Your Lungs

You do something about twenty times a minute without even thinking about it—you breathe! In
fact, every day you take about twenty-thousand breaths. The organs of your body that allow you
to breathe are called your lungs. You have two of them that work together, located in your chest
inside the rib cage.

The main purpose of your lungs is to breathe in good air and breathe out bad air. The good air
contains oxygen, which your body needs. The bad air is a gas called carbon dioxide, which your
body cannot use.

When you breathe in through your nose or mouth, air travels down the back of your throat. It
passes through your voice box and into your trachea, or windpipe. Your trachea is divided into
two air passage tubes. One leads to your left lung. The other leads to your right lung. Inside
your lungs, oxygen is removed from the air you breathe and pumped into blood cells. Your
lungs also get rid of harmful carbon dioxide from these cells. This process takes place inside
hundreds of millions of tiny air sacs.

Each adult lung is about the size of a football. When they are healthy, your lungs feel a little
like a sponge and are pinkish-gray. When lungs are damaged by smoking, they can appear gray
or have black spots on them.

One disease that is very common in children involves the lungs. Asthma narrows the breathing
tubes, making it harder to breathe. As many as nine million kids in the United States have
asthma.

You probably already know that your lungs are important when you swim. But you may not
know this—your lungs are the only part of your body that can float on water!

1. Where are your lungs located?

In chest inside the rib cage.

2. Complete the graphic organizer.

Type of air that your lungs remove from your Type of air that your lungs put into your
blood cells blood cells
carbon dioxide oxygen

3. What is your trachea? (khí quản của bạn là gì)

_____________________________________________________________________________

4. What do lungs look like when they've been damaged from smoking?

When lungs are damaged by smoking, they can appear gray or have black spots on them.

5. Why does asthma make it hard for people to breathe?

Because Asthma narrows the breathing tubes.

Read the passage again and decide if the statements are True or False

6. The main purpose of your lungs is breathing T/F

7. In respiration, the air may come to your mouth or nose T/F

8. The trachea is inside the voice box T/F

9. The blood is oxygenated in the lungs before travelling its new journey T/F

10. When smoking damages the lungs, they can appear pinkish- gray T/F

II. Vocabulary (8)

Complete each statement using a term or terms from the list below. Write your answers in
the spaces provided. Some words may be used more than once.

alveoli inhaling mouth

windpipe bronchi exhale

nose capillaries
smaller and smaller
 1. Breathing in is called ________ inhaling _________.

2. We inhale through the _______ mouth ________ or _____ nose _________.

3. The trachea is the scientific name for the ________ windpipe ________.

4. The trachea divides into two tubes called ______ bronchi __________.

5. In the lungs, the tubes branch into ________ smaller and smaller_________ tubes.

6. The lungs have millions of tiny air sacs called _________ alveoli ________.

7. Air sacs have many _______ capillaries_____________.

8. We get rid of carbon dioxide waste when we _________ exhale___________.

III. Grammar
1. Asthma is a chronic disease which makes it difficult …..
A. breath B. breathing C. to breathe D. to breath
2. In emphysema, the alveoli …. their shape and functionality
A. is losing B. loses C. has lost D. lose
3. In a patient with asthma, less oxygen ….. to enter the bloodstream
A. is allowed B. allows C. allowing D. can allow
4. Air passes ….. the bronchial tubes to the lungs
A. through B. to C. in D. from
5. In patients with emphysema, their bronchial tubes become…..
A. inflamed B. inflammatory C. inflammation D. inflame
6. Allergens cause patients with asthma ….
A. cough B. be coughed C. being cough D. coughing
7. Oxygen is a natural gas which is necessary … human survival
A. for B. with C. of D. on
Read and fill into the blank with One suitable word

Asthma

Asthma is characterized by episodes of coughing, dyspnea, wheezing, and chest tightness—

alone or in combination. Most acute attacks are accompanied by a sense of panic. Although
sometimes classed (1)…………….. COPD because it is an obstructive dis- order, asthma is
marked by acute exacerbations followed by symptom-free periods—that is, the obstruction is
(2)……………...

