Chapter 15 Airway Management: Vital Vocabulary Flashcards
1
Q
A method used to predict difficult intubation. A mouth opening of less than three fingerbreadths, a mandible length of less than three fingerbreadths, and a distance from hyoid bone to thyroid notch of less than two fingerbreadths indicate a possibly difficult airway.
A
3-3-2 rule
2
Q
Abdominal thrusts performed to relieve a foreign body airway obstruction.
A
Abdominal thrust maneuver
3
Q
The muscles not normally used during normal breathing; include the sternocleidomastoid muscles of the neck, he petoralis major muscles of the chest, and the abdominal muscles.
A
Accessory muscles
4
Q
A chemical neurotransmitter of the parasympathetic nervous system.
A
Acetylcholine (ACh)
5
Q
Abnormal
A
Adventitious
6
Q
The pressure gradient against which the heart must pump; an increase can decrease cardiac output.
A
Afterload
7
Q
Slow, shallow, irregular respiration’s or occasional gasping breaths that result from cerebral anoxia.
A
Agonal gasps
8
Q
An absence of oxygen
A
Anoxia
9
Q
An inability to remember events after the onset of amnesia.
A
Anterograde amnesia
10
Q
The inability to speak.
A
Aphonia
11
Q
The continued alveolar uptake of oxygen, even when the patient is Aeneid; can be facilitated by administering oxygen via nasal cannula during intubation.
A
Apneic oxygenation
12
Q
Prolonged gasping inspirations followed by extremely short, ineffective expirations; associated with brainstem insult.
A
Apneustic respirations
13
Q
Unequal movement of the two sides of the chest; indicates decreased airflow into one lung.
A
Asymmetric chest wall movement
14
Q
A portable mechanical ventilator attached to a control box that allows the variables of ventilation (such as rate and tidal volume) to be set.
A
Automatic transport ventilator (ATV)
15
Q
A manual ventilation device that consists of a bag, mask, reservoir, and oxygen inlet; capable of delivering up to 100% oxygen.
A
Bag-mask device
16
Q
Trauma resulting from excessive pressure.
A
Barotrauma
17
Q
Sedative-hypnotic drugs that provide muscle relaxation and mild sedation; include drugs such as diazepam (Valium) and midazolam (Versed).
A
Benzodiazepines
18
Q
An effective technique to improve laryngoscopic view of the vocal cords by external manipulation of the larynx.
A
Bimanual laryngoscopy
19
Q
A form of noninvasive positive pressure ventilation that delivers two pressures (a higher inspiratory positive airway pressure, and a lower expiratory positive airway pressure).
A
Bilevel positive airway pressure (BPAP)
20
Q
Irregular pattern, rate, and depth of respiration’s with intermittent periods of apnea; result from increased intracranial pressure.
A
Biot (ataxic) respirations
21
Q
An oxygen flowmeter that is commonly used because it is not affected by gravity and can be placed in any position.
A
Bourdon-gauge flowmeter
22
Q
A combination of the tracheal and vesicular breath sounds; heard where airways and alveoli are found, the upper part of the sternum and between the scapulas.
A
Bronchovesicular sounds
23
Q
The backward, upward, and rightward pressure used during intubation to improve the laryngoscopic view of the glottic opening and vocal cords; also called external laryngeal manipulation.
A
BURP maneuver
24
Q
A device that attaches between the endotracheal tube and ventilation device; provides graphic information about the presence of exhaled carbon dioxide.
A
Capnographer
25
A device that performs the same function and attaches in the same way as a capnographer but provides a digital reading of the exhaled carbon dioxide.
Capnometer
26
A device that measures absorption at several wavelengths to distinguish oxyhemoglobin from carboxyhemoglobin.
Carbon monoxide oximeter
27
Hemoglobin loaded with carbon monoxide.
Carboxyhemoglobin (COHb)
28
A gradually increasing rate and depth of respirations followed by a gradual decrease with intermittent periods of apnea; associated with brainstem insult.
