Chapter 42 Cardiovascular, Respiratory, and Lymphatic Disorders Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved

Chapter 42Chapter 42

Cardiovascular, Respiratory, Cardiovascular, Respiratory,

and Lymphatic Disordersand Lymphatic Disorders

Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Cardiovascular DisordersCardiovascular Disorders

The circulatory (cardiovascular) system The circulatory (cardiovascular) system delivers blood to the body’s cells. Problems delivers blood to the body’s cells. Problems that occur in the heart or blood vessels include:that occur in the heart or blood vessels include: HypertensionHypertension Coronary artery disease (CAD)Coronary artery disease (CAD) AnginaAngina Myocardial infarctionMyocardial infarction Heart failureHeart failure DysrhythmiasDysrhythmias

Slide 2Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

With hypertension, the resting blood pressure is With hypertension, the resting blood pressure is too high.too high.• Systolic pressure = 140 mm Hg or higher; orSystolic pressure = 140 mm Hg or higher; or• Diastolic pressure = 90 mm Hg or higherDiastolic pressure = 90 mm Hg or higher

Pre-hypertension will likely develop into Pre-hypertension will likely develop into hypertension in the future.hypertension in the future.• Systolic pressure = 120 – 139 mm Hg; orSystolic pressure = 120 – 139 mm Hg; or• Diastolic pressure = 80 – 89 mm HgDiastolic pressure = 80 – 89 mm Hg

Causes include:Causes include:• Narrowed blood vessels, kidney disorders, head Narrowed blood vessels, kidney disorders, head

injuries, some pregnancy problems, and adrenal gland injuries, some pregnancy problems, and adrenal gland tumors.tumors.


Cardiovascular Disorders (cont’d)Cardiovascular Disorders (cont’d)

Hypertension can lead to:Hypertension can lead to:• StrokeStroke• Hardening of the arteriesHardening of the arteries• Heart attackHeart attack• Heart failureHeart failure• Kidney failureKidney failure• BlindnessBlindness

Life-style changes can lower blood pressure.Life-style changes can lower blood pressure.• A diet low in fat and saltA diet low in fat and salt• A healthy weightA healthy weight• Regular exerciseRegular exercise• Not smokingNot smoking• Limiting alcohol and caffeine Limiting alcohol and caffeine • Managing stress and sleeping wellManaging stress and sleeping well

Certain drugs can lower blood pressure.Certain drugs can lower blood pressure.



In coronary artery disease (CAD; coronary heart In coronary artery disease (CAD; coronary heart disease; heart disease), the coronary arteries disease; heart disease), the coronary arteries become hardened and narrow. become hardened and narrow. • One or all of the arteries are affected.One or all of the arteries are affected.• The heart muscle gets less blood and oxygenThe heart muscle gets less blood and oxygen

The most common cause is atherosclerosis.The most common cause is atherosclerosis. The major complications of CAD are:The major complications of CAD are:

• AnginaAngina• Myocardial infarction (heart attack)Myocardial infarction (heart attack)• Irregular heartbeatsIrregular heartbeats• Sudden deathSudden death

The more risk factors, the greater the chance of CAD The more risk factors, the greater the chance of CAD and its complications.and its complications.



CAD can be treated. Treatment goals are to:CAD can be treated. Treatment goals are to:• Relieve symptoms.Relieve symptoms.• Slow or stop atherosclerosis.Slow or stop atherosclerosis.• Lower the risk of blood clots.Lower the risk of blood clots.• Widen or bypass clogged arteries.Widen or bypass clogged arteries.• Reduce cardiac events.Reduce cardiac events.

CAD requires life-style changes. The person must:CAD requires life-style changes. The person must:• Quit smoking.Quit smoking.• Exercise.Exercise.• Reduce stress.Reduce stress.• Eat a healthy diet.Eat a healthy diet.• If over-weight, lose weight.If over-weight, lose weight.



Some persons need drugs to:Some persons need drugs to:• Decrease the heart’s workload and relieve symptoms.Decrease the heart’s workload and relieve symptoms.• Prevent a heart attack or sudden death.Prevent a heart attack or sudden death.• Delay the need for medical and surgical procedures that Delay the need for medical and surgical procedures that

open or bypass diseased arteries.open or bypass diseased arteries. CAD complications may require cardiac rehabilitation.CAD complications may require cardiac rehabilitation.

