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EMT 1 > Chapter 10 > Flashcards

Chapter 10 Flashcards

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1
Q

———— is the process of gas exchange that occurs between the alveoli, the pulmonary capillaries, between the body’s cells and their adjacent capillaries as well as the use of glucose and oxygen during normal metabolism within the cells.

A

Respiration

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2
Q

The terms ——— and ——— refer to moving air in and out of the lungs, these are sometimes used as if they are synonyms for respiration.

A

Ventilation and Breathing

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3
Q

Respiration can be broken down into 4 distinct components, what are they?

A

-Pulmonary ventilation
-External respiration
-Internal respiration
-Cellular respiration and metabolism

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4
Q

———-, or simply ventilation or breathing, is the mechanical process of moving air in and out of the lungs. It is related to minute ventilation and alveolar ventilation.

A

Pulmonary ventilation

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5
Q

———- is the gas exchange process that occurs between the alveoli and the surrounding pulmonary capillaries, can also be referred to as alveoli/capillary exchange, serves to oxygenate blood and eliminate carbon dioxide in the lungs.

A

External respiration

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6
Q

———-is the gas exchange process that occurs between the cells and the systemic capillaries. this is also known as cell/capillary gas exchange, is responsible for delivering oxygen to the cells and removing carbon dioxide from the cell.

A

Internal respiration

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7
Q

————, also known as aerobic metabolism, occurs in the cell. The process breaks down glucose in the presence of oxygen, produces high amounts of energy in the form of ATP, and releases carbon dioxide from the cell.

A

Cellular respiration and metabolism

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8
Q

The ———- takes oxygen from air that is breathed in, transports it to the alveoli where the oxygen crosses over into the capillary, and attaches the oxygen to the hemoglobin in the red blood cell or dissolves it in the plasma of the blood.

A

Respiratory system

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9
Q

If oxygen supply is decreased by an obstructed airway, inadequate breathing, ineffective oxygen exchange in the lungs, or an inadequate delivery system to the cells, the body cells will become ——— (low in oxygen) and eventually die.

A

Hypoxic

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10
Q

The ———- extends from the nose and mouth to the cricoid cartilage, the most inferior portion of the larynx.

A

Upper airway

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11
Q

What structures do the nasal cavity contain?

A

-Superior, middle, and inferior turbinates
-Hard and soft palates

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12
Q

What structures do the nasopharynx contain?

A

-Tonsils/adenoids
-Uvula

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13
Q

What structure does the oropharynx contain?

A

-Tongue

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14
Q

What structures do the laryngopharynx (hypopharynx) contain?

A

-Vallecula
-Epiglottis

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15
Q

What structures do the larynx contain?

A

-Esophagus
-Trachea

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16
Q

Air normally enters the body through the nostrils. It is warmed, moistened, and filtered as it flows over the damp, sticky ———- lining the nose.

A

Mucous membranes

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17
Q

What is a common cause of airway obstruction in a patient with an altered mental status?

A

The tongue

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18
Q

Air entering the body through the mouth and nostrils travels into the ———- (throat).

A

Pharynx

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19
Q

Air from the nasal passages enter through what is referred to as the ———

A

Nasopharynx

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20
Q

Air entering through the mouth travels through the ———-

A

Oropharynx

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21
Q

What are the two passageways found at the lower end of the pharynx?

A

-Trachea
-Esophagus

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22
Q

The trachea is protected by a small, leaf shaped flap of cartilaginous tissue called the ————

A

Epiglottis

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23
Q

Just superior to (above) the trachea and just inferior to (below) the epiglottis is the ———-, or voice box, which contains the vocal cords.

A

Larynx

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24
Q

The anterior portion of the larynx is composed of the large bulky ————, which can be felt at the front of the throat (adams apple).

A

Thyroid cartilage

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25
Q

The ———, which forms the most inferior portion of the larynx and is the only completely circular cartilaginous ring of the upper airway, is found at the lower portion of the larynx just below the thyroid cartilage.

A

Cricoid cartilage

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26
Q

The ———- extends from the cricoid cartilage at the lower edge of the larynx to the alveoli of the lungs.

A

Lower airway

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27
Q

The ———-, commonly known as the windpipe, is the passageway for air entering the lungs.

A

Trachea

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28
Q

The trachea extends from the larynx to the ———-, the point at which the trachea splits into right and left mainstream bronchi.

