Airway Management - Anatomy & Physiology Flashcards

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1
Q

The upper airway consists of all anatomic airway structures above the level of the ___

A

Vocal cords

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2
Q

Upper airway structures

A
  1. Nose
  2. Mouth
  3. Jaw
  4. Oral cavity
  5. Pharynx
  6. Larynx
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3
Q

The major function of the upper airway

A

To warm, filter, and humidify air as it enters the body through thr mouth and nose

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4
Q

A muscular tube that extends from the nose and mouth to the level of the esophagus and trachea

A

Pharynx (throat)

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5
Q

The pharynx is composed of ___

A
  1. Nasopharynx
  2. Oropharynx
  3. Laryngopharynx
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6
Q

The laryngopharynx is also called the ___

A

Hypopharynx

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7
Q

Lowest portion of the pharynx

A

Laryngopharynx

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8
Q

At the base, the laryngopharynx ___

A

Splits into two lumens, the larynx (and ultimately the trachea) anteriorly and the esophagus posteriorly

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9
Q

The nasopharynx is lined with ___

A

A ciliated mucous membrane that keeps contaminants such as dust out of the respiratory tract

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10
Q

The mucous membranes in the nose ___ air as it enters the body, in addition to filtering it

A

Warm and humidify

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11
Q

After air enters the nose, it passes into the ___

A

Nasopharynx

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12
Q

Forms the posterior portion of the oral cavity

A

Oropharynx

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13
Q

The oral cavity is bordered by ___

A
  1. Superiorly by the hard and soft palates
  2. Laterally by the cheeks
  3. Inferiorly by the tongue
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14
Q

Helps separate the digestive system from the respiratory system

A

Epiglottis

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15
Q

The epiglottis is located ___

A

Superior to the larynx

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16
Q

When swallowing occurs, the larynx is ___ and the epiglottis ___

A
  1. Elevated
  2. Folds over the glottis to prevent aspiration of contents into the trachea
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17
Q

The larynx is a complex structure formed by ___

A

Many independent cartilaginous structures

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18
Q

The thyroid cartilage is ___

A

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

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19
Q

The cricoid cartilage, or cricoid ring, lies ___

A

Inferiorly to the thyroid cartilage

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20
Q

Forms the lowest portion of the larynx

A

Cricoid cartilage

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21
Q

First ring of the trachea

A

Cricoid cartilage

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22
Q

The only lower airway structure that forms a complete ring

A

Cricoid cartilage

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23
Q

The elastic tissue that connects the thyroid cartilage superiorly to the cricoid ring inferiorly

A

Cricothyroid membrane

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24
Q

The space between the vocal cords and the narrowest portion of the adult’s airway

A

Glottis

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25
Q

The glottis is also called the ___

A

Glottic opening

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26
Q

The lateral borders of the glottis are the ___

A

Vocal cords

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27
Q

These white bands of thin muscle tissue are partially separated at rest and serve as the primary center for speech production

A

Vocal cords

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28
Q

Vocal cords defense reflexes

A

Protect the lower airway, causing a spasmodic closure to the lower airway to prevent substances from entering the trachea

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29
Q

The function of the lower airway

A

Deliver oxygen to the alveoli

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30
Q

External boundaries of the lower airway

A

4th cervical vertebra and the xiphoid process

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31
Q

Internally the lower airway spans the ___

A

Glottis to the pulmonary capillary membrane

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32
Q

Conduit for air entry into the lungs

A

Trachea (windpipe)

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33
Q

The trachea is a ___

A

Tubular structure about 4 to 5 inches long and consists of C-shaped cartilaginous rings

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34
Q

The trachea begins ___ and descends ___

A
  1. Directly below the cricoid cartilage
  2. Anteriorly down the midline of the neck into the thoracic cavity
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35
Q

Once in the thoracic cavity, the trachea ___

A

Divides at the level of the carina into the two main stem bronchi (right & left)

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36
Q

The hollow bronchi are supported by ___ and distribute ___

A
  1. Cartilage
  2. Air into the right and left lungs
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37
Q

Infants and small children have a proportionately larger occiput (posterior portion of the cranium), which causes ___. To mitigate this ___

A
  1. The neck to flex, moving the head forward and backward when supine
  2. Place a folded towel under the child’s shoulders to maintain a neutral position of the head
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38
Q

Children have a proportionately smaller mandible and a proportionately larger tongue. Both factors increase the incidence of ___