The cause of asthma has been hard to pin down. Initially it was viewed as a consequence of
bronchospasm triggered by various factors such as cold air, exercise, or (3)……………...

However, when it was discovered that bronchoconstriction has relatively little effect on air flow
through normal lungs, researchers probed more deeply and found that in asthma, active inflam-
mation of the airways comes first. The airway (4)…………….. is an immune response under
the control of TH2 cells, a subset of T lymphocytes that, by secreting certain interleukins,
stimulate the production of IgE and recruit inflammatory cells (notably eosinophils) to the site.

Once someone has allergic asthma, the inflammation per- sists even during symptom-free
periods and makes the airways (5)…………….. to almost any irritant. (The most common trig-
gers are in the home—the allergens from dust mites, cock- roaches, cats, dogs, and fungi.) Once
the airway walls are thickened with inflammatory exudate, the effect of bron- chospasm is
vastly magnified and can dramatically reduce air flow.

About one (6)…………….. ten people in North America suffer from asthma—children more
than adults. Over the past 20 years, the number of cases of asthma has risen dramatically, an
increase (7) …………….. may now be plateauing. While asthma remains a major health
problem, better treatment options have begun to reduce the number of deaths due to asthma.
Instead of merely (8)…………….. the symptoms of asthma with fast-acting bronchodilators,
we now treat the underlying inflammation using inhaled cortico- steroids. New approaches to
limiting the airway inflammation include antileukotrienes and antibodies (9)…………….. the
patient’s own IgE class of antibodies.
Writing: Use the cues given to complete the leaflet about Covid-19 prevention for students in
the classroom and dorm
DORM

1. Avoid/ share items / roommates or others.

Avoid sharing items with roommates or others

2. If/ do, /clean / disinfect/ before /share/ or /use.

If you do, clean and disinfect them before sharing or using

SHARED BATHROOM

3. Avoid/ place/ toothbrushes /direct/ counter surfaces.

Avoid placing the toothbrushes directly on the counter surfaces

4. Use /totes/ person/ items /limit/ contact / other /surface/ the bathroom.

CLASSROOM

5. Enroll /online classes /if /they /fit/ education/ needs.

enroll in online classes if they fit educational needs

6. Wipe down/ desk/ disinfectant wipe/ if possible.

Wipe down your desk with disinfectant wipe if possible.

7. Skip/ seat / row / create/ physical distance/ other /student.

8. Avoid/ place/ personal items/ (e.g., cell phone) / your desk.

avoid placing personal items (e.g., cell phone) on your desk

DINING HALL & MEALS

9. Avoid/ share/ food, drink, utensils/ or/ other/ item/ people.

10. Pick /up/ grab-and-go/ option/ meals /if /offer.

use hand sanitizer with at least 60% alcohol T

Speaking: What is asthma?
- Who may get asthma?
- Which parts of the body does it affect?
- Is it curable?
- Is it fatal? Why?
- What should a patient with asthma do in an asthma attack?

Part 3:
- How is asthma classified?
- How to prevent an asthma attack?
- Give some tips to have a healthy life for patients with asthma

Speaking: Use the conversation from Task 8 and the information from the Reading task to
break the bad news to a patient who has asthma.

DOCTOR
PATIENT
- greet - greet
- ask for the information
- deliver the information - say thanks
- explain the condition
Extra reading
Diagnosis

Physical exam

Your doctor will perform a physical exam to rule out other possible conditions, such as a respiratory
infection or chronic obstructive pulmonary disease (COPD). Your doctor will also ask you questions
about your signs and symptoms and about any other health problems. 

Tests to measure lung function

You may be given lung function tests to determine how much air moves in and out as you breathe.
These tests may include:

 Spirometry. This test estimates the narrowing of your bronchial tubes by checking how much
air you can exhale after a deep breath and how fast you can breathe out.