A

Carina

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29
Q

The right and left mainstream ———, which are the two major branches of the trachea, extend from the carina into the lungs, where they continue to divide into smaller sections or branches known as ———.

A

-Bronchi
-Bronchioles

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30
Q

The bronchioles terminate in millions of tiny air sacs in the lungs, these are called?

A

Alveoli

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31
Q

Each alveoli is wrapped in a web of thin walled capillaries referred to as the ————. This is the site for gas exchange between the alveoli and the blood in the capillaries.

A

Pulmonary capillaries

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32
Q

The lungs are surrounded by two layers of connective tissue called the ———

A

Pleura

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33
Q

The ———— is the innermost covering of the lung.

A

Visceral pleura

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34
Q

The ———- is a thicker, more elastic layer of connective tissue that adheres to the inner portion of the chest wall.

A

Parietal pleura

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35
Q

Between the two layers of pleura is the ———-, a small space that is at negative pressure

A

Pleural space

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36
Q

The pleural space contains a small amount of ——— that acts as a lubricant to reduce friction when the layers of the pleura rub against each other during breathing

A

Serous fluid

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37
Q

The ——— is a muscle that separates the chest cavity from the abdominal cavity, it is the major muscle used in breathing.

A

Diaphragm

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38
Q

The diaphragm is responsible for what percentage of the effort of ventilation?

A

60-70%

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39
Q

If contraction of the diaphragm is ineffective because of trauma or illness, the patient may show signs of ———— from inadequate breathing.

A

Significant respiratory distress

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40
Q

——- or ——- is the process of breathing air in

A

Inhalation or inspiration

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41
Q

——— or ——— is the process of breathing air out

A

Exhalation or expiration

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42
Q

During inhalation, the diaphragm and the external ———, or muscles between the ribs, contract.

A

Intercostal muscles

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43
Q

Inhalation is an ———- because it requires energy to contract the muscles

A

Active process

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44
Q

In some respiratory diseases affecting the lower airway such as ———-, the patient has a difficult time moving air out of the lungs because of an increased resistance in the airways or diseased lung tissue.

A

Asthma

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45
Q

The ——— (DRG), ———-(VRG), and ———- (pneumotaxic center) in the brain stem are respiratory rhythm centers that control the impulses being sent to the respiratory muscles.

A

-Dorsal respiratory group
-Ventral respiratory group
-Pontine respiratory center

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46
Q

The ———— continuously monitor levels of oxygen, carbon dioxide, and PH in the arterial blood and stimulate and increase or decrease in impulses from the respiratory rhythm centers to control the rate and depth of ventilation.

A

Chemoreceptors

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47
Q

The ———— located in the medulla are the most sensitive to changes in the blood PH and carbon dioxide, whereas the ———- located in carotid arteries and aortic arch are more sensitive to changes in arterial oxygen.

A

-Central chemoreceptors
-Peripheral chemoreceptors

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48
Q

The respiratory system responds primarily to changes in the ———- levels.

A

Carbon dioxide

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49
Q

If the carbon dioxide level in the arterial blood increases, the chemoreceptors sense the increase and the brainstem sends impulses to the respiratory muscles to ——— the rate and depth of respiration.

A

Increase

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50
Q

When the carbon dioxide level decreases in the blood, the chemoreceptors sense this and send signals to the respiratory muscles to ——— the respiratory rate and depth and the respirations return to normal.

A

Slow down

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51
Q

——- is much less of a stimulus for breathing in healthy people

A

Oxygen

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52
Q

In patients with a category of conditions known as COPD, which includes emphysema and chronic bronchitis, the carbon dioxide level in arterial blood is typically chronically ——— because of the disease process.

A

Elevated

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53
Q

——— is the process by which the blood and the cells become saturated with oxygen

A

Oxygenation

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54
Q

———- is a low oxygen content in the arterial blood, typically occurs from a ventilation-perfusion mismatch

A

Hypoxemia

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55
Q

A ————- occurs when there is a lack of available oxygenated air in the alveoli even though perfusion (blood flow) to the alveoli is adequate, or when the alveoli are adequately oxygenated but perfusion to alveoli is poor, or when there is a combo of of both poor ventilation and poor perfusion in the alveolar-capillary structures

A

Ventilation-perfusion mismatch

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56
Q

——- refers to an inadequacy in the amount of oxygen being delivered to the cells

A

Hypoxia

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57
Q

What are the mild to moderate signs of hypoxia?

