AIRWAY Flashcards
1
Q
a method used to predict difficult intubation. A mouth opening of less than three fingers wide, a mandible length of less than three fingers wide, and a distance from the hyoid bone to thyroid notch of less than two fingers wide indicate a possibly difficult airway.
A
3-2-2
2
Q
abdominal thrusts performed to relieve a foreign body airway obstruction
A
abdominal thrust manuever
3
Q
the muscles not normally used during breathing; these include the sternocleidomastoid muscles of the neck, the chest pectoralis major muscles, and the abdominal muscles
A
accessory muscles
4
Q
a chemical NT of the parasympathetic nervous system
A
acetylcholine (ACh)
5
Q
the pharyngeal tonsil
A
adenoid
6
Q
abnormal
A
adventitious
7
Q
the metabolism that occurs in the presence of oxygen
A
aerobic metabolism
8
Q
the pressure gradient against which the heart must pump; increasing the after load can decrease the cardiac output
A
afterload
9
Q
slow, shallow, irregular respirations or occasional gasping breaths; result from cerebral anoxia
A
agonal gasps
10
Q
the amount of air that actually reaches the alveoli per minute and participates in gas exchange
A
alveolar minute volume (V sub A)
11
Q
volume of inhaled air that participates in gas exchange; equal to tidal volume minus dead space and approx 350 mL in an average adult; also called alveolar ventilation
A
alveolar volume
12
Q
ballonlike clusters of single layer air sacs that are the functional site for the exchange of oxygen and carbon dioxide in the lungs
A
alveoli
13
Q
the metabolism that takes place in the absence of oxygen
A
anaerobic metabolism
14
Q
an absence of oxygen
A
anoxia
15
Q
the inability to speak
A
aphonia
16
Q
prolonged gasping aspirations followed by short, ineffective expirations; associated with brainstem insult
A
apneustic respirations
17
Q
pyramid like cartilaginous structures that form the posterior attachment of the vocal cords
A
arytenoid cartilages
18
Q
the entry of fluids or solids into the trachea, bronchi, and lungs
A
aspirations
19
Q
unequal movement of the two sides of the chest; indicates decreased airflow into one lung
A
asymmetric chest wall movement
20
Q
collapse of the alveoli
A
atelectasis
21
Q
the joint formed at the articulation of the atlas of the vertebral column and the occipital bone of the skull
A
atlanto occipital joint
22
Q
a portable mechanical ventilator attached to a control box that allows the variables of ventilation like rate and tidal volume to be set
A
automatic transport ventilator (ATV)
23
Q
a manual ventilation device that consists of a bag, mask, reservoir, and oxygen inlet; capable of delivering up to 100% oxygen
A
bag mask device
24
Q
sedative hypnotic medications
A
barbiturates
25
trauma resulting from excessive pressure
barotrauma
26
sedative hypnotic drugs that provide muscle relaxation and mild sedation such diazepam (Valium) and midazlolam (Versed)
benzodiazepines
27
irregular pattern, rate, and depth of respirations with intermittent periods of apnea; result from increased intracranial pressure
Biot (ataxic) respirations
28
an oxygen flowmeter that is commonly used because it is not affected by gravity and can be placed in any position
Bourdan-guage flowmeter
29
states that the pressure of a gas is inversely proportional to its volume
Boyle's law
30
the main branches of the trachea
bronchi
31
the subdivision of smaller bronchi in the lungs
bronchioles
32
a combination of the tracheal and vesicular breath sounds; heard where the airway and alveoli are found, in the upper part of the sternum and between the scapulas
bronchovesicular sounds
33
the backward, upward, rightward pressure used during intubation to improve the laryngoscopic view of the glottic opening and vocal cords
BURP manuever
34
potent, effective sedatives; include drugs such as haloperidol (Haldol) and droperidol (Inspine)
butyrophenones
35
indicates information about exhaled carbon dioxide
capnometer
36
hemoglobin loaded with carbon monoxide
carboxyhemoglobin
37
a ridgelike projection of tracheal cartilage located where the trachea bifurcates into the right and left mainstem bronchi
carina
38
a biochemical process resulting in the production of energy in the form of ATP
cellular respiration
39
