Ptosis, 434
Pulmonary air leak syndrome, 541–549 admitting history, 547
airway clearance protocol, 544–546 arterial blood gases, 545 b
cardiopulmonary clinical manifestations associated with, 545–546 case study, 547–548
chest assessment findings, 545 chest radiograph, 546 discussion, 548
etiology and epidemiology, 544 illustration, 542 f
laboratory tests and procedures, clinical data, 545 lungs
anatomic alterations, 542–543 expansion therapy protocol, 546
management of, 544–546 mechanical ventilation protocol, 546 needle thoracentesis, 546 , 547 f neonatal, risk factors, 544 b
oxygen therapy protocol, 544 oxygenation indices, 546 b patient bedside, clinical data, 545 physical examination, 545 , 547
pulmonary function test findings, 545 b radiologic findings, 546
respiratory assessment and plan, 547–548 respiratory care treatment protocols, 544–546 respiratory rate, increased (tachypnea), 545 transillumination, increased, 545
vital signs, 545
Pulmonary alveolar proteinosis, 405 Pulmonary angiogram, 112–113
abnormality of, 113 f
for pulmonary embolism, 324 , 328 , 329 f
Pulmonary artery, catheter, 97–98 Pulmonary barotrauma, 541
drowning and, 602–603
Pulmonary capillary blood (CcO2 ), 84 Pulmonary capillary congestion, 528 , 529 f Pulmonary capillary wedge pressure (PCWP), 97
position, 98 f
Pulmonary catheter, insertion of, 98 f Pulmonary diffusion capacity, 62–65 , 65 t Pulmonary edema, 311–319
admitting history, 318 afterload reducers in, 314 arterial blood gases, 315 b
cardiogenic, 312–313 , 313 b , 316–317
cardiopulmonary manifestations associated with, 315–317 case study, 318–319
cephalogenic, 313 Cheyne-Stokes respiration in, 315
chronic lung disease of infancy caused by, 564 t clinical data in, 315
decompression, 313
decreased intrapleural pressure in, 313 decreased oncotic pressure in, 313 discussion, 319
etiology and epidemiology of, 312–313 hemodynamic indices, 316 b high-altitude, 313–314
increased capillary permeability in, 313 increased respiratory rate in, 315 laboratory tests and procedures
abnormal, 316 clinical data, 315
lungs
anatomic alterations, 311–312 , 312 f expansion therapy protocol, 317–318
lymphatic insufficiency in, 313 management of, 314–318 mechanical ventilation protocol, 318 noncardiogenic, 313–314 , 314 b , 317 oxygen therapy protocols, 317
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oxygenation indices, 316 b
paroxysmal nocturnal dyspnea and orthopnea in, 315 photographic negative, 409
physical examination, 315 , 318 positive inotropic agents for, 314–317 preload reducers for, 314
pulmonary function test findings, 315 b radiologic findings in, 316–317 , 316 f –317 f respiratory assessment and plan, 318 respiratory care treatment protocols for, 317–318 respiratory rate, increased (tachypnea), 315 vital signs in, 315
Pulmonary embolectomy, for pulmonary embolism, 330 Pulmonary embolism (PE), 321–330
abnormal electrocardiographic patterns in, 328 admitting history, 335
aerosolized medication protocol, 330 arterial blood gases, 327 b
cardiopulmonary clinical manifestations associated with, 325–328 case study, 335–337
chest radiograph, 328 chest x-ray, 323 clinical data, 325–327
common tests for, 322–324 blood tests, 322
chest x-ray, 323
computed tomography pulmonary angiogram, 323 , 328 , 329 f D -dimer blood test, 322
magnetic resonance angiography, 324 magnetic resonance imaging, 324 pulmonary angiogram, 324 , 328 , 329 f ultrasonography, 322–323
ventilation-perfusion scan, 323–324 , 328 , 329 f deep vein thrombosis and, 321
diagnosis and screening of, 322–324 discussion, 336–337
etiology and epidemiology of, 321–322 heart rate, increased, 326 hemodynamic indices, 327 b
laboratory tests and procedures, clinical data, 327–328 lungs
anatomic alterations, 321 , 321 f expansion therapy protocol, 330
