Glossary of Common Respiratory Related Terms
A
Alveoli - small air sacs at the end of the bronchial tree in the lungs, and through the walls of these air sacs Oxygen (O2) diffuses into the blood and Carbon Dioxide (CO2) diffuses out of the blood.
Apnea – no breathing; during apnea, there is no movement of the muscles of inhalation and the volume of the lungs initially remains unchanged. Depending on how blocked the airways are (patency), there may or may not be a flow of gas between the lungs and the environment; gas exchange within the lungs and cellular respiration is not affected.
Arterial blood gas – (ABG) is a test of blood from an artery and measures the amounts of certain gases (such as oxygen or PaO2 and carbon dioxide PaCO2) that are in arterial blood. An ABG test involves puncturing an artery with a thin needle and syringe and drawing a small volume of blood.
Assisted ventilation – see Mechanical ventilation
Atelectasis - the collapse or closure of a lung resulting in reduced or absent gas exchange. It may affect part or all of a lung. It is usually not bilateral and is a condition where the alveoli are deflated down to little or no volume.
B
Bi-level ventilation – positive airway pressure (BPAP), commonly referred to by the trademarked names BiPAP and BIPAP, and is a form of non-invasive mechanical pressure support ventilation that uses a time-cycled or flow-cycled change between two different applied levels of positive airway pressure known as inspiratory positive airway pressure (IPAP) and expiratory positive airway pressure (EPAP).
Breathing muscles -Inspiratory muscles used for inhaling air into the lungs, expiratory muscles (mainly abdominal and chest wall) used for coughing, and the bulbar muscles, including the glottis, that protects the airways and holds deep volumes of air for coughing.
C
Capnograph – also known as capnometer; a monitoring device that painlessly measures the concentration of carbon dioxide in exhaled air (end tidal CO2)
CoughAssist – a trademarked device by Philips Respironics that uses positive airway pressure that rapidly reverses to negative pressure to assist an individual’s cough; sometimes called a cough stimulating device or device for cough augmentation; latest model at the time of this writing is the T70 in the US
Cough Peak Flow (CPF) – unassisted cough peak flows can be determined by coughing into a simple peak flow meter, a device commonly used by those who have the obstructive condition asthma. CPF tells the total strength of one’s cough in Liters per min (L/min).
CPAP – Continuous Positive Airway Pressure is used to help keep the airways open and is no longer recommended for use in neuromuscular disease patients as it provides one continuous pressure of air for both inhaling and exhaling. As such, it can be uncomfortable for weakened breathing muscles and does not assist with ventilation (moving air into and out of the lungs) for those with weak inspiratory muscles.
D
Diaphragm - primary muscle of breathing that stretches across the area between your chest and waist to support your lungs
E
EPAP – expiratory positive airway pressure, the pressure we exhale against with a bi-level ventilation device or as part of a bi-level mode of ventilation on a ventilator
Extubation - the process of removing an endotracheal tube from the trachea after intubation
F
Forced Vital Capacity (FVC) – the total amount of air forcibly blown out after taking your largest breath
FVC1 – the amount of air forcibly blown out in the first second during pulmonary function testing.
H
Hypercapnia - too much carbon dioxide (CO2) in the blood; often caused by inadequate ventilation
Hypopnea - shallow breathing
Hypoventilation – Also known as underventilation; The respiratory center in the brain can tell the inspiratory muscles of the body to breathe more shallowly than normal to prevent fatigue. As a result, blood carbon dioxide (CO2) levels rise, and the drive to breathe is further reduced.
Hypoxemia - an abnormally low level of oxygen in the blood.
I
IPAP – inspiratory positive airway pressure delivered through a bi-level device (i.e. BiPAP or portable ventilator)
IPPV – (Intermittent Positive Pressure Ventilation) is provided via portable ventilators to augment breathing. IPPV permits the person to exhale without the need to overcome expiratory positive airway pressure (EPAP) or positive end-expiratory pressure (PEEP)
Inspiratory Capacity - the total amount of air that can be drawn into the lungs by maximal inspiration
Interface – a ventilation interface can be non-invasive (oral, nasal, oronasal, and mouthpiece) or invasive (tracheostomy and endotracheal tubes). The ventilation interface is connected to tubing that connects to a bi-level ventilation device or ventilator that in turn delivers air to the individual.
Intubation - passing an “endotracheal tube” through the nose or mouth into the trachea to deliver invasive mechanical ventilation and/or to suction the airways
Invasive ventilation - ventilation delivered via tubing from a ventilator through a tracheostomy, a surgically inserted hole in the windpipe (trachea)
L
Lung volume recruitment (LVR) – It can be done passively or actively. Passive LVR is done with mechanical insufflation exsufflation, (MIE) at high insufflation pressures or with a manual resusistator or ambu bag with the exhalation valve closed. Active LVR is also referred to as air stacking.
