Airways Flashcards
Concentration of CO2 at the end of exhalation. Normal value is 35-45 mmHg.
End tidal (CO2 - EtCO2)
Rare medical condition where the immune system attacks the PNS leading to respiratory failure and then hypercapnia
Guillain-Barre Syndrome (GBS) [“gwi-anne bari”]
Ox level for Nebulizer treatment
6-8 litters of Ox an hour
Peds Epinephrine dossage
0.15mg under 5yo, 0.5mg over
Surgical incision into the trachea
Tracheostomy (tray ki asta mi)
Pattern of breathing that moves from quick to deep to apnea
Cheyne-Stokes breathing (chain stokes)
Where to auscultate lungs
Mid clavicular, axial, posterior
Location of second rib, tracheal bifurcation
Sternal angle/ Angle of Louis / Manubriosternal joint
below xiphoid, upper center of abdomen
Epigastric region
Anterior to larynx, forms the Adam’s apple
Thyroid cartilage (kar de lich)
Chemical sensors in the brain and blood vessels that identify changing levels of oxygen and co2
Chimoreceptors (kimo receptors)
Ring-shaped structure that forms the lower portion of the larynx
Cricoid cartilage (cry coid - car da lidgd)
Area directly posterior to the mouth and nose
Pharynx (fe rinks)
Leaf-shaped structure that prevents food and foreign matter from entering the trachea
Epiglottis (epa glotis)
Windpipe
Trachea (tray ki ya)
Quick shallow breathing
Tachypneic (ta KIP nek), tachypnea
An inadequate blood supply to an organ or part of the body, especially the heart muscles.
Ischemia (e SKI mi ya)
Labored or difficult breathing
Dyspnea (DISP ni ah)
Accumulation of fluids in lungs
Pulmonary edema (a DI ma)
Contraction of smooth muscles, decreasing internal diameter of airways
Bronchoconstriction
Pattern of irregular and unpredictable breathing commonly caused by brain injury
Ataxic respiration (e TAK sik)
- Air in the chest cavity
- Air in chest cavity that can’t escape
- Chest cavity fills with blood
- Chest cavity fills with both air and blood
- Pneumothorax
- Tension pneumothorax
- Hemothorax
- Hemopneumothorax
Rapid and deep breathing due injury to brain
Central neurogenic hyperventilation
Adrenergic receoptors
- Alpha 1 - vasoconstriction
- Beta 1 - increase heart rate, contraction force, myocardial conduction
- Beta 2 - Bronchodilation
A common excitatory neurotransmitter
Acetylcholine (ACh) (asido KO lin)
A condition in which fluid collects in spaces within your abdomen.
Ascites (a SAI tis)
The accumulation of fluid around the lungs,in between the parietal and visceral pleura
Pleural effusion
Genetic tendency to develop allergic diseases such as allergic rhinitis, asthma and atopic dermatitis (eczema)
Atopy (ey TA pi)
A skin reaction that causes itchy welts.
Urticaria (ur te KE ria) aka Hives.
An enlarged right ventricle of the heart that happens because the ventricle is pushing against higher than normal pressure from the pulmonary artery
Cor pulmonale (kor Pul menali)
An inflammatory process that causes a blood clot to form and block one or more veins, usually in the legs.
Thrombophlebitis (throm-bo-fluh-BY-tis)
Chronic autoimmune disorder in which antibodies destroy the communication between nerves and muscle, resulting in weakness of the skeletal (voluntary) muscles. Impacts breathing.
Myasthenia gravis (maya STInya gra ves)
Shortness of breath or difficulty breathing when lying down. Patients have stacked up pillows.
Orthopnea
Sudden shortness of breath when sleeping
Paroxysmal (perek SIZ mul) nocturnal dyspnea
Refers to an increase in the absolute red blood cell (RBC) mass in the body. A compensatory reaction to chronic hypoxia
Polycythemia (Poli sy thimia), or erythrocytosis (ee ri thro sy Tosis)
Air in and out of the lungs
Ventilation
The amount of air that moves in or out of the lungs with each respiratory cycle.
Tidal volume/Healthy adult 500ml
Respiratory rate x tidal volume.