• The cardiac rehab team includes:The cardiac rehab team includes: Doctors (the person’s doctor, heart specialist, heart surgeon)Doctors (the person’s doctor, heart specialist, heart surgeon) NursesNurses Exercise specialists, physical and occupational therapists, Exercise specialists, physical and occupational therapists,

dietitians, and mental health professionalsdietitians, and mental health professionals

• Cardiac rehab has two parts.Cardiac rehab has two parts. Exercise trainingExercise training Education, counseling, and trainingEducation, counseling, and training



Angina (pain) is chest pain from reduced blood flow to part Angina (pain) is chest pain from reduced blood flow to part of the heart muscle (myocardium).of the heart muscle (myocardium).• It occurs when the heart needs more oxygen.It occurs when the heart needs more oxygen.• It is described as tightness, pressure, squeezing, or burning in It is described as tightness, pressure, squeezing, or burning in

the chest.the chest. Symptoms can be relieved.Symptoms can be relieved.

• Rest often relieves symptoms in 3 to 15 minutes.Rest often relieves symptoms in 3 to 15 minutes.• A nitroglycerin tablet is taken when angina occurs.A nitroglycerin tablet is taken when angina occurs.• Some persons have nitroglycerin patches.Some persons have nitroglycerin patches.

Things that cause angina are avoided.Things that cause angina are avoided. Chest pain lasting longer than a few minutes and not Chest pain lasting longer than a few minutes and not

relieved by rest and nitroglycerin may signal a heart attack. relieved by rest and nitroglycerin may signal a heart attack. The person needs emergency care.The person needs emergency care.



With myocardial infarction (MI), part of the heart With myocardial infarction (MI), part of the heart muscle dies.muscle dies.• Sudden cardiac death (cardiac arrest) can occur.Sudden cardiac death (cardiac arrest) can occur.

MI also is called:MI also is called:• Heart attackHeart attack• Acute myocardial infarction (AMI)Acute myocardial infarction (AMI)• Acute coronary syndrome (ACS)Acute coronary syndrome (ACS)• CoronaryCoronary• Coronary thrombosisCoronary thrombosis

• Coronary occlusionCoronary occlusion In MI, blood flow to the heart muscle is suddenly In MI, blood flow to the heart muscle is suddenly

blocked.blocked.Slide 9Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.


CAD, angina, and previous MI are risk factors.CAD, angina, and previous MI are risk factors. MI is an emergency.MI is an emergency. Efforts are made to:Efforts are made to:

• Relieve pain.Relieve pain.• Restore blood flow to the heart.Restore blood flow to the heart.• Stabilize vital signs.Stabilize vital signs.• Give oxygen.Give oxygen.• Calm the person.Calm the person.• Prevent death and life-threatening problems.Prevent death and life-threatening problems.

The person may need:The person may need:• Medical or surgical procedures to open or bypass the Medical or surgical procedures to open or bypass the

diseased arterydiseased artery• Cardiac rehabilitationCardiac rehabilitation



Heart failure or congestive heart failure (CHF) occurs when Heart failure or congestive heart failure (CHF) occurs when the weakened heart cannot pump normally.the weakened heart cannot pump normally.• When the left side of the heart cannot pump blood normally, When the left side of the heart cannot pump blood normally,

blood backs up into the lungs.blood backs up into the lungs. Respiratory congestion occurs.Respiratory congestion occurs. The person has dyspnea, increased sputum, cough, and gurgling The person has dyspnea, increased sputum, cough, and gurgling

sounds in the lungs.sounds in the lungs.

• When the right side of the heart cannot pump blood normally, When the right side of the heart cannot pump blood normally, blood backs up into the venous system.blood backs up into the venous system. Feet and ankles swell.Feet and ankles swell. Neck veins bulge.Neck veins bulge. Liver congestion affects liver function.Liver congestion affects liver function. The abdomen is congested with fluid.The abdomen is congested with fluid.

• A very severe form of heart failure is pulmonary edema (fluid in A very severe form of heart failure is pulmonary edema (fluid in the lungs).the lungs).