M
Mechanical insufflation exsufflation - (MIE) achieved via devices such as the CoughAssist by alternating positive and negative pressure to the airways to simulate a stronger cough and increase cough peak flows to clear airway secretions
Mechanical ventilation - also known as assisted ventilation, a method to augment or completely replace the effort of breathing (depending on the user’s level of function). It’s a means for the user to inhale enough air to fill the lungs and can aid in exhaling. Devices prescribed for those living with NMD to assist with their ventilation (moving air into and out of the lungs) include bi-level devices (i.e. BiPAP) and portable ventilators.
N
Non-invasive ventilation - (NIV) uses a mask (i.e. full face, nasal, or nasal pillows) or other type of mouthpiece interface (i.e. angled mouthpieces or straw) than can be wheelchair-connected via gooseneck tubing to deliver air from a bi-level device (BiPAP) or portable ventilator to ventilate the lungs (move air into and out of them). Non-invasive ventilation does not require a surgical procedure.
P
Peak Cough Flow – (PCF); the velocity of air being expelled from the lungs after a cough maneuver usually from maximum inspiration. This measurement can be expressed and reported in L/min or L/sec.
Pulmonary Function Test – (PFT); a test that is designed to measure how well the lungs are working; PFTs gauge how the lungs are expanding and contracting (when a person inhales and exhales) and measure the efficiency of the exchange of oxygen and carbon dioxide between the blood and the air within the lungs.
Pulse oximeter - device that measures the oxygen saturation of arterial blood by utilizing a sensor attached typically to a finger, toe, or ear to determine the percentage of oxyhemoglobin in blood
T
TLC = total lung capacity, the maximum volume of air the lungs can hold
Tracheostomy – the result of a tracheostomy, a stoma (hole), can serve independently as an airway or as a site for a tracheostomy tube to be inserted
Tracheostomy tube –tube that allows a person to breathe without the use of his or her nose or mouth
tracheotomy - a surgical procedure which consists of making an incision on the anterior aspect of the neck and opening a direct airway through an incision in the trachea (windpipe)
S
Spirometry - (meaning the measuring of breath) is the most common of the pulmonary function tests (PFTs), measuring lung function, specifically the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled
V
Ventilation – the process by which the exchange of oxygen (O2) and carbon dioxide (CO2) occurs in the alveoli in the lungs; a constant process of maintaining the proper balance between the O2 and CO2
Ventilator – a machine designed to move breathable air into and out of the lungs, to provide breathing for a patient who is physically unable to breathe, or breathing insufficiently; can be used with noninvasive ventilation or with invasive ventilation
A
Alveoli - small air sacs at the end of the bronchial tree in the lungs, and through the walls of these air sacs Oxygen (O2) diffuses into the blood and Carbon Dioxide (CO2) diffuses out of the blood.
Apnea – no breathing; during apnea, there is no movement of the muscles of inhalation and the volume of the lungs initially remains unchanged. Depending on how blocked the airways are (patency), there may or may not be a flow of gas between the lungs and the environment; gas exchange within the lungs and cellular respiration is not affected.
Arterial blood gas – (ABG) is a test of blood from an artery and measures the amounts of certain gases (such as oxygen or PaO2 and carbon dioxide PaCO2) that are in arterial blood. An ABG test involves puncturing an artery with a thin needle and syringe and drawing a small volume of blood.
Assisted ventilation – see Mechanical ventilation
Atelectasis - the collapse or closure of a lung resulting in reduced or absent gas exchange. It may affect part or all of a lung. It is usually not bilateral and is a condition where the alveoli are deflated down to little or no volume.
B
Bi-level ventilation – positive airway pressure (BPAP), commonly referred to by the trademarked names BiPAP and BIPAP, and is a form of non-invasive mechanical pressure support ventilation that uses a time-cycled or flow-cycled change between two different applied levels of positive airway pressure known as inspiratory positive airway pressure (IPAP) and expiratory positive airway pressure (EPAP).
Breathing muscles -Inspiratory muscles used for inhaling air into the lungs, expiratory muscles (mainly abdominal and chest wall) used for coughing, and the bulbar muscles, including the glottis, that protects the airways and holds deep volumes of air for coughing.
C
Capnograph – also known as capnometer; a monitoring device that painlessly measures the concentration of carbon dioxide in exhaled air (end tidal CO2)
CoughAssist – a trademarked device by Philips Respironics that uses positive airway pressure that rapidly reverses to negative pressure to assist an individual’s cough; sometimes called a cough stimulating device or device for cough augmentation; latest model at the time of this writing is the T70 in the US
Cough Peak Flow (CPF) – unassisted cough peak flows can be determined by coughing into a simple peak flow meter, a device commonly used by those who have the obstructive condition asthma. CPF tells the total strength of one’s cough in Liters per min (L/min).
CPAP – Continuous Positive Airway Pressure is used to help keep the airways open and is no longer recommended for use in neuromuscular disease patients as it provides one continuous pressure of air for both inhaling and exhaling. As such, it can be uncomfortable for weakened breathing muscles and does not assist with ventilation (moving air into and out of the lungs) for those with weak inspiratory muscles.
