CHAPTER 11- AIRWAY MANAGEMENT Flashcards

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1
Q

WHAT IS THE PROCESS OF DIFFUSION?

A

WHEN MOLECULES MOVE FROM AN AREA OF HIGH CONCENTRATION TO LOW CONCENTRATION

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2
Q

STRUCTURES THAT HELP US BREATH?

A

DIAPHRAGM
INTERCOSTAL MUSCLES (MUSCLES BETWEEN THE RIBS)
NERVES FROM BRAIN AND SPINAL CORD

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3
Q

WHAT DOES THE UPPER AIRWAY CONSIST OF? AND WHAT ARE ITS MAJOR FUNCTIONS?

A

ALL ANATOMIC AIRWAY STRUCTURES ABOVE THE VOCAL CORDS.

NOSE, MOUTH, JAW, ORAL CAVITY, PHARYNX, AND LARYNX.

MAJOR FUNCTIONS ARE TO WARM, FILTER, AND HUMIDIFY AIR AS IT ENTERS THE BODY.

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4
Q

WHAT DOES THE PHARYNX CONSIST OF?

ORDER FROM TOP TO BOTTOM.

A

NASOPHARYNX
OROPHARYNX
LARYNGOPHARYNX (LOWEST PART BRANCHES INTO 2 LUMES, TRACHEA AND ESOPHAGUS)

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5
Q

NASOPHARYNX

A

LINED WITH A MUCOUS MEMBRANE TO WARM AND HUMIDIFY AIR

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6
Q

OROPHARYNX

A

WHERE THE EPIGLOTTIS IS FOUND, MAIN FUNCTION IS TO PREVENT FOOD AND WATER FROM ENTERING THE TRACHEA.

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7
Q

LARYNX

A

COMPLEX STRUCTURE FORMED BY MANY INDEPENDENT STRUCTURES.

THYROID CARTILAGE (ADAMS APPLE)
CRICOID CARTILAGE-FIRST RING OF TRACHEA
GLOTTIS- SPACE BETWEEN VOCAL CORDS AND NARROWEST PORTION OF AIRWAY
VOCAL CORDS

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8
Q

2 TYPES OF PLEURA’S AND WHAT EACH ENCOMPASS

A

VISCERAL PLUERA- COVERS THE OUTER SURFACE OF THE LUNGS
PARIETAL PLEURA-LINES THE INSIDE OF THE THORACIC CAVITY

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9
Q

DIFFERENCE BETWEEN VENTILATION, OXYGENATION, AND RESPIRATION?

A

VENTILATION- THE PHYSICAL ACT OF MOVING AIR INTO AND OUT OF THE LUNGS.
OXYGENATION- THE PROCESS OF LOADING OXYGEN MOLECULES ONTO HEMOGLOBIN MOLECULES.
RESPIRATION- THE ACTUAL EXCHANGE OF OXYGEN AND CARBON DIOXIDE IN THE ALVEOLI AND TISSUES.

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10
Q

TIDAL VOLUME

A

THE AMOUNT OF AIR (IN ML) THAT IS MOVED IN OR OUT DURING A SINGLE BREATH.

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11
Q

RESIDUAL VOLUME

A

THE AIR THAT REMAINS IN THE LUNGS AFTER MAXIMAL EXHALATION.

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12
Q

ALVEOLAR VENTILATION

A

THE VOLUME OF AIR THAT REACHES THE ALVEOLI. CAN BE CALCULATED BY TIDAL VOLUME-DEAD SPACE.

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13
Q

MINUTE VOLUME

A

THE AMOUNT OF AIR MOVED IN A SINGLE MINUTE.
TIDAL VOLUME X RESPIRATORY RATE

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14
Q

ALVEOLAR MINUTE VOLUME

A

THE AMOUNT OF AIR THAT REACHES THE ALVEOLI IN A SINGLE MINUTE MINUS THE DEAD SPACE.
TIDAL VOLUME(MINUS DEAD SPACE)X RESPIRATOTY RATE

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15
Q

VITAL CAPACITY

A

THE AMOUNT OF AIR THAT CAN BE FORCIBLY EXPELLED FROM THE LUNGS AFTER BREATHING IN AS DEEPLY AS POSSIBLE.

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16
Q

DEAD SPACE

A

PORTION OF THE TIDAL VOLUME THAT DOES NOT REACH THE ALVEOLI

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17
Q

HYPOXIA

A

DANGEROUS CONDITION IN WHICH THE TISSUES AND CELLS OF THE BODY DO NOT GET ENOUGH OXYGEN.

18
Q

METABOLISM

A

CELLULAR RESPIRATION

CELLS TAKE ENERGY FROM NUTRIENTS AND GIVE OFF WASTE PRODUCTS SUCH AS WATER AND CARBON DIOXIDE.

19
Q

EXTERNAL RESPIRATION

A

IS THE PROCESS OF BREATHING IN FRESH AIR THROUGH THE RESPIRATORY SYSTEM AND EXCHANGING OXYGEN AND CARBON DIOXIDE BETWEEN THE ALVEOLI AND TISSUES.

20
Q

WHAT DOES FRESH AIR CONSIST OF?

