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Patient Care 1 > Chapter 13 - Airway Managment > Flashcards

Chapter 13 - Airway Managment Flashcards

1
Q

What are the major functions of the upper airway?

A

Warm, filter and humidify air as it enters the body through the nose and mouth

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2
Q

Where does the upper airway end?

A

The vocal chords

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3
Q

What are the three major components of the Pharynx?

A

Nasopharynx, Oropharynx, Laryngopharynx

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4
Q

What is a major risk of fractured sinus cavities?

A

Cerebrospinal fluid leaks from the nose and/or ears.

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5
Q

What is cerebrospinal rhinorrhea?

A

CSF leak from the nose

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6
Q

What is cerebrospinal otorrhea?

A

CSF leak from the ears

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7
Q

What are sinuses?

A

Cavities formed by the cranial bones.

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8
Q

What is the purpose of sinuses?

A

They prevent contaminants from entering the respiratory tract and act as tributaries for fluid to flow to and from the eustachian tubes and tear ducts.

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9
Q

What is the pharynx?

A

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

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10
Q

On normal inhalation, where does air enter the body?

A

Through the nose, and into the nasopharynx.

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11
Q

What is the purpose of the ciliated mucous membrane in the nasal cavity?

A

It keeps contaminants such as dust and other small particles out of the respiratory tract.

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12
Q

What is the risk of trauma to the nasal passage?

A

Profuse bleeding form the posterior nasal cavity, which cant be controlled by direct pressure.

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13
Q

What are the turbinates?

A

Three bony shelves that protrude from the lateral walls of the nasal cavity. They serve to increase the surface area of mucosa.

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14
Q

What divides the nasopharynx into two separate passages?

A

The nasal septum, a rigid partition composed of bone and cartilage.

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15
Q

What is a deviated septum?

A

The nasal septum is not in the midline of the nose and has deviated to one side or the other. Important to consider with insertion of nasal airway.

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16
Q

Where is the oropharynx?

A

The posterior portion of the oral cavity.

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17
Q

What borders the oropharynx?

A

Superiorly- hard and soft palates
Laterally- the cheeks
Inferiorly- the tongue

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18
Q

How many adult teeth are there?

A

32

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19
Q

What are the risks of a fracture or avulsion of the teeth?

A

Potential obstruction of the upper airways, or causing aspiration of tooth fragments into the lungs.

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20
Q

What is the tongue attached to ?

A

The mandible and hyoid bone

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21
Q

What is the hyoid bone?

A

A small horseshoe shaped bone which the jaw, epiglottis and thyroid cartilage attach to.

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22
Q

What is the biggest risk of the tongue in an airway perspective?

A

Its tendency to fall back and occlude the posterior pharynx when the mandible relaxes.

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23
Q

What is the most common cause of an airway obstruction?

A

The tongue. Especially in patients with decreased levels of consciousness.

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24
Q

Where is the palate?

A

Forms the roof of the mouth and separates the oropharynx and nasopharynx.