management of, 324–330 oxygen therapy protocol, 330 oxygenation indices, 327 b
physical examination, 325–327 , 335 preventive measures for, 324–330 radiologic findings in, 328 respiratory assessment and plan, 335
respiratory care treatment protocols for, 330 respiratory rate, increased (tachypnea), 325 risk factors associated with, 322 b
signs and symptoms, 323 b transudative pleural effusion and, 358 vital signs, 325
Wells clinical prediction rule for, 323 t
Pulmonary emphysema, microscopic, 191 f Pulmonary fibrosis, 398
end stage pulmonary fibrosis, 398
Pulmonary flow to systemic flow (QP /QT ) ratio, 578–579 Pulmonary function test (PFT) findings
acute respiratory distress syndrome, 418 b asthma, 227 b
bronchiectasis, 263 b –264 b chronic bronchitis, 200 b
chronic interstitial lung disease, 406 b chronic lung disease of infancy, 563 b congenital diaphragmatic hernia, 571 b cystic fibrosis, 249 b
emphysema, 200 b flail chest, 342 b
Guillain-Barré syndrome, 427 b kyphoscoliosis, 368 b
lung cancer, 386
meconium aspiration syndrome, 523 b myasthenia gravis, 436 b
near wet drowning, 601 b neuromuscular disease, 450 b pleural effusion and empyema, 360 b pneumonia, 294 b
pneumothorax, 350 b postoperative atelectasis, 275 b pulmonary air leak syndrome, 545 b pulmonary edema, 315 b
respiratory distress syndrome, 536 b respiratory syncytial virus infection, 553 b sleep apnea, 468 b
smoke inhalation and thermal injuries, 610 b transient tachypnea of the newborn, 530 b tuberculosis, 306 b
Pulmonary function testing, 54–68 asthma, diagnostic tests for, 66
impulse oscillometry in, 66 , 67 f cardiopulmonary exercise testing in, 65–66 , 66 b
expense and complexity of, general hierarchy of, 55 t
forced expiratory flow rate, volume measurements and, 58–62 flow-volume loop in, 61–62 , 62 f , 63 t –65 t
forced expiratory flow 25% to 75%, 60 , 60 f
forced expiratory flow between 200 and 1200 mL of forced vital capacity in, 60 , 60 f forced expiratory volume in 1 second/forced vital capacity (FEV1 /FVC) ratio, 59–60 forced expiratory volume timed in, 58 , 60 f
forced vital capacity in, 58 , 59 f maximum voluntary ventilation in, 61 , 61 f peak expiratory flow rate in, 61 , 61 f
myasthenia gravis, 435
normal lung volumes and capacities in, 55–58 , 56 t obstructive lung disorders, 55 , 56 t , 57 f
restrictive lung disorders, 55 , 56 t pulmonary diffusion capacity in, 62–65 , 65 t
residual volume, indirect measurements of, lung capacities containing, 55–58 , 58 f –59 f respiratory muscle strength, assessment of, 65
Pulmonary hyperperfusion, 535
Pulmonary hypertension, 157 , 330–337 , 333 f , 570 clinical classification of, 331 b
common signs and symptoms of, 331 b –332 b diagnosis of, 330
management of, 330 severity of, 333 t
test and procedures for, 332 t treatment selections for, 334 f , 334 t
Pulmonary hypoperfusion, 535 Pulmonary hypoplasia, 569–570 Pulmonary infarction, 321
transudative pleural effusion and, 358
Pulmonary interstitial emphysema (PIE), 542–543 , 542 f lung, hyperinflation, 543 f
overdistention, association, 542
Pulmonary Langerhans cell histiocytosis (PLCH), 405 Pulmonary nodule, 107
Pulmonary oxygen toxicity, 494 Pulmonary reflexes, 97
ventilatory pattern and, 40–41
Pulmonary shunt fraction (Q S /Q T ), 86–88 study calculation in, 88 b
Pulmonary shunting, 157–159 , 158 f clinical significance of, 88 t
hypoxemia and, 38 types of, 159 t
Pulmonary vascular disease, 320–338 case study, 335–337
emerging role of the respiratory therapist in, 330–335 pulmonary embolism, 321–330
pulmonary hypertension, 330–337
Pulmonary vascular resistance (PVR), 99 , 491–492 Pulmonary vascular system
decreased cross-sectional area of, because of the embolus, 327 loss of, 113
Pulmonary vasculitides, 405
