17.2

• Respiratory therapists


  Responsible for helping people who suffer from chronic respiratory diseases such as asthma, bronchitis, and emphysema. They also function to help people with sleep disorders such as sleep apnea and infants who are born prematurely and have not yet acquired normal breathing function.
• Respiratory therapists


  • Work in a wide variety of settings including hospitals, clinics, doctor's offices, long-term care facilities, and sleep disorder centers
  • Entry-level respiratory therapists may assume clinical responsibility for specified respiratory care functions involving therapeutic techniques under the supervision of an advanced-level therapist or a physician
  • The advanced-level respiratory therapist participates in clinical decision-making and patient education, develops and implements respiratory care plans, utilizes evidence-based clinical practice guidelines, and participates in health promotion, disease prevention, and disease management
• More information on careers in Respiratory Therapy can be found at the American Association for Respiratory Care (http://www.aarc.org)
• Oral cavity (mouth)


  A complex ecosystem suitable for growth and interrelationships of many types of microorganisms
• The actual indigenous microbiota of the mouth varies greatly from one person to another, but studies have shown that they include about 300 identified species of bacteria, both aerobes and anaerobes
• Beneficial members of the oral microbiota

  Produce secretions that are antagonistic to other bacteria
• Streptococcus and Actinomyces spp.


  Often interact to protect the oral surfaces, but in other circumstances, they are involved in oral disease
• Saliva


  Secreted by salivary glands, helps control the growth of opportunistic oral microbes. It contains enzymes (including lysozyme), immunoglobulins, and buffers to control the near-neutral pH and continually flushes microbes and food particles through the mouth
• Tooth enamel


  Hard, complex, calcium-based, bathed in protective saliva, usually resists damage by oral microbes
• If the ecologic balance is upset or is not properly maintained, oral disease may result
• Dental caries


  Tooth decay or cavities. Dental caries start when the external surface (the enamel) of a tooth is dissolved by organic acids produced by masses of microorganisms attached to the tooth (dental plaque). This is followed by enzymatic destruction of the protein matrix, cavitation, and bacterial invasion. The most common cause of tooth decay is S. mutans, which produces lactic acid as an end product in the fermentation of glucose.
• Gingivitis


  Inflammation of the gingiva (gums)
• Periodontitis


  Inflammation of the periodontium (tissues that surround and support the teeth, including the gingiva and supporting bone); in severe cases, teeth loosen and fall out
• Thrush


  An infection of the oral tissues (mostly the tongue) with Candida albicans that occurs mainly in immunocompromised patients
• Oral infections result from a combination of the unique microbial population, reduced host defenses, improper diet, and poor dental hygiene
• Oral diseases, such as gingivitis, periodontitis, and trench mouth, are collectively known as periodontal diseases
• Preventing periodontal diseases


  1. Maintaining good health

  2. Proper oral hygiene (tooth brushing, using tartar-control toothpaste, and flossing)

  3. Adequate diet without sugars

  4. Regular fluoride treatments to help control the microbial population and to prevent damaging bacterial interactions
• Severe gingivitis and periodontitis require professional care by a specially trained dentist called a periodontist
• Periodontist treatment


  1. Using scaling and root planing technique to remove tartar that has accumulated on tooth surfaces up to one-fifth of an inch below the gum line

  2. Prescribing a chlorhexidine mouth rinse as a temporary substitute for brushing and flossing after dental surgery
• Bacterial cell walls have peptidoglycan as their main component, while plant cell walls contain cellulose microfibrils embedded in a matrix of hemicelluloses and pectin.
• Cell walls are rigid structures that protect the cells from osmotic lysis (bursting) when placed in hypotonic solutions.
• The cell wall is composed mainly of polysaccharides, with some proteins.
• Terms relating to infectious diseases of the genital tract

  • Bartholinitis
  • Cervicitis
  • Endometritis
  • Epididymitis
  • Pelvic inflammatory disease
  • Vaginitis
  • Vulvovaginitis
• Vaginitis

  Inflammation of the vagina
• Three most common causes of vaginitis in the United States

  • C. albicans (a yeast)
  • Trichomonas vaginalis (a protozoan)
  • Mixture of bacteria (including bacteria in the genera Mobiluncus and Gardnerella)
• Bacterial vaginosis


  Infection caused by a mixture of bacteria
• Infections that result from the actions of two or more bacteria are called synergistic or polymicrobial infections
• A saline wet mount preparation or Gram stain is often used to diagnose vaginitis
• Sexually transmitted disease (STD)


  Any of the infections transmitted by sexual activities
• STDs affect not only the genital tract but also the skin, mucous membranes, blood, lymphatic and digestive systems, and many other body areas
• The Centers for Disease Control and Prevention (CDC) estimates that 20 million cases of STDs occur annually in the United States
• Epidemic STDs


  • Acquired immunodeficiency syndrome (AIDS)
  • Chlamydial infections
  • Herpes infections
  • Gonorrhea
  • Syphilis
• AIDS virus (human immunodeficiency virus [HIV])

  Primarily causes damage to helper T cells and thus inhibits antibody production
• Diseases such as hepatitis B, amebiasis, and giardiasis can also be transmitted by sexual activities
• Bacteremia


  The presence of bacteria in a person's bloodstream
• Normally, blood is sterile and contains no resident microbiota
• Transient bacteremia often results from dental extractions, wounds, bites, and damage to the intestinal, respiratory, or reproductive tract mucosa
• Septicemia


  A disease in which the patient experiences chills, fever, and prostration (extreme exhaustion) and has bacteria or their toxins in their bloodstream
• Routine tests performed on donor blood in the United States

  • Treponema pallidum antigen (T. pallidum is the cause of syphilis)
  • HIV-1 antibody
  • HIV-2 antibody
  • HTLV-1 and HTLV-II antibody
  • Hepatitis B virus (HBV) surface antigen
  • HBV core antibody
  • Hepatitis C virus (HCV) antibody
  • Nucleic acid amplification testing for HIV-1, HCV, West Nile virus, and Zika virus
  • Antibody test for Trypanosoma cruzi, the cause of Chagas disease
• Lymphatic system


  Consists of lymphatic vessels, lymphoid tissue (including the lymph nodes, tonsils, thymus, and spleen), and lymph (the liquid that circulates through the lymphatic system)