Airway Management Flashcards
agonal respirations
slow shallow irregular respirations resulting from anoxic brain injury
air trapping
a respiratory pattern associated with an obstruction in the pulmonary tree, the breathing rate increases to overcome resistance in getting air out the respiratory effort becomes more shallow, the volume of trapped air increases, and the lungs inflate
alveolar air volume
in contrast to dead air space, alveolar volume is the amount of air that does reach the alveoli for gas exchange (approx 350 ml in the adult male). it is the difference between tidal volue and dead space volume
angle of louis
an angulation of the sternum that indicates the point where the second rib joins the sternum, also called the masubriosternal junction
anoxia
a total lack of oxygen availability to the tissues
apnea
respiratory arrest
atelectasis
an abnormal condition characterized by the collapse of alveoli, preventing the respiratory exchange of carbon dioxide and oxygen in a part of the lungs
barrier device
a thin film of material placed on the patients face used to prevent direct contact with the patients mouth during positive pressure ventilation
bilevel positive aitway pressure (BiPAP)
the delivery of two levels of positive pressure ventilation, one during inspiration to keep the airway open as the patient inhales, and the other (lower) pressure during expiration to reduce the work of exhalation
biot respirations
irregular respirations varying in rate and depth and interrupted by periods of apnea; associated with increased intracranial pressure, brain damage at the level of the medulla, and respiratory compromise from drug poisoning
bradypnea
a respiratory rate that i persistently slower than normal for age; in adults a rate slower than 12 breaths/min
capnograph
a device that provides a numerical reading of exhaled CO2 concentrations and a waveform (tracing)
capnography
continuous analysis and recording of CO2 concentrations in respiratory gases
capnometer
a device used to measure the concentration of CO2 at the end of exhalation
capnometry
a numeric reading of exhaled CO2 concentrations without a continuous written record or waveform
carina
the point where the trachea divides into the right and left mainstem bronchi
central neurogenic hyperventilation
similar to kussmaul respirations characterized as deep rapid breathing associated with increased intracranial pressure
cheyne stokes respirations
a pattern of gradually increasing rate and dept of breathing that tapers to slower and shallower breathing with a period of apnea before the cycle repeats itself; often described as a crescendo decrescendo pattern or periodic breathing
chronic obstructive pulmonary disease (COPD)
a progressive and irreversible condition characterized by diminished inspiratory and expiratory capacity of the lungs
compliance
the resistance of the patients lung tissue to ventilation
continuous positive airway pressure (CPAP(
the delivery of slight positive pressure throughout the respiratory cycle to prevent airway collapse reduce the work of breathing and improve alveolar ventilation
costal angle
the angle formed by the margins of the robs at the sternum
coughing
a protective mechanism usually induced by mucosal irritation; the forceful, spastic expiration experienced during coughing aied in the clearance of the bronchi and bronchioles
crackles (rales)
as teh name implies, when fluid accumulates in the smaller airway passages, air passing through the fluid creates a moist crackling or popping sound heard on inspiration
crepitation
a crackling sound indicative of bone ends grinding together
cricothyroid membrane
a fibrous membrane located between the cricoid and thyroid cartilages
cricothyrotomy
an emergency procedure preformed to allow rapid entrance to the airway for temporary oxygenation and ventilation
dead air space
not all the air inspired during a breath participates in gas exchange and can be further classified as anatomic or physiologic dead space. In the average adult male, this equates to approx 150 ml. Anatomic dead space includes airway passages such as the trachea and bronch, which are incapable of participation in gas exchange. Alveoli that have the potential to participate in gas exchange but do not because of disease or obstruction, as in COPD or atelectasis, are referred to as physiologic dead space
dyspnea
an uncomfortable awareness of ones breathing that may be associated with a change in the breathing rate, effort, or pattern
endotracheal (ET)
within or through the trachea
endotracheal intubation
an advanced airway procedure in which a tube is placed directly into the trachea
exhaled CO2 detector
a capnometer that provides a noninvasive estimate of alveolar ventilation, the concentration of exhaled CO2 from the lungs, and arterial carbon dioxide content; also called an endtidal CO2 detector
expiratory reserve volume
amount of gas that can be forcefully expired at the end of a normal expiration
external respiration
the exchange of gases between the alveoli of the lungs and the blood cells traveling through the pulmonary capillaries
extubation
removal of an ET tube from the trachea
FiO2
fraction of inspired oxygen
flail segment
a free floating section of the chest wall that results when two or more adjacent ribs are fractured in two or more places or when the sternum is detached
functional reserve capacity
at the end of a normal expiration, the volume of air remaining in the lungs
gagging
a reflex caused by irritation of the posterior pharunx that can result in vomiting
gag reflex