Minute volume - Normal minute volume 5-8 L for an adult (note that our adult BVM bags are more than a litter)
Remaining in lungs after normal exhalation
Expiratory reserve volume
Air expelled in maximal exhalation. Use for the measurement of lung functions.
Forced Expiratory Volume (FEV)
Remaining in lungs after maximal exhalation (cannot be expelled)
Residual volume
- Oxygen from alveoli to blood
- Low oxygen levels in your blood
- Oxygenation (aka external respiration)
- Hypoxemia
- Ox to tissue
- Low oxygen levels in your tissues.
- Perfusion (aka internal/cellular respiration)
- Hypoxia (Hypoxemia can lead to hypoxia)
Ventilation-perfusion (V/Q) mismatch
When either the ventilation (airflow) or perfusion (blood flow) in the lungs is impaired. This prevents the lungs from optimally delivering oxygen to the blood.
Wet Adventitious lung sound
- Fine Crackles/Rales (Wet): Crackles are brief, discontinuous, popping, sound of Velcro / cellophane being crumpled.
- Rhonchi (Wet, expiration): Rhonchi are continuous, low-pitched , have a snoring, gurgling, or rattle-like quality.
Dry Adventitious lung sound
Stridor (Dry, barking, upper airway): upper airway that is narrowed or obstructed. Stridor is a loud, high-pitched crowing breath sound. Causes - obstructions, croup, epiglottis, aspirations.
Wheeze (Dry, central airway): Air flowing through a narrowed bronchus Highest sound intensity when auscultating over or near the central airways.
Stopping the exhalation and inhaling until the lung explode. We can also do by bagging them too hard
Air trapping (result of stacking of breathing)
Systolic blood pressure drops more than 10 mmHg during inhalation (tamponade, trauma to chest)
Pulsus Paradoxus
A mixture of saliva and mucus coughed up from the respiratory tract
Sputum (spYOO dem)
Abnormal breathing pattern that involves long, gasping inhalations followed by brief, ineffective exhalations and apnea.
Apneustic (up NOO stik) breathing
Rapid, deep breathing at a consistent pace. They are indicative of metabolic acidosis, or when the body accumulates too much acid. Occasionally described as air hunger. Elevated capnography
Kussmaul (koos mal) respirations
Cannot speak fluently due to lack of ox
Conversational dyspnea
Body fat
Adipose tissue
The only bone in humans that does not articulate with any other bone
Hyoid bone
The nerve that connects to diaphragm
Phrenic nerve
During intubation, the tube may get stuck on them
Arytenoid (a RI te noid) cartilages
Impacted by edema
Edematous (e DE ma tes)
Lifts the epiglotis
HYOEPIGLOTTIC (HAyo epiglotic) LIGAMENT
External larynx anatomy (top to bottom)
- Hyoid bone,
- Thyrohyoid membrane,
- Thyroid cartilage,
- Cricothyroid membrane,
- Cricoid cartilage,
- Cricotracheal ligament
The main areas in the brain impacting breathing/respiratory drive
Pons and Medulla
Sudden increase in epi and norepinephrine in blood
High adrenergic state
Diminished responsiveness to stimuli
Obtunded (ob tan ded)
A sudden dip in the waveform during phase III. Happens in RSI intubation indicating neuromuscular blockade is wearing off and the patient is making an effort to breathe on their own
Curare (koo RA ri) cleft
Ox goes into the alveoli and to the blood without any breathing
Apneic (up NEE yek) oxygenation
The emergency procedure for inserting an aiway surgically through the larynx
Cricothyroidotomy (Crico-thyroi-dotomy)
Intubation without a video device
DL - Direct Laryngoscopy
Removal of intubation tube
Extubation
Putting air in the stomach/gastric tract when pushing air into patient
Gastric insufflation
Total lung capacity
The maximum amount of air lungs can hold (total lung capacity) is about 6 liters. Lungs mature by age 20-25 and start declining after age 35.
Chemoreceptors and speed of breathing
- Central chemorecptors monitor CO2 and increase breathing when its high.
- Peripheral chemoreceptors monitor O2 and speed breathing when its low.