D
Diaphragm - primary muscle of breathing that stretches across the area between your chest and waist to support your lungs
E
EPAP – expiratory positive airway pressure, the pressure we exhale against with a bi-level ventilation device or as part of a bi-level mode of ventilation on a ventilator
Extubation - the process of removing an endotracheal tube from the trachea after intubation
F
Forced Vital Capacity (FVC) – the total amount of air forcibly blown out after taking your largest breath
FVC1 – the amount of air forcibly blown out in the first second during pulmonary function testing.
H
Hypercapnia - too much carbon dioxide (CO2) in the blood; often caused by inadequate ventilation
Hypopnea - shallow breathing
Hypoventilation – Also known as underventilation; The respiratory center in the brain can tell the inspiratory muscles of the body to breathe more shallowly than normal to prevent fatigue. As a result, blood carbon dioxide (CO2) levels rise, and the drive to breathe is further reduced.
Hypoxemia - an abnormally low level of oxygen in the blood.
I
IPAP – inspiratory positive airway pressure delivered through a bi-level device (i.e. BiPAP or portable ventilator)
IPPV – (Intermittent Positive Pressure Ventilation) is provided via portable ventilators to augment breathing. IPPV permits the person to exhale without the need to overcome expiratory positive airway pressure (EPAP) or positive end-expiratory pressure (PEEP)
Inspiratory Capacity - the total amount of air that can be drawn into the lungs by maximal inspiration
Interface – a ventilation interface can be non-invasive (oral, nasal, oronasal, and mouthpiece) or invasive (tracheostomy and endotracheal tubes). The ventilation interface is connected to tubing that connects to a bi-level ventilation device or ventilator that in turn delivers air to the individual.
Intubation - passing an “endotracheal tube” through the nose or mouth into the trachea to deliver invasive mechanical ventilation and/or to suction the airways
Invasive ventilation - ventilation delivered via tubing from a ventilator through a tracheostomy, a surgically inserted hole in the windpipe (trachea)
L
Lung volume recruitment (LVR) – It can be done passively or actively. Passive LVR is done with mechanical insufflation exsufflation, (MIE) at high insufflation pressures or with a manual resusistator or ambu bag with the exhalation valve closed. Active LVR is also referred to as air stacking.
M
Mechanical insufflation exsufflation - (MIE) achieved via devices such as the CoughAssist by alternating positive and negative pressure to the airways to simulate a stronger cough and increase cough peak flows to clear airway secretions
Mechanical ventilation - also known as assisted ventilation, a method to augment or completely replace the effort of breathing (depending on the user’s level of function). It’s a means for the user to inhale enough air to fill the lungs and can aid in exhaling. Devices prescribed for those living with NMD to assist with their ventilation (moving air into and out of the lungs) include bi-level devices (i.e. BiPAP) and portable ventilators.
N
Non-invasive ventilation - (NIV) uses a mask (i.e. full face, nasal, or nasal pillows) or other type of mouthpiece interface (i.e. angled mouthpieces or straw) than can be wheelchair-connected via gooseneck tubing to deliver air from a bi-level device (BiPAP) or portable ventilator to ventilate the lungs (move air into and out of them). Non-invasive ventilation does not require a surgical procedure.
P
Peak Cough Flow – (PCF); the velocity of air being expelled from the lungs after a cough maneuver usually from maximum inspiration. This measurement can be expressed and reported in L/min or L/sec.
Pulmonary Function Test – (PFT); a test that is designed to measure how well the lungs are working; PFTs gauge how the lungs are expanding and contracting (when a person inhales and exhales) and measure the efficiency of the exchange of oxygen and carbon dioxide between the blood and the air within the lungs.
Pulse oximeter - device that measures the oxygen saturation of arterial blood by utilizing a sensor attached typically to a finger, toe, or ear to determine the percentage of oxyhemoglobin in blood
T
TLC = total lung capacity, the maximum volume of air the lungs can hold
Tracheostomy – the result of a tracheostomy, a stoma (hole), can serve independently as an airway or as a site for a tracheostomy tube to be inserted
Tracheostomy tube –tube that allows a person to breathe without the use of his or her nose or mouth
tracheotomy - a surgical procedure which consists of making an incision on the anterior aspect of the neck and opening a direct airway through an incision in the trachea (windpipe)
S
Spirometry - (meaning the measuring of breath) is the most common of the pulmonary function tests (PFTs), measuring lung function, specifically the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled
V
Ventilation – the process by which the exchange of oxygen (O2) and carbon dioxide (CO2) occurs in the alveoli in the lungs; a constant process of maintaining the proper balance between the O2 and CO2
Ventilator – a machine designed to move breathable air into and out of the lungs, to provide breathing for a patient who is physically unable to breathe, or breathing insufficiently; can be used with noninvasive ventilation or with invasive ventilation