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25
What are adenoids?
A lymphatic tissue that filters bacteria, located on the posterior nasopharyngeal wall.
26
What are tonsils?
A lymphatic tissue located in the posterior pharynx, they help to trap bacteria.
27
What is a potential risk of severe tonsil swelling?
Obstruction of the upper airway.
28
What is the uvula?
A soft tissue structure located in the posterior aspect of the oral cavity, originating from the soft palate and hanging just above the base of the tongue. (Resembles a punching bag)
29
What is the epiglottis?
A leaf-shaped cartilaginous flap which prevents food and liquid from entering the larynx during swallowing.
30
What is the vallecula?
An anatomic space between the base of the tongue and the epiglottis. This is an important landmark for tracheal intubation.
31
What is the larynx?
A complex structure formed by many independent cartilaginous structures. It marks where the upper airway ends and lower airway begins.
32
What is the thyroid cartilage?
Sometimes known as the Adams apple.
33
What is the cricoid cartilage?
It forms the lowest portion of the larynx. It is the first ring in the trachea, and the only complete ring in the upper airway.
34
What is the cricothyroid membrane?
Its between the thyroid and cricoid cartilages, and a site for surgical and non surgical access to the airway.
35
What is the glottis?
The space in between the vocal chords and the narrowest portion of the adults airway. The lateral borders are the vocal chords.
36
What are the vocal chords?
White bands of tough tissue that are partially separated at rest.
37
What are arytenoid cartilages?
Pyramidlike cartilaginous structures that form the posterior attachment of the vocal cords.
38
Why are arytenoid cartilages important for tracheal intubation?
As they arytenoid cartilages pivot, the vocal chords open and close which regulates the passage of air through the larynx.
39
What are piriform fossae?
Two pockets of tissue on the lateral borders of the larynx.
40
What is a laryngospasm?
A spasmodic closure of the vocal chords, which can obstruct the airway. Normally lasts a few seconds.
41
What causes a laryngospasm?
When the airway is stimulated.
42
What is the function of the lower airway?
To exchange oxygen and carbon dioxide.
43
What is the trachea?
Its the conduit for air entry into the lungs. It is 10-12 cm in length and consists of a series of c-shaped cartilaginous rings.
44
Where does the trachea divide?
At the level of the carina.
45
What causes bronchodilation?
The bronchi are lined with mucus-producing cells and beta-2 receptors that, when stimulated, results in bronchodilation.
46
Which bronchus is shorter and straighter?
The right one.
47
What is the average adult lung capacity?
6 liters
48
How many lobes are in the right lung?
3
49
How many lobes are in the left lung?
2
50
What is the visceral pleura?
A thin, slippery, outer lining of the lungs.
51
What is the parietal pleura?
Lines the inside of the thoracic cavity.
52
What is the purpose of the fluid found between the parietal and visceral pleura?
Decreases friction during breathing.
53
What are bronchioles?
Smooth muscle that dilates or constricts in response to various stimuli. The smaller ones branch into alveolar ducts.
54
What is the substance that lines the alveoli?
Surfactant, which decreases surface tension on the alveolar walls and keeps them expanded.
55
What are alveoli?
The alveoli are balloon like structures which are the functional site for the exchange of oxygen and carbon dioxide.
56
What is atelectasis?
The alveoli collapse due to lack of inflation, or lack of pulmonary surfactant.
57
What is Tidal volume (Vt)
A measure of the depth of breathing, the volume of air that is inhaled or exhaled during a single respiratory cycle.
58
What is the average tidal volume in the adult male?
5-7 mL/kg (500ml)
59
What is the normal average tidal volume in infants and children?
6-8 mL/kg
60
What is inspiratory reserve volume?
The amount of air that be inhaled in addition to the normal tidal volume.
61
What is dead space?
Any portion of the airway where air lingers but does not participate in gas exchange.
62
What are the anatomic dead spaces?
Trachea and larger bronchi
63
What physiologic dead spaces?
Respiratory disease created dead spaces such as intrapulmonary obstructions or atelectasis.
64
What is ventilation?
the physical act of moving air into and out of the lungs
65
What are the two phases of ventilation?
Inspiration and Expiration
66
What is inspiration?
the process of moving air into the lungs
67
What is expiration?
the process of moving air out of the lungs
68
Phrenic nerves
The phrenic nerves innervate the diaphragm
69
M Tank Cylinder Constant
1.56
70
D Tank Cylinder Constant
0.16
71
What are the 5 distinct phases of Normal Capnographic Waveform?
1. Respiratory baseline 2. Expiratory upstroke 3. Alveolar plateau 4. Measured EtCO2 5. Inspiratory downstroke
72
What is the flow rate and FiO2​ of the Nasal Cannula?
1-6 L/min 22-44%
73
What is the flow rate and FiO2​ of the Non-Rebreather?
10-15 L/min Up to 90%
74
What is the flow rate and FiO2​ of the Bag-Valve Mask?
0-15 L/min 21-100%
75
What is hyperoxia?
Excess oxygen in body tissues is caused by breathing oxygen-rich gases at normal atmospheric pressure for a prolonged period.
76
Describe a nonrebreathing mask.
It has a face mask with a valve to ensure they don't breathe the same air. It has a reservoir bag.
77
Why would you use a Hi-Ox mask instead of an NRB?
It has better filters and protects paramedics against suspected infections.
78
What is a nebulizer mask?
They are used to deliver aerosolized medications. Not used as a regular oxygen delivery device.
79
When do you ventilate?
-VSA -Respiratory Arrest -Unresponsive over 30 -Hypotensive -Nothing else is working -Agonal breathing -Hyperventilating and unable to take adequate breaths. -Chest trauma
80
In what order do you build a BVM or Ventilation tree?
(BEFT) 1. BVM 2. EtCo2 Device 3. Filter 4. Tube extender 5. Advanced Airway
81
What are the risks of ventilation to the stomach?
- Promotes regurgitation/vomiting of stomach contents (can lead to aspiration) -A distended stomach pushes the diaphragm upward into the chest, reducing the amount of space in which the lungs can expand. -Dead patients do not vomit… you’re causing them to vomit ;)
82
What is a Thomas bite block?
If the patient bites the tube or has a seizure, it can occlude airway. The bite lock is a facial attachment that inhibits this.
83
What is the maximum number of supraglottic airway insertion attempts?
2 per patient, not paramedic
84
What are the primary and secondary confirmations for a supraglottic airway?
ETCO2 (Waveform capnography) ETCO2 Numerical readings Chest Auscultation Chest rise and fall
85
What are possible complications of the king LT tube?
-Laryngospasm, vomiting, and possible hypoventilation may occur. -Trauma may also result from improper insertion technique. -Ventilation may be diffi­cult if the pharyngeal balloon pushes the epiglottis over the glottic opening.

Patient Care 1 (5 decks)

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