Chapter 9 Airway management Flashcards
Airway Physiology
3 parts of pharynx
- oropharynx-where oral cavity joins the pharynx
- nasopharynx-where nasal passages empty into pharynx
- laryngopharynx- structure surrounding the trachea
Vocal cords
curtain like fibers that line the sides of tracheal opening.
-can close shut for protection, and can vibrate to create voice
thyroid cartilage
shield like, and protects the front of larynx, creating the adams apple
lower airway
begins below the larynx, and is composed of-
- trachea
- bronchial passages (tubes)
- aveoli
cricoid ring
the top ring of the 16 cartilage rings.
- is a complete ring (360) arround the trachea
- the rest of the 15 are only C shaped
-also connected posteriorly by smooth muscle
carina
where the trachea branches off to the two mainstream bronchi
All air passages are supported by______?
and lined with______?
- Supported by cartilage
- lined with smooth muscle (able to change their internal diameter in response to a specific stimulation)
bronchoconstriction (or bronchospasm)
when the lower airway smooth muscle constrict restricting airflow
strider
high pitched sound generated from partially obstructed airflow in the upper airway
intact muscle tone
control of the muscles that form that airway
-altered mental status and neurologic disorders can result in a loss of this muscle tone and the collapse of the airway
common obstruction in a person with decreased muscle tone is ______?
the tongue, or the epiglottis connected to the tongue.
airway obstruction
can occur acutely or over time
- burns or blunt force trauma
- certain infections
can cause swelling of the tissues in and around the glottic opening
signs of an inadequate airway
- no signs of breathing or airway
- evidence of foreign bodies in the airway (blood, vomit, or objects like broken teeth
- difficulty speaking
- noises such as strider are heard during breathing
- retractions
- nasal flaring
head tilt, chin lift maneuver
- patient is supine
- tilt head by applying gentle pressure to forehead
- use finger tips to lift chin and support the lower jaw.
jaw thrust maneuver
used when c spine injury is suspected
airway adjuncts
devices that aid in maintaining an open airway, and continually used to help keep an airway open.
- only used on patients who do not have gag reflex
- if gag reflex is present then nasopharynx can be used
rules for using airway adjuncts
- open airway manually before using an adjunct device
- anytime airway adjunct is used, the maneuver must be maintained and monitored
- if an oversized adjust is used then there is a chance that air will be allowed to flow into the esophagus
-
nasopharyngeal
- designed to be used in the right nostril
- should point to the base of the nostril or septum
- do not use nasopharyngeal if cerebrospinal fluid is coming from nose or ears (clear fluid)
oropharyngeal
adults install with tip facing upward then rotating downward
children and infants tip faces downward reflecting the curvature of the airway
