Chapter 9 Airway, Respiration And Artificial Ventilation

Question 1

Basic idea of ventilation

Answer 1

The moving of air in and out of the lungs.
- required for effective oxygen and respiration

Question 2

Inhalation process

Answer 2

Inhalation- active part of ventilation. Diaphragm and intercostal muscle contract, intrathoracic pressure decreases, vacuum is created, thorax enlarges, air passes through the upper to the lower airway then to the alveoli

Question 3

Exhalation process

Answer 3

Passive; diaphragm and intercostal muscles relax, thorax decreases in size, air is compressed put of lungs, intrathoracic pressure exceeds atmospheric pressure

Question 4

What is Tidal Volume

Answer 4

The amount of air inhaled/exhaled in one breath

Question 5

What is hypoxia

Answer 5

Inadequate delivery of O2 to the cells

Question 6

Early indications of hypoxia

Answer 6

Restlessness, anxiety, irritability, dyspnea, tachycardia

Question 7

Late signs of hypoxia

Answer 7

Altered or decreased LOC, severe dyspnea, Cyanosis, bradycardia

Question 8

CO2 drive and Hypoxic drive

Answer 8

CO2- the body’s primary system for monitoring breathing status; CO2 levels are monitored in the blood and cerebral fluid

Hypoxic- backup to the CO2 drive; monitors O2 levels in plasma

Question 9

What is oxygenation

Answer 9

The delivery of O2 to the blood
- ventilation is required but does not insure oxygenation

Question 10

What percent of O2 is in the air ?
What percent is in expired air?

Answer 10

Surrounding air: 21%
Expired air- 16%

Question 11

What is Respiration

Answer 11

The gas exchange of O2 and CO2

Question 12

Time frame for brain damage due to lack of O2

Answer 12

Begins- 4min
Permanent- 6min
Irrecoverable- 10min

Question 13

Signs of inadequate breathing

Answer 13

-abnormal RR
- Nasal Flaring
- paradoxical motion ( flail chest)
- unequal chest rise and fall
- dyspnea
- cyanosis
- agonal respiration ( dying gasps or apnea [no breathing] )

Question 14

What is Auscultation

Answer 14

Using a stethoscope to listen to lung sounds

Question 15

What are the points you listen to lungs

Answer 15

point to/ look up picture of unsure

Question 16

List 4 different lung sounds and what they indicate

Answer 16

Absent/ diminished- indicates little /no air exchange

Wheezing- High pitched sounds usually heard on exhalation (asthma COPD)

Rales- wet/ crackling sounds

Stridor- high pitch sound in the upper airway indicating a partial blockage in the upper airway (neck)

Question 17

Atelectasis occurs when

Answer 17

A deficiency of surfactant causes alveolar collapsed.

Question 18

In contrast to negative pressure ventilation positive pressure ventilation

Answer 18

May impair blood return to a heart.

Question 19

When does negative pressure ventilation occur?

Answer 19

When air is drawn into the lungs then intrathorasic pressure decreases.

Question 20

What does the fraction of inspired oxygen increase with?

Answer 20

Supplemental oxygen.

Question 21

The exchange of oxygen and carbon dioxide between the alveoli and the blood in the pulmonary capillaries is called.

Answer 21

External respiration

Question 22

The lowest portion of the pharynx anteriorly and the esophagus posteriorly is the ?

Answer 22

Laryngopharynx

Question 23

How does the Central nervous system regulate breathing?

Answer 23

The rate and depth are regulated by the brainstorm specifically than the medulla omblongata and the pons. These centers respond to changes in blood levels of carbon dioxide oxygen and ph to adjust breathing patterns. Chemoreceptors monterwood gas levels and sen signals to the respiratory centers to modify breathing as needed.

Question 24

Describe. Biot(ataxic) respirations

Answer 24

Irregular pattern rate and depth of respiration with intermittent periods of apnea. Results from increased ICP

Question 25

What are bronchovesicular sounds

Answer 25

Combination of tracheal and vehicular sounds. Heard at the upper part of sternum and between the scapula

Question 26

Cheyne- stoles respirations

Answer 26

Gradually increasing rate and depth of respirations followed by a gradual decrease of with intermittent periods of apnea

Question 27

Delayed sequence innovation.

Answer 27

The sedating medication is given before the paralytic

Question 28

Depolarizing neuromuscular blocker characteristics

Answer 28

A drug that competitively binds with acetylcholine receptor sites but it’s not affected as quickly by acetylcholinesterase. Ex. Sux

Question 29

Dysphonia

Answer 29

Difficulties speaking

Question 30

Fasciculations

Answer 30

Brief on coordinated twitching of small muscle groups in the face neck trunk and extremities maybe seen after the administration of depolarizing drugs

Question 31

Hypercapnia

Answer 31

Increase carbon dioxide content in arterial blood

Question 32

Hypoexemia

Answer 32

A decrease in arterial oxygen level

Question 33

Negative pressure ventilation

Answer 33

Airflow from a region of higher pressure ( outisde) to a region of lower pressure. (Inside) the case in regular respirations.

Question 34

Orthopnea

Answer 34

Positional dyspnea

Question 35

Vesicular breath sounds

Answer 35

Soft muffled bread sounds in which the expiratory phase is barely audible

Question 36

Apneustic respirations

Answer 36

Prolonged gasping inhalation followed by extremely short ineffective exhalation associated with brainstein insult.

Question 37

Phase 1(A-B) of capnographic waveform

Answer 37

The initial stage of exhalation. Gas sample consists of dead space gas which is free of carbon dioxide.

Question 38

Phase 2(B-C) of capnographic waveform

Answer 38

Expiratory upslope. At point B alveolar gas mixes with dead space gas.

Question 39

Phase 3 (C-D) of capnographic waveform

Answer 39

Alveolar plateau. Point D is max ETCO2 levels

Question 40

Phase 4 (D-E) of capnographic waveform

Answer 40

Inspiratpry downstroke. Fresh gas is introduced. This downstairs displaces carbon dioxide.

Question 41

What does shark fin capnography indicate

Answer 41

Bronchospasm

Question 42

When should you replace an oxygen cylinder

Answer 42

200psi