CSF draining from the ears
cerebrospinal otorrhea
40
CSF draining from the nose
cerebrospinal rhinorrhea
41
chemoreceptors
sense organs that monitor the levels of oxygen and carbon dioxide and the pH of the CSF and blood and provide feedback to the respiratory centers to modify the rate and depth of breathing based on the body's needs at any given time
42
a gradually increasing rate and depth of respirations followed by a gradual decrease with intermittent periods of apnea
Cheyne stokes respirations
43
a supraglottic airway device with a shape that allows the device to slide easily along the hard palate and to hold the soft tissue away from the laryngeal inlet
Cobra perilaryngeal airway (CobraPLA)
44
a device that attaches between the endotracheal tube and bag mask device;
colorimetric capnographer
45
a multilumen airway device that consists of a single tube with two lumens, two balloons, and two ventilation ports; an alternative device if endotracheal intubation is not possible or has failed
Combitube
46
a method of ventilation used primarily in the treatment of critically ill patients with respiratory distress; can prevent the need for endotracheal intubation
CPAP
47
a device that measures absorption at several wavelengths to distinguish oxyhemoglobin from carboxyhemoglobin
CO-oximeter
48
the breath sounds produced as fluid filled alveoli pop open under increasing inspiratory pressure; can be fine or course; also called rales
crackles
49
forms of the lowest portion of the larynx
cricoid cartilage
50
a thin, superficial membrane located between the thyroid and cricoid cartilage that is relatively vascular and contains few nerves
cricothyroid membrane
51
a blade designed to fit into the valecula, indirectly lifting the epiglottis and exposing the vocal cords
curved laryngoscope blade
52
blue or purple skin
cyanosis
53
any portion of the airway that does not contain air and cannot participate in gas exchange
dead space volume
54
a drug that competitively binds with the ACh receptor sites but is not affected as quickly acetylcholinesterase; succinylcholine is the only one
depolarizing neuromuscular blocker
55
visualization of the airway with a laryngoscope
direct laryngoscopy
56
a portion of the medulla oblongata where the primary respiratory pacemaker is located
dorsal respiratory group
57
difficulty speaking
dysphonia
58
difficulty or labored breathing
dyspnea
59
a tube that is inserted into the trachea for definitive airway maintenance
endotracheal (ET) tube
60
inserting an endotracheal tube through the glottic opening and sealing the tube with a cuff inflated against the tracheal wall
endotracheal intubation
61
devices that detect the presence of carbon dioxide in exhaled air
end tidal CO2 monitors
62
a leaf shaped cartilaginous structure that closes over the trachea during swallowing
epiglottis
63
a bulb or syringe that is attached to the proximal end of the ET tube; a device used to confirm proper ET tube placement
esophageal detector device
64
a nonnarcotic, non barbiturate hypnotic sedative drug also called Amidate
etomidate
65
passive movement of air out of the lungs; also called expiration
exhalation
66
contraction of a patient's lower eyelid when the upper eyelashes are gently stroked
eyelash reflex
67
the amount of air that can be exhaled following a normal exhalation; average volume is about 1200 mL
expiratory reserve volume
68
the exchange of gases between the lungs and the blood cells in the pulmonary capillaries
external respiration
69
the process of removing the tube form an intubated patient
extubation
70
face to face intubation
performing intubation at the same level as the patient's face; used when the standard position is not possible. In this position, the laryngoscope is held in the provider's right hand and the endotracheal tube in the left
71
brief, uncoordinated twitching of small muscle groups in the face, neck, trunk, and extremities; may be seen after the administration of a depolarizing neuromuscular blocking agent
fasciculations
72
the percentage of oxygen in inhaled air
fraction of inspired oxygen
73
the amount of air that can be forced from the lungs in a single exhalation
functional reserve capacity
74