Cheyenne-Stokes respirations
29
A supraglottic airway device with a shape that allows the device with a shape that allows the device o slide easily along the hard palate and to hold the soft tissue away from the laryngeal inlet.
Cobra perilarygeal airway (CobraPLA)
30
A device that attaches between the endotracheal tube and ventilation device; uses special paper that should turn from purple to yellow during exhalation, indicating the presence of exhaled carbon dioxide.
Colorimetric carbon dioxide detector
31
A multilumen airway device that consists of a single tube with two lumens, two balloons, and two ventilation ports; an alternative device if endotracheal intubation is not possible or has failed.
Combitube
32
A method of ventilation that delivers a single pressure, used primarily in the treatment of critically ill patients with respiratory distress; can prevent the need for endotracheal intubation.
Continuous positive airway pressure (CPAP)
33
A system used to predict intubation difficulty based on the airway structures observed during laryngoscopy.
Cormack-Lehane classification
34
The breath sounds produced as fluid-filled alveoli pop open under increasing inspiratory pressure; can be fine or coarse; formerly called rales.
Crackles
35
A blade designed to fit into the vallecula, indirectly lifting the epiglottis and exposing the vocal cords; also called the Macintosh blade.
Curved laryngoscope blade
36
Blue or purple skin; indicates inadequate oxygen in the blood.
Cyanosis
37
A procedure in which a patient is sedated for the purpose of preoxygenation prior to the administration of a paralytic and intubation.
Delayed sequence intubation (DSI)
38
The process of replacing nitrogen in the lungs with oxygen to maintain a normal oxygen in the lungs with oxygen saturation level during intubation.
Denitrogenation
39
A drug that competitively binds with the acetylcholine receptor sites but is not affected as quickly by acetylcholinesterase; an example is succinylcholine chloride.
Depolarizing neuromuscular blocker
40
A method of intubation that involves directly palpating the glottic structures and elevating the epiglottis with the middle finger while guiding the endotracheal tube into the trachea by using the sense of touch.
Digital intubation
41
Visualization of the airway with a laryngoscope.
Direct laryngoscopy
42
A medication that distorts perception of sight and sound and induces a feeling of detachment from environment and self.
Dissociative anesthetic
43
Difficulty speaking
Dysphonia
44
Difficult or labored breathing.
Dyspnea
45
A tube that is inserted into the trachea for definitive airway maintenance; equipped with a distal cuff, proximal inflation port, a 15/22-mm adapter, and centimeter markings on the side.
Endotracheal (ET) tube
46
Inserting an endotracheal tube through the glottic opening and sealing the tube with a cuff inflated against the tracheal wall.
Endotracheal (ET) intubation
47
Devices that detect the presence of carbon dioxide in exhaled air.
End-tidal carbon dioxide (ETCO2) monitor
48
A leaf-shaped cartilaginous structure that closes over the trachea during swallowing.
Epiglottis
49
A bulb or syringe that is attached to the proximal end of the of the endotracheal tube; a device used to confirm proper endotracheal tube placement.
Esophageal detector device
50
The process of removing the endotracheal tube from an intubated patient.
Extubation
51
Performing intubation at the same level as the patient’s face; used when the standard position is not possible. In this position, the laryngoscope is held in the provider’s right hand and the endotracheal tube in the left.
Face-to-face intubation
52
Brief, uncoordinated twitching of small muscle groups in the face, neck, trunk, and extremities; may be seen after the administration of a depolarizing neuromuscular blocking agent (succinylcholine chloride)
Fasciculations
53
An automatic reaction when something touches an area deep in the oral cavity that helps protect the lower airway from aspiration.
Gag reflex
54
The enlargement or expansion of the stomach, often with air; can be a complication of ventilating the esophagus instead of the trachea.
Gastric distention
55
A tube that is inserted into the stomach to remove its contents.
Gastric tube
56
A flexible device that is inserted between the glottis under direct laryngoscopy; the endotracheal tube is threaded over the device, facilitating its entry into the trachea. Also called a tracheal tube introducer.