a normal neural reflex elicited by touching the soft palate or posterior pharynx; the responses are symmetric elevation of the palate, retraction of the tongue, and contraction of the pharyngeal muscles
gastric distention
swelling of the abdomen caused by an influx of air or fluid
glottis
the true vocal cords and the space between them
hemoglobin
a protein found on red blood cells that is rich in iron
hering breuer reflex
a reflex that limits inspiration and prevents overinflation of the lungs in a conscious, spontaneously breathing person; also called the inhibito inspiratory reflex
hiccup
intermittent spasm of the diaphragm resulting in sudden inspiration with spastic closure of the glottis; usually annoying and serves no known physiologic purpose
hilum
the pint of entry for bronchial vessels, bronchi, and nerves in each lung
hypercarbia
an excess of CO2 in the blood
Hyperpnea (hyperventilation)
a respiratory pattern characterized by rapid, deep breathing
hyperventilation
blowing off too much carbon dioxide
hypocarbia
an inadequate amount of carbon dioxide in the blood
hypoventilation
occurs when the volume of air that enters the alveoli and takes part in gas exchange is not adequate for the body’s metabolic needs
hypoxemia
an abnormal deficiency in the concentration of oxygen in arterial blood
hypoxia
inadequate oxygenation of the cells
inspiratory reserve volume
amount of gas that can be forcefully inspired in addition to a normal breaths tidal volume
internal respiration
the exchange of gases between blood cells and tissues
kussmaul respirations
an abnormal respiratory pattern characterized by deep, gasping respirations that may be slow or rapid
laryngoscope
an instrument used to examine the interior of the larynx; during ET intubation, the device is used to visualize the glotic opening
minute volume
amound of gas moved in and out of the respiratory tract per minute. Tidal volume multiplied by ventilatory rate equals minute volume. the minute volume is the true measurement of a patient’s ventilatory status and is vital in assessing pulmonary function. It ascertains the ventilatory rate and the depth of each inhalation
orthopnea
dyspnea relieved by a change in position (either sitting upright or standing)
oxyhemoglobin
hemoglobin that has oxygen molecules bound to it
paradoxic motion (segment of chest wall)
part of the chest moves in an opposite direction from the rest during respiration
partial pressure
the pressure exerted by an individual gas in a mixture
peak expiratory flow
the greatest rate of airflow that can be achieved during forced expiration beginning with the lungs fully inflated
peak flow meter
a device used to assess the severity of respiratory distress
pocket mask
a clear semirigid mask designed for mouth to mask ventilation of a nonbreathing adult, child, or infant
positive end expiratory pressure (PEEP)
the amount of pressure above atmospheric pressure present in the airway at the end of the expiratory cycle
positive pressure ventilation
forcing air into the lungs
pulse oximetry
a noninvasive method of measuring the percentage of oxygen bound hemoglobin
rapid sequence intubation (RSI)
the use of medications to sedate and paralyze a patient to achieve endotracheal intubation rapidly
rattles
attributable to inflammation and mucus or fluid in the larger airway passages, rattles or rhonchi are descriptive of airway congestion heard on inspiration. Rhonchi are commonly associated with bronchitis or pneumonia
residual volume
after a maximal forced exhalation the amount of air remaining in the lungs and airawy passages not able to e expelled
respiration
the exchange of gases between a living organism and its environment
saturation of peripheral oxygen
the percentage of hemoglobin saturated with oxygen (SpO2)
sellick maneuver
techique used to compress the cricoid cartilage against the cervical vertebrae, causing occlusion of the esophagus, thereby reducing the risk of aspiration; cricoid pressure
sighing
involuntary and periodic slow, deep breathing followed by a prolonged expiratory phase. occurring approximately once per minute, the act of sighing is thought to open atelectatic (collapsed)
sneezing
occurs from nasal irruption and allows clearance of the nose
stylet
a relatively stiff but flexible metal rod covered by plastic and inserted into an ET tube; used for maintaining the shape of the relatively pliant ET tube and steering it into position
suprasternal notch
a depression easily felt at the bease of the anterior aspect of the next. just above the angel of louis
surfactant
specialized cells within each alveolus that keeps it from collapsing when little or no air is inside
trachypnea
a respiratory rate persistently faster than normal for age; in adults, a rate faster than 20 breaths per min
tidal volume
the volume of gas exhaled during a single respiratory cycle. in average adult male this is approximately 500 ml (5to 7 ml/kg
tracheal stoma
surgical opening in the anterior neck that extends from the skin surface into the trachea, opening the trachea to the atmosphere
tracheostomy
the surgical creation of an opening into the trachea
tripod position
sitting upright and leaning forward supported by the arms, with the neck slightly extended, chin projected, and mouth open to maintain an airway
uvula
fleshy tissue resembling a grape that hangs down from the soft palate
vallecula
the depression or pocket between the base of the tongue and the epiglottis
ventilation
the mechanical process of moving air into and out of the lungs
wheeze
a musical, whistling sound heard on inspiration and or expiration resulting from constriction or obstruction of the pharynx, trachea, or bronchi, wheezing is commonly associated with asthma