A

-tachypnea (increased respiratory rate)
-dyspnea (shortness of breath)
-pale, cool, clammy skin (early)
-tachycardia (increase in heart rate)
-elevation in blood pressure
-restlessness and agitation
-disorientation and confusion (from high carbon dioxide levels in the blood)
-headache

58
Q

What are the signs of severe hypoxia?

A

-tachypnea
-dyspnea
-cyanosis
-tachycardia that may lead to dysrhythmias and eventually bradycardia
-severe confusion
-loss of coordination
-slow reaction time
-altered mental status
-seizure

59
Q

When carbon dioxide builds up in the blood this is known as?

A

Hypercarbia

60
Q

What are two signs of hypercarbia that typically appear with hypoxemia or hypoxia?

A

-sleepy appearance (from high carbon dioxide levels in the brain)
-head bobbing (head bobs upwards with inhalation and downward with exhalation as if falling asleep while sitting upright) with droopy eyelids

61
Q

In a newborn, ———- may be an early sign of hypoxia

A

Bradycardia

62
Q

A heart rate of 80 bpm, which is normal in an adult, may be an indication of ———- in a week old infant where a heart rate of 100-180 bpm is normal.

A

Hypoxia

63
Q

———-, a bluish gray color, is a late sign of hypoxia and may be found in and around several areas of the body, including the lips, mouth, nose, fingernail beds, the bottom of the eyelid, and oral mucosa

A

Cyanosis

64
Q

———- occurs when adequate amounts of oxygen are no longer attached to the hemoglobin molecules.

A

Cyanosis

65
Q

What is the process of forcing air into a patients lungs?

A

Positive pressure ventilation (PPV)

66
Q

The blood moving into the capillaries is ——-, that is, it has low oxygen concentration, but high carbon dioxide

A

Deoxygenated

67
Q

The blood in the capillaries is ———, that is, with high oxygen concentration and low carbon dioxide

A

Oxygenated

68
Q

———-, found in the cytoplasm of the red blood cells, is responsible for picking up most oxygen in the blood, approx 97 percent of total oxygen content in the blood, and carrying it through the arterial system to the capillaries throughout the body.

A

Hemoglobin

69
Q

What are the differences in children’s/ infants airways?

A
  • nose and mouth are smaller
    -larger tongue takes up more space in the pharynx
    -epiglottis is u-shaped and protrudes into the pharynx
    -cricoid cartilage is less rigid and less developed
    -trachea is narrower, softer, and more flexible
70
Q

What are the common changes in the elderly airway?

A

-tooth decay
-decrease in flexibility of the neck
-oropharyngeal tumors
-loss of muscle around the lips and mouth in the dentulous mouth make creating a mask seal for BVM difficult
-higher incidence of COPD, increases incidence of a faster onset of hypoxia
-obstructive sleep apnea
-increase in gastroesophageal reflux disease, increased risk of aspiration of gastric contents
-dementia and confusion
-lower functional residual volume in the lungs

71
Q

An open airway is commonly referred to as?

A

A patent airway

72
Q

What are the signs of an open airway?

A

-air can be felt and heard moving in and out of the mouth and nose
-the patient is speaking in full sentences or with little difficulty
-the sound of the voice is normal for the patient

73
Q

What are some sounds that can indicate airway obstruction?

A

-snoring
-the sound of a crow cawing
-gurgling
-stridor (harsh, high pitched sound heard during inspiration)

74
Q

What are the signs of a blocked or inadequate airway?

A

-abnormal upper airway sound (stridor, snoring, crowing, gurgling)
-an awake patient who is unable to speak
-evidence of a foreign body airway obstruction
-swelling to the mouth, tongue, or oropharynx

75
Q

What are the steps of conducting the crossed fingers technique when opening the mouth?

A
  1. Kneel above and behind the patient
  2. Cross the thumb and forefinger of one hand
  3. Place the thumb on the patients lower incisors or your forefinger on the upper incisors
  4. Use a scissors motion or finger snapping motion to open the mouth
76
Q

What are the manual airway maneuvers used to maintain a patent airway?

A
  • head tilt, chin lift, maneuver
    -jaw thrust maneuver
77
Q

What are the mechanical airway maneuvers used to maintain a patent airway?