Gum elastic bougie
57
Manual airway maneuver that involves tilting the head back while lifting up on the chin; used to open the airway of an unresponsive non trauma patient.
Head tilt-chin lift maneuver
58
An iron-containing protein within red blood cells that has the ability to combine with oxygen.
Hemoglobin
59
Increased carbon dioxide content in arterial blood.
Hypercapnia
60
A condition in which an increased amount of air enters the alveoli; carbon dioxide elimination exceeds carbon dioxide production.
Hyperventilation
61
Decreased carbon dioxide content in arterial blood.
Hypocapnia
62
A condition in which a decreased amount of air enters the alveoli; carbon dioxide production exceeds the body’s ability to eliminate it by ventilation.
Hypoventilation
63
A decrease in arterial oxygen level.
Hypoxemia
64
A lack of oxygen to cells and tissues.
Hypoxia
65
A supraglottic airway device that uses a non-inflatable, gel-like mask to isolate the larynx and facilitate ventilation.
I-gel
66
An expression for comparing the length of inspiration with that of expiration, normally 1:2, meaning that expiration is twice as long as inspiration (not measured in seconds).
Inspiratory/ expiratory (I/E) ratio
67
Bypassing of oxygen-poor blood past nonfunctional alveoli.
Intrapulmonary shunting
68
A technique to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward; used when a patient may have a cervical spine injury
Jaw-thrust maneuver
69
A single-lumen airway that is blindly inserted into the esophagus; when properly placed in the esophagus, one cuff seals the esophagus, and the other seals the oropharynx.
King LT airway
70
A respiratory pattern characteristic of diabetic ketoacidosis, with marked hyper pea and tachypnea; represents the body’s attempt to compensate for the acidosis.
Kussmaul respirations
71
A device that surrounds the opening of the larynx with an inflatable silicone cuff positioned in the hypopharynx; an alternative to bag-mask ventilation.
Laryngeal mask airway (LMA)
72
A surgical procedure in which the larynx is removed.
Laryngectomy
73
A device that is used in conjunction with a laryngoscope blade to perform direct laryngoscopy.
Laryngoscope
74
The ability of the alveoli to expand when air is drawn into the lungs during negative pressure ventilation or positive pressure ventilation.
Lung compliance
75
A special type of forceps that is curved, thus allowing paramedics to maneuver it in the airway.
McGill forceps
76
A system for predicting the relative difficulty of intubation based on the amount of oropharyngeal structures visible in an upright, seated patient who I’d fully able to open his or her mouth.
Mallempati classification
77
The chemical processes that provide the cells with energy from nutrients.
Metabolism
78
A compound formed by oxidation of the iron on hemoglobin.
Methemoglobin (metHb)
79
Airway device with a single long tube that can be used for esophageal obturation or endotracheal tube ventilation, depending on where the device comes to rest following blind positioning.
Multilumen airway
80
An opening on the side of an endotracheal tube tube at its distal tip that permits ventilation to occur even if the tip becomes occluded by blood, mucus, or the tracheal wall.
Murphy eye
81
A device that delivers oxygen via two small prongs that fit into the patient’s nostrils; with an oxygen flow rate of 1 to 6 L/min, an oxygen concentration of 24% to 44% can be delivered.
Nasal cannula
82
A gastric tube is inserted into the stomach through the nose.
Nasogastric (NG) tube
83
A soft rubber tube about 6 inches (15 cm) long that is inserted through the nose into the posterior pharynx behind the tongue, thereby allowing passage of air from the nose to the lower airway.
Nasopharyngeal (nasal) airway
84
Insertion of an endotracheal tube into the trachea through the nose.
Nasotracheal intubation
85
Insertion of a 14- to 16-gauge over-the -needle intravenous catheter (such as an Angiocath) through the cricothyroid membrane and into the trachea.
Needle cricothyrotomy
86
Drawing of air into the lungs; airflow from a region of higher pressure (outside the body) to a region of lower pressure (the lungs); occurs during normal (unassisted) breathing.