 Peak flow. A peak flow meter is a simple device that measures how hard you can breathe out.
Lower than usual peak flow readings are a sign that your lungs may not be working as well and
that your asthma may be getting worse. Your doctor will give you instructions on how to track
and deal with low peak flow readings.

Lung function tests often are done before and after taking a medication to open your airways called a
bronchodilator (brong-koh-DIE-lay-tur), such as albuterol. If your lung function improves with use of a
bronchodilator, it's likely you have asthma.

Additional tests

Other tests to diagnose asthma include:

 Methacholine challenge. Methacholine is a known asthma trigger. When inhaled, it will cause

your airways to narrow slightly. If you react to the methacholine, you likely have asthma. This
test may be used even if your initial lung function test is normal.

 Imaging tests. A chest X-ray can help identify any structural abnormalities or diseases (such
as infection) that can cause or aggravate breathing problems.

 Allergy testing. Allergy tests can be performed by a skin test or blood test. They tell you if
you're allergic to pets, dust, mold or pollen. If allergy triggers are identified, your doctor may
recommend allergy shots.

 Nitric oxide test. This test measures the amount of the gas nitric oxide in your breath. When
your airways are inflamed — a sign of asthma — you may have higher than normal nitric oxide
levels. This test isn't widely available.
  Sputum eosinophils. This test looks for certain white blood cells (eosinophils) in the mixture
of saliva and mucus (sputum) you discharge during coughing. Eosinophils are present when
symptoms develop and become visible when stained with a rose-colored dye.

 Provocative testing for exercise and cold-induced asthma. In these tests, your doctor
measures your airway obstruction before and after you perform vigorous physical activity or take
several breaths of cold air.
How asthma is classified

To classify your asthma severity, your doctor will consider how often you have signs and symptoms
and how severe they are. Your doctor will also consider the results of your physical exam and
diagnostic tests.

Determining your asthma severity helps your doctor choose the best treatment. Asthma severity often
changes over time, requiring treatment adjustments.

Asthma is classified into four general categories:

Asthma Signs and symptoms

classification

Mild intermittent Mild symptoms up to two days a week and up to two nights a
month

Mild persistent Symptoms more than twice a week, but no more than once
in a single day

Moderate persistent Symptoms once a day and more than one night a week

Severe persistent Symptoms throughout the day on most days and frequently
at night

Treatment

Prevention and long-term control are key to stopping asthma attacks before they start. Treatment
usually involves learning to recognize your triggers, taking steps to avoid triggers and tracking your
breathing to make sure your medications are keeping symptoms under control. In case of an asthma
flare-up, you may need to use a quick-relief inhaler.

Medications

The right medications for you depend on a number of things — your age, symptoms, asthma triggers
and what works best to keep your asthma under control.

Preventive, long-term control medications reduce the swelling (inflammation) in your airways that
leads to symptoms. Quick-relief inhalers (bronchodilators) quickly open swollen airways that are
limiting breathing. In some cases, allergy medications are necessary.

Long-term asthma control medications, generally taken daily, are the cornerstone of asthma
treatment. These medications keep asthma under control on a day-to-day basis and make it less
likely you'll have an asthma attack. Types of long-term control medications include:

 Inhaled corticosteroids. These medications include fluticasone propionate (Flovent HFA,

Flovent Diskus, Xhance), budesonide (Pulmicort Flexhaler, Pulmicort Respules, Rhinocort),
ciclesonide (Alvesco), beclomethasone (Qvar Redihaler), mometasone (Asmanex HFA,
Asmanex Twisthaler) and fluticasone furoate (Arnuity Ellipta).

You may need to use these medications for several days to weeks before they reach their
maximum benefit. Unlike oral corticosteroids, inhaled corticosteroids have a relatively low risk of
serious side effects.

 Leukotriene modifiers. These oral medications — including montelukast (Singulair),

zafirlukast (Accolate) and zileuton (Zyflo) — help relieve asthma symptoms.

Montelukast has been linked to psychological reactions, such as agitation, aggression,

hallucinations, depression and suicidal thinking. Seek medical advice right away if you
experience any of these reactions.

