Key Terms

acute respiratory distress syndrome (ARDS)

potentially fatal lung injury that can be triggered by a variety of events; fluid builds up in the lungs, oxygen levels drop, and scarring can occur

adventitious lung sounds

breath sounds other than a clear sound of air

alveolar sac

group of alveoli

alveolus

individual, grapelike sac in the lungs where gas exchange occurs

angioedema

soft tissue swelling in the deep layers of the skin, most commonly in the mouth, eyelids, and genitals

aspiration

food, fluid, upper airway secretions, or emesis enter the trachea and respiratory tract

asthma attack

(also: asthma exacerbation) inflammation narrows the airway, making it harder for the lungs to expand

atelectasis

condition that causes a partial or complete collapse of the lung

BiPAP

bilevel positive airway pressure, a form of noninvasive ventilation that uses a tight-fitting mask over the nose and/or mouth to increase oxygen levels and lower carbon dioxide levels; bilevel means there are two pressure settings: inhalation positive airway pressure (IPAP) and exhalation positive airway pressure (EPAP)

black lung disease

pulmonary disease that leads to lung scarring due to inhaled coal dusts, also known as pneumoconiosis

bradypnea

less than twelve breaths per minute

bronchial breath sounds

heard over the trachea and larynx and are high-pitched and loud

bronchiectasis

condition in which the elastic, supportive structures of the bronchial wall become damaged, and the bronchi abnormally dilate

bronchoconstriction

smooth muscles in the airways contract, causing the airway to narrow

bronchodilator

medication that opens narrowed airways

bronchoscope

thin tube inserted into the mouth or nose with a camera for visual examination of lung tissue, can obtain biopsy samples and treat blockages

bronchovesicular breath sounds

medium-pitched and heard over the major bronchi

cachexia

disorder that causes loss of muscle and adipose tissue

capnography

(also: end-tidal carbon dioxide [EtCO₂] monitoring) noninvasive way to measure exhaled carbon dioxide and provide information about ventilation

carina

point where the trachea splits into the right and left primary bronchi

chest physical therapy

airway clearance technique that can improve drainage and mobilization of mucus

chest tube

(also: thoracostomy tube) tube inserted through the skin, into the pleural space, to drain air, fluid, or blood

chronic obstructive pulmonary disease (COPD)

widely prevalent obstructive respiratory disease

clubbing

bulbous enlargement of the tips of the fingers due to chronic hypoxia

conducting zone

all parts of the respiratory system that do not participate in gas exchange, the passageways for air to flow into and out of the lungs

crepitus

feels like a popping or crackling sensation when the skin is palpated; is a sign of air trapped under the subcutaneous tissues

diffusion

movement of substances from an area of high concentration to an area of low concentration

droplet nuclei

tiny particles expelled from an infected person during talking, coughing, or singing; they remain airborne for several hours

emphysema

occurs when alveolar walls become damaged and lose elasticity, resulting in problems with exhalation

fine crackles

(also: rales) popping or crackling sounds heard on inspiration as collapsed airways reopen

forced expiratory volume (FEV₁)

maximum exhaled volume of air in one second

forced vital capacity (FVC)

overall maximum volume of air that can be exhaled

granuloma

walled-off capsule that develops as the body attempts to contain tubercle bacilli

hemoptysis

coughing up blood

hospital-acquired pneumonia (HAP)

pneumonia that develops in a hospital setting

hypercapnia

high blood levels of carbon dioxide

hypoxemia

low blood levels of oxygen

iatrogenic pneumothorax

air enters the pleural space due to a complication from surgery or invasive procedure (e.g., placement of a central venous catheter)

idiopathic

having an unknown cause

immune globulin

product that may be administered intravenously or subcutaneously to provide necessary antibodies to strengthen the immune system

laryngopharynx

most inferior portion of the pharynx, allows passage of both air and food

larynx

cartilaginous structure that joins the pharynx to the trachea and regulates how much air goes in and out of the lungs, allows vibrations in the vocal cords to produce sound