A

-oropharyngeal airway (OPA or oral airway)
-nasopharyngeal airway (NPA or nasal airway)

78
Q

If you suspect that a patient has suffered a spinal injury, then use the ——- maneuver in conjunction with spine motion restriction

A

Jaw thrust

79
Q

This type of catheter is a rigid plastic tube. It is called a hard catheter or a yankauer catheter and is commonly referred to as a “tonsil tip” or “tonsil sucker” what is this type of catheter?

A

Rigid catheter

80
Q

The ——— catheter should be used to suction the mouth and oropharynx of an unresponsive patient.

A

Rigid catheter

81
Q

The soft suction catheter consists of flexible tubing. It is also called a French catheter, what is this type of catheter?

A

Soft catheter

82
Q

The ———- catheter should be used when suctioning the nose and nasopharynx and in other situations where the rigid catheter cannot be used.

A

Soft catheter

83
Q

In adults, suctioning should last for no more than —— seconds at a time.

A

15 seconds

84
Q

In infants and children, suctioning should last for no more than —- seconds at a time.

A

5 seconds

85
Q

——— is defined as the air remaining in the lungs after a maximal exhalation.

A

Residual volume

86
Q

The ———-, also known as the oral airway or OPA, is a semicircular device of hard plastic or rubber that holds the tongue away from the back of the airway.

A

Oropharyngeal airway

87
Q

The ———, also known as the nasal airway or NPA is a curved hollow tube of soft plastic or rubber with a flange or flare at the top end and a bevel at the distal end

A

Nasopharyngeal airway

88
Q

——— is the amount of air moved in and out of the lungs in one respiration

A

Tidal volume

89
Q

———- is the amount of air moved in and out of the lungs in one minute

A

Minute volume

90
Q

What is the formula for minute volume?

A

Minute volume= tidal volume x respiratory rate

91
Q

A normal minute volume in a healthy individual at rest is about ———

A

5 to 8 L/minute

92
Q

What is the best method to assess for tidal volume?

A

Look for adequate chest rise and to feel and listen for air movement from the nose and mouth

93
Q

——- is the amount of air breathed in that reaches the alveoli

A

Alveolar ventilation

94
Q

What is the formula for alveolar ventilation?

A

Alveolar ventilation= (tidal volume - dead air space) x respiratory rate

95
Q

When inspecting the chest, look for ——-, or pulling inward of the intercostal muscles of the chest.

A

Retractions

96
Q

What is the term used when referring to both sides?

A

Bilateral

97
Q

What are the signs of adequate breathing?

A

-adequate respiratory rate
-clear and equal breath sounds bilaterally
-adequate air movement heard and felt from nose and mouth (tidal volume)
-good chest rise and fall with each ventilation (tidal volume)

98
Q

What is the normal respiratory rate/minute in adults and adolescents 12-15 years?

A

12-20 respirations per minute

99
Q

What is the normal respiratory rate/ minute in a school age child 6-11 years?

A

18-25 respirations per minute

100
Q

What is the normal respiratory rate / minute in a preschooler 3-5 years?

A

20-28 respirations per minute

101
Q

What is the normal respiratory rate / minute in a toddler 1-2 years?

A

22-37 respirations per minute

102
Q

What is the normal respiratory rate / minute in infants 1-12 months?

A

30-53 respirations per minute

103
Q

What is the normal respiratory rate / minute in neonate birth 1 month

A

40-60 respirations per minute

104
Q

———- is a condition in which the patient is working harder to breathe

A

Respiratory distress

105
Q

——— occurs when the respiratory rate and or tidal volume is insufficient

A

Respiratory failure

106
Q

———, also called apnea, occurs when the patient completely stops breathing

A

Respiratory arrest

107
Q

What are the common causes of respiratory failure or respiratory arrest?

A

-stroke
-myocardial infarction
-drug overdose
-toxic inhalation
-electrocution and lightening strike
-suffocation
-traumatic injuries to the head, spine, chest, or abdomen
-infection to the epiglottis
-airway obstruction by a foreign body

108
Q

——— respirations are gasping type breaths, may be seen in cardiac arrest patients

A

Agonal respirations

109
Q

——— is an excessively rapid breathing rate and may indicate inadequate oxygenation and breathing, especially in an adult

A

Tachypnea

110
Q

———- is an abnormally slow breathing rate and an ominous sign of inadequate breathing and oxygenation in infants and children

A

Bradypnea

111
Q

Adequate respiratory rate and an adequate tidal volume with each breath equals?

