Chpt. 11: Airway Management Flashcards
Acidosis
A pathological condition that results from the accumulation of acids in the body
Can be caused by hypoventilation (CO2 retention)
Rapid, shallow breathing
Aerobic metabolism
Metabolism that can only proceed in the presence of oxygen
Agonal gasps
Occasional gasps that are ineffective attempts at breathing, occuring after the heart has stopped
Should not be considered breathing
Airway
The upper airway tract or the passage above the larynx (nose, mouth, and throat) and the lower airway (trachea and lungs)
Alkalosis
The buildup of excess base (lack of acids) in the body
Rapid, deep breathing
Hyperventilation
Anaerobic metabolism
The metabolism that takes place in the absence / lack of oxygen
Lactic acid and stiff muscles
Anoxia
The absense of oxygen
Stroke causes hypoperfusion in the brain
Apnea
Absence of breathing; periods of not breathing
Aspiration
The introduction of vomit or other foreign materials into the lungs
Asymmetric chest wall movement
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
Atelectasis
A condition of airless or collapsed alveoli that causes pulmonary shunting, ventilation/perfusion mismatch, hypoxemia
Bag-valve mask
A device with a face mask attached to a ventilation bag containing a reservoir and connected to oxygen; delivers more than 90% oxygen
Bilateral
A body part or condition that appears on both sides of the midline
Bradypnea
Slow respiratory rate
<12 breaths per minute in adults
Bronchioles
Small airways made of smooth muscle that lead to the alveoli
Capnometry / End-tidal carbon dioxide (EtO2)
The measurment of exhaled carbon dioxide (35-45 mmHg)
Carina
Point at which the trachea divides into the left and right mainstem bronchi
Cellular respiration
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
Chemoreceptors
Receptors the monitor chemicals in the blood
Tracks rising levels of CO2 and determine when to take a breath
Colormetric carbon dioxide detector
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)
Continuous positive airway pressure (CPAP)
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
Dead space
The amount of inhaled air that does not reach the alveoli (150 ml)
Dyspnea
Shortness of breath or difficulty breathing
Exhalation
The inactive part of breathing where the diaphragm and intercostal muscles relax, forcing air out of the lungs
External respiration
The exchange of gases between the lungs and blood cells in the pulmonary capillaries
Gag reflex
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
Glottic opening
The narrowest part of the adult airway; the space between the vocal cords
Head tilt-chin lift maneuver
A combo of 2 movements to open the airway by tilting the forehead back and lifting the chin
Used for non-trauma patients
Hemothorax
Accumlulation of blood in the pleural space
Hering-Breuer reflex
The mechanism that terminates inhalation and prevents overexpansion of the lungs
Hypercapnia
Increased carbon dioxide levels in the bloodstream
Hyperventilation
Rapid/deep breathing that results in excess respiration
Hypovolemic shock
A condition in which low blood volume, due to massive internal or external bleeding or extensive loss of body water, results in hypoperfusion
Hypoxemia
A deficiency of oxygen in arterial blood
Hypoxia
A dangerous condition in which the body’s tissues and cells do not have enough oxygen
Hypoxic drive
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
Inhalation
The active part of breathing, drawing air into the lungs by negative pressure
Internal respiration
The exchange of gases between the blood cells and tissues
Jaw-thrust maneuver
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
Labored breathing
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)
Laryngospasm
An involuntary contraction of the vocal cords, completely closing off the airway
Larynx
The most inferior portion of the upper airway / voice box
Epiglottis, thyroid cartilage, cricoid cartilage, arytenoid cartilage, corniculate cartilage, cuneiform cartilage
Lung complience
The ability of the alveoli to fully expand when air is drawn in during inhalation
Mediastinum
Space within the chest that contains the heart, major blood vessels, vagus nerve, trachea, major bronchi, and esophagus
Located between the lungs
Metabolism
The chemical processes that provide cells with energy from nutrients
Minute volume
The amount of air moved in and out of the respiratory tract per minute
Tidal volume x respiratory rate
Nasal cannula
An oxygen delivery device that goes into the nose
2-6 L/minute
Nasopharyngeal airway (NPA)
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
Negative pressure ventilation
Normal, unassisted breathing
Diaphragm contracts and creates a lower pressure space in the chest
Nonrebreathing mask (NRB)
A combo mask and reservior bag system that covers the nose and mouth
10-15 L/min
Obstruction
An object blocking airflow to the airway
Can be aspirated material, large or small objects, and patients tongue (unconscious)
Oropharyngeal airway (OPA)
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
Orthopnea
Difficulty breathing when lying down that can be relieved by standing or sitting
Oxygenation
The process of oxygen being delivered into the blood through the alveoli by diffusion
Oxygen saturation (SpO2)
The measure of the percentage of oxygen molecules that are bound to hemoglobin in arterial blood
Oxygen toxicity
Excessive oxygen being delivered to the body resulting in cellular and tissue damage
Paradoxical motion
The inward movement of the chest during inhalation and outward movement during exhalation
Sign of broken / flail ribs
Parietal pleura
Thin membrane lining the chest cavity
Partial pressure
The term used to describe the amount of gas in air or dissolved in fluid, such as blood
Patent
Open, clear of obstruction
Phrenic nerves
The nerves that innervate the diaphragm
C3-C5
Pneumothorax
A partial or complete accumulation of air in the pleural space
Positive end-expiratory pressure (PEEP)
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)
Pulmonary edema
A buildup of fluid in the lungs, usually a result of congestive heart failure
Recovery position
A side-laying position used to maintain a clear airway in patients without injury
Left lateral recumbent
Residual volume
Air that remains in the lungs after maximal expiration
Respiration
The process of exchanging oxygen and carbon dioxide
Respiratory rate
The number of breaths in 1 minute
12-20 breaths for adults
Retractions
Movements in which the skin pulls in and around the ribs during inspiration
Considered labored breathing
Stoma
A surgical opening in the body that connects an internal structure to the skin, like the trachea
“trach”
Stridor
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
Surfactant
An oily substance released by cells of the alveoli designed to reduce surface tension and allow the alveoli to stay open
Tachypnea
Fast respiratory rate
> 20 breaths in adults
Tidal volume
The amount of air moved during 1 breath
Involuntary, casual breathing (500 ml average)
Trachea
