respiratory

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respiratory

 [res´pir-ah-tor″e]
pertaining to respiration.
acute respiratory distress syndrome (adult respiratory distress syndrome) a group of symptoms accompanying fulminant pulmonary edema and resulting in acute respiratory failure; see also acute respiratory distress syndrome.
respiratory care
1. the health care profession providing, under qualified supervision, diagnostic evaluation, therapy, monitoring, and rehabilitation of patients with cardiopulmonary disorders; it also employs educational activities to support patients and their families and to promote cardiovascular health among the general public.
2. the care provided by members of this profession.
3. the diagnostic and therapeutic use of medical gases and their administering apparatus, environmental control systems, humidification, aerosols, medications, ventilatory support, bronchopulmonary drainage, pulmonary rehabilitation, cardiopulmonary resuscitation, and airway management.
respiratory distress syndrome, neonatal (respiratory distress syndrome of the newborn (RDS)) a condition of the newborn marked by dyspnea with cyanosis, heralded by such prodromal signs as dilatation of the nares, grunting on exhalation, and retraction of the suprasternal notch or costal margins. It usually occurs in newborns who are preterm, have diabetic mothers, or were delivered by cesarean section; sometimes there is no apparent predisposing cause.



This is the major cause of death in neonates and survivors have a high risk for chronic neurologic complications. No one factor is known to cause the condition; however, prematurity and interrupted development of the surfactant system is thought to be the major causative factor. Surfactant is secreted by the epithelial cells of the alveoli. It acts as a detergent, decreasing the surface tension of fluids that line the alveoli and bronchioles and allowing for uniform expansion of the lung and maintenance of lung expansion. When there is an inadequate amount of surfactant, a great deal of effort is required to re-expand the alveoli with air; thus the newborn must struggle for each breath. Insufficient expansion of the alveoli results in partial or complete collapse of the lung (atelectasis). This in turn produces hypoxemia and elevated serum carbon dioxide levels.

The hypoxemia causes metabolic acidosis from increased production of lactic acid and respiratory acidosis due to the hypercapnia. The lowered pH constricts pulmonary blood vessels and inhibits intake of oxygen, thus producing more hypoxemia and interfering with the transport of substances necessary for the production of the sorely needed surfactant.
Patient Care. In order to minimize the hazards of oxygen toxicity and retinopathy of prematurity, the blood gases of the newborn with respiratory distress syndrome must be carefully monitored to assess response to therapy. The goal is to administer only as much oxygen as is necessary to maintain an optimal level of oxygenation.



To improve respiratory function, intubation, suctioning of the air passages, and continuous positive airway pressure via nasal prongs are commonly used, as well as instillation of artificial surfactant. Monitoring is conducted using transcutaneous oxygen monitoring or a pulse oximeter. To optimize breathing effort and facilitate air exchange, the newborn is positioned on the back with a shoulder support to keep the neck slightly extended, or on the side with the head supported. Because of the drying effect of oxygen therapy and the prohibition of oral fluids, mouth care must be given frequently to prevent drying and cracking of the lips and oral mucosa.
respiratory failure a life-threatening condition in which respiratory function is inadequate to maintain the body's need for oxygen supply and carbon dioxide removal while at rest; it usually occurs when a patient with chronic airflow limitation develops an infection or otherwise suffers an additional strain on already seriously impaired respiratory functions. Inadequate or unsuccessful treatment of respiratory insufficiency from a variety of causes can lead to respiratory failure. Called also ventilatory failure.



Early symptoms include dyspnea, wheezing, and apprehension; cyanosis is rarely present. As the condition worsens the patient becomes drowsy and mentally confused and may slip into a coma. blood gas analysis is an important tool in diagnosing respiratory failure and assessing effectiveness of treatment. The condition is a medical emergency that can rapidly progress to irreversible cardiopulmonary failure and death. Treatment is concerned with improving ventilation and oxygenation of tissues, restoring and maintaining fluid balance and acid-base balance, and stabilizing cardiac function.
respiratory insufficiency a condition in which respiratory function is inadequate to meet the body's needs when increased physical activity places extra demands on it. Insufficiency occurs as a result of progressive degenerative changes in the alveolar structure and the capillary tissues in the pulmonary bed, as, for example, in chronic airflow limitation and pulmonary fibrosis. Treatment is essentially supportive and symptomatic. If the condition is not successfully managed it may progress to respiratory failure.
respiratory therapist a health care professional skilled in the treatment and management of patients with respiratory problems, who administers respiratory care. The minimum educational requirement is an associate degree, providing knowledge of anatomy, physiology, pharmacology, and medicine sufficient to serve as a supervisor and consultant. Those registered by the National Board for Respiratory Therapy are designated Registered Respiratory Therapist (RRT).
respiratory therapy respiratory care.
respiratory therapy technician a health care professional who has completed a specialized one- or two-year educational program and who performs routine care, management, and treatment of patients with respiratory problems under the supervision of a respiratory therapist. Such programs are usually found in community colleges and are accredited by the Joint Review Committee for Respiratory Therapy Education.

res·pi·ra·to·ry

(res'pi-ră-tōr'ē, rĕ-spīr'ă-tōr-ē), Although the pronunciation of this word with stress on the second syllable is more correct, the first syllable is often stressed in the U.S.
Relating to respiration.

respiratory

/res·pi·ra·to·ry/ (res´pĭ-rah-tor″e) pertaining to respiration.

respiratory

(rĕs′pər-ə-tôr′ē, rĭ-spīr′ə-)
adj.
Of, relating to, used in, or affecting respiration.

respiratory

respiratory

adjective Referring to respiration or breathing.

