Airway & Breathing terms

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accessory muscles

ac·ces·so·ry mus·cles

/akˈses(ə)rē ˈməsəls/

Noun

The muscles of the sternocleidomastoids and scalenes, which the body employs to increase tidal volume when the respiratory rate is not sufficient to correct hypoxemia. The intercostal muscles increase outward expansion of the chest and raise the height of the chest. Sternal notch retraction as well as intercostal retractions might be seen as these muscles work to assist in breathing.

adventitious

ad·ven·ti·tious

/ad vuhn tish uhs/

Adjective

Unusual breath sounds

alveolus

al·ve·o·lus

/alˈvēələs/

Noun

These small pockets of the alveolar ducts and sacs and terminal bronchioles through whose walls the exchange of carbon dioxide and oxygen takes place between the alveolar air and capillary blood. The bronchioles divide and become smaller until they terminate in the air sacs, known as alveoli. Each alveolus is surrounded by capillaries; like a capillary wall, the alveolar wall is also one cell thin. This allows gases like oxygen and carbon dioxide to pass through easily. Hundreds of millions of alveoli make up the bulk of the lungs.

aspiration

as·pi·ra·tion

/ˌaspəˈrāSHən/

Noun

The inhalation of foreign bodies into the airway.

aspiration pneumonia

as·pi·ra·tion pneu·mo·nia

/ˌaspəˈrāSH(ə)n n(y)o͞oˈmōnyə/

Noun

A form of pneumonia caused by aspiration of a foreign body (usually food) into the lower airways.

asthma

asth·ma

/ˈazmə/

Noun

The most common type of reactive airway disorders, marked by spasms in the bronchi of the lungs, causing difficulty in breathing

atrial kick

a·tri·al kick

/ˈātrēuhl kik/

Noun

The atria push blood into the ventricles with a certain amount of volume and force. This produces an atrial kick that allows the ventricles to fill with about 20% more blood that what would normally enter if the atrial did not contract efficiently.

automatic transport ventilator

au·to·mat·ic trans·port ven·ti·la·tor

/aw tuh mat ik trans-pawrt ven tl ey ter/

Noun

A mechanical device with electronic circuitry to precisely regulate the rate and volume of positive pressure ventilations. Automatic transport ventilators typically require the patient to have an advanced airway such as an endotracheal tube or a tracheostomy.

bradypnea

brad·yp·ne·a

/brād'ĭp nē'ə, brād'ē nē'ə/

Noun

A ventilatory rate of less than 12 respirations per minute in adults.

bronchiole

bron·chi·ole

/ˈbräNGkēˌōl/

Noun

The bronchi continue to divide again and again into numerous bronchioles. Each of these bronchioles can expand or constrict depending upon the needs of the body for air exchange as well as reacting to certain substances. For example, pollen can cause the bronchioles to abnormally constrict in a patient with asthma, making it very difficult to breathe.

bronchiolitis

bron·chi·o·li·tis

/ˌbräNGkēəˈlīdəs/

Noun

A lower respiratory infection in infants younger than 1 year of age

bronchoconstriction

bron·cho·con·stric·tion

/brong'kō kənˈstrikSHən/

Noun

Constriction of the larger conducting airways including the bronchi and several generations of bronchioles

bronchus

bron·chus

/ˈbräNGkəs/

Noun

Either of the two main airway branches that begin at the trachea before dividing into the left and right bronchi, which enter the lungs. The bronchi continue to divide again and again into numerous bronchioles.

carbon dioxide

car·bon di·ox·ide

/ˈkärbən dīˈäkˌsīd/

Noun

An odorless, colorless gas that results from oxidation of carbon formed in the tissues. It is formed during respiration and is a primary regulator of blood flow to the brain through vasodilation and vasoconstriction.

carina

ca·ri·na

/kəˈrēnə,-ˈrī-/

Noun

The structure where the trachea divides, or bifurcates, into left and right main stem bronchi. The carina is located near the junction of the fourth and fifth thoracic vertebra.

