Chapter 9: Airway Managment Flashcards
brain tissue will begin to die within ____ minutes when deprived of oxygen
4-6 minutes
____ of the brain is lost every minute without oxygen
10%
oxygen reaches the bodies tissues through what two processes
circulation and breathing
the airway is divided into upper and lower portions by the
larynx
_____ is the exchange of air between lungs and the environment
ventilation
ventilation is necessary for _____ and ____ to occur
oxygenation and respiration
the upper airway consists of these 6 anatomical structures
- nose
- mouth
- jaw
- oral cavity
- pharynx
- larynx
the function of the upper airway is to
warm, filter, and humidify air entering the mouth and nose
the ____ is a muscular tube that starts at the nose and ends at the trachea level
pharynx
the pharynx consists of these three structures
- nasopharynx
- oropharynx
- laryngopharynx
the ____ is the entrance to the respiratory and digestive systems
oropharynx
the ____ prevents food and liquid from entering the larynx during swallowing
epiglottis
the larynx consists of these two structures
adam’s apple and vocal cords
function of the lower airway
gas exchange
lower airway consists of these three structures
- trachea
- thoracic cavity
- lungs
the ____ is where air enters into the lungs
trachea
the trachea divides at the ____ into the ______
carina, into the two main stem bronchi (right and left)
function of the bronchi is to
distribute O2 into the lungs
bronchi –> _____ –> ______
bronchi –> bronchioles –> alveoli
the bronchioles are ______ that _____ and ____ as O2 passes through
the bronchioles are smooth muscle that dilate and constrict as O2 passes through
____ are where O2 and CO2 exchange
alveoli
alveoli are surrounded by ______ where oxygen is diffused from the alveoli and transported to the heart for distribution through the body
pulmonary capillaries
also in the thoracic cavity is the ____
mediastinum
the mediastinum is the area between the
lungs
the mediastinum consists of these 6 things
- heart
- great vessels (vena cava and aorta)
- esophagus (not part of resp. system)
- trachea
- major bronchi
- nerves
the ____ and ____ systems work together to supply cells with O2 and nutrients and to remove waste
respiratory and cardiovascular systems
_____ is the amount of air (in ml) that move into the lung s in one breath
tidal volume (TV)
ventilation consists of ____ and _____
inhalation and exhalation
inhalation is an ____ process
active
during inhalation the diaphragm ______
contracts
____ is tidal volume that does not reach the alveoli
dead space
____ is the amount of air that can be forcibly expelled from the lungs after breathing deeply
vital capacity
____ is the air that remains after maximal expiration
residual volume
exhalation is a _____ process
passive
during exhalation the diaphragm _____
relaxes
during exhalation air pressure in the ______ is higher than the outside so air is _____ through the trachea
during exhalation air pressure in the THORAX is higher than the outside so air is PUSHED OUT through the trachea
regulation of ventilation is accomplished by ___ of ____
pH of CSF
regulation of ventilation is directly related to the amount of ___ in the blood
CO2
____ involves difficulty in eliminating CO2 through exhalation
COPD
patients with COPD have a back up system known as _____ to control breathing
hypoxic drive
_____ is the process of loading oxygen molecules into hemoglobin in the bloodstream
oxygenation
oxygenation does not guarantee ____
internal respiration
____ is the exchange of gases in alveoli and body tissues
respiration
_______ is the exchange of gases between alveoli and blood in the pulmonary capillaries
external/pulmonary respiration
_____ is the exchange of gases between systemic circulatory system and the cells of the body (oxygen from blood to tissue)
internal respiration
without oxygen in: 0-1 minute \_\_\_\_ 0-4 minutes \_\_\_\_\_ 4-6 minutes \_\_\_\_ 6-10 minutes \_\_\_\_ over 10 minutes \_\_\_\_
0-1 minute: cardiac irritability 0-4 minutes: brain damage not likely 4-6 minutes: brain damage possible 6-10 minutes: brain damage very likely over 10 minutes: irreversible brain damage
____ monitor O2, CO2, hydrogen ions, and pH of CSP to control respiration
chemoreceptors
circulatory compromise can result from 1. 2. 3. 4. 5.
- pulmonary embolism
- tension pneumothorax
- open pneumothorax
- hemothorax
- hemopneumothorax
_____ causes poor TV
tension pneumothorax
_____ is a hole through the lung and chest wall
open pneumothorax
____ is blood in a lung
hemothorax
_____ is a collapsed lung with blood
hemopneumothorax
adequate breathing is
- ____ breaths per minute
- ___ pattern
- ______ lung sounds
- ______ chest rise and fall
- ____ depth
- 12-20 breaths per minute
- regular pattern of inspiration and expiration
- clear bilateral lung sounds
- regular and equal chest rise and fall
- adequate depth
_____ is when the patient’s heart has stopped and they have ocassional gasping breaths
agonal respirations
_____ happen often with stroke and head injury, are INC rate and depth followed by apnea
cheyne-stokes respirations
_____ have an irregular or unidentifiable pattern
ataxic respirations
_____ are deep gasping respirations (associated with metabolic or toxic disorders)
kussmaul respirations
to open the airway the patient should be in the ____ position
supine
in an unconscious patient the ____ is the most common obstruction
tongue
the _____ is the most often used method to open the airway
head-tilt chin lift
_____ is used to open the airway if cervical trauma is suspected
jaw thrust
OPA keeps ____ off of the airway and should be used only for an ____ patient with no ____
OPA keeps tongue off of the airway and should be used only for an unconscious patient with no gag reflex
NPA’s are for a patient with
gag reflex
____ tips are used on a suctioning device for the pharynx
yankauer tips (rigid pharyngeal suction tips)
_____ tips are used to suction the nose or back of mouth
whistle-tip (nonrigid plastic)
suction no more than
___ s for adult
___ s for child
___ s for infant
15 s/ adult
10 s/child
5 s/ infant
(or as long as necessary)
______ is used to maintain a clear airway in an unconscious patient who is not injured and is breathing on his or her own with a normal respiratory rate and adequate TV
recover position
always give supplemental oxygen to patients who are
hypoxic
never withold oxygen especially if you are giving
ventilations
____ are the preferred way to give oxygen to patients who are breathing adequately but are suspected of having hypoxia
nonrebreathing masks
NRB masks should be set to a rate of ____L/min and provide up to ___% inspired O2
12-15 L/min
90% inspired O2
_____ give 24-44% inspired O2
nasal cannula
nasal cannula should be set at a rate of ____L/min
4-6 L/min
with a ____ mask the patient rebreathes a small amount of their exhaled air
partial rebreathing mask
the partial rebreathing mask is advantageous for a patient who is
hyperventilating
venturi mask can vary the _____ and is for long term management
% of oxygen
3 signs and symptoms of inadequate venilation
altered mental status
inadequate minute volume
excessive accessory muscle use and fatigue
with normal breathing the diaphragm _____ and the ____ pressure generated in the chest cavity brings air into the lungs
contracts, negative pressure
with positive pressure ventilation, the positive pressure generated by the device forces air into the chest cavity and the _____ intra thoracic pressure ____ the amount of blood pumped by the heart
with positive pressure ventilation, the positive pressure generated by the device forces air into the chest cavity and the INC intra thoracic pressure DEC the amount of blood pumped by the heart
ventilation rates for patients with a pulse
adult
child
infant
adult: 1 breath every 5-6 sec
child: 1 breath every 3-5 sec
infant: 1 breath every 3-5 sec
______ ventilation is preferred over BVM for apnic person
mouth to mask ventilation
4 signs you are performing adequate ventilations
- improved color
- chest rise
- no resistance
- you can hear and feel air escape at patient exhales
_____ occurs with artificial ventilations (stomach fills with air)
gastric distension
gastric distension occurs most commonly amongst
children
gastric distension occurs when you ventilate too ____ or _____ with a ______ or ______
forcefully or rapidly with a mag mask or pocket mask
gastric distension can also occur when there is _____ or when you use improper ____
FBAO or when you use improper head position
gastric distension can cause ____ and INC risk of _____
can cause vomiting and INC risk of aspiration
gastric distension can also DEC _____ by elevating _____
DEC lung volume by elevating the diaphragm
if dentures are _____ you should leave them in place when performing ventilations but if they are _____ they should be removed
if dentures are well-fitting you should leave them in place when performing ventilations but if they are loose they should be removed
when fresh air is inspired into the lungs it is ___% O2, but when it is exhaled it is ____%
21% on inhalation, 16% on exhalation
common causes of inaccurate \_\_\_\_\_\_ readings include: hypovolemia anemia dirty fingers nail polish CO poisoning peripheral vasoconstriction
pulse oximetry
the aspect of natural ventilation that involves the diaphragm contracting and the chest wall expanding is
inhalation
which of the following structures is not part of the upper airway
- nasopharynx
- epiglottis
- trachea
- larynx
trachea
the process by which CP2 moves from a high conc in the capillaries to a lower conc in the alveoli
diffusion
a patient who is developing early stages of hypoxia may exhibit
restlessness
NPA’s _____ get inserted with a rotating motion
DO NOT
if a d-sized oxygen cylinder contains 300L of oxygen and is at 2,000 PSI at the start of a call, the best estimate for the amount of time a patient can receive 15 L/min with a NRB mask is
20 min
properly performed suctioning of a patient may still cause
vomiting
the most common complication of the flow-restricted, oxygen-powered ventilation device is
gastric distension
the structure also known as the wind-pipe is
the trachea
some cells may become severely or permanently damaged after what period of time without oxygen
4-6 minutes
with an oxygen rate of 15 L/min and an adequate mask to mouth seal a bag mask device with an O2 reservoir can deliver nearly what % of O2
100%