Common causes of heart failure are:Common causes of heart failure are:• CADCAD

• MIMI

• HypertensionHypertension

• DiabetesDiabetes

• AgeAge

• Irregular heart rhythmsIrregular heart rhythms

• Damaged heart valves Damaged heart valves

• Kidney diseaseKidney disease



Treatment involves:Treatment involves:• Drugs are ordered to strengthen the heart.Drugs are ordered to strengthen the heart.

• Drugs are ordered to reduce the amount of fluid in the body.Drugs are ordered to reduce the amount of fluid in the body.

• A sodium-controlled diet is ordered.A sodium-controlled diet is ordered.

• Oxygen is given.Oxygen is given.

• Semi-Fowler’s position is preferred for breathing.Semi-Fowler’s position is preferred for breathing.

• The person must reduce CAD risk factors.The person must reduce CAD risk factors.

• If acutely ill, the person needs hospital care.If acutely ill, the person needs hospital care.



Dysrhythmia is an abnormal heart rhythm. The rhythm may Dysrhythmia is an abnormal heart rhythm. The rhythm may be:be:• Too fast, too slow, or irregularToo fast, too slow, or irregular

Dysrhythmias are caused by:Dysrhythmias are caused by:• Changes in the heart’s electrical systemChanges in the heart’s electrical system

• CAD, MI, or heart failureCAD, MI, or heart failure

• Weakening and changes in the heart muscleWeakening and changes in the heart muscle

• Drug and alcohol abuseDrug and alcohol abuse

• Excess caffeine intakeExcess caffeine intake

• Thyroid problemsThyroid problems

• Some drugsSome drugs

Some dysrhythmias are minor. Others are life-threatening.Some dysrhythmias are minor. Others are life-threatening.



Treatment depends on the type of dysrhythmia.Treatment depends on the type of dysrhythmia.• Drugs may be given.Drugs may be given.

• A procedure may be needed.A procedure may be needed. Defibrillation or cardioversion—an electrical shock is given Defibrillation or cardioversion—an electrical shock is given

to stop an abnormal rhythmto stop an abnormal rhythm Ablation—areas of tissue in the heart sending abnormal Ablation—areas of tissue in the heart sending abnormal

electrical signals are destroyedelectrical signals are destroyed

• Internal devices may be placed.Internal devices may be placed. Pacemaker—device that is inserted under the skin near the Pacemaker—device that is inserted under the skin near the

heart; it monitors and regulates the heart’s rhythm.heart; it monitors and regulates the heart’s rhythm. Implantable cardioverter defibrillator (ICD)—used for life-Implantable cardioverter defibrillator (ICD)—used for life-

threatening dysrhythmias; it delivers a shock when the heart threatening dysrhythmias; it delivers a shock when the heart is in a life-threatening rhythm; some devices are both a is in a life-threatening rhythm; some devices are both a pacemaker and an ICD.pacemaker and an ICD.



The respiratory system brings oxygen (OThe respiratory system brings oxygen (O22) into ) into the lungs and removes carbon dioxide (COthe lungs and removes carbon dioxide (CO22) ) from the body.from the body.

Respiratory disorders that interfere with this Respiratory disorders that interfere with this function and threaten life include:function and threaten life include: Chronic obstructive pulmonary disease (COPD)Chronic obstructive pulmonary disease (COPD) Chronic bronchitisChronic bronchitis AsthmaAsthma Sleep apneaSleep apnea InfluenzaInfluenza PneumoniaPneumonia TuberculosisTuberculosis


Respiratory Disorders Respiratory Disorders

Chronic obstructive pulmonary disease (COPD) involves Chronic obstructive pulmonary disease (COPD) involves two disorders that interfere with the exchange of oxygen two disorders that interfere with the exchange of oxygen and carbon dioxide in the lungs.and carbon dioxide in the lungs.• Chronic bronchitis and emphysemaChronic bronchitis and emphysema

Risk factors for COPD include:Risk factors for COPD include:• Cigarette smoking; pipe, cigar, and other tobaccosCigarette smoking; pipe, cigar, and other tobaccos• Exposure to second-hand smokeExposure to second-hand smoke

Not smoking is the best way to prevent COPD.Not smoking is the best way to prevent COPD. COPD has no cure.COPD has no cure. COPD affects the airways and alveoli.COPD affects the airways and alveoli.

