848
UNIT 4
Maintenance of the Body
of an aspirator); done during surgery to keep an area free of
blood or other body fluids; mucus is aspirated from the trachea
of tracheotomy patients.
Bronchoscopy
(
scopy
5
viewing) Use of a viewing tube inserted through
the nose or mouth to examine the internal surface of the main
bronchi in the lung. Forceps attached to the tip of the tube can
remove trapped objects or take samples of mucus for examination.
Cheyne-Stokes breathing
(chān
9
stōks) Abnormal breathing pattern
sometimes seen just before death (the “death rattle”) and in
people with combined neurological and cardiac disorders. It
consists of bursts of tidal volume breaths (increasing and then
decreasing in depth) alternating with periods of apnea. Trauma
and hypoxia of the brain stem centers, as well as P
CO
2
imbalances
between arterial blood and brain, may be causative factors.
Deviated septum
Condition in which the nasal septum takes a more
lateral course than usual and may obstruct breathing; o±en
manifests in old age or from nose trauma.
Endotracheal tube
A thin plastic tube threaded into the trachea
through the nose or mouth; used to deliver oxygen to patients
who are breathing inadequately, in a coma, or under anesthesia.
Epistaxis
(ep
0
ĭ-stak
9
sis;
epistazo
5
to bleed at the nose) Nosebleed;
commonly follows trauma to the nose or excessive nose blowing.
Most nasal bleeding is from the highly vascularized anterior
septum and can be stopped by pinching the nostrils closed or
packing them with cotton.
Nasal polyps
Mushroomlike benign growths of the nasal mucosa;
sometimes caused by infections, but most o±en cause is
unknown. May block air flow.
Orthopnea
(or
0
thop-ne
9
ah;
ortho
5
straight, upright) Inability to
breathe in the horizontal (lying down) position.
Otorhinolaryngology
(o
0
to-ri
0
no-lar
0
in-gol
9
o-je;
oto
5
ear;
rhino
5
nose) Branch of medicine that deals with diagnosis and treatment
of diseases of the ears, nose, and throat.
Pneumonia
Infectious inflammation of the lungs, in which fluid
accumulates in the alveoli; the eighth most common cause of
death in the United States. Most of the more than 50 varieties of
pneumonia are viral or bacterial.
Pulmonary embolism
Obstruction of the pulmonary artery or one
of its branches by an embolus (most o±en a blood clot that has
been carried from the lower limbs and through the right side of
the heart into the pulmonary circulation). Symptoms are chest
pain, productive bloody cough, tachycardia, and rapid, shallow
breathing. Can cause sudden death unless treated quickly; usual
treatment is oxygen by mask, pain relievers, and anticoagulant
drugs. Severe cases may also require clot busters (thrombolytic
drugs).
Stuttering
A problem of voice production in which the first syllable
of words is repeated in “machine-gun” fashion. Primarily a
problem with neural control of the larynx and other voice-
producing structures. Many stutterers become fluent when
whispering or singing, both of which involve a change in the
manner of vocalization.
Sudden infant death syndrome (SIDS)
Unexpected death of an
apparently healthy infant during sleep. Commonly called crib
death, SIDS is one of the most frequent causes of death in infants
under 1 year old. Believed to be a problem of immaturity of the
respiratory control centers. Most cases occur in infants placed
in a prone position (on their abdomen) to sleep—a position
that may result in hypoxia and hypercapnia due to rebreathing
exhaled (CO
2
-rich) air. Since 1992, a campaign recommending
placing infants on their back to sleep has lowered the incidence
of SIDS in the U.S. by 40% or more.
Tracheotomy
(tra
0
ke-ot
9
o-me) Surgical opening of the trachea; done
to provide an alternate route for air to reach the lungs when
more superior respiratory passageways are obstructed (as by
food or a crushed larynx).
Barbara Joley was in the bus that was
hit broadside. When she was freed
from the wreckage, she was deeply
cyanotic and her respiration had
stopped. Her heart was still beating, but her pulse was fast and
thready. The emergency medical technician reported that when
Barbara was found, her head was cocked at a peculiar angle and
it looked like she had a fracture at the level of the C
2
vertebra. The
following questions refer to these observations.
1.
How might the “peculiar” head position explain Barbara’s
cessation of breathing?
2.
What procedures (do you think) the emergency personnel
should have initiated immediately?
3.
Why is Barbara cyanotic? Explain cyanosis.
4.
Assuming that Barbara survives, how will her accident affect her
lifestyle in the future?
Barbara survived transport to the hospital and notes recorded at
admission included the following observations.
Right thorax compressed; ribs 7 to 9 fractured
Right lung atelectasis
Relative to these notes:
5.
What is atelectasis and why is only the right lung affected?
6.
How do the recorded injuries relate to the atelectasis?
7.
What treatment will be done to reverse the atelectasis? What is
the rationale for this treatment?
(Answers in Appendix H)
Case Study
22
Related Clinical Terms
(continued)
Respiratory System
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