A

21% OXYGEN
78% NITROGEN
.3% CARBON DIOXIDE

21
Q

INTERNAL RESPIRATION

A

THE EXCHANGE OF OXYGEN AND CARBON DIOXIDE BETWEEN THE SYSTEMIC CIRCULATORY SYSTEM AND THE CELLS OF THE BODY

22
Q

AEROBIC METABOLISM & ANAEROBIC METABOLISM

A

AEROBIC- CELLS CONVERT GLUCOSE INTO ENERGY (CARBON DIOXIDE IS THE MAIN WASTE PRODUCT)

ANAEROBIC- CELLS DO NOT OBTAIN ADEQUATE OXYGEN AND LACTIC ACID AND OTHER CHEMICAL ACCUMULATE.

23
Q

NERVOUS SYSTEMS & CHEMORECEPTORS

A

1.Chemoreceptors monitor levels of oxygen, carbon dioxide, hydrogen ions, and the pH of cerebrospinal fluid and provide feedback to the respiratory centers.

2.​When serum carbon dioxide or hydrogen ions levels increase, chemoreceptors stimulate the medulla to increase the respiratory rate.

3.​Stimulation from the pons affects the rate and depth of respirations.

24
Q

HYPERCARBIA

A

EXCESS CARBON DIOXIDE IN THE BLOOD STREAM

25
Q

INTRAPULMONARY SHUNTING

A

WHEN BLOOD RETURNS TO THE LEFT SIDE OF THE HEART UNOXYGENATED

26
Q

NORMAL RESPIRATORY RATE RANGES

A

ADULT 12-20
CHILDREN 12-40
INFANTS 30-60

27
Q

RETRACTIONS

A

SKIN PULLING IN AROUND THE RIBS OR ABOVE THE CLAVICLES DURING INSPIRATION

28
Q

CHEYNE-STOKES RESPIRATIONS

A

IRREGULAR RESPIRATIONS IN WHICH THE PATIENT BREATHES WITH AN INCREASING RATE AND DEPTH OF RESPIRATIONS THAT IS FOLLOWED BY A PERIOD OF APNEA

29
Q

THE MEDIASTINUM CONTAINS

A

i.​Heart
ii.​Great vessels
iii.​Esophagus
iv.​Trachea
v.​Major bronchi
vi.​Many nerves

30
Q

PULSE OXIMETRY

A

THE OXYGEN SATURATION (SPO2) LEVEL MEASURES THE PERCENTAGE OF HEMOGLOBIN MOLECULES THAT ARE FOUND IN THE BLOOD.

UNDER NORMAL CONDITIONS SHOULD BE 94% OR GREATER

31
Q

HOW DOES INHALATION WORK?

A

The diaphragm and intercostal muscles contract during inhalation, creating a negative pressure within the thorax which allows air to enter the body and travel to the lungs.

32
Q

WHAT IS PARTIAL PRESSURE?

A

Partial pressure: the amount of gas in the air or dissolved in fluid, such as blood
i.​The partial pressure of oxygen in the alveoli is 104 mm Hg.
ii.​The partial pressure of carbon dioxide in the alveoli is 40 mm Hg.

33
Q

Ventilation/perfusion ratio and mismatch

A

1.​Ventilation and perfusion must be directed to the same place at the same time.

When perfusion across the alveolar membrane is disrupted optimal exchange of gases is prevented.

34
Q

Factors affecting pulmonary ventilation

A

1.​Intrinsic factors:
a.​Infections
b.​Allergic reactions
c.​Unresponsiveness (eg, tongue obstruction)

2.​Extrinsic factors:
a.​Trauma

35
Q

Factors affecting respiration

A

1.​External factors include atmospheric pressure and the partial pressure of oxygen in the environment.

2.​Internal factors include conditions that reduce the surface area for gas exchange and decrease the body’s oxygen supply, leading to inadequate tissue perfusion (eg, pneumonia, pulmonary edema, COPD/emphysema).

36
Q

Recognizing adequate breathing

A

Signs of normal breathing for adults:

a.​12–20 breaths/min
b.​Regular pattern of inhalation and exhalation
c.​Bilateral clear and equal lung sounds
d.​Regular, equal chest rise and fall
e.​Adequate depth (tidal volume)

37
Q

Recognizing abnormal breathing

A

Fewer than 12 breaths/min
​More than 20 breaths/min in the presence of shortness of breath (dyspnea)
​Irregular rhythm
​Diminished, absent, or noisy auscultated breath sounds
Skin that is pale, cyanotic, cool, or moist
Skin pulling in around ribs or above clavicles during inspiration (retractions)

38
Q

Causes of inaccurate pulse oximetry readings:

A

i.​Hypovolemia
ii.​Severe peripheral vasoconstriction (eg, chronic hypoxia, smoking, hypothermia)
iii.​Time delay in detecting respiratory insufficiency
iv.​Dark or metallic nail polish
v.​Dirty fingers
vi.​Carbon monoxide poisoning

39
Q

End-tidal CO2

A

-is measured using capnometry and capnography devices
a.​Capnometry refers to use of a device that provides a digital numeric reading of the end-tidal CO2 level.
b.​Capnography provides both a numeric reading and a graph, from breath to breath.
c.​Normal range is 35 to 45 mm Hg.

40
Q

SUCTIONING

A

A fixed suctioning unit should generate airflow of more than 40 L/min and a vacuum of more than 300 mm Hg when the tubing is clamped.

Never suction the mouth or nose for more than 15 seconds at one time for adult patients, 10 seconds for children, and 5 seconds for infants.

41
Q

OXYGEN CYLINDERS SIZES

A

D 350
JUMBO D 500
E 625
M 3000
G 5300
H,A,K 6900