• Airways and alveoli become less elastic.Airways and alveoli become less elastic.• The walls between many alveoli are destroyed.The walls between many alveoli are destroyed.• Airway walls become thick, inflamed, and swollen.Airway walls become thick, inflamed, and swollen.• Airways are clogged by excess mucus secretion.Airways are clogged by excess mucus secretion.


Respiratory Disorders (cont’d) Respiratory Disorders (cont’d)

Chronic bronchitis occurs after repeated episodes of Chronic bronchitis occurs after repeated episodes of bronchitis.bronchitis.• Bronchitis means inflammation of the bronchi.Bronchitis means inflammation of the bronchi. Smoking is the major cause.Smoking is the major cause. Infection, air pollution, and industrial dusts are risk factors.Infection, air pollution, and industrial dusts are risk factors.

Smoker’s cough in the morning is often the first Smoker’s cough in the morning is often the first symptom.symptom.

Treatment involves:Treatment involves:• The person must stop smoking.The person must stop smoking.• Oxygen therapy and breathing exercises are often ordered.Oxygen therapy and breathing exercises are often ordered.• Respiratory tract infections are prevented.Respiratory tract infections are prevented. If one occurs, the person needs prompt treatment.If one occurs, the person needs prompt treatment.



In emphysema, the alveoli enlarge and become less In emphysema, the alveoli enlarge and become less elastic.elastic.• As a result, some air is trapped in the alveoli when exhaling.As a result, some air is trapped in the alveoli when exhaling.

• Over time, more alveoli are involved; OOver time, more alveoli are involved; O22 and CO and CO22 exchange exchange cannot occur in affected alveoli, trapping more air in the lungs.cannot occur in affected alveoli, trapping more air in the lungs.

Smoking is the most common cause.Smoking is the most common cause.• Air pollution and industrial dusts are risk factors.Air pollution and industrial dusts are risk factors.

The person has shortness of breath and a cough.The person has shortness of breath and a cough.• Breathing is easier when the person sits upright and slightly Breathing is easier when the person sits upright and slightly

forward.forward. TreatmentsTreatments

• The person must stop smoking.The person must stop smoking.• Respiratory therapy, breathing exercises, oxygen, and drug Respiratory therapy, breathing exercises, oxygen, and drug

therapy are ordered.therapy are ordered.



With asthma, the airway becomes inflamed and narrow. Extra With asthma, the airway becomes inflamed and narrow. Extra mucus is produced.mucus is produced.

Signs and symptoms include:Signs and symptoms include:• Dyspnea Dyspnea • Wheezing and coughing Wheezing and coughing • Pain and tightness in the chestPain and tightness in the chest

Asthma usually is triggered by allergies.Asthma usually is triggered by allergies.• Other triggers include air pollutants, smoking, second-hand smoke, Other triggers include air pollutants, smoking, second-hand smoke,

respiratory infections, exertion, cold air.respiratory infections, exertion, cold air. Sudden attacks (asthma attacks) can occur.Sudden attacks (asthma attacks) can occur. Asthma is treated with drugs.Asthma is treated with drugs.

• Severe attacks may require emergency care.Severe attacks may require emergency care.• Repeated attacks can damage the respiratory system.Repeated attacks can damage the respiratory system.



In sleep apnea, pauses in breathing occur during In sleep apnea, pauses in breathing occur during sleep.sleep.• Pauses last from a few seconds to over a minute.Pauses last from a few seconds to over a minute.

• They can occur many times during sleep.They can occur many times during sleep.

The most common cause is blockage of the The most common cause is blockage of the airway.airway.• Obstructive sleep apnea—during sleep, muscles in the Obstructive sleep apnea—during sleep, muscles in the

throat relax and soft tissues collapse, closing the throat relax and soft tissues collapse, closing the airway.airway.

• Central sleep apnea (less common)—occurs when the Central sleep apnea (less common)—occurs when the brain does not send signals to the muscles to breathe.brain does not send signals to the muscles to breathe.



