AIRWAY: CHAPT. 14 Flashcards
The procedure to have the Larynx removed is known as what?
Laryngectomy
5 year old boy at home has a trach-tube and is on a vent. Patients mother states unable to suction teach-tube adequately and patients oxygen saturation is dropping. Patient has been ill for 2 days with a fever, congested lungs, and copious amounts of thick green tinged mucus. You attempt to suction tube with no results. What is your best course of action?
Remove tracheostomy tube and replace it with a new one
Pharynx
Throat
Carina
Point where the main stem bronchi branch, important land mark for ET Tube
Peak Expiratory Flow
Greatest rate of air flow that can be achieved during forced expiration beginning with the lungs fully inflated
Barotrauma
An injury resulting from rapid or extreme changes in pressure
FiO2
Percentage of oxygen in inspired air (increases with suppl. O2)
Commonly documented as a decimal (FiO2 = 0.85)
Trachea
Windpipe
The distal cuff of the ET tube should hold how many mL of air after placement?
6-10mL
Who pioneered mouth to mouth ventilation?
James O. Elam (1954)
Larynx
Voice box
Alveolar Air Volume
Amount of air that reaches the alveolar for gas exchange.
Avg Adult Male = 350mL
It’s the difference between Tidal Volume and Dead Air Space
While using a BVM to ventilate the lungs of a medical patient, you make notice that the patients chest is not rising adequately and the pulse ox is low, suggesting that the patient is not oxygenating properly. What do you suspect?
Inadequate Tidal Volume with each breath
A patient in respiratory failure. Using a laryngoscope you attempt to visualize the vocal chords with no success.. Your partner attempts with no success. What is the next appropriate action?
Utilize a dual lumen airway
A patient has ingested hydrochloric acid. You would like to secure and airway. What is the best method for doing so?
ET Tube
77 year old female in respiratory distress. Tracheostomy tube has come dislodged. What is the next action?
Attempt to replace tube or incubate if necessary
Miller
Straight Laryngoscope blade that is placed under the epiglottis.
Automatic Transport Ventilators (ATV) are typically contraindicated in patients who what?
Have Asthma
Dead Air space
Air inspired that does not participate in gas exchange.
Average adult male -150mL
Rhonchi
Rattling sounds from mucus obstructions of the large airways
Macintosh
Curved laryngoscope blade that is placed in the vallecula
Upper airway consists of what?
Nose, Nasal Cavities, Pharynx, Laynx
Sniffing position is indicative of what kind of airway obstruction?
Upper airway
SupraSternal Notch
Depression that is easily felt at the base of the anterior aspect of the neck; just above the angle of Louise.
Angle of Louise
Angular ion of the sternum that indicated the point where the second rib joins with the sternum.
Used as a starting point from which the ribs and intercostal muscle can be counted
To correctly position a patients head for combitube insertion you should…
Place the head in the neutral position
Stridor
High pitched crowing sounds on inspiration resulting from right upper airway
Alveoli
Airway sacs in which gas exchange occurs
You have just delivered a newborn baby and need to suction secretions from the airway. Suctioning of a newborn should be between how may second?
3-5 seconds
Suctioning (application of negative pressure) should be activated upon what?
Extraction of the suction catheter
In ideal circumstances; suctioning an adult patients airway should not exceed how many seconds?
15 seconds
What best defines the purpose of humidified oxygen?
Help moisten respiratory mucosa and loosen thick secretions
Define tracheostomy
A surgical opening between the tracheal rings
A stoma is best described as what?
A surgical opening into the trachea that bypasses the upper airway
Helium
Point of entry for the bronchial vessels, bronchi, and nerves in each lung
Thyroid Cartilage
Largest cartilage that is shaped like a shield and can be identified externally
The adult trachea is approx. how many CM in length?
10-12 CM
Croup
Also known as Laryngotracheobronchitis.
Infection of the airway below the level of the vocal chords, usually caused by a virus
62 year old female in an MVA, in obvious respiratory distress; has a stoma because of a laryngectomy. What do you do to assists the patients breathing?
Insert ET tube in stoma and ventilate
Tripod position is indicative of what kind of airway issue?
Lower airway obstruction
21 year old male has been struck in the neck several times with a metal baseball bat during a gang fight. Patient has stridor with each breath. Appropriate management for this patient includes what?
Early intubation to protect airway
Expiratory Reserve Volume
Volume that can be maximally exhaled after a normal expiration
Minute Volume
Volume inhaled/exhaled in 1 minute
Vellecula
“Little Valley”
Depression between base of the tongue and the epiglottis
Bronchioles
Smaller airway without cartilage in their walls
Functional Residual Capacity
Volume remaining after the end of normal expiration
Epiglottis
Leaf like structure composed of cartilage covering trachea’s pending
Residual Volume
Volume left in lungs after max expiration
Tidal Volume (TV)
Volume inhaled/exhaled in one respiratory cycle
(In an adult male: approx. 5-7 mL/kg
Wheezing
Whistling sound on exhalation caused by narrow or tight lower airways
Interatrial septum
Separates right and left atria
Crackles
(Rales)
Fine bubbling sounds caused by fluid in the small airways
Pleura
Double membrane covering lungs
Inspirations Reserve Volume
Amount of gas that can be forcefully inspired in addition to a normal breath’s TV
Costal Angle
Angle formed by the margins of the ribs at the sternum
Lower Airway consists of what?
Trachea, Bronchial tree, alveoli and lungs
Placed a nasogastric tube in patient with gastric distinction. Patient has no facial injuries, or other trauma. After inserting the tube, no reduction in distention even though air flows freely through the tube. A likely reason for this is what?
Tube misplaced in trachea
After ensuring the patients airway is open and inserting an OPA, you use a BVM to ventilate the patients lungs. You notice each breath the chest rises minimally but the abdomen gets larger. What action do you perform to prevent this problem in the future?
Cricoid pressure
You are inserting a NPA and are eating resistance during the insertion. What is next?
Take out NPA, Re-Lubricate it, and try other nostril.
During the transfer on an incubated patient, you notice that coarse breath sounds are developing. You attempt to suction the trachea for secretions. The suction catheter become obstructed. What is the. Next appropriate action?
Flush the suction catheter with sterile saline to clear the obstruction
Epiglottitis
(Supraglottitis)
Infection of the soft tissue in the area above the vocal chord
Bronchiolitis
Specific viral illness of newborns and toddlers, often caused by RSV, that causes inflammation of bronchioles.
highly contagious, occurs during first 2 yrs of life, more common in males