an automatic reaction when something touches an area deep in the oral cavity that help protects the lower airway from aspiration
gag reflex
75
the enlargement or expansion of the stomach, often with air; can be a complication of ventilating the esophagus instead of the trachea
gastric distension
76
a tube that is inserted into the stomach to remove its contents
gastric tube
77
the ligament between the tongue and the epiglottis
glossoepiglottic ligament
78
the vocal cords and the opening between them
glottis
79
mucus producing cells found mainly in the respiratory and intestinal tract
goblet cells
80
a flexible device that is inserted between the glottis under direct laryngoscopy; the ET tube is threaded over the device, facilitating its entry into the trachea
gum elastic bougie
81
manual airway maneuver that involves tilting the head back while lifting up in the chin
head chin tilt lift maneuver
82
an iron containing protein with red blood cells that has the ability to combine with oxygen
hemoglobin (Hb)
83
a law of gas that states that the amount of gas in a solution varies directly with the partial pressure of a gas over the solution
Henry's Law
84
a protective mechanism that terminates inhalation, preventing over expansion of the lungs
Hering-Breuer reflex
85
the point of entry of blood vessels, nerves, and bronchi into each lung
hilum
86
the ligament between the hyoid bone and the epiglottis
hyoepiglottic ligament
87
a small, horseshoe-shaped bone to which the jaw, tongue, epiglottis, and thyroid cartilage attach
hyoid bone
88
increased carbon dioxide content in arterial blood
hypercarbia
89
a condition in which an increased amount of air enters the alveoli; CO2 production exceeds carbon dioxide prduction
hyperventilation
90
decreased carbon dioxide content in the arterial blood
hypcarbia
91
a condition in which a decreased amount of air enters the alveoli
hypoventilation
92
a decrease in arterial oxygen level
hypoxemia
93
secondary control of breathing that stimulates breathing based on decreased O2 levels
hypoxic drive
94
inspiratory/expiratory ratio
I/E ratio
95
the active process of moving air into the lungs; also called inspiration
inhalation
96
the amount of air that can be inhaled in addition to the normal tidal volume
inspiratory reserve volume
97
the exchange of gases between the blood cells and the tissues
internal respiration
98
bypassing of oxygen poor blood past nonfunctional alveoli
intrapulmonary shunting
99
a technique to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward
jaw thrust maneuver
100
a single lumen airway that is blindly inserted into the esophagus; when properly placed in the esophagus, one cuff seals the esophagus, and the other seals the oropharynx
King LT airway
101
deep, gasping respirations; common in DKA
kussmaul respirations
102
a device that surrounds the opening of the larynx with an inflatable silicone cuff positioned in the hypo pharynx; an alternative device to bag-mask ventilation
laryngeal mask airway (LMA)
103
a surgical procedure in which the larynx is removed
laryngectomy
104
a device that is used in conjunction with a laryngoscope blade to perform direct laryngoscopy
laryngoscope
105
spasmodic closure of the vocal cords
laryngospasm
106
a complex structure formed by many independent cartilaginous structures that all work together; where the upper airway ends and the lower airway begins
larynx
107
the ability of the alveoli to expand when air is drawn into the lungs during negative pressure ventilation or positive pressure ventilation
lung compliance
108
a special type of forceps that is curved, thus allowing paramedics to maneuver in in the airway
magill forceps
109
a system for predicting the relative difficulty of intubation based on the amount of oropharyngeal structures visible in an upright, seated patient who is fully able to open his or her mouth
Mallampati classification
110
the chemical processes that provide the cells with energy from nutrients
metabolism
111
a compound formed by oxidation of the iron on hemoglobin
methemoglobin (metHb)
112
the amount of air that moves in and out of the respiratory tract per minute
minute volume
113
airway devices with a single long tube that can be used for esophageal obturation or endotracheal tube ventilation, depending on where the device comes to rest following blind positioning