meconium

newborn’s first stool

medulla oblongata

respiratory center of the brain, controls breathing by responding to shifts in carbon dioxide, oxygen, and blood pH

nasopharynx

region of the pharynx allows air to pass from the nasal cavity toward the trachea

needle decompression

treatment for tension pneumothorax where a large needle is inserted through the skin, between the ribs, into the pleural space; the large volume of air in the pleural space escapes through the needle and the lung can reexpand

oropharynx

region of the pharynx, allows passage of both air and food

oxygenation

process that occurs when oxygen from the air makes its way into the bloodstream

oxyhemoglobin

bright red molecule formed when oxygen binds to hemoglobin

pancreatic enzymes

supplementary medication required by patients with CF due to pancreatic insufficiency

partial pressure

how much of a gas is dissolved in the blood

peak flow meter

device that measures lung function and allows patients to track and observe trends

perfusion

blood flow

pharynx

muscular tube with an inner mucous membrane lining, it connects the nasal passages and oral cavity to the trachea and esophagus

pleurae

protective membranes that encase the lungs

pleural effusion

accumulation of fluid in the pleural space

pleuritic

severe, sudden type of chest pain that occurs with inhalation and exhalation; described as burning, stabbing, or sharp

pleurodesis

technique used to heal the break in the pleural space by creating an inflammatory reaction in the pleural space

pneumoconiosis

pulmonary disease that leads to lung scarring due to inhaled coal dusts, also known as black lung disease

positive expiratory pressure device

airway clearance device that lets the patient breathe in easily but creates resistance as they exhale, slowing down the breath and causing the patient to increase the force of exhalation; air is more able to move behind the mucus and helps to dislodge it

primary spontaneous pneumothorax

air enters the pleural space spontaneously; there is no underlying lung disease

pulse oximeter

noninvasive device that provides information about blood oxygen saturation

rales

(also: fine crackles) popping or crackling sounds heard on inspiration as collapsed airways reopen

respiratory zone

parts of the respiratory system that perform gas exchange

ronchi

coarse, loud sounds that occur due to constriction in the larger airways due to mucus or fluid

rub

grating sound

secondary spontaneous pneumothorax

air enters the pleural space spontaneously as a complication of underlying lung disease

spirometry

pulmonary function test that measures the maximum volume of air that can be inhaled and how much someone can forcefully exhale in one second

stridor

harsh, high-pitched sound heard only on inspiration that is often loud enough to hear without a stethoscope

subcutaneous emphysema

occurs when high-pressure air is forced through the tissues, creates a “popping” sensation with palpation and can cause visible swelling

sweat test

conclusive diagnostic test for CF; a chemical and a small amount of electrical stimulation are applied to the skin to encourage sweat production. Sweat is collected and analyzed; elevated levels of sodium and chloride confirm a diagnosis of CF

tachypnea

more than twenty breaths per minute

tension pneumothorax

when a large volume of air enters the pleural space, in addition to causing a major amount of lung collapse, the high pressure also forces the heart and trachea to shift

thoracostomy tube

(also: chest tube) tube inserted through the skin, into the pleural space, to drain air, fluid, or blood

trachea

anterior to the esophagus, this tube extends downward from the larynx to the lungs

tracheal deviation

trachea in a non-midline position

traumatic pneumothorax

air enters the pleural space due to traumatic injury

tripod position

upright position with hands braced on knees or a table. This position maximizes the space available for the lungs to expand and is often seen in respiratory distress

vaping

using an e-cigarette that heats a solution so it vaporizes and can be inhaled, the solution can contain nicotine, THC, butane hash oils, cannabidiol, and other additives

ventilation

movement of air into and out of the lungs

ventilator-associated pneumonia (VAP)

pneumonia that occurs after a ventilator is initiated

vesicular breath sounds

heard over the lung surfaces, are lower-pitched, and often described as soft, rustling sounds

wheezes

whistling-type noises produced during expiration (and sometimes inspiration)