chest cage

chest cage

/CHest kāj/

Noun

The structure composed of ribs and muscles that protects the organs inside the chest.

collar bone

col·lar bone

/ˈkälər bōn/

Noun

The top of the lungs that extends superiorly just past the clavicle

cricoid cartilage

cri·coid car·ti·lage

/ˈkrīˌkoid ˈkärtl-ij/

Noun

A continuous firm ring of cartilage located below the thyroid cartilage. Both of these cartilages together provide airway structure and support so they do not collapse and obstruct flow in and out of the lungs.

cystic fibrosis

cys·tic fi·bro·sis

/ˈsistik fīˈbrōsəs/

Noun

A genetic disease that affects the cells in the respiratory system that produce mucus. The mucus producing cells make mucus that is so thick that it can interfere with airway clearance and lung function.

diaphragm

di·a·phragm

/ˈdīəˌfram/

Noun

The diaphragm is the muscle that divides the abdominal cavity from the thoracic cavity. When stimulated by the brain, the diaphragm contracts, increasing the size of the thoracic cavity. This results in a small but significant negative pressure inside the chest, which causes air to rush into the lungs. At the end of this inhalation phase, the brain signals the diaphragm to stop contracting. As the muscle relaxes, the now positive pressure in the chest pushes air out of the lungs.

eupnea

eup·ne·a

/ūp-ne´ah/

Noun

Breathing at a normal rate

exhalation

ex·ha·la·tion

/ˌeks(h)əˈlāSHən/

Noun

During exhalation, the thoracic cavity decreases in size causing the air in the lungs to be pushed out.

expiratory

ex·pir·a·to·ry

/ex·pir·a·to·ry/

Adjective

One of two phases of normal breathing, this is the act of breathing oit. Visual signs include chest fal.

Fick's law

ficks law

/fiks lô/

Noun

A principle developed by Adolf Eugen Fick that states that blood flow is proportional to the difference in concentration of a substance in the blood as it enters and leaves an organ and which is used to determine cardiac output from the difference in oxygen concentration in blood before it enters and after it leaves the lungs and from the rate at which oxygen is consumed.

flow restricted oxygen powered ventilation device

flow re·strict·ed ox·y·gen pow·ered ven·ti·la·tion mask

/floh ri strik tid ok si juhn pou erd ven tl ey shuhn mask, mahsk/

Noun

A mechanical device with a valve that can be manually triggered either by a lever or a button. When the valve is open, oxygen flows at approximately 40 lpm. The device can produce positive pressure. It must be used with caution when ventilating patients, especially with potentially inelastic lungs, such as emphysema patients.

gasket

gas·ket

/gas kit/

Noun

A rubber or plastic piece that is placed between the oxygen regulator and oxygen tank to ensure a leak proof seal. This gasket should be replaced each time the regulator is fitted to a new tank.

glottis

glot·tis

/ˈɡlädəs/

Noun

The opening between the vocal cords that expands and contracts in size, causing low and high pitched sounds, respectively.

grunt

grunt

/grənt/

Noun

An abnormal breath sound caused by diminished airway patency that can be heard without a stethoscope during inspiration.

gurgle

gur·gle

/ˈgərgəl/

Noun

An abnormal breath sound caused by diminished airway patency that can be heard without a stethoscope during inspiration.

head tilt, chin lift

head tilt chin lift

/hed tilt CHin lift/

Noun

This is the most common manual airway maneuver. The index and third finger of one hand lifts the mandible forward while the palm of the other hand gently restrains the patient’s forehead.

hypercapnia

hy·per·cap·ni·a

/hī′ pər kăp ′nē ə/

Noun

Elevated carbon dioxide (CO2) levels in the blood

hyperpnea

hy·perp·ne·a

/hahy perp nee uh, hahy per nee uh/

Noun

Breathing more deeply

hypoxia

hy·pox·i·a

/hīˈpäksēə/

Noun

The condition in which low levels of oxygen reaches the tissues of the body

impedance threshold device

im·ped·ance thresh·old de·vice

/im peed ns thresh ohld dih vahys/

Noun

A device inserted between the mask and bag during a cardiac arrest that acts as a “supervalve” that allows air to enter the lungs during bag compression. During cardiac compression, the valve allows air to escape from the lungs, but prevents atmospheric air from entering the chest. A small amount of negative pressure is created, promoting better blood flow through the heart and its coronary arteries.