multilumen airways
114
an opening on the side of an endotracheal tube at its distal tip that permits ventilation to occur even if the tip becomes occluded by blood, mucus, or the tracheal wall
murphy's eye
115
a device that delivers oxygen via two small prongs that into the patient's nostrils; with an oxygen flow rate of 1 to 6 L/min, an oxygen concentration of 24% to 44% can be delivered
nasal cannula
116
a rigid partition composed of cartilage and bone; divides the nasopharynx into two passages
nasal septum
117
a gastric tube is inserted into the stomach through the nose
nasogastric (NG) tube
118
a soft rubber tube about 6" long that is inserted through the nose into the posterior pharynx behind the tongue, thereby allowing passage of air from the nose to the lower airway
nasopharyngeal (nasal) airway
119
the nasal cavity; formed by the union of the facial bones
nasophayrnx
120
insertion of an endotracheal tube into the trachea through the nose
nasotracheal intubation
121
insertion of a 14- to 16 gauge over the needle IV catheter like an angiocath through the cricothyroid membrane into the trachea
needle cricothyrotomy
122
drawing of air into the lungs; airflow from a region of higher pressure (outside the body) to a region of lower pressure (the lungs); occurs during normal (unassisted breathing)
negative-pressure ventilation
123
drugs that bind to acetylcholine receptor sites; they do not cause depolarization of the muscle fiber; examples are vecuronium (Norcuron) and pancuronium (Pavulon)
nonpolarizing neuromuscular blockers
124
a combination mask and reservoir bag system in which oxygen fills a reservoir bag attached to the mask by a one way valve permitting a patient to inhale from the reservoir bag but not to exhale into it; at a flow rate of 15 L/min, it can deliver 90% and 100% inspired oxygen
nonrebreathing mask
125
an emergency incision of the cricothyroid membrane with a a scalpel and insertion of an endotracheal or a tracheostomy tube directly into the subglottic area of the trachea; also called surgical cricothyrotomy
open cricothyrotomy
126
potent analgesics with sedative properties; examples are fentanyl (Sublimaze) and alfentanil (Alfenta); also called narcotics
opiods
127
a gastric tube inserted into the stomach through the mouth
orogastric (OG) tube
128
a hard plastic device that is curved so that it fits over the back of the tongue with the tip in the posterior pharynx
oropharyngeal (oral) airway
129
forms the posterior portion of the oral cavity, which is bordered superiorly by the hard and soft palates, laterally by the cheeks, and inferiorly by the tongue
oropharynx
130
insertion of an endotracheal tube into the trachea through the mouth
orotracheal intubation
131
positional dypsnea
orthopnea
132
a small bottle of water through which the oxygen leaving the cylinder is moisturized before it reaches the patient
oxygen humidifier
133
the process of adding oxygen, such as for delivery to the cells
oxygenation
134
hemoglobin that is occupied by oxygen
oxyhemoglobin
135
the structure that forms the roof of the mouth and separates the oropharynx and nasopharynx
palate
136
paired lymphatic tissues that lie on the lateral walls of the palatoglossal arch and anterior to the palatopharyngeal arch
palatine tonsils
137
the posterior border of the oral cavity
palatoglossal arch
138
the entrance from the oral cavity into the throat
palatopharyngeal arch
139
a non depolarizing neuromuscular blocking agent; used to maintain paralysis following succinylcholine-facilitated intubation; also called Pavulon
pancuronium
140
the inward movement of the chest during inhalation and outward movement during exhalation; the opposite of normal chest wall movement during breathing
paradoxical motion
141
drugs that paralyze skeletal muscles; used in emergency situations to facilitate intubation; also called neuromuscular blocking agents
paralytics
142
the frontal and maxillary sinuses
paranasal sinuses
143
thin membrane that lines the chest cavity
parietal pleura
144
surgical removal of a portion of the larynx
partial laryngectomy
145
the amount of gas in air or dissolved in fluid, such as the blood; measured in mm of mercury (mm Hg) or torr.
