CHAPTER 11- AIRWAY MANAGEMENT

Question 1

WHAT IS THE PROCESS OF DIFFUSION?

Answer 1

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

Question 2

STRUCTURES THAT HELP US BREATH?

Answer 2

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

Question 3

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

Answer 3

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.

Question 4

WHAT DOES THE PHARYNX CONSIST OF?

ORDER FROM TOP TO BOTTOM.

Answer 4

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

Question 5

NASOPHARYNX

Answer 5

LINED WITH A MUCOUS MEMBRANE TO WARM AND HUMIDIFY AIR

Question 6

OROPHARYNX

Answer 6

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

Question 7

LARYNX

Answer 7

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

Question 8

2 TYPES OF PLEURA’S AND WHAT EACH ENCOMPASS

Answer 8

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

Question 9

DIFFERENCE BETWEEN VENTILATION, OXYGENATION, AND RESPIRATION?

Answer 9

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.

Question 10

TIDAL VOLUME

Answer 10

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

Question 11

RESIDUAL VOLUME

Answer 11

THE AIR THAT REMAINS IN THE LUNGS AFTER MAXIMAL EXHALATION.

Question 12

ALVEOLAR VENTILATION

Answer 12

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

Question 13

MINUTE VOLUME

Answer 13

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

Question 14

ALVEOLAR MINUTE VOLUME

Answer 14

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

Question 15

VITAL CAPACITY

Answer 15

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

Question 16

DEAD SPACE

Answer 16

PORTION OF THE TIDAL VOLUME THAT DOES NOT REACH THE ALVEOLI

Question 17

HYPOXIA

Answer 17

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

Question 18

METABOLISM

Answer 18

CELLULAR RESPIRATION

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

Question 19

EXTERNAL RESPIRATION

Answer 19

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

Question 20

WHAT DOES FRESH AIR CONSIST OF?

Answer 20

21% OXYGEN
78% NITROGEN
.3% CARBON DIOXIDE

Question 21

INTERNAL RESPIRATION

Answer 21

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

Question 22

AEROBIC METABOLISM & ANAEROBIC METABOLISM

Answer 22

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.

Question 23

NERVOUS SYSTEMS & CHEMORECEPTORS

Answer 23

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.

Question 24

HYPERCARBIA

Answer 24

EXCESS CARBON DIOXIDE IN THE BLOOD STREAM

Question 25

INTRAPULMONARY SHUNTING

Answer 25

WHEN BLOOD RETURNS TO THE LEFT SIDE OF THE HEART UNOXYGENATED

Question 26

NORMAL RESPIRATORY RATE RANGES

Answer 26

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

Question 27

RETRACTIONS

Answer 27

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

Question 28

CHEYNE-STOKES RESPIRATIONS

Answer 28

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

Question 29

THE MEDIASTINUM CONTAINS

Answer 29

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

Question 30

PULSE OXIMETRY

Answer 30

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

Question 31

HOW DOES INHALATION WORK?

Answer 31

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.

Question 32

WHAT IS PARTIAL PRESSURE?

Answer 32

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.

Question 33

Ventilation/perfusion ratio and mismatch

Answer 33

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.

Question 34

Factors affecting pulmonary ventilation

Answer 34

1.​Intrinsic factors: a.​Infections b.​Allergic reactions c.​Unresponsiveness (eg, tongue obstruction) 2.​Extrinsic factors: a.​Trauma

Question 35

Factors affecting respiration

Answer 35

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).

Question 36

Recognizing adequate breathing

Answer 36

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)

Question 37

Recognizing abnormal breathing

Answer 37

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)

Question 38

Causes of inaccurate pulse oximetry readings:

Answer 38

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

Question 39

End-tidal CO2

Answer 39

-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.

Question 40

SUCTIONING

Answer 40

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.

Question 41

OXYGEN CYLINDERS SIZES

Answer 41

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