Respiratory System and Pulmonology

Respiratory System

• The respiratory system is a branch of medicine that specializes in diagnosing and treating diseases of the lungs and other parts of the respiratory system.
• The process of exchange of gases is called respiration, which is an involuntary activity involving inhalation and exhalation of oxygen and carbon dioxide respectively.
• The respiratory system consists of two major units: the respiratory passage and the respiratory organ.

Respiratory Passage

• The respiratory passage takes air from the atmosphere through the nostrils, nasal cavity, pair of internal nares, nasopharynx, larynx, trachea, bronchi, and branches of bronchi on the lung surface (alveoli).
• The upper respiratory tract consists of:
  • External nostrils: for the intake of air
  • Nasal chamber: lined with hair and mucus to filter air from dust and dirt
  • Pharynx: a common passageway for both air and food
  • Internal nares: posterior opening of nasal cavity that leads to nasopharynx
  • Nasopharynx: contains pharyngeal tonsils, or adenoids, which are collections of lymphatic tissue
• The lower respiratory tract consists of:
  • Larynx: contains the vocal cords and is surrounded by pieces of cartilage for support
  • Epiglottis: a flap of cartilage attached to the root of the tongue, prevents choking or aspiration of food
  • Trachea: a long tube passing through the mid-thoracic cavity
  • Bronchi: the trachea divides into left and right bronchi
  • Bronchioles: each bronchus leads to a separate lung where it divides and subdivides into smaller and finer tubes

Respiratory Tract Functions

• The functions of the human respiratory system are:
  • Inhalation and exhalation: the respiratory system helps in breathing (also known as pulmonary ventilation)
  • Exchange of gases between lungs and bloodstream: inside the lungs, oxygen and carbon dioxide enter and exit respectively through millions of microscopic sacs called alveoli

Respiratory Diseases

• Asthma: a condition where airways are constantly inflamed and may spasm, causing wheezing and shortness of breath
• Chronic obstructive pulmonary disease (COPD): a lung condition where you can’t exhale the way you usually would, causing trouble breathing
• Emphysema: a form of COPD where lung damage allows air to be trapped in your lungs
• Acute bronchitis: a sudden infection of your airways, usually caused by a virus
• Cystic fibrosis: a condition where you have trouble clearing mucus out of your bronchi, leading to repeated lung infections

Alveoli

• Air sacs (alveoli): tiny sacs where gas exchange occurs between the lungs and bloodstream
• Lung diseases affecting the alveoli include:
  • Pneumonia: an infection of the alveoli, usually by bacteria or viruses
  • Tuberculosis: a type of pneumonia that slowly gets worse, caused by the bacteria Mycobacterium tuberculosis

Interstitium and Blood Vessels

• Interstitium: the thin, delicate lining between the alveoli where tiny blood vessels run through, allowing gas transfer between the alveoli and the blood
• Lung diseases affecting the interstitium include:
  • Interstitial lung disease (ILD): a group of lung conditions that includes sarcoidosis, idiopathic pulmonary fibrosis, and autoimmune disease
  • Pulmonary embolism: a blood clot that breaks off, travels to the heart, and gets pumped into the lungs, causing shortness of breath and low blood oxygen levels

Pleura and Chest Wall

• Pleura: the thin lining that surrounds the lung and lines the inside of the chest wall
• Lung diseases of the pleura include:
  • Pleural effusion: fluid collects in the space between the lung and the chest wall
  • Pneumothorax: air gets into the space between the chest wall and the lung, collapsing the lung

Medical Terminology

• Adenoid/O- Adenoids
• Alveol/O- Alveolus
• Bronch/O- Bronchial tube
• Epiglott/O- Epiglottis
• Laryng/O- Voice box

Medical Abbrevations

• ABGS: Arterial Blood Gases
• COPD: Chronic Obstructive Pulmonary Disease
• CPAP: Continuous Positive Airway Pressure
• CPR: Cardiopulmonary Resuscitation
• ICU: Intensive Care Unit

ICD Codes

• Bradypnea-R06.89
• Chronic obstructive pulmonary disease-J44.9
• Chronic cough-R05.3
• Cystic fibrosis, unspecified -E84.9
• Emphysema, unspecified -J43.9

CPT Procedure Codes

• Endotracheal intubation-31500
• Laryngoscopy, flexible; diagnostic-31575