Negative pressure ventilation
87
Drugs that bind to acetylcholine receptor sites; they do not cause depolarization of the muscle fiber; examples are vecuronium (Norcuron) and pancuronium (Pavulon); also called paralytics.
Nondepolarizing neuromuscular blockers
88
A combination mask and reservoir bag system in which oxygen fills a reservoir bag attached to the mask by a one-way valve permitting a patient to inhale from the reservoir bag but not to exhale into it; at a flow rate of 15 L/min, it can deliver 90% to 100% inspired oxygen.
Nonrebreathing mask
89
An emergency incision of the cricothyroid membrane with a scalpel and insertion of an endotracheal or a tracheostomy tube directly into the sub glottic area of the trachea; also called surgical cricothyrotomy.
Open cricothyrotomy
90
Potent analgesics with sedative properties; examples are fentanyl (Sublimaze) and alfentanil (Alfenta); also called narcotics.
Opioids
91
A gastric tube inserted into the stomach through the mouth.
Orogastric (OG) tube
92
A hard plastic device that is curved so that it fits over the back of the tongue with the tip in the posterior pharynx.
Oropharynx (oral) airway
93
Insertion of an endotracheal tube into the trachea through the mouth.
Orotracheal intubation
94
Positional dyspnea
Orthopnea
95
A small bottle of water through which the oxygen leaving the cylinder is moisturized before it reaches the patient.
Oxygen humidifier
96
Hemoglobin that is occupied by oxygen.
Oxyhemoglobin (HbO2)
97
A nondepolarizing neuromuscular blocking agent; used to maintain paralysis following succinylcholine-facilitated intubation.
Pancuronium
98
The inward movement of the chest during inhalation and outward movement during exhalation; the opposite of normal chest wall movement during breathing.
Paradoxical motion
99
Drugs that paralyze skeletal muscles; used in emergency situations to facilitate intubation; also called neuromuscular blocking agents.
Paralytics
100
Surgical removal of a portion of the larynx.
Partial laryngectomy
101
A mask similar to the nonrebreathing mask but without a one-way valve between the mask and the reservoir; room air is not drawn in with inspiration; residual expired air is mixed in the mask and rebreathed.
Partial rebreathing mask
102
Open
Patent
103
An approximation of the extent of bronchoconstriction; used to determine whether therapy (such as with inhaled bronchodilators) is effective.
Peak expiratory flow
104
The result of an inflammation that causes the pleura to thicken, decreasing the pleural space and allowing the pleural to rub together.
Pleural friction rub
105
Mechanical maintenance of pressure in the airway at the end of expiration to increase the volume of gas remaining in the lungs.
Positive and-expirartory pressure (PEEP
106
Forcing of air into the lungs.
Positive pressure ventilation
107
The pressure of blood that is returned to the heart (venous return).
Preload
108
An oxygen flowmeter that incorporates a float ball in a tapered calibrated tube; the float rises or falls according to the gas flow in the tube; is affected by gravity and must remain in an upright position for an accurate reading.
Pressure-compensated flowmeter
109
A device that measures oxygen saturation level (Spo2).
Pulse oximeter
110
A drop in the systolic blood pressure of 10 mm Hg or more; commonly seen in patients with pericardial tampon are or severe asthma.
Pulsus paradoxus
111
A specific set of procedures, combined in rapid succession, to induce sedation and paralysis and incubate a patient quickly.
Rapid sequence intubation (RSI)
112
Left lateral recumbent position; used in all unresponsive nontrauma patients who are able to maintain their own airway spontaneously and are breathing adequately.
Recovery position
113
The hemoglobin after the oxygen has been released to the cells.
Reduced hemoglobin
114
The occurrence of dreams, nightmares, or delirium that can take place during the end of the half-life of ketamine.
Reemergence phenomenon
115
A pathologic condition characterized by a blood pH of less than 7.35 and caused by the accumulation of acids in the body from a respiratory cause.