Pulmonary ventilation-perfusion ratio, 159 f Pulmonary volutrauma, 541
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drowning and, 602–603
Pulmonary/systemic vascular resistance ratio (PVR/SVR ratio), 492–493 Pulmozyme (dornase alpha), usage, 252
Pulse, 13 , 15–17 heart rate, 97 pressure, 17–18 rate of, 17 , 17 b rhythm of, 17 sites for, 16 f strength of, 17
Pulse oximetric saturation to fractional concentration of inspired oxygen ratio (SpO2 /FIO2 ratio), 84
Pulse oximetry, 13
in neonatal patient, 487 sampling, reliable, 491 , 491 f
screening test, 576
Pulsus alternans, 17 Pulsus paradoxus, 17 , 21
Purified protein derivative (PPD), 304 , 304 f Pursed-lip breathing, 45 , 45 f
PVR, Pulmonary vascular resistance P wave, 94–95
Pyrazinamide, 308 Pyrexia, 14
Pyridostigmine (Mestinon), selection, 437 Pyrolysis, 608
Q
Q fever, 285 QRS complex, 94
Q s /Q T , Pulmonary shunt fraction QuantiFERON-TB Gold Test, 305 Quartz silicosis, 400
Questions
closed or direct, 4 , 4 b leading or biased, 7 open-ended, 4 , 4 b
R
Racemic epinephrine, for laryngotracheobronchitis, bacterial tracheitis, and epiglottitis, 595 Radial pulse site, 15–16
Radiation safety, 116–117 techniques, 117
Radiation therapy, 378 , 401 acute pneumonitic phase, 401 BCNU, impact, 401
late fibrotic phase, 401 small cell lung cancer, 393
Radiofrequency ablation (RFA), 391 , 471 Radiography
anteroposterior, 102–103
chest, positions and techniques of, 102–103 exposure quality, 105–106
lateral, 103 , 104 f decubitus, 103
technical quality of, 105–106
Radiologic examination, of chest, 101–118 Radiologic terms, 105 t
Radiology, fundamentals of, 102 RAP, Right atrial pressure
Rapid and shallow breathing pattern (hallmark clinical manifestation), 530 Rapid eye movement (REM) sleep, 30-second epoch, 466 f
RDI, Respiratory disturbance index Reactance (Xrs) pressure oscillations, 66 Reactivation tuberculosis, 302 Reassurance, 6
Recording, 179
Rectus abdominis, 42 , 44 f Red blood cell (RBC)
count, 125 indices, 126 t
production, increase, 90
Reflection, 5 Refractory asthma, 239
Refractory hypoxemia, 164 t Reinfection tuberculosis, 302 Relapsing fever, 14
Relative shunt (shunt-like effect), 158 types of, 158 f
Reliever medications, for asthma, 231 , 232 t Religion, 3
Religious and spirituality considerations, in patient interview, 3 Remittent fever, 14
Remodeling, 220 Renal dyspnea, 35
Repetitive nerve stimulation (RNS), 435 RERAs, Respiratory effort-related arousals
Residual volume (RV), indirect measurements of, lung capacities containing, 55–58 , 58 f –59 f Residual volume/total lung capacity ratio (RV/TLC × 100), 56 t
Resistance pressure oscillation, 66 Respiration, 17
muscles, 443 f
Respiratory acid-base disturbances, 70
Respiratory acidosis, metabolic acidosis (combination), 72 Respiratory bronchioles, fibrotic thickening, 398 Respiratory care
blood chemistry tests, monitoring of, 128 t electrolytes, monitoring of, 129 t
protocol
guide, 182 f –183 f severity assessment, 137 t
Respiratory disorders
associated with hypercapnic respiratory failure, 162 b chronic ventilatory failure, association, 75 b
clinical manifestations of, 156 clinical scenarios and, 156 hemodynamic changes in, 99 t hemodynamic monitoring in, 99
hypoxemic respiratory failure and, 157 b lungs, anatomic alterations, 152 , 153 t organisms, associated with, 120 b oxygenation index changes, 89 t pathophysiologic mechanisms, 156
activation in, 147 b
pulmonary shunting associated with, 159 t
Respiratory distress, signs of, 488 , 488 t , 504–505 , 506 b Respiratory distress syndrome (RDS), 534–540
admitting history, 539
alveolar type II cells (granular pneumocytes), 535 alveoli, cross-sectional view, 535 f
arterial blood gases, 536 b beractant (Survanta), 537–538 calfactant (Infasurf), 537–538
cardiopulmonary clinical manifestations associated with, 536–537 case study, 539–540