inhalation

in·ha·la·tion

/ˌinhəˈlāSHən/

Noun

The respiratory system draws in air from the atmosphere through an expansion of the thoracic cavity, known as inhalation.

inspiratory

in·spir·a·to·ry

/inˈspīrəˌtôrē/

Adjective

One of two phases of normal breathing, this is the act of breathing in. Visual signs include chest rise.

intercostal

in·ter·cos·tal

/ˌintərˈkästəl/

Adjective

The intercostal muscles are located between the ribs. As they contract, they pull the rib cage up, increasing the size of the thoracic cavity and allowing the lungs to fill with air.

larynx

lar·ynx

/ˈlariNGks,/

Noun

Composed primarily of cartilage, the larynx is the organ in the upper airway that protects the airway from food, fluid, and secretions during eating, drinking, and swallowing. It also contains the vocal chords and is responsible for the production of sound and speech.

lower airway

low·er air·way

/ˈlō(ə)r ˈerwā/

Noun

The lower airway begins at the vocal cords and extends to the alveoli, where gases are exchanged.

lung

lung

/ləNG/

Noun

Located in the thoracic cavity, there is a right and a left lung that lie between the inner wall of the cavity and the surface of the lungs lie two membranes. They are responsible for the exchange of gases, mainly oxygen and carbon dioxide between the atmosphere and the body.

minute volume

mi·nute vol·ume

ˈminit ˈvälyəm,-ˌyo͞om

Noun

The amount of air breathed in over a minute's time.

modified jaw thrust

mod·i·fied jaw thrust

/ˈmädəˌfīed jô THrəst/

Noun

A technique of opening an unconscious patient's airway if cervical spine trauma is suspected. While the thumbs of both hands are resting on the patient’s zygomatic arches, the index and third fingers of both hands reach behind the mandible at the temporomandibular joint (TMJ) and push it forward. This allows the cervical spine to remain fixed while opening the airway.

mouth

mouth

/mouTH/

Noun

The opening between the lips that contains teeth and the tongue, both of which play a large role in the process of eating food.

nasal cannula

na·sal can·nu·la

/ney zuh l kan-yuh-luh/

Noun

A single-use device that is a simple tube with an opening on one end that allows it to be connected to an oxygen regulator and two prongs on the other end that rest at the base of the patient’s nares.

nasopharyngeal airway

na·so·pha·ryn·geal air·way

/nā zō fə ˈrin j(ē-)əlˌfa rən ˈjē-əl ˈeərˌwā/

Noun

A device used on a patient who has an altered mental status but has at least a partial gag reflex that would prohibit the use of an oropharyngeal airway. Made of rubber, NPAs also come in a variety of sizes, and are designed to be placed primarily in the patient’s right nare. Use of a water-soluble lubricant can reduce the chances of causing a nosebleed during insertion.

non-rebreather mask

non·re·breath·er mask

/non′′rēbrēth′ər mask, mahsk/

Noun

An oxygen-delivery device that is fitted to the patient’s face. The mask has a nose and chin section, with a moldable metal tab on the nose section. The tab can be shaped to make the NRB snug against the patient’s nose. An elastic band goes behind the patient’s head to hold the mask on the face. The mask has two exhaust ports on its sides, each with a thin flap that act as a valve to allow air to escape the mask but not enter it. Near the chin section of the mask is a port, where an oxygen reservoir is attached. A tube extends from the reservoir that allows it to be attached to the oxygen regulator. The reservoir is filled with oxygen before the NRB is placed onto the patient’s face. The standard oxygen flow rate for the NRB is 10 to 15 lpm. Properly fitted, the NRB can deliver in excess of 90% inspired oxygen. As the patient exhales, a flap closes over the reservoir port, allowing carbon dioxide to exit the mask through side ports.

