Chpt. 11: Airway Management Flashcards

1
Q

Acidosis

A

A pathological condition that results from the accumulation of acids in the body

Can be caused by hypoventilation (CO2 retention)

Rapid, shallow breathing

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2
Q

Aerobic metabolism

A

Metabolism that can only proceed in the presence of oxygen

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3
Q

Agonal gasps

A

Occasional gasps that are ineffective attempts at breathing, occuring after the heart has stopped

Should not be considered breathing

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4
Q

Airway

A

The upper airway tract or the passage above the larynx (nose, mouth, and throat) and the lower airway (trachea and lungs)

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5
Q

Alkalosis

A

The buildup of excess base (lack of acids) in the body

Rapid, deep breathing

Hyperventilation

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6
Q

Anaerobic metabolism

A

The metabolism that takes place in the absence / lack of oxygen

Lactic acid and stiff muscles

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7
Q

Anoxia

A

The absense of oxygen

Stroke causes hypoperfusion in the brain

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8
Q

Apnea

A

Absence of breathing; periods of not breathing

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9
Q

Aspiration

A

The introduction of vomit or other foreign materials into the lungs

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10
Q

Asymmetric chest wall movement

A

Unequal movement of the two sides of the chest; indicating decreased airflow into one lung

“flail chest” = broken ribs, usually 2 or more in more than one place

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11
Q

Atelectasis

A

A condition of airless or collapsed alveoli that causes pulmonary shunting, ventilation/perfusion mismatch, hypoxemia

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12
Q

Bag-valve mask

A

A device with a face mask attached to a ventilation bag containing a reservoir and connected to oxygen; delivers more than 90% oxygen

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13
Q

Bilateral

A

A body part or condition that appears on both sides of the midline

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14
Q

Bradypnea

A

Slow respiratory rate

<12 breaths per minute in adults

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15
Q

Bronchioles

A

Small airways made of smooth muscle that lead to the alveoli

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16
Q

Capnometry / End-tidal carbon dioxide (EtO2)

A

The measurment of exhaled carbon dioxide (35-45 mmHg)

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17
Q

Carina

A

Point at which the trachea divides into the left and right mainstem bronchi

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18
Q

Cellular respiration

A

A biochemical process resulting in the production of energy in the form of ATP

Occurs after internal respiration has allowed oxygen to leave the blood and goes to the tissue

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19
Q

Chemoreceptors

A

Receptors the monitor chemicals in the blood

Tracks rising levels of CO2 and determine when to take a breath

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20
Q

Colormetric carbon dioxide detector

A

A device that attaches between the endotracheal tube or supraglottic airway to determine the presence of exhaled CO2

Barney = bad (no CO2 exchange)
Big Bird= good (CO2 exchange)

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21
Q

Continuous positive airway pressure (CPAP)

A

A method of ventilation used primarily in the treatment of critically ill patients with respiratory distress (bronchoconstriction, atelectasis, pulmonary edema)

Pressure on inhalation and exhalation to allow for full lung expansion

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22
Q

Dead space

A

The amount of inhaled air that does not reach the alveoli (150 ml)

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23
Q

Dyspnea

A

Shortness of breath or difficulty breathing

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24
Q

Exhalation

A

The inactive part of breathing where the diaphragm and intercostal muscles relax, forcing air out of the lungs

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25
Q

External respiration

A

The exchange of gases between the lungs and blood cells in the pulmonary capillaries

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26
Q

Gag reflex

A

A normal reflex mechanism that causes retching; activated by touching the soft palate or the back of the throat

Prohibits the use of an OPA or supraglottic airway

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27
Q

Glottic opening

A

The narrowest part of the adult airway; the space between the vocal cords

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28
Q

Head tilt-chin lift maneuver

A

A combo of 2 movements to open the airway by tilting the forehead back and lifting the chin

Used for non-trauma patients

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29
Q

Hemothorax

A

Accumlulation of blood in the pleural space

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30
Q

Hering-Breuer reflex

A

The mechanism that terminates inhalation and prevents overexpansion of the lungs

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31
Q

Hypercapnia

A

Increased carbon dioxide levels in the bloodstream

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32
Q

Hyperventilation

A

Rapid/deep breathing that results in excess respiration

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33
Q

Hypovolemic shock

A

A condition in which low blood volume, due to massive internal or external bleeding or extensive loss of body water, results in hypoperfusion

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34
Q

Hypoxemia

A

A deficiency of oxygen in arterial blood

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35
Q

Hypoxia

A

A dangerous condition in which the body’s tissues and cells do not have enough oxygen

36
Q

Hypoxic drive

A

A backup system to control respirations based on oxygen levels instead of the body’s default state, which is to measure CO2 levels to control respirations

37
Q

Inhalation

A

The active part of breathing, drawing air into the lungs by negative pressure

38
Q

Internal respiration

A

The exchange of gases between the blood cells and tissues

39
Q

Jaw-thrust maneuver

A

Technique used to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward

Used when trauma has occured or is unknown

40
Q

Labored breathing

A

Breathing that requires greater than normal effort; may be slower or faster than normal and usuakky requires the use of accessory muscles

Pursed lips, intercostal retractions and nasal flaring (pediatrics)

41
Q

Laryngospasm

A

An involuntary contraction of the vocal cords, completely closing off the airway

42
Q

Larynx

A

The most inferior portion of the upper airway / voice box

Epiglottis, thyroid cartilage, cricoid cartilage, arytenoid cartilage, corniculate cartilage, cuneiform cartilage

43
Q

Lung complience

A

The ability of the alveoli to fully expand when air is drawn in during inhalation