 Combination inhalers. These medications — such as fluticasone-salmeterol (Advair HFA,

Airduo Digihaler, others), budesonide-formoterol (Symbicort), formoterol-mometasone (Dulera)
and fluticasone furoate-vilanterol (Breo Ellipta) — contain a long-acting beta agonist along with a
corticosteroid.

 Theophylline. Theophylline (Theo-24, Elixophyllin, Theochron) is a daily pill that helps keep

the airways open by relaxing the muscles around the airways. It's not used as often as other
asthma medications and requires regular blood tests.
Quick-relief (rescue) medications are used as needed for rapid, short-term symptom relief during
an asthma attack. They may also be used before exercise if your doctor recommends it. Types of
quick-relief medications include:

 Short-acting beta agonists. These inhaled, quick-relief bronchodilators act within minutes to

rapidly ease symptoms during an asthma attack. They include albuterol (ProAir HFA, Ventolin
HFA, others) and levalbuterol (Xopenex, Xopenex HFA).

Short-acting beta agonists can be taken using a portable, hand-held inhaler or a nebulizer, a
machine that converts asthma medications to a fine mist. They're inhaled through a face mask
or mouthpiece.

 Anticholinergic agents. Like other bronchodilators, ipratropium (Atrovent HFA) and tiotropium

(Spiriva, Spiriva Respimat) act quickly to immediately relax your airways, making it easier to
breathe. They're mostly used for emphysema and chronic bronchitis, but can be used to treat
asthma.

 Oral and intravenous corticosteroids. These medications — which include prednisone

(Prednisone Intensol, Rayos) and methylprednisolone (Medrol, Depo-Medrol, Solu-Medrol) —
relieve airway inflammation caused by severe asthma. They can cause serious side effects
when used long term, so these drugs are used only on a short-term basis to treat severe asthma
symptoms.

If you have an asthma flare-up, a quick-relief inhaler can ease your symptoms right away. But you
shouldn't need to use your quick-relief inhaler very often if your long-term control medications are
working properly.

Keep a record of how many puffs you use each week. If you need to use your quick-relief inhaler
more often than your doctor recommends, see your doctor. You probably need to adjust your long-
term control medication.

Allergy medications may help if your asthma is triggered or worsened by allergies. These include:

 Allergy shots (immunotherapy). Over time, allergy shots gradually reduce your immune
system reaction to specific allergens. You generally receive shots once a week for a few months,
then once a month for a period of three to five years.

 Biologics. These medications — which include omalizumab (Xolair), mepolizumab (Nucala),

dupilumab (Dupixent), reslizumab (Cinqair) and benralizumab (Fasenra) — are specifically for
people who have severe asthma.
Bronchial thermoplasty

This treatment is used for severe asthma that doesn't improve with inhaled corticosteroids or other
long-term asthma medications. It isn't widely available nor right for everyone.

During bronchial thermoplasty, your doctor heats the insides of the airways in the lungs with an
electrode. The heat reduces the smooth muscle inside the airways. This limits the ability of the
airways to tighten, making breathing easier and possibly reducing asthma attacks. The therapy is
generally done over three outpatient visits.

Treat by severity for better control: A stepwise approach

Your treatment should be flexible and based on changes in your symptoms. Your doctor should ask
about your symptoms at each visit. Based on your signs and symptoms, your doctor can adjust your
treatment accordingly.

For example, if your asthma is well controlled, your doctor may prescribe less medication. If your
asthma isn't well controlled or is getting worse, your doctor may increase your medication and
recommend more-frequent visits.

Asthma action plan

Work with your doctor to create an asthma action plan that outlines in writing when to take certain
medications or when to increase or decrease the dose of your medications based on your symptoms.
Also include a list of your triggers and the steps you need to take to avoid them.

Your doctor may also recommend tracking your asthma symptoms or using a peak flow meter on a
regular basis to monitor how well your treatment is controlling your asthma.

https://www.mayoclinic.org/diseases-conditions/asthma/diagnosis-treatment/drc-20369660