A

Airway obstruction

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39
Q

The child’s epiglottis is more ___ than an adult’s

A

Floppy and omega-shaped

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40
Q

In general, the infant’s and child’s airway is ___ at all levels

A

Smaller and narrower

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41
Q

The larynx of a child lies ___

A

More superior and anterior than that of an adult

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42
Q

The larynx of a child is ___ shaped due to the ___

A
  1. Funnel
  2. Narrow, underdeveloped cricoid cartilage
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43
Q

In children younger than 8 years, the narrowest portion of the airway is at the ___

A

Cricoid ring

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44
Q

Children do not have well-developed chest musculature, and their ribs are softer and more pliable than those of an adult. As a result ___

A

The thoracic cavity cannot optimally contribute to lung expansion, and children rely heavily on the diaphragm for breathing

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45
Q

Children and infants are commonly referred to as ___ breathers

A

Belly

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46
Q

The lungs consist of the entire mass of tissue that includes the ___

A

Smaller bronchi, bronchioles, and alveoli

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47
Q

Thin serous membranes that cover the lungs and line the thoracic cavity

A

Pleurae

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48
Q

The visceral pleura covers the ___

A

Outer surface of the lung tissue

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49
Q

The parietal pleura lines the ___

A

Inside of the thoracic cavity

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50
Q

A small amount of ___ is found between the two pleural layers and serves as a ___

A
  1. Fluid
  2. Lubricant to prevent friction during breathing
51
Q

On entering the lungs, each bronchus divides into ___, which in turn subdivide into ___

A
  1. Increasingly smaller bronchi
  2. Bronchioles
52
Q

The bronchioles are ___

A

Think hollow tubes made of smooth muscle

53
Q

The tone of the smooth muscles of the bronchioles allows them to ___

A

Dilate or constrict in response to various stimuli

54
Q

The smaller bronchioles branch into ___ that end at ___

A
  1. Alveolar ducts
  2. Alveolar sacs
55
Q

Millions of thin-walled, balloon-like sacs that serve as the functional site for the exchange of oxygen and carbon dioxide

A

The alveoli

56
Q

Surrounding each alveolar sac is an ___

A

Intricate bed of blood vessels known as pulmonary capillaries

57
Q

Muscles between the ribs that facilitate normal breathing with the diaphragm

A

Intercostal muscles

58
Q

Space between the lungs

A

Mediastinum

59
Q

The mediastinum is surrounded by ___

A

Tough connective tissue

60
Q

The mediastinum effectively separates the ___

A

Right and left lungs spaces

61
Q

The phrenic nerves originate from ___

A

The third, fourth, and fifth cervical nerves

62
Q

What do the phrenic nerves do?

A

Innervate the diaphragm muscle, allowing it to contract

63
Q

Contraction of the diaphragm occurs in a ___ direction

A

Downward

64
Q

The physical act of moving air into and out of the lungs

A

Ventilation

65
Q

The process of loading oxygen molecules onto hemoglobin molecules in the bloodstream

A

Oxygenation

66
Q

The actual exchange of oxygen and CO2 in the alveoli as well as the tissues of the body

A

Respiration

67
Q

The active muscular part of breathing

A

Inhalation

68
Q

What causes air to move into the lungs

A

Negative pressure from diaphragm contracting downwards, and intercostal muscles contracting, lifting the ribs up and out

69
Q

Why can’t the lungs move on their own?

A

They contain no muscle tissue

70
Q

Describes the amount of gas in air or dissolved in fluid, such as blood

A

Partial pressure

71
Q

Partial pressure is measured in ___

A

mm/Hg

72
Q

The partial pressure of oxygen in air within the alveoli is ___

A

104 mm/Hg

73
Q

CO2 entering the alveoli from the blood causes a partial pressure of ___

A

40 mm/Hg

74
Q

Deoxygenated arterial blood from the right side of the heart has lower levels of ___ than ___. The body attempts to ___

A
  1. Oxygen
  2. CO2
  3. Equalize the two, resulting in oxygen diffusion across the membrane into the blood and CO2 diffusion in the opposite direction
75
Q

The air pressure outside the body is normally ___ than the air pressure within the thorax

A

Higher

76
Q

Average tidal volume for an adult man

A

500 mL

77
Q

The portion of the tidal volume that does not reach alveoli and thus does not participate in gas exchange

A

Dead space

78
Q

The amount of air (in mL) that is moved into or out of the lungs during one breath

