition where fluid accumulates in the pleural space, the area between the layers of tissue that line the lungs and chest cavity. (Chapter 4.4)

Pleural rub (plur-uhl ruhb)

An abnormal lung sound that is caused by inflammation of the pleura membranes that results in friction as the surfaces rub against each other. (Chapter 4.5)

Pneumonia (nū-MŌ-nē-ă)

An infection that inflames the air sacs in one or both lungs, which may fill with fluid or pus. (Chapter 4.4)

Positron emission tomography scan (pŏz-Ĭ-trŏn ĭ-MĬSH-ən tŏ-mŏG-ră-fē skăn) (PET)

A diagnostic imaging test using a radioactive substance to look for disease in the body, often used for detecting cancer. (Chapter 4.7)

Pruritus (PRŪ-rī-tŭs)

Itching or an uncomfortable irritation of the skin. (Chapter 4.6)

Pulmonary arteries (PŬL-mō-nĕ-rē ăr-tĕ-rēs)

The arteries carrying blood from the right ventricle of the heart to the lungs for oxygenation. (Chapter 4.5)

Pulmonary circulation (PŬL-mō-nĕ-rē sĭr-kyū-LĀ-shŭn)

The part of the circulatory system which carries blood from the heart to the lungs and back to the heart. (Chapter 4.5)

Pulmonary edema (PŬL-mŏn-ăr-ē ĕ-DĒ-mă)

Fluid accumulation in the alveoli of the lungs, often caused by heart or kidney failure​​. (Chapter 4.5)

Pulmonary embolism (PŬL-mŏ-nā-rē ĕm-BŌ-lĭ-zŭm) (PE)

A blockage in one of the pulmonary arteries in the lungs, usually caused by blood clots that travel to the lungs from the legs or other parts of the body. (Chapter 4.6)

Pulmonary function tests (PŬL-mŏ-nā-rē fŭnk-shŭn tĕsts) (PFTs)

A group of tests that measure how well the lungs take in and release air and how well they move gases such as oxygen from the atmosphere into the body’s circulation. (Chapter 4.7)

Pulmonologist (pŭl-mŏn-ŎL-ŏ-jĭst)

A physician who specializes in the diagnosis and treatment of diseases and disorders related to the respiratory system. (Chapter 4.7)

Pulse oximeter (pŭls ŏk-SĬM-ĭ-tŏr)

A small, clip-like device that attaches to a body part, like toes or an earlobe, but most commonly to a finger, to measure the oxygen saturation of arterial blood. (Chapter 4.5)

Radiographs (RĀ-dē-ŏ-grăf)

Images produced on a sensitive plate or film by X-rays, gamma rays, or similar radiation, and used in medical examinations. (Chapter 4.6)

Rales (rāylz)

An abnormal lung sound, also called fine crackles, that sound like popping or crackling sounds on inspiration. Rales are associated with medical conditions that cause fluid accumulation within the alveolar and interstitial spaces, such as heart failure or pneumonia. (Chapter 4.5)

Respiration (rĕs-pĭ-RĀ-shŏn)

The process of inhaling oxygen from the air and exhaling carbon dioxide out of the body. It is a vital function for the survival of humans and many other organisms, facilitating the exchange of gases in the lungs and tissues. (Chapter 4.5)

Respiratory rate (RES-pĭr-ă-tō-rē rāt)

The number of breaths a person takes per minute. (Chapter 4.5)

Respiratory syncytial virus (rĕs-pĭ-RĂ-tōr-ē SĬN-sĭ-shē-ăl VĪ-rŭs) (RSV)

A common and highly contagious virus that causes infections of the respiratory tract. It can lead to mild, cold-like symptoms in adults and older children but can be severe in infants, young children, and older adults, especially those with underlying health conditions. (Chapter 4.6)

Respiratory therapists (rĕ-spĭr-ă-tōr-ē THĔR-ă-pĭsts)

Health care professionals who specialize in providing care for patients with breathing or other cardiopulmonary disorders. (Chapter 4.7)

Rhinitis (rye-NYE-tis)