chest assessment findings, 536 chest radiograph, 537
continuous positive airway pressure (CPAP), 537 diagnosis of, 537
discussion, 539–540 early stages of, 535 f
etiology and epidemiology, 535–537 identification, names, 534 b
infant, chest x-ray films, 538 f
laboratory tests and procedures, clinical data, 536 lungs
anatomic alterations, 534–535 expansion therapy protocol, 538
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management of, 537–538 mechanical ventilation protocol, 538 oxygen therapy protocol, 538 oxygenation indices, 536 b pathologic or structural changes, 535 patient bedside, clinical data, 536 physical examination, 536 , 539 poractant alfa (Curosurf), 537–538
pulmonary function test findings, 536 b radiologic findings, 537
respiratory assessment and plan, 539 respiratory care treatment protocols, 538 respiratory rate, increased (tachypnea), 536 surfactant administration protocol, 538 type II, 528
vital signs, 536
whole body x-ray film, 537 f
Respiratory disturbance index (RDI), 466 calculation, 467
Respiratory disturbances, polysomnography measurements (usage), 461 t Respiratory effort–related arousals (RERAs), 459–460
Respiratory efforts, 463 f
Respiratory equipment, pediatric, sizing of, 508 , 510 t –511 t Respiratory failure, 156
classifications of, 156–163
hypoxemic respiratory failure-type I, 156–161
Respiratory impedance (Zrs), 66 Respiratory infections, 192
Respiratory infectious disease panel (RIDP), 240 , 551–552 Respiratory muscle strength, assessment of, 65 Respiratory protective devices, tuberculosis and, 303 Respiratory rate, 13
normal values, in children, 505 t
Respiratory syncytial virus (RSV), 224 , 285 Respiratory syncytial virus infection, 550–558
admitting history, 556
aerosolized medication protocol, 555–556 trial, 556
airway clearance protocol, 554–555 antigen assay tests, 551–552 arterial blood gases, 553 b bronchodilators, 555
cardiopulmonary clinical manifestations associated with, 553–554 case study, 556–558
chest assessment findings, 553 chest radiograph, 554
chest x-ray film, 554 f corticosteroids, 556 discussion, 557–558
etiology and epidemiology, 550–552
heart rate (pulse) and blood pressure, increased, 553 high-flow nasal cannula, 552–554
example, 557 f impact, 551 f
laboratory testing for, 551–552 procedures, clinical data, 553
lungs, anatomic alterations, 550 management, 552–556
protocol, bronchiolitis score, 555 t monitoring of, 552
oxygen therapy protocol, 552–554 , 556 oxygenation indices, 553 b palivizumab (Synagis), 552
patient bedside, clinical data, 553 physical examination, 553 , 556 polymerase chain reaction (PCR), 551–552 prophylaxis, 552
pulmonary function test findings, 553 b radiologic findings, 554
rehydration, 555–556
respiratory assessment and plan, 556–557 respiratory care treatment protocols, 554–556 respiratory infectious disease panel (RIDP), 551–552 respiratory rate, increased (tachypnea), 553
RSV-enzyme immunoassay (RSV-EIA), 551–552 season (US), 552 f
smoking counseling, 556 transmission, 551
vital signs, 553
Respiratory therapist, clinical manifestations, assessments, and treatment selections by, 134 t –135 t Respiratory therapy protocols, ACCP definition of, 132
Restrictive lung disorders, 55 , 56 t
forced expiratory flow rate and volume findings in, 65 t lung volumes and capacities in, 57 f
Resuscitation techniques, in neonatal patient, 486–488 , 487 f Retinopathy of prematurity (ROP), 495
Retractions, substernal and intercostal, 45 , 46 f Revision, in SOAPIER, 180
RFA, Radiofrequency ablation Rheumatoid arthritis, 403
treatment, 401
Rheumatoid disease, pleural effusion, 409 f Rheumatoid pneumoconiosis, 403 Rhonchial fremitus, 24
Rib series (radiograph), 107
Richmond Agitation-Sedation Scale (RASS), 172 , 175 t Rickettsiae, 291