A

Tidal volume

79
Q

The air that remains in the lungs after maximal expiration

A

Residual volume

80
Q

The volume of air that reaches the alveoli

A

Alveolar ventilation

81
Q

How to calculate alveolar ventilation

A

Subtract the amount of dead space air from the tidal volume

82
Q

The volume of air moved through the lungs in 1 minute

A

Minute volume

83
Q

How to calculate minute volume

A

Multiply tidal volume and respiratory rate

84
Q

The volume of air moved through the lungs in 1 minute minus the dead space

A

Alveolar minute volume

85
Q

How to calculate alveolar minute volume

A

Multiply tidal volume (minus dead space) and respiratory rate

86
Q

The amount of air that can be forcibly expelled from the lungs after breathing in as deeply as possible

A

Vital capacity

87
Q

Exhalation does not normally require ___

A

Muscular effort

88
Q

Exhalation is a ___ process

A

Passive

89
Q

Clearing the airway means ___

A

Removing obstructing material, tissue, or fluids from the nose, mouth, and throat

90
Q

Maintaining an airway means ___

A

Keeping the airway patent

91
Q

Open, free of obstructions

A

Patent

92
Q

Tissues and cells of the body do not get enough oxygen

A

Hypoxia

93
Q

The drive to breathe is based on ___

A

pH changes in the blood and CSF

94
Q

When CO2 levels in the blood increase, the pH of CSF ___

A

Decreases

95
Q

When the pH of CSF decreases ___

A

A message is sent to the respiratory centers in the brain, which stimulates breathing

96
Q

COPD

A

Chronic Obstructive Pulmonary Disease

97
Q

Patients with COPD have difficulty eliminating ___

A

CO2 through exhalation

98
Q

In patients with COPD, the body uses ___ to control breathing

A

A backup system called the hypoxic drive

99
Q

The hypoxic drive is based on ___

A

Levels of oxygen dissolved in plasma

100
Q

Patients who are breathing inadequately will show varying signs and symptoms of ___

A

Hypoxia

101
Q

The onset and degree of tissue damage caused by hypoxia often depend on the ___

A

Quality of the ventilations

102
Q

Early signs of hypoxia

A
  1. Restlessness
  2. Irritability
  3. Apprehension
  4. Tachycardia
  5. Anxiety
103
Q

Late signs of hypoxia

A
  1. Mental status changes
  2. Thready pulse
  3. Cyanosis
104
Q

Conscious hypoxia patients will complain of ___

A

Shortness of breath and may not be able to talk in complete sentences

105
Q

Shortness of breath

A

Dyspnea

106
Q

The best time to give a patient oxygen

A

Before signs and symptoms of hypoxia appear

107
Q

Difference between hypoxemia and hypoxia

A

Hypoxemia: Low level of oxygen in arterial blood
Hypoxia: Low level of oxygen at the cellular level

108
Q

Uncorrected hypoxemia will lead to ___

A

Hypoxia

109
Q

Oxygenation requires that the air used for ventilation contains an ___

A

Adequate percentage of oxygen

110
Q

CO affinity for hemoglobin vs oxygen

A

250 times more

111
Q

Cellular respiration

A

Metabolism

112
Q

During metabolism, each cell ___

A

Combines nutrients and oxygen and produces energy and waste products

113
Q

Energy produced in the cells

A

Adenosine triphosphate

114
Q

Waste products of cells are primarily ___

A

Water and CO2

115
Q

The process of breathing fresh air into the respiratory system and exchanging oxygen and CO2 between the alveoli and the blood in the pulmonary capillaries

A

External respiration (pulmonary respiration)

116
Q

Makeup of fresh air

A

21% oxygen
78% nitrogen
0.3% CO2

117
Q

As the fresh air reaches the alveoli, it comes in contact with a fluid called ___

A

Surfactant

118
Q

Reduces surface tension within the alveoli and keeps them expanded, making it easier for the gas exchange between oxygen and CO2 to occur

A

Surfactant

119
Q

Although adequate ventilation is necessary for external respiration to occur, it does not guarantee that ___

A

External respiration is being achieved

120
Q

Under normal conditions, ___ of the hemoglobin receptor sites contain oxygen

A

96% to 100%

121
Q

The exchange of oxygen and CO2 between the systemic circulatory system and the cells of the body is called ___

A

Internal respiration

122
Q

To deliver sufficient oxygen to the tissues of the body, adequate ___ must occur

A

Ventilation and perfusion

123
Q

With aerobic metabolism, cells convert ___ into energy

A

Glucose