Respiratory acidosis
116
A pathologic condition characterized by a blood pH of greater than 7.45 and resulting from the accumulation of bases in the body from a respiratory cause.
Respiratory alkalosis
117
The drawing in of the intercostal muscles and the muscles above the clavicles that can occur in respiratory distress.
Retractions
118
A technique in which a wire is placed through the trachea and into the mouth with a needle via the cricoid membrane; the endotracheal tube is then placed over the wire and guided into the trachea.
Retrograde intubation
119
A continuous, low-pitched sound; indicates mucus or fluid in the larger lower airways.
Rhonchi
120
A nondepolarizing neuromuscular blocking agent; used to maintain paralysis following succinylcholine-facilitated intubation.
Rocuronium
121
The pressure at which an oxygen cylinder should be replaced with a full one; often is 200 psi.
Safe residual pressure
122
The reduction of a patient’s anxiety, induction of amnesia, and suppression of the gag reflex, usually by pharmacologic means.
Sedation
123
A narrowing, such as of a blood vessel or stoma.
Stenosis
124
In the context of the airway, the resultant orifice of a tracheostomy that connects the trachea to the outside air; located in the midline of the anterior part of the neck.
Stoma
125
A blade designed to lift the epiglottis and expose the vocal cords; also called the Miller blade.
Straight laryngoscope blade
126
A high-pitched inspiratory sound representing air moving past an obstruction within or immediately above the glottic opening.
Stridor
127
In the context of intubation, a semirigid wire inserted into an endotracheal tube to mold and maintain the shape of the tube.
Stylet
128
A depolarizing neuromuscular blocker frequently used as the initial paralytic during rapid sequence intubation; causes muscle fasciculations.
Succinylcholine chloride
129
A device that attaches to the stem of the oxygen cylinder and reduces the high pressure of gas to a safe range (about 50 psi).
Therapy regulator
130
A manual maneuver that involves grasping the tongue and jaw and lifting; commonly used to suction the airway and to place certain airway devices.
Tongue-jaw lift maneuver
131
A hard or rigid suction catheter; also called a Yankauer catheter.
Tonsil-tip catheter
132
Surgical removal of the entire larynx.
Total laryngectomy
133
Breath sounds heard by placing the stethoscope diaphragm over the trachea or sternum; also called bronchial breath sounds.
Tracheal breath sounds
134
Inserting a suction catheter into the endotracheal tube to remove pulmonary secretions.
Tracheobronchial suctioning
135
A surgical opening into the trachea.
Tracheostomy
136
A plastic tube placed within the tracheostomy site (stoma).
Tracheostomy tube
137
A method of intubation that uses a lighted stylet to guide the endotracheal tube into the trachea.
Transillumination intubation
138
A method used in conjunction with needle cricothyrotomy to ventilate a patient; requires a high-pressure jet ventilator.
Translaryngeal catheter ventilation
139
Clenched teeth caused by spasms of the jaw muscles.
Trismus
140
A nondepolarizing neuromuscular blocking agent; used to maintain paralysis following succinylcholine-facilitated intubation.
Vecuronium
141
A mask with a number of interchangeable adapters that draws room air into the mask along with the oxygen flow; allows for the administration of highly specific oxygen concentrations.
Venturi mask
142
Soft, muffled breath sounds in which the expiratory phase is barely audible.
Vesicular breath sounds
143
Visualization of the epiglottis and vocal cords through a video monitor that is attached to a laryngoscope.
Video laryngoscopy
144
An imbalance between the anatomic portions of the lung being ventilated (V) and the anatomic portions being perfumed (Q).
V/Q mismatch
145
A waveform display of exhaled carbon dioxide shown on a portable cardiac monitor/ defibrillator.
Waveform capnographry
146
A high-pitched whistling sound that may be heard on inspiration, expiration, or both; indicates air movement through a constricted lower airway, such as with asthma.
Wheezing
147
Soft plastic, nonrigid catheters; also called French catheters.
Whistle-tip catheter