Rickettsial infections, 291
RIDP, Respiratory infectious disease panel Rifampin, 308
Right atrial pressure (RAP), 99 Right lateral decubitus view, 104 f
Right lung squamous cell carcinoma, 387 f
Right ventricular heave or lift, in pulmonary embolism, 326 , 327 f Right ventricular hypertrophy, 581–582
Right ventricular stroke work index (RVSWI), 99 Right-sided heart failure, 358
left-sided versus , 330 , 333 b
Right-to-left shunting, 491
in persistent pulmonary hypertension of the newborn, 494
RNS, Repetitive nerve stimulation Rod instrumentation, 371
ROP, Retinopathy of prematurity Rosettes, 127
Round ligament, 482 R-R interval, 95 Rubella virus, 285 , 291 RV, Residual volume
RVSWI, Right ventricular stroke work index
S
SABR, Stereotactic ablative radiotherapy Saccular bronchiectasis, 260, 265f , 267f –268f Saddle embolus, 321
Salmeterol, usage, 252
San Joaquin Valley disease, 289 Sarcoidosis, 404
honeycomb cysts, 408 f
SARS, Severe acute respiratory syndrome Sawtooth pattern, 468f
SBRT, Stereotactic body radiation Scalenes, 41, 43f
Scaphoid abdomen, 571 , 573 Scheuermann disease, 367 SCLC, Small cell lung carcinoma Scleroderma, 402–403 Sclerosants, 125
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Scoliosis, 365–367 adolescent, 366 congenital, 366
conservative treatment for, 369 diagnosis of, 366–367 idiopathic, 366
infantile, 366 juvenile, 366
management of, 369–371 neuromuscular, 366 nonstructural, 366 structural, 366
surgery for, 370–371
Second heart sound, increased in pulmonary embolism, 326 splitting, in pulmonary embolism, 326
Secondary apnea, 486
Secondary central sleep apnea, 460–461 Secondary hypertension, 20
Secondary tuberculosis, 302 Seesaw chest, 489 Segmentectomy, 391
Sepsis, acute respiratory distress syndrome, 417 Serology, histoplasmosis, 289
Seronegative myasthenia gravis, 433 Seropositive myasthenia gravis, 433
Severe acute respiratory syndrome (SARS), 291–292 Severe hypoxemia, 88–89
Severity assessment, 134–136 case example, 136 b
respiratory care protocol, 137 t
Sex, asthma and, 221
SFEMG, Single-fiber electromyography Short-acting beta 2 -agonist (SABA), for asthma, 231
Shunt-like effects (relative shunt), 158 types of, 158 f
SIADH, Syndrome of inappropriate antidiuretic hormone Silence, 5
Silent aspiration, 287 Silica, 400
exposure, occupations (association), 401 b
Silicosis, 400
Silverman scoring system, 492 f Simple mask, 513 b –514 b
Simple transposition of the great arteries, 584 Single-fiber electromyography (SFEMG), 435 Sinoatrial (SA) node, 94
Sinus arrhythmia, 17 , 95 example of, 95 f
Sinus bradycardia, 94 examples of, 94 f
Sinus rhythm, premature ventricular complex (impact), 96 f Sinus tachycardia, 94
example of, 94 f
Sinusitis, cystic fibrosis, 251
Situation, Background, Assessment, and Recommendation (SBAR) technique, 503 , 503 b , 503 t Sjögren syndrome, 403
Skin
color, altered, 46 tests, 120
SLE, Systemic lupus erythematosus Sleep
airway, obstruction, 470 f events, terms/phrases, 460 t
in-home portable monitoring, 467 b nocturnal asthma, 224
respiratory disturbances (frequency calculation), polysomnography measurements (usage), 461 t
total recording time (TRT), 466 total sleep time (TST), 466 waveforms, stages, 464 t –465 t
Sleep apnea, 458–476 arterial blood gases, 468 b cardiac arrhythmias, 469
cardiopulmonary clinical manifestations associated with, 468–469 central, 460–462
diagnosis, 463–467 hemodynamic indices, 469 b
laboratory tests and procedures, clinical data, 468–469 mixed, 462
obstructive, 459–460 oxygen therapy, 473 oxygenation indices, 469 b
patient bedside, clinical data, 468 pharmacologic therapy, 473 positive airway pressure, 470–471
pulmonary function testing findings, 468 b radiologic findings, 469
sawtooth pattern, 468 f screening programs, 475 treatment, 473