44
Q

Mediastinum

A

Space within the chest that contains the heart, major blood vessels, vagus nerve, trachea, major bronchi, and esophagus

Located between the lungs

45
Q

Metabolism

A

The chemical processes that provide cells with energy from nutrients

46
Q

Minute volume

A

The amount of air moved in and out of the respiratory tract per minute

Tidal volume x respiratory rate

47
Q

Nasal cannula

A

An oxygen delivery device that goes into the nose

2-6 L/minute

48
Q

Nasopharyngeal airway (NPA)

A

An airway adjunct inserted into the nostril of a responsive patient who is not able to maintain a natural airway

Should not be used when trauma to the back of the head is suspected (basilar skull fracture)

Measure:

  • Corner of the nose to the earlobe
  • Tragus to the lateral side of the nostril
49
Q

Negative pressure ventilation

A

Normal, unassisted breathing

Diaphragm contracts and creates a lower pressure space in the chest

50
Q

Nonrebreathing mask (NRB)

A

A combo mask and reservior bag system that covers the nose and mouth

10-15 L/min

51
Q

Obstruction

A

An object blocking airflow to the airway

Can be aspirated material, large or small objects, and patients tongue (unconscious)

52
Q

Oropharyngeal airway (OPA)

A

An airway adjunct inserted into the mouth to keep the tongue from blocking the upper airway and to make suctioning easier

Unable to be used on a patient with a gag reflex

Measure:

  • Corner of the mouth to the earlobe
  • Center of the mouth to the angle of the jaw
53
Q

Orthopnea

A

Difficulty breathing when lying down that can be relieved by standing or sitting

54
Q

Oxygenation

A

The process of oxygen being delivered into the blood through the alveoli by diffusion

55
Q

Oxygen saturation (SpO2)

A

The measure of the percentage of oxygen molecules that are bound to hemoglobin in arterial blood

56
Q

Oxygen toxicity

A

Excessive oxygen being delivered to the body resulting in cellular and tissue damage

57
Q

Paradoxical motion

A

The inward movement of the chest during inhalation and outward movement during exhalation

Sign of broken / flail ribs

58
Q

Parietal pleura

A

Thin membrane lining the chest cavity

59
Q

Partial pressure

A

The term used to describe the amount of gas in air or dissolved in fluid, such as blood

60
Q

Patent

A

Open, clear of obstruction

61
Q

Phrenic nerves

A

The nerves that innervate the diaphragm

C3-C5

62
Q

Pneumothorax

A

A partial or complete accumulation of air in the pleural space

63
Q

Positive end-expiratory pressure (PEEP)

A

Mechanical / physical maintenance of pressure in the airway aimed at increasing alveolar opening and allowing for better respiration

Prevents air from immediately coming out and allows for back pressure (pursed lips)

64
Q

Pulmonary edema

A

A buildup of fluid in the lungs, usually a result of congestive heart failure

65
Q

Recovery position

A

A side-laying position used to maintain a clear airway in patients without injury

Left lateral recumbent

66
Q

Residual volume

A

Air that remains in the lungs after maximal expiration

67
Q

Respiration

A

The process of exchanging oxygen and carbon dioxide

68
Q

Respiratory rate

A

The number of breaths in 1 minute

12-20 breaths for adults

69
Q

Retractions

A

Movements in which the skin pulls in and around the ribs during inspiration

Considered labored breathing

70
Q

Stoma

A

A surgical opening in the body that connects an internal structure to the skin, like the trachea

“trach”

71
Q

Stridor

A

A harsh, high-pitched respiratory sound, generally heard during inspiration, that is caused by partial blockage or narrowing of the upper airway

Upper airway problem

72
Q

Surfactant

A

An oily substance released by cells of the alveoli designed to reduce surface tension and allow the alveoli to stay open

73
Q

Tachypnea

A

Fast respiratory rate

> 20 breaths in adults

74
Q

Tidal volume

A

The amount of air moved during 1 breath

Involuntary, casual breathing (500 ml average)

75
Q

Trachea

A

The windpipe; the main conduit for air passing to and from the lungs

76
Q

Tracheostomy tube

A

A tube inserted through the hole created by a tracheostomy

77
Q

Turbinates

A

Bony shelves that extend from the lateral walls of the nose into the nasal passageway

Increases surface area, improves filtration, humidification, and warming of inhaled air

Without this, lung butter is produced (thick mucous)

78
Q

Vasodilatory shock

A

A type of shock related to relaxation of the blood vessels, allowing blood to pool and impair circulation

79
Q

Ventilation

A

The physical movement of air into the lungs

80
Q

Visceral pleura

A

Thin membrane that covers the lungs

81
Q

Vital capacity

A

The amount of air that can be forcibly expelled from the lungs after breathing in as deeply as possible

Voluntary

82
Q

Wheezing

A

A high-pitched, whistling breath sound that is prominent on expiration, and suggests an obstruction or narrowing of the lower airways (bronchoconstriction)

83
Q

Rhonchi

A

Lung sound:

  • Thick mucous
  • Asthma
  • Chronic Bronchitis
  • COURSE CRACKLES
84
Q

Wheezes

A

Lung sound:

  • Polyphonic –> Bronchospasms
  • Monophonic –> Inflammation & chronic sound
85
Q

Crackles / Rales

A

Lung sound:

  • Fine crackles
  • –> Pulmonary Effusion (fluid around the alveoli)
  • Pulmonary Edema (bubbles)
86
Q

Pleural Friction Rub

A

Lung sound:

  • Inflammation
  • Rubbing balloons