partial pressure
146
a mask similar to the nonrebreathing mask but without a one way valve between the mask and the reservoir; room air is not drawn in with inspiration; residual expired air is mixed in the mask and rebreathed
partial rebreathing mask
147
open
patent
148
an approx of the extent of bronchoconstriction; used to determine whether therapy such as with inhaled bronchodilators) is effective
peak expiratory flow
149
the throat
pharynx
150
additional dead space created by intrapulmonary obstructions or atelectasis
physiologic dead space
151
two pockets of tissue on the lateral borders of the larynx
piriform fossae
152
the result of an inflammation that causes the pleura to thicken, decreasing the pleural space and allowing the pleurae to rub together
pleural friction rub
153
mechanical maintenance of pressure in the airway at the end of expiration to increase the volume of gas remaining in the lungs
positive end expiratory pressure (PEEP)
154
forcing air into the lungs
positive pressure ventilation
155
the pressure of the blood that is returned ti the heart (venous return)
preload
156
an oxygen flowmeter that incorporates a float ball in a tapered calibrated tube; the float rises or falls according to the gas flow in the tube
pressure compensated flowmeter
157
the normal stimulus to breathe; based on fluctuations in PaCO2 and pH of the cerebrospinal fluid
primary respiratory drive
158
a device that measures oxygen saturation (spO2)
pulse oximeter
159
a drop in the systolic blood pressure of 10 mm Hg or more; commonly seen in patients with pericardial tamponade or severe asthma
pulsus paradoxus
160
a specific set of procedures, combined in rapid succession, to induce sedation and paralysis and intubate a patient quickly
rapid sequence intubation (RSI)
161
left lateral recumbent position
recovery position
162
the hemoglobin after the oxygen has been released to the cells
reduced hemoglobin
163
the air that remains in the lungs after maximal exhalation
residual volume
164
the process of exchanging oxygen and carbon dioxide
respiration
165
a pathologic condition characterized by a blood pH of less than 7.35 and caused by the accumulation of acids in the body from a respiratory cause
respiratory acidosis
166
a pathologic condition characterized by a blood pH of greater than 7.45 and resulting from the accumulation of bases in the body from a respiratory causes
respiratory alkalosis
167
the number of times a person breathes in 1 minute
respiratory rate
168
skin pulling between and around the ribs during inhalation; a sign of respiratory distress
retractions
169
a technique in which a wire is placed through the trachea and into the mouth with a needle via the cricoid membrane; the endotracheal tube is then placed over the wire and guided into the trachea
retrograde intubation
170
a continuous, low pitched sound; indicates mucus or fluid in the larger lower airways
rhonchi
171
a non depolarizing neuromuscular blocking agent used to maintain paralysis following succinylcholine facilitated intubation; also called Zemuron
rocuronium
172
the pressure at which an oxygen cylinder should be replaced with a full one; often is 200 psi
safe residual pressure
173
the reduction of a patient's anxiety, induction of amnesia, and suppression of the gag reflex, usually by pharmacologic means
sedation
174
a technique that involves inserting a needle with a syringe, then inserting a guide wire into the needle, removing the needle, making an incision, and inserting a catheter over the guide wire; the guide wire is then removed
Seldinger technique
175
a type of tracheostomy tube
shiley
176
cavities formed by the cranial bones that trap contaminants from entering the respiratory tract and act as tributaries for fluid to and from the eustachian tubes and tear ducts
sinuses
177
a narrowing, such as of a blood vessel or stoma
stenosis
178
in the context of the airway, the resultant orifice of a tracheostomy that connects the trachea to the outside air; located in the midline of the anterior part of the neck
stoma
179
a blade designed to lift the epiglottis and expose the vocal cords; also called the Miller blade
straight laryngoscope blade
180
a high pitched inspiratory sound representing air moving past an obstruction within or immediately above the glottic opening
stridor
181