Inflammation of the nasal mucosa. (Chapter 4.4)

Rhinorrhagia (rī-nō-RĀ-jē-ă)

Bleeding from the nose, also known as epistaxis. (Chapter 4.4)

Rhinorrhea (rye-noh-REE-uh)

Excess mucous production by the nasal cavities, commonly referred to as a “runny nose.” (Chapter 4.4)

Rhonchi (rŏng-kahy)

An abnormal lung sounds, also referred to as coarse crackles, that are are low-pitched, continuous sounds heard on expiration that are a sign of turbulent airflow through mucus in the large airways. (Chapter 4.5)

Septum (SĔP-tŭm)

The structure separating the left and right airways in the nose, dividing the two nostrils. (Chapter 4.4)

Sinusitis (sī-nŭ-SĪ-tĭs)

Inflammation of the sinus cavities. (Chapter 4.4)

Spirometry (spī-RŎM-ĕ-trē)

A common office test used to assess how well the lungs work by measuring how much air is inhaled, how much is exhaled, and how quickly it is exhaled. (Chapter 4.7)

Sputum (SPŪT-ŭm)

Mucous secretions from the respiratory tract that can be expelled through the mouth​​. (Chapter 4.4)

Sputum culture (SPYŌŌ-tŭm KŬL-chŭr)

A test to detect and identify bacteria or fungi that are infecting the lungs or breathing passages. (Chapter 4.7)

Stethoscope (STĔTH-ō-skōp)

A medical instrument used for listening to the internal sounds of an organism, typically used for heart and lung sounds. (Chapter 4.5)

Stridor (strī-door)

An abnormal lungs sound heard during inspiration that is associated with obstruction of the trachea/upper airway. (Chapter 4.5)

Surfactant (SŬR-făk-tănt)

A substance that reduces the surface tension of fluid in the lungs and helps make the alveoli more stable. (Chapter 4.4)

Tachypnea (tăk-ĬP-nē-ă)

Rapid breathing. (Chapter 4.5)

Thoracentesis (thŏr-ă-sĕn-TĒ-sĭs)

A procedure to remove fluid from the space between the lining of the outside of the lungs (pleura) and the wall of the chest. (Chapter 4.7)

Thoracic cavity (thō-RĂS-ĭk KĂV-ĭ-tē)

The area of the body located between the neck and the diaphragm, housing the lungs and heart. (Chapter 4.5)

Thoracic surgeon (thō-RĂS-ĭk SŬR-jŏn)

A surgeon who specializes in surgical procedures of the chest, including the heart, lungs, esophagus, and other organs in the chest. (Chapter 4.7)

Tonsillitis (tŏn-sĭl-Ī-tĭs)

Inflammation of the tonsils. (Chapter 4.4)

Trachea (TRĀ-kē-ă)

The windpipe; a tube that connects the larynx to the bronchi, providing a pathway for air to enter the lungs. (Chapter 4.4)

Tracheostomy (trā-kē-ŎS-tŏ-mē)

A surgical procedure to create an opening through the neck into the trachea (windpipe) to allow direct access to the breathing tube. (Chapter 4.4)

Tuberculosis (tū-bĕr-kyū-lō-sĭs) (TB)

A serious infectious disease that mainly affects the lungs, caused by the bacterium Mycobacterium tuberculosis. (Chapter 4.6)

Upper respiratory infection (ŬP-er RES-pĭr-ă-tō-rē ĭn-FEK-shun) (URI)

A viral infection of one or more structures of the upper respiratory system, including the nose, nasal cavities, sinuses, pharynx, and larynx. (Chapter 4.4)

Ventilation (vĕn-tĭ-LĀ-shŭn)

The movement of air in and out of the lungs. (Chapter 4.5)

Wheezing (HWĒ-zĭng)

A high-pitched whistling sound made while breathing, typically heard when exhaling, often associated with asthma or lung diseases. (Chapter 4.6)

Figure 4.1

Figure 4.1

Major Respiratory Anatomic Structures

Copyright Notice

Licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/.

Bookshelf ID: NBK607438
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