Chapter 15 - Respiratory

Question 1

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.

Answer 1

3-3-2 rule

Question 2

Abnormal.

Answer 2

adventitious

Question 3

The pressure gradient in the aorta against which the left ventricle of the heart must pump; an increase in this pressure can decrease cardiac output.

Answer 3

Afterload

Question 4

The inability to speak.

Answer 4

aphonia

Question 5

Prolonged gasping inspirations followed by extremely short, ineffective expirations; associated with brainstem insult.

Answer 5

apneustic respirations

Question 6

The family of sedative-hypnotics that provide muscle relaxation and mild sedation; most commonly used to treat anxiety, seizures, and alcohol withdrawal; include drugs such as diazepam (Valium) and midazolam (Versed).

Answer 6

benzodiazepines

Question 7

Irregular pattern, rate, and depth of respirations with intermittent periods of apnea; result from increased intracranial pressure.

Answer 7

Biot respirations

Question 8

A gradually increasing rate and depth of respirations followed by a gradual decrease with intermittent periods of apnea; associated with brainstem insult.

Answer 8

Cheyne-Stokes respirations

Question 9

A system used to predict intubation difficulty based on the airway structures observed during laryngoscopy.

Answer 9

Cormack-Lehane classification

Question 10

Difficulty speaking.

Answer 10

dysphonia

Question 11

A leaf-shaped cartilaginous structure that closes over the trachea during swallowing.

Answer 11

Epiglottis

Question 12

Increased carbon dioxide levels in arterial blood. hypercapnia

Answer 12

hypercapnia

Question 13

Decreased carbon dioxide content in arterial blood.

Answer 13

hypocapnia

Question 14

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).

Answer 14

inspiratory/expiratory ratio

Question 15

A system for predicting the relative difficulty of intubation based on the amount of oropharyngeal structures visible in an upright, seated patient who is fully able to open his or her mouth.

Answer 15

Mallampati classification

Question 16

A compound formed by oxidation of the iron on hemoglobin.

Answer 16

methemoglobin

Question 17

An opening on the side of an endotracheal tube at its distal tip that permits ventilation to occur even if the tip becomes occluded by blood, mucus, or the tracheal wall.

Answer 17

Murphy eye

Question 18

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.

Answer 18

negative pressure ventilation

Question 19

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.

Answer 19

nondepolarizing neuromuscular blockers

Question 20

Severe dyspnea experienced when lying down that is relieved by a change in position, such as sitting up or standing.

Answer 20

orthopnea

Question 21

A nondepolarizing neuromuscular blocking agent; used to maintain paralysis following succinylcholine-facilitated intubation.

Answer 21

pancuronium

Question 22

The inward movement of the chest during inhalation and outward movement during exhalation; the opposite of normal chest wall movement during breathing.

Answer 22

paradoxical motion

Question 23

An approximation of the extent of bronchoconstriction; used to determine whether therapy (such as with inhaled bronchodilators) is effective.

Answer 23

peak expiratory flow

Question 24

Mechanical maintenance of pressure in the airway at the end of expiration to increase the volume of gas remaining in the lungs.

Answer 24

positive end-expiratory pressure

Question 25

The precontraction pressure in the heart, which increases as the volume of blood builds up, stretching the cardiac muscle; the pressure of blood that is returned to the heart (venous return).

Answer 25

preload

Question 26

A drop in the systolic blood pressure of 10 mm Hg more during inspiration; characteristic of conditions that cause profound pressure changes in the thorax; commonly seen in patients with cardiac tamponade or severe asthma.

Answer 26

pulsus paradoxus

Question 27

A pathologic condition characterized by a blood pH of less than 7.35 and caused by an accumulation of acids in the body from a respiratory cause.

Answer 27

respiratory acidosis

Question 28

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.

Answer 28

respiratory alkalosis

Question 29

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.

Answer 29

retrograde intubation

Question 30

A nondepolarizing neuromuscular blocking agent; used to maintain paralysis following succinylcholine-facilitated intubation.

Answer 30

rocuronium

Question 31

A narrowing, such as of a blood vessel or stoma.

Answer 31

stenosis

Question 32

The involuntary contraction of the mouth resulting in clenched teeth; occurs during seizures and head injuries.

Answer 32

trismus

Question 33

A nondepolarizing neuromuscular blocking agent; used to maintain paralysis following succinylcholine-facilitated intubation.

Answer 33

vecuronium