Pronunciation 
Medspeak-UK: pronounced, reh SPEAR uh tory
Medspeak-US: pronounced, RESS pur uh tory

res·pi·ra·to·ry

(res'pir-ă-tōr-ē)
Relating to respiration.

res·pi·ra·to·ry

(res'pir-ă-tōr-ē)
Relating to respiration.

respiratory

pertaining to respiration. See also pulmonary.

acute respiratory disease of turkeys
see turkey coryza.
acute respiratory distress syndrome
a noncardiogenic pulmonary edema characterized by disruption of pulmonary capillary endothelium and accumulation of high-protein edema fluid in the lungs. See also shock lung, atypical interstitial pneumonia, neonatal maladjustment syndrome.
respiratory arrest
sudden complete cessation of respiratory movement.
respiratory burst of neutrophils
the series of biochemical reactions that take place within a neutrophil when a particle is phagocytosed. Important in the host defense mechanisms.
respiratory centers
see respiratory centers.
chronic respiratory disease
see chronic respiratory disease.
respiratory cilia
see cilia.
respiratory clearance
clearance of inhaled particles from the respiratory system by absorption of finally solubilized material through the respiratory epithelium, passage through the alveolar epithelium at special sites near the alveolar ducts, or to the exterior by a flow of alveolar fluid to the bronchi, a moving sheet of mucus into the bronchioles, up the bronchioles, bronchi and trachea with the assistance of repiratory cilia to the pharynx.
respiratory control
quantitative relationship between oxidative phosphorylation and electron transfer. Traditionally presented as a P/O ratio indicating the number of ATP molecules synthesized per atom of oxygen consumed.
respiratory control ratio
ratio of oxygen uptake in the presence of ADP to that in the absence of ADP. Used as an index of the functional integrity of prepared mitochondria since it is above 10 in good preparation and unity in aged or damaged mitochondria.
respiratory cycle
the cycle of inspiration, expiration, pause of the normal resting cycle depends on sensors in the respiratory system which provide stimuli to initiate the next part of the cycle.
respiratory dead space
see dead space (2).
respiratory depression
the rate and/or depth of respiration are insufficient to maintain adequate gas exchange in the lungs; a subjective judgment tending to be superseded, at least during anesthesia, by instrumentation. See respiration monitors.
respiratory depth
amplitude of each respiratory movement.
respiratory difficulty
see dyspnea.
respiratory disease pattern
may be aerogenous when the pathogen is inhaled or hematogenous when the pathogen is delivered to the lungs in the blood supply.
respiratory distress syndrome of newborn (RDS)
see hyaline membrane disease.
respiratory exchange ratio
the carbon dioxide output divided by the oxygen uptake; see also respiratory quotient (below).
respiratory failure
a life-threatening condition in which respiratory function is inadequate to maintain the body's need for oxygen supply and carbon dioxide removal while at rest; called also acute ventilatory failure. The type of failure varies with the CO2 content of the blood and may be asphyxial, when there is gasping, dyspneic when there is dyspnea, paralytic when the respiratory movements gradually fade away, tachypneic when the movements are fast and shallow.
respiratory grunting
grunting at the peak of each inspiration, or on percussion of the chest wall; indicates pain in the pleura.
respiratory insufficiency
a condition in which respiratory function is inadequate to meet the body's needs when increased physical activity places extra demands on it. Insufficiency occurs as a result of progressive degenerative changes in the alveolar structure and the capillary tissues in the pulmonary bed.
respiratory noises
includes sneezing, snorting, stridor, stertor (snoring), wheezing, roaring, grunting.
respiratory paralysis
see respiratory failure (above).
respiratory quotient (RQ)
the ratio of the volume of expired carbon dioxide to the volume of oxygen absorbed by the lungs per unit of time. Called also respiratory exchange ratio (above).
respiratory rate
the number of respirations per minute. Normal rates per minute are: horses 8 to 10; cattle 10 to 30; sheep and pigs 10 to 20; goats 25 to 35; dogs 10 to 30; cats 20 to 30.
respiratory rhythm
normally consists of three phase cycles of inspiration, expiration, pause; prolongation of inspiration suggests obstruction of the upper respiratory tract, prolongation of expiration, or a double respiratory effort suggests loss of recoil elasticity of the lungs. See also biot's respirations, cheyne-stokes respiration.
respiratory secretion
includes samples collected by nasal swab, nasopharyngeal swab, percutaneous tracheobronchial lavage and fiberoptic endoscopic sampling. Assessment is by laboratory examination for cellular content, bacteria, viruses, helminth parasites, fungi.
respiratory system
the group of specialized organs whose specific function is to provide for the transfer of oxygen from the air to the blood and of waste carbon dioxide from the blood to the air. These functions are performed by the tubular and cavernous organs which allow atmospheric air to reach the membranes across which gases are exchanged with the blood. The system includes the organs of the respiratory tract (below) plus the respiratory centers in the medulla. The supportive roles of the nervous system, the muscular, cardiovascular and hemopoietic systems are also essential.
respiratory tract
the organs of the tract include the upper respiratory tract of the nasal cavities, the pharynx, larynx, trachea and bronchi, and the lower respiratory tract comprising the bronchioles and alveoli of the lungs.
respiratory viruses
see Table 8.2.
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