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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
Q

What are adenoids?

A

A lymphatic tissue that filters bacteria, located on the posterior nasopharyngeal wall.

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26
Q

What are tonsils?

A

A lymphatic tissue located in the posterior pharynx, they help to trap bacteria.

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27
Q

What is a potential risk of severe tonsil swelling?

A

Obstruction of the upper airway.

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28
Q

What is the uvula?

A

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)

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29
Q

What is the epiglottis?

A

A leaf-shaped cartilaginous flap which prevents food and liquid from entering the larynx during swallowing.

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30
Q

What is the vallecula?

A

An anatomic space between the base of the tongue and the epiglottis. This is an important landmark for tracheal intubation.

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31
Q

What is the larynx?

A

A complex structure formed by many independent cartilaginous structures. It marks where the upper airway ends and lower airway begins.

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32
Q

What is the thyroid cartilage?

A

Sometimes known as the Adams apple.

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33
Q

What is the cricoid cartilage?

A

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.

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34
Q

What is the cricothyroid membrane?

A

Its between the thyroid and cricoid cartilages, and a site for surgical and non surgical access to the airway.

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35
Q

What is the glottis?

A

The space in between the vocal chords and the narrowest portion of the adults airway. The lateral borders are the vocal chords.

36
Q

What are the vocal chords?

A

White bands of tough tissue that are partially separated at rest.

37
Q

What are arytenoid cartilages?

A

Pyramidlike cartilaginous structures that form the posterior attachment of the vocal cords.

38
Q

Why are arytenoid cartilages important for tracheal intubation?

A

As they arytenoid cartilages pivot, the vocal chords open and close which regulates the passage of air through the larynx.

39
Q

What are piriform fossae?

A

Two pockets of tissue on the lateral borders of the larynx.

40
Q

What is a laryngospasm?

A

A spasmodic closure of the vocal chords, which can obstruct the airway. Normally lasts a few seconds.

41
Q

What causes a laryngospasm?

A

When the airway is stimulated.

42
Q

What is the function of the lower airway?

A

To exchange oxygen and carbon dioxide.

43
Q

What is the trachea?

A

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
Q

Where does the trachea divide?

A

At the level of the carina.

45
Q

What causes bronchodilation?

A

The bronchi are lined with mucus-producing cells and beta-2 receptors that, when stimulated, results in bronchodilation.

46
Q

Which bronchus is shorter and straighter?

A

The right one.

47
Q

What is the average adult lung capacity?

A

6 liters

48
Q

How many lobes are in the right lung?

A

3

49
Q

How many lobes are in the left lung?

A

2

50
Q

What is the visceral pleura?

A

A thin, slippery, outer lining of the lungs.

51
Q

What is the parietal pleura?

A

Lines the inside of the thoracic cavity.

52
Q

What is the purpose of the fluid found between the parietal and visceral pleura?

A

Decreases friction during breathing.

53
Q

What are bronchioles?

A

Smooth muscle that dilates or constricts in response to various stimuli. The smaller ones branch into alveolar ducts.

54
Q

What is the substance that lines the alveoli?

A

Surfactant, which decreases surface tension on the alveolar walls and keeps them expanded.

55
Q

What are alveoli?

A

The alveoli are balloon like structures which are the functional site for the exchange of oxygen and carbon dioxide.

56
Q

What is atelectasis?

A

The alveoli collapse due to lack of inflation, or lack of pulmonary surfactant.

57
Q

What is Tidal volume (Vt)

A

A measure of the depth of breathing, the volume of air that is inhaled or exhaled during a single respiratory cycle.

58
Q

What is the average tidal volume in the adult male?

A

5-7 mL/kg (500ml)

59
Q

What is the normal average tidal volume in infants and children?

A

6-8 mL/kg

60
Q

What is inspiratory reserve volume?

A

The amount of air that be inhaled in addition to the normal tidal volume.

61
Q

What is dead space?

A

Any portion of the airway where air lingers but does not participate in gas exchange.

62
Q

What are the anatomic dead spaces?

A

Trachea and larger bronchi

63
Q

What physiologic dead spaces?

A

Respiratory disease created dead spaces such as intrapulmonary obstructions or atelectasis.

64
Q

What is ventilation?

A

the physical act of moving air into and out of the lungs

65
Q

What are the two phases of ventilation?

A

Inspiration and Expiration

66
Q

What is inspiration?

A

the process of moving air into the lungs

67
Q

What is expiration?

A

the process of moving air out of the lungs

68
Q

Phrenic nerves

A

The phrenic nerves innervate the diaphragm

69
Q

M Tank Cylinder Constant

A

1.56

70
Q

D Tank Cylinder Constant

A

0.16

71
Q

What are the 5 distinct phases of Normal Capnographic Waveform?

A
  1. Respiratory baseline
  2. Expiratory upstroke
  3. Alveolar plateau
  4. Measured EtCO2
  5. Inspiratory downstroke
72
Q

What is the flow rate and FiO2​
of the Nasal Cannula?

A

1-6 L/min
22-44%

73
Q

What is the flow rate and FiO2​
of the Non-Rebreather?

A

10-15 L/min
Up to 90%

74
Q

What is the flow rate and FiO2​
of the Bag-Valve Mask?

A

0-15 L/min
21-100%

75
Q

What is hyperoxia?

A

Excess oxygen in body tissues is caused by breathing oxygen-rich gases at normal atmospheric pressure for a prolonged period.

76
Q

Describe a nonrebreathing mask.

A

It has a face mask with a valve to ensure they don’t breathe the same air. It has a reservoir bag.

77
Q

Why would you use a Hi-Ox mask instead of an NRB?

A

It has better filters and protects paramedics against suspected infections.

78
Q

What is a nebulizer mask?

A

They are used to deliver aerosolized medications. Not used as a regular oxygen delivery device.

79
Q

When do you ventilate?

A

-VSA
-Respiratory Arrest
-Unresponsive over 30
-Hypotensive
-Nothing else is working
-Agonal breathing
-Hyperventilating and unable to take adequate breaths.
-Chest trauma

80
Q

In what order do you build a BVM or Ventilation tree?

A

(BEFT)
1. BVM
2. EtCo2 Device
3. Filter
4. Tube extender
5. Advanced Airway

81
Q

What are the risks of ventilation to the stomach?

A
  • 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
Q

What is a Thomas bite block?

A

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
Q

What is the maximum number of supraglottic airway insertion attempts?

A

2 per patient, not paramedic

84
Q

What are the primary and secondary confirmations for a supraglottic airway?

A

ETCO2 (Waveform capnography)
ETCO2 Numerical readings
Chest Auscultation
Chest rise and fall

85
Q

What are possible complications of the king LT tube?

A

-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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