nose

nose

/nōz/

Noun

The facial structure located above the mouth that contains the nasal cavity, which warms, humidifies, and filters the air that we breathe

oropharyngeal airway

oro·pha·ryn·geal air·way

/ˌȯr ə ˌfa rən ˈjē əl, fə ˈrin-j(ē-)əl ˈeərˌwā/

Noun

A device used to maintain the airway of an unconscious patient who does not have a gag reflex and is unable to maintain their own airway. Generally made of plastic, OPAs come in a variety of sizes, designed to fit a variety of patients from pediatric to adult. Once inserted, the OPA will depress the tongue to the floor of the mouth, thereby keeping a passage open. However, the OPA does not reach all of the way to the posterior tongue. A manual airway maneuver will still be required to fully maintain airway patency.

oxygen cylinder

ox·y·gen cyl·in·der

/ˈäksəjən ˈsiləndər/

Noun

Oxygen is stored under pressure in cylinders that vary in size and capacity. D cylinders store up to 350 liters. E cylinders store up to 625 liters. M cylinders store up to 3,000 liters. G cylinders store up to 5,300 liters. H cylinders store up to 6,900 liters

oxygen humidifier

ox·y·gen hu·mid·i·fi·er

/ˈäksəjən (h)yo͞oˈmidəˌfī(ə)r/

Noun

A device that attaches to oxygen delivery devices and allows for humidification of administered oxygen by bubbling the oxygen through sterile water or saline. This prevents drying of the mucosa and can help thin respiratory secretions.

oxygen regulator

ox·y·gen reg·u·la·tor

/ok si juhn reg yuh ley ter/

Noun

A valve that can be controlled by the user. Generally made of brass or other nonreactive metal, the regulator is attached to an oxygen cylinder by lining up the regulator inlet valve to the outlet valve of the cylinder

parietal pleura

pa·ri·e·tal pleu·ra

/pəˈrīəd(ə)l ˈplo͝orə/

Noun

The pleural membrane that lines the inner surface of the thoracic cavity.

partial rebreather mask

par·tial re·breath·er mask

/pahr shuhl rēbrēth′ər mask, mahsk/

Noun

An oxygen delivery device in which a flap valve is removed from one of the side ports, which allows atmospheric air to pass into the mask in case oxygen abruptly stops flowing. It delivers less oxygen than an NRB mask, approximately 60%, inspired oxygen at a liter flow of 10 to 15 lpm.

pertussis

per·tus·sis

/pərˈtəsis/

Noun

A highly contagious disease transmitted human-to-human through airborne droplets containing the bacteria Bordetella pertussis. It is commonly referred to as “whooping cough” due to the typical whooping sound that occurs during inspiration of air after the cough

pneumonia

pneu·mo·nia

/n(y)o͞oˈmōnyə/

Noun

A lower respiratory infection caused by a viral, bacterial, parasitic, or fungal organism

pocket mask

pock·et mask

/pok it mask, mahsk/

Noun

A mask that allows the provider to administer mouth-to-barrier ventilation. The pocket mask contains a one-way valve that reduces the chances of being exposed to the patient’s secretions and communicable diseases. In addition, some masks have oxygen ports that can increase the amount of oxygen being delivered to the patient.

potential space

po·ten·tial spacwe

/pəˈten(t)SHəl spās/

Noun

The space in the pleural cavity that contains a small amount of fluid to minimize friction. It has the potential to expand be filled with air, fluid, or blood.

pulmonary capillary

pul·mo·nar·y cap·il·lar·y

/ˈpəlməˌnerē ˈkapəˌlerē/

Noun

Capillaries in the lungs that allow gases to easily enter and leave the bloodstream.

pulmonary surfactant

pul·mo·nar·y sur·fac·tant

/ˈpəlməˌnerē sərˈfaktənt/

Noun

A fluid that acts as a lubricant, preventing friction in the alveoli and in turn prevents the air sacs from sticking together and collapsing.