Signs and symptoms of sleep apnea include:Signs and symptoms of sleep apnea include:• Pauses in breathing during sleepPauses in breathing during sleep• Loud snoringLoud snoring• Waking during sleep with a gasp or shortness of breathWaking during sleep with a gasp or shortness of breath• Difficulty staying asleepDifficulty staying asleep• Daytime sleepinessDaytime sleepiness• Headache in the morningHeadache in the morning• Dry mouth or sore throat after sleepingDry mouth or sore throat after sleeping

Treatment includes:Treatment includes:• Mild sleep apneaMild sleep apnea

Life-style changes, weight loss, quitting smoking, and avoiding alcohol Life-style changes, weight loss, quitting smoking, and avoiding alcohol and sedatives before sleepand sedatives before sleep

• More severe sleep apneaMore severe sleep apnea Surgery Surgery Positive airway pressure device: CPAP or BiPAPPositive airway pressure device: CPAP or BiPAP



Influenza is a respiratory infection caused by viruses.Influenza is a respiratory infection caused by viruses.• Older persons are at great risk.Older persons are at great risk.

• Pneumonia is a common complication.Pneumonia is a common complication.

Treatment involves:Treatment involves:• Fluids and restFluids and rest

• Drugs ordered by the doctor for symptom relief and to Drugs ordered by the doctor for symptom relief and to shorten the flu episode.shorten the flu episode.

Coughing and sneezing spread flu viruses.Coughing and sneezing spread flu viruses.• Follow Standard Precautions.Follow Standard Precautions.

The flu vaccine is the best prevention.The flu vaccine is the best prevention.



The Centers for Disease Control and Prevention (CDC) recommends The Centers for Disease Control and Prevention (CDC) recommends the flu vaccine for persons who: the flu vaccine for persons who: • Are 6 months to 4 years of ageAre 6 months to 4 years of age• Are 50 years of age and olderAre 50 years of age and older• Have chronic heart, lung, liver, or kidney diseasesHave chronic heart, lung, liver, or kidney diseases• Have diabetesHave diabetes• Have immune system, nervous system, or blood disordersHave immune system, nervous system, or blood disorders• Are pregnant or will be pregnant during the flue seasonAre pregnant or will be pregnant during the flue season• Are 6 months–18 years old and receiving long-term aspirin therapyAre 6 months–18 years old and receiving long-term aspirin therapy• Are nursing center or other long-term care residentsAre nursing center or other long-term care residents• Are American Indians or Alaska NativesAre American Indians or Alaska Natives• Are very obeseAre very obese• Are in close contact with children under 5 years of age (especially those in Are in close contact with children under 5 years of age (especially those in

contact with children under 6 months)contact with children under 6 months)• Are in close contact with adults 50 years of age and olderAre in close contact with adults 50 years of age and older• Are health care workersAre health care workers• Have contact with persons at high risk for flu-related complicationsHave contact with persons at high risk for flu-related complications



Pneumonia is an inflammation and infection of lung Pneumonia is an inflammation and infection of lung tissue.tissue.• Affected tissues fill with fluid.Affected tissues fill with fluid.

• OO22 and CO and CO22 exchange is affected. exchange is affected. Bacteria, viruses, and other microbes are causes.Bacteria, viruses, and other microbes are causes. Microbes reach the lungs by being:Microbes reach the lungs by being:

• InhaledInhaled• AspiratedAspirated• Carried in the blood to the lungs from an infection in the Carried in the blood to the lungs from an infection in the

bodybody Children under 2 years of age and adults over 65 Children under 2 years of age and adults over 65

years of age are at risk.years of age are at risk.



Factors that increase the risk of pneumonia include:Factors that increase the risk of pneumonia include:• SmokingSmoking• AgingAging• StrokeStroke• BedrestBedrest• ImmobilityImmobility• Chronic diseasesChronic diseases• Tube feedingsTube feedings

Treatment may include:Treatment may include:• Drugs for infection and painDrugs for infection and pain• Increased fluid intake to treat fever and to thin secretionsIncreased fluid intake to treat fever and to thin secretions• Intravenous therapy and oxygenIntravenous therapy and oxygen• Semi-Fowler’s position to ease breathingSemi-Fowler’s position to ease breathing



Tuberculosis (TB) is a bacterial infection in the lungs.Tuberculosis (TB) is a bacterial infection in the lungs.• It also can occur in other parts of the body.It also can occur in other parts of the body.

• If TB is not treated, the person can die.If TB is not treated, the person can die.

TB is spread by airborne droplets with coughing, TB is spread by airborne droplets with coughing, sneezing, speaking, singing, or laughing.sneezing, speaking, singing, or laughing.

Those who have close, frequent contact with an Those who have close, frequent contact with an infected person are at risk.infected person are at risk.

Risk factors include:Risk factors include:• Living in close, crowded areasLiving in close, crowded areas

• AgeAge

• Poor nutritionPoor nutrition

• HIV (human immunodeficiency virus)HIV (human immunodeficiency virus)Slide 27Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.


TB can be present in the body but not cause signs and TB can be present in the body but not cause signs and symptoms.symptoms.• Only persons with an active infection can spread the disease to others.Only persons with an active infection can spread the disease to others.

Chest x-rays and TB testing can detect the disease.Chest x-rays and TB testing can detect the disease. Signs and symptoms include:Signs and symptoms include:

• Tiredness, loss of appetite, weight loss, fever, and night sweats.Tiredness, loss of appetite, weight loss, fever, and night sweats. Treatment involves:Treatment involves:

• Drugs for TBDrugs for TB• Standard Precautions and Isolation Precautions Standard Precautions and Isolation Precautions • The person covering his or her mouth and nose with tissues when The person covering his or her mouth and nose with tissues when

sneezing, coughing, or producing sputumsneezing, coughing, or producing sputum• Flushing tissues down the toilet, placing them in a biohazard bag, or in Flushing tissues down the toilet, placing them in a biohazard bag, or in

a paper bag to be burneda paper bag to be burned Hand washing after contact with sputum is essential.Hand washing after contact with sputum is essential.



Lymphatic DisordersLymphatic Disorders

The lymphatic system drains extra fluid from The lymphatic system drains extra fluid from the tissues, helps fight infection, and absorbs the tissues, helps fight infection, and absorbs and transports fats.and transports fats.

Lymphatic disorders that affect these Lymphatic disorders that affect these functions include:functions include: LymphedemaLymphedema LymphomaLymphoma


Lymphedema is a build-up of lymph in the tissues Lymphedema is a build-up of lymph in the tissues causing edema (swelling). It occurs when there is a causing edema (swelling). It occurs when there is a blockage or damage to the lymph system.blockage or damage to the lymph system.

Causes include:Causes include:• CancerCancer• InfectionInfection• Surgical removal of lymph nodesSurgical removal of lymph nodes• Scar tissue from radiation therapy or surgeryScar tissue from radiation therapy or surgery• Absent or abnormal lymph nodes present at birthAbsent or abnormal lymph nodes present at birth

Lymphedema usually affects an arm or leg.Lymphedema usually affects an arm or leg. Daily activities are often affected.Daily activities are often affected. Damage to the lymph system cannot be reversed.Damage to the lymph system cannot be reversed.


Lymphatic Disorders (cont’d)Lymphatic Disorders (cont’d)

Treatment for lymphedema includes:Treatment for lymphedema includes:• Elastic garments or bandagesElastic garments or bandages

• ExerciseExercise

• Good skin careGood skin care

• Massage therapyMassage therapy

The goals are to:The goals are to:• Control swelling.Control swelling.

• Decrease pain.Decrease pain.

• Improve movement and use of the body part.Improve movement and use of the body part.

• Allow daily activities.Allow daily activities.



Lymphoma is cancer involving cells in the immune Lymphoma is cancer involving cells in the immune system (lymphocytes).system (lymphocytes).• Lymphocytes are a type of WBC that protect the body Lymphocytes are a type of WBC that protect the body

from infection.from infection. They are found in lymph nodes and other lymph tissues.They are found in lymph nodes and other lymph tissues. In lymphoma, these cells do not function normally.In lymphoma, these cells do not function normally.

There are two main types of lymphoma:There are two main types of lymphoma:• Hodgkin lymphomaHodgkin lymphoma• Non-Hodgkin lymphomaNon-Hodgkin lymphoma

Lymphoma begins with an abnormal lymphocyte.Lymphoma begins with an abnormal lymphocyte.• The abnormal cell divides and makes more abnormal The abnormal cell divides and makes more abnormal

cells.cells.• A mass of abnormal cells develops into a tumor.A mass of abnormal cells develops into a tumor.



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Chapter 42 Cardiovascular, Respiratory, and Lymphatic Disorders Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved