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EMT 221 > Airway Block > Flashcards

Airway Block Flashcards

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1
Q

Minute alveolar ventilation formula

A

(Tidal volume - Dead space) x Respiratory rate

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2
Q

Upper Airway Structures

A

Nasopharynx
Oropharynx
Laryngopharynx
Larynx

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3
Q

Lower Airway Structures

A

Trachea
Lungs
Bronchial Tree
Alveoli

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4
Q

Airway Openings

A

Nose (Nasopharynx)
Mouth (Oropharynx)

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5
Q

Larynx (I C ET)

A

In the anterior neck
Contains vocal cords
ET tube passes through vocal cords

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6
Q

Trachea

A

Air passage from larynx to lungs

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7
Q

Carina

A

Ridge that separates opening of right and left bronchus

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8
Q

Bronchi

A

Branch into secondary and tertiary bronchi and bronchioles

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9
Q

Alveoli

A

Functional units where respiratory gas exchange takes place.
* Surrounded by fine capillaries
* Surfactant prevents the alveoli from collapsing

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10
Q

Mediastinum

A

Separate the lungs; include the heart, blood vessels, trachea, esophagus, lymphatic tissue, and lymphatic vessels

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11
Q

Pleural Cavity

A

Surrounds both lungs

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12
Q

Primary function of lungs?

A

Respiration

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13
Q

Support Structures

A

Thoracic cage
Phrenic nerve
Mediastinum

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14
Q

Respiration

A

Exchange of oxygen and carbon dioxide between an organism and environment

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15
Q

Oxygen

A

Essential nutrient

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16
Q

Carbon Dioxide

A

By-product of energy production

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17
Q

Pulmonary Ventilation

A

Mechanical process of respiration

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18
Q

External Respiration

A

Transfer of O2 and CO2 between air and capillaries

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18
Q

Internal respiration

A

Transfer of O2 and CO2 between capillary cells and tissue cells

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19
Q

Diffusion

A

Gas flows from higher pressure to lower pressure

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20
Q

Atmospheric pressure

A

Pressure of gas around us (varies with altitude)

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21
Q

Intrapulmonic pressure

A

Pressure of gas in alveoli

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22
Q

Intrathoracic pressure

A

Pressure in the thoracic cavity

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23
Q

What happens during inspiration?

A

Chest wall expands
Lung space increases
Pressure gradient between intrapulmonic and atmosphere results in gas flowing into lungs

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24
Q

What happens during expiration?

A

Chest wall relaxes
Lung space decreases
Intrapulmonic pressure decreases
Pressure gradient makes gas flow out

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25
Q

What moves the lungs?

A

Diaphragm, internal, and external intercostal muscles

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26
Q

Factors that increase work of breathing

A

Loss of surfactant
Increase in airway resistance
Decrease in pulmonary compliance
Trauma or disease

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27
Q

Do pulmonary alveoli have a tendency to collapse?

A

Yes

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28
Q

Surfactant

A

Lipoproteins that reduce surface tension of pulmonary fluids

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29
Q

Nasal passages

A

Cause 50% of airway resistance during nasal breathing

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30
Q

Airway resistance

A

Decreases as bronchial tree continues to alveoli

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31
Q

Lung capacity

A

8 times a normal resting inhalation

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32
Q

Tidal volume

A

Volume inhaled or exhaled during a normal breath

33
Q

Inspiratory reserve volume

A

Amount of gas that can be forcibly inhaled after normal inspiration

34
Q

Maximum lung volume (TIER)

A

Combined:
* Tidal volume
* Inspiratory reserve volume
* Expiratory reserve volume
* Residual volume

35
Q

Expiratory reserve volume

A

Amount of gas that can be forcibly exhaled after normal expiration

36
Q

Inspiratory capacity (T+I)

A

Tidal volume + Inspiratory reserve volume

37
Q

Functional residual capacity (E+R)

A

Expiratory reserve volume + Residual volume

38
Q

Vital capacity (I+T+E)

A

Inspiratory reserve volume + Tidal volume + Expiratory reserve volume

39
Q

Minute volume

A

Amount of gas inhaled/exhaled in 1 minute

40
Q

Combined partial pressure (Dalton’s Law)

A

Total atmospheric pressure is exerted by all gases
Partial pressure is a single gas

41
Q

Pulmonary circulation

A

Respiratory system brings oxygen from gas to blood and removes CO2

42
Q

Forms of oxygen in the blood

A

Can be physically dissolved or chemically bound to hemoglobin

43
Q

Hemoglobin

A

Unload CO2 and absorb O2 60x faster than plasma
* Degree of O2 combination increases when PO2 is 10-60 mmHg
* Venous blood entering lungs has PO2 of 40 mmHg and HG saturation of 75%

44
Q

Carbon dioxide in the blood

A

Transported in plasma, blood proteins, and bicarbonate ions (primary form)
* Binds more readily to HG than O2 does

45
Q

Hypoxemia

A

State of decreased arterial O2 content
May lead to hypoxia

46
Q

Hypovolemia

A

Decreases total blood circulating and therefore cellular O2 levels

47
Q

Respiration regulation (mechanical)

A

Rate, depth, and pattern of breathing

48
Q

Voluntary respiration

A

Voluntary hyperventilation or apnea

49
Q

Medullary respiratory center

A

Stimulates inspiratory muscles
* Inspiratory center active
* Expiratory center stimulated by inspiratory activity

50
Q

Hering-Breuer reflex

A

Prevents overinflation of lungs via vagus nerve

51
Q

Pneumotaxic center

A

Active only in labored breathing
Prevents overexpansion of lungs during rapid breathing

52
Q

Apneustic center

A

Stimulates inspiratory center
-constantly active during normal respiratory rates (can be overriden by pneumotaxic center)

53
Q

Chemical respiration factors

A

Changes in O2 and CO2
pH of fluids
* O2 is a small part

54
Q

Outside respiration factors

A

Body temp
Drugs/medications
Pain/emotion
Sleep

55
Q

Modified respirations

A

Cough
Sneeze
Sigh
Hiccups

56
Q

Laryngeal spasm

A

Spasmatic closure of vocal cords

57
Q

Laryngeal edema

A

Swelling of glottic and subglottic tissues

58
Q

Fractured larynx

A

Motor vehicle crash common cause
Vocal cords collapse in tracheal-laryngeal opening
Cricothyrotomy may be required

59
Q

Aspiration

A

Inhalation of non-gaseous substance into lungs

60
Q

Aspiration risk factors

A

Diminished LOC
Iatrogenic obstructions
Mechanical disturbances of airway and GI tract

61
Q

Pulsus paradoxus

A

Abnormal drop in systolic pressure during inspiration

62
Q

Supplemental oxygen therapy

A

Administered only when clinically appropriate and indicated
Can help manage a wide range of conditions
Clinical goals:
* Treat hypoxia
* Decrease WOB
* Decrease myocardial work

63
Q

Liquid oxygen

A

Converts to gas when warmed
Used when weight/space must be considered
More expensive than pressurized O2

64
Q

Nasal cannula

A

Maximum flow rate of 6L/min

65
Q

Simple face mask

A

O2 of 35-60% at 6-10L/min

66
Q

Partial rebreathing mask

A

O2 of 35-60%
Allows some exhaled gas into reservoir bag

67
Q

Nonrebreathing mask

A

O2 up to 95%
No exhaled air bag into reservoir bag

68
Q

Venturi mask

A

O2 24-50%
Jet mixes atmospheric gases and O2

69
Q

CPAP

A

Transmits positive pressure into airways
Can be invasive or noninvasive
Pressure of 5-7.5 cm
* Pulmonary edema
* Obstructive airway disease

70
Q

Positive end-expiratory pressure (PEEP)

A

Maintains positive pressure at end of exhalation
Used for intubation and mechanical ventilation

71
Q

Factors affecting bag-mask seal

A

Age over 55 years
BMI greater than 26kg/m2
Absence of teeth
Presence of beard
History of snoring

72
Q

Bag-mask device

A

O2 from 21 to nearly 100%

73
Q

Automatic transport ventilators

A

Plastic control module connected to 50 psi gas source
Can select tidal volumes and respiratory rates based on age
Most provide flow rate of 40L/min
* Contraindicated in patients under 5, who are awake, who have obstructed airway, or increased airway resistance

74
Q

Suction devices

A

Fixed suction devices - powered by vacuum pumps or vacuum produced by vehicle engine manifold
Portable suction - powered by oxygen or air, electrically or manually

75
Q

Suction catheter complications

A

Hypoxemia secondary to decreased lung volume
* May lead to cardiac rhythm disturbances and cardiac arrest
Airway stimulation may increase arterial pressure and cardiac rhythm disturbances
Coughing that may increase ICP with reduced blood flow
Increased risk of herniation in patients with head injury
Bradycardia from vagal stimulation
Soft-tissue damage to respiratory tract

76
Q

Gastric tubes

A

Nasogastric or orogastric

77
Q

Complications of decompression

A

Discomfort
Nausea/vomiting
Interference with mask seals or airway visualization
Nasal/esophageal/gastric trauma

78
Q

Drugs used for sedation

A

Etomidate
Ketamine
Midazolam (Versed)

79
Q

Drugs used for paralysis

A

Succinylcholine - depolarizing
Vecuronium, Rocuronium - non-depolarizing

80
Q

Six P’s of RSI

A

Preparation
Preoxygenation
Pretreatment
Paralysis
Placement of tube
Postintubation management

EMT 221 (2 decks)

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