A

Adequate breathing

112
Q

Inadequate respiratory rate and an adequate tidal volume equals?

A

Inadequate breathing

113
Q

Adequate respiratory rate and an inadequate tidal volume equals?

A

Inadequate breathing

114
Q

A ——— is a surgical opening in the front of the neck through which the patient breathes air into the trachea

A

Stoma

115
Q

What is the volume of oxygen in a D cylinder?

A

350 L

116
Q

What is the volume of oxygen in an E cylinder?

A

625 L

117
Q

What is the volume of oxygen in an M cylinder?

A

3,000 L

118
Q

What is the volume of oxygen in a G cylinder?

A

5,300 L

119
Q

What is the volume of oxygen in an H cylinder?

A

6,900 L

120
Q

Gas flow from an oxygen cylinder is controlled by a ———- that reduces the high pressure in the cylinder to a safe range, from 30 to 70 PSI, and controls the flow of oxygen from 1 to 15 LPM

A

Pressure regulator

121
Q

What are the two types of regulators that may be attached to an oxygen cylinder?

A

-high pressure regulator
-therapy regulator

122
Q

The ———- can provide 50 PSI to power a flow restricted, oxygen powered ventilation device

A

High pressure regulator

123
Q

The ——— can administer oxygen from 0.5 LPM up to 25 LPM

A

Therapy regulator

124
Q

It is possible to add moisture to the oxygen by attaching an —— to the regulator

A

Oxygen humidifier

125
Q

The method for delivering a high concentration of oxygen in the prehospital setting is with a ——-

A

Nonrebreather mask

126
Q

The preferred device to deliver oxygen in most medical patients is a ——-

A

Nasal cannula

127
Q

The liter flow for the nasal cannula should be at no less than —— lpm and no greater than —— lpm

A

-1 LPM
-6 LPM

128
Q

The liter flow for the nonrebreather mask should be typically set at —— lpm

A

15LPM

129
Q

A —— has no reservoir and can deliver up to 60 percent oxygen, depending on the patients tidal volume and oxygen flow rate

A

Simple face mask

130
Q

The ——- looks similar to the nonrebreather mask but is equipped with a two way valve that allows the patient to rebreathe about 1/3 of his exhaled air.

A

Partial rebreather mask

131
Q

Both the partial rebreather mask and the simple face mask has a flow rate that is usually set at —- LPM but should be set no lower than —- LPM

A

-10 LPM
-6LPM

132
Q

The ———- mask is a low flow oxygen system that provides precise concentrations of oxygen through an entrainment valve connected to the face mask. Commonly used on patients with a history of COPD

A

Venturi mask

133
Q

The ——- mask is used to deliver aerosolized medication, bland aerosol therapy, or oxygen to a patient with a tracheostomy tube

A

Tracheostomy mask

134
Q

If the patient breathes adequately but has other signs of early respiratory distress, administer oxygen to maintain an SpO2 of ——% or greater

A

94%

135
Q

If the patient is unresponsive, not breathing and has no pulse, perform ——

A

CPR

136
Q

If the patient is unresponsive but adequately breathing, insert appropriate airway adjunct and apply oxygen via a ——-

A

Nonrebreather mask

137
Q

An unresponsive 24 year old male with shallow breathing at 4 breaths per minute would require what?

A

Positive pressure ventilation with supplemental oxygen

138
Q

A 42 year old female complaining of difficulty breathing who can only speak one or two words at a time. She is breathing 30 times per minute with normal rise and fall of the chest. Her pulse oximeter is 92%. What type of oxygen is needed?

A

Nonrebreather mask at 15 LPM

139
Q

A 26 year old female tripped over her dog and fell fracturing her wrist. Her skin is warm and dry. She is breathing 18 times per minute and normal tidal volume what type of oxygen does she need, if any?

A

No oxygen required

140
Q

An 83 year old female contacts EMS complaining of abdominal pain. She denies difficulty breathing or any history of respiratory problems. She is breathing 20 times per minute with a normal rise and fall of the chest. Her pulse oximeter is 93% on room air. What type of oxygen does she need, if any?

A

Nasal cannula at 2 LPM

141
Q

An unresponsive 24 year old male with shallow breathing at 4 breaths per minute, what type of oxygen does he need?

A

Positive pressure ventilation with supplemental oxygen

EMT 1 (3 decks)

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