Sleep disorder categories, 459 b diagnosis, inability, 467 b
scalp electrodes, application, 461 f
Sleep-related breathing disorders, 459 sleep events, terms/phrases, 460 t
stand-alone sleep-related breathing disorders, 462
Sleep-related hypoventilation/hypoxemia syndromes (SRHHSs), 462 Sleeve resection, 391
Small cell carcinoma, 378 illustration, 379 f
tumor, bronchoscopic view, 391 f
Small cell lung carcinoma (SCLC), 378–379 aerosolized medication protocol, 393 chemotherapy, 393
extensive stage, 385
5-year survival rate, 385 , 385 t limited stage, 382–385
lung expansion therapy protocol, 393 oxygen therapy protocol, 393 radiation therapy, 393
respiratory care treatment protocols, 393 staging, 382–385
surgery, 393 treatment option, 393
Smoke inhalation, 606–616 , 607 f admitting history, 614
aerosolized medication therapy protocol, 614 airway clearance therapy protocol, 614 airway management, 613
arterial blood gases, 610 b
body surface burns, 608–609 , 608 t bronchoscopy, 613
cardiopulmonary clinical manifestations associated with, 610–612 case study, 614–615
chest assessment findings, 610 chest radiograph, 612 , 612 f cough and sputum production, 610 discussion, 615
early stage, 607
etiology and epidemiology of, 608 general emergency care, 613
hemodynamic indices cardiogenic pulmonary edema, 611 b hyperbaric oxygen therapy, 613
intermediate stage, 607–608
laboratory tests and procedures, clinical data, 610–611 late stage, 608
lung expansion therapy protocol, 614 lungs, anatomic alterations, 607–608 management of, 613–614 mechanical ventilation protocol, 614
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oxygen therapy protocol, 613–614 oxygenation indices, 611 b patient bedside, clinical data, 610 pharmacology, 613
physical examination, 610 , 614 pulmonary function test findings, 610 b radiologic findings, 612
respiratory assessment and plan, 614–615 respiratory care treatment protocols, 613–614 respiratory rate, increased (tachypnea), 610
toxic substances and sources associated with, 609 t vital signs, 610
Smokers and ex-smokers, asthma in, 226 SOAP, Subjective Objective Assessment Plan SOAPIER acronym, 180
Socioeconomic status, 192 Soft tissues, extrathoracic, 107 Sonography, 114 Source-oriented record, 180
Speaking valve, Passy Muir type, 453 , 454 f Special populations, asthma in, 226 Spectral Doppler, 115
Speech, tracheostomy, 453–454 Spinal cord injury
American Spinal Injury Association (ASIA) Impairment Scale, classification, 443 causes, 443 t
clinical presentation, 442–443 diagnosis, 443
diaphragm pacing, 444 etiology and epidemiology, 442 intubation risk, 444 management, 443–444
paradoxical abdominal breathing, 442–443 video-assisted thorascopic surgery (VATS), 444
Spinal fluid, albuminocytologic dissociation, 426 Spinal fusion, for scoliosis, 371
SpineCor brace, 370 , 370 f
Spiral computed tomography, principle of, 107 f Spiral scans, 107–108
Spirituality, 3
Spirometry testing, usage, 261 Splinting, 45–46
Split-night attended in-laboratory polysomnograph, 463 Spontaneous pneumothorax, 347–348 , 348 f
case study, 353–354
Sputum
color of, 52 f , 52 t correlation, 120 t examination, 120
for asthma, 228
Sputum culture
results and sensitivity, bronchiectasis, 264 for tuberculosis, 304–305 , 305 f
Sputum production abnormal, 50–51
in smoke inhalation and thermal injuries, 610 in tuberculosis, 306
Squamous cell carcinoma (epidermoid cell carcinoma), 378–379 illustration, 379 f
SRHHSs, Sleep-related hypoventilation/hypoxemia syndromes SRS, Stereotactic radiosurgery
Stand-alone sleep-related breathing disorders, 462 Standard Mendelian pattern, 244 , 247 f
Standard of care, 209
Staphylococcus, 283
Staphylococcus aureus , bacterial tracheitis and, 590 Starbursts, 531
Starling equation, 312