reactive airway disorder

re·ac·tive air·way dis·or·der

/rēˈaktiv ˈerwā ˌdisˈôrdər/

Noun

A disorder caused by a complex interaction of environmental factors such as airborne allergens, viral respiratory infections, and genetics

respiratory distress

res·pi·ra·to·ry dis·tress

/ˈrespərəˌtôrē,riˈspīrə- disˈtres/

Noun

When a patient cannot maintain an adequate concentration of oxygen and carbon dioxide in the blood. The patient will increase breathing rate and depth.

respiratory failure

res·pi·ra·to·ry fail·ure

/ˈrespərəˌtôrē,riˈspīrə- ˈfālyər/

Noun

The condition when the body can no longer compensate for abnormal oxygen and carbon dioxide levels in the bloodstream. As a result, the contraction of the diaphragm and accessory muscles fatigue and slow down.

snore

snore

/snôr/

Noun

An abnormal breath sound caused by diminished airway patency that can be heard without a stethoscope during inspiration.

stridor

stri·dor

/ˈstrīdər/

Noun

An abnormal breath sound that is harsh and high-pitched sound that can be heard without a stethoscope during inspiration. It is caused by diminished airway patency.

tachypnea

tach·yp·ne·a

/ˌtakə(p)ˈnēə/

Noun

A ventilatory rate of greater than 20 respirations per minute in adults.

tidal volume

ti·dal vol·ume

/tahyd l vol yoom, -yuhm/

Noun

The average amount of air, approximately 500 mL, an average person moves with each breath

trachea

tra·che·a

/ˈtrākēə/

Noun

A structure 4 - 5 inches long that is composed of a number of C-shaped rings made of cartilage, joined together by a membrane that prevents the trachea from collapsing. The posterior portion of the trachea is “open”, allowing the trachea to expand or contract.

tracheostomy mask

tra·che·os·to·my mask

/treykee os tuh mee mahsk/

Noun

An oxygen delivery device that is designed to be placed over a tracheostomy tube that is surgically placed through the patient’s anterior neck.

tripod position

tri·pod po·si·tion

/ˈtrīpäd pəˈziSHən/

Noun

A position of leaning forward and supporting weight on the hands and arms. This position allows the weight of the chest to be distributed off the diaphragm and is a sign of respiratory distress.

upper airway

up per air way

/ˈəpər ˈeərˌwā/

Noun

Extends from the nose and mouth (or stoma) to the level of the vocal cords. This section of the airway is responsible for the intake of air and its initial warming, filtering, and humidifying. It includes the tongue, oropharynx, nasopharynx, and the epiglottis

vagal response

va·gal re·sponse

/vey guhl ri-spons/

Noun

When the heart rate slows and blood pressure falls

vasodilation

vas·o·di·la·tion

/ˌvāzōdīˈlāSHən/

Noun

The widening of blood vessels due to smooth muscle relaxation surrounding the vessels

ventilation

ven·ti·la·tion

/ˌventəˈlāSHən/

Noun

The process of breathing effort and its rate. A person at rest will primarily use the diaphragm to breath, moving an average of 500 mL of tidal volume into the lungs with each breath.

ventilatory rate

ven·ti·la·to·ry rate

/ˈventələˌtôrē rāt/

Noun

The normal ventilatory rate for an adult is approximately 12 to 20 times per minute. The normal ventilatory rate for pediatric patients varies with age.

Venturi mask

Ven·tu·ri mask

/ven toor ee mask, mahsk/

Noun

This type of mask is useful when the patient requires a precise amount of oxygen. A special fitting or port on the mask mixes atmospheric air with supplemental oxygen through a venturi effect. A venturi mask is typically used with patients with chronic respiratory illnesses such as emphysema.

visceral pleura

vis·cer·al pleu·ra

/ˈvis(ə)rəl ˈplo͝orə/

Noun

The inner pleural membrane that covers the lungs.