in the context of intubation, a semirigid wire inserted into an endotracheal tube to mold and maintain the shape of the tube
stylet
182
a depolarizing neuromuscular blocker frequently used as the initial paralytic during rapid sequence intubation; causes muscle fasciculations; also called Anectine
succinylcholine chloride
183
a proteinaceous substance that lines the alveoli; decreases alveolar surface tension and keeps the alveoli expanded
surfactant
184
a device that attaches to the stem of the oxygen cylinder and reduces the high pressure of a gas to a safe range (about 50 psi)
therapy regulator
185
the attachment of the thyroid cartilage to the epiglottis
thyroepiglottic ligament
186
the main supporting cartilage of the larynx; a shield shaped structure formed by two plates that join in a "V" shape anteriorly to form the laryngeal prominence known as the Adam's apple
thyroid cartilage
187
a measure of the depth of breathing; the volume of air that is inhaled or exhaled during a single respiratory cycle
tidal volume
188
a manual maneuver that involves grasping the tongue and jaw and lifting; commonly used to suction the airway and to place certain airway devices
tongue jaw lift maneuver
189
a hard or rigid suction catheter; also called a Yankauer catheter
tonsil tip catheter
190
surgical removal of the entire larynx
total laryngectomy
191
the total volume of air that the lungs can hold; approx 6 L in an average man
total lung capacity
192
the conduit for all entry into the lungs; a tubular structure that is approx 10 to 12 cm long and composed of a series of C-shaped cartilaginous rings; also called the windpipe
trachea
193
breath sounds heard by placing the stethoscope diaphragm over the trachea or sternum; also called bronchial breath sounds
tracheal breath sounds
194
inserting a suction catheter into the endotracheal tube to remove pulmonary secretions
tracheobronchiol suctioning
195
a surgical opening into the trachea
tracheostomy
196
a plastic tube placed within the tracheostomy site (stoma)
tracheostomy tube
197
a method of intubation that uses a lighted stylet to guide the endotracheal tube into the trachea
transillumination intubation
198
a method used in conjunction with needle cricothyrotomy to ventilate a patient; requires a high pressure jet ventilator
translaryngeal catheter ventilation
199
clenched teeth caused by spasms of the jaw muscles
trismus
200
three bony shelves that protrude from the lateral walls of the nasal cavity and extend into the nasal passageway, parallel to the nasal floor
turbinates
201
consists of all anatomic airway structures above the level of the vocal cords
upper airway
202
a soft tissue structure that resembles a punching bag; located in the posterior aspect of the oral cavity, at the base of the tongue
uvula
203
an anatomic space, or pocket, located between the base of the tongue and the epiglottis; an anatomic landmark for endotracheal intubation
vallecula
204
a non depolarizing neuromuscular blocking agent; used to maintain paralysis following succinylcholine facilitated intubation; also called Norcuron
vecuronium
205
the process of moving air into and out of the lungs
ventilation
206
a portion of the medulla oblongata that is responsible for modulating breathing during speech
ventral respiratory group
207
a mask with a number of interchangeable adapters that draws room air into the mask along with the oxygen flow; allows for the administration of highly specific oxygen concentrations
venturi mask
208
soft, muffled breath sounds in which the expiratory phase is barely audible
vesicular breath sounds
209
the thin membrane that covers the lungs
visceral pleura
210
the amount of air that can be forcefully exhaled after a full inhalation; approx 4800 mL in an average man
vital capacity
211
white bands of tough tissue that are the lateral borders of the glottis
vocal cords
212
an imbalance in the amount of oxygen received in the alveoli and the amount of blood flowing through the alveolar capillaries
V/Q mismatch
213
a waveform display of exhaled carbon dioxide shown on a portable cardiac monitor/defibrillator
waveform capnography
214
a high pitched whistling sound that may be heard on inspiration, expiration, or both; indicates air movement through a constricted lower airway, as with asthma
wheezing
215
soft plastic, nonrigid catheters;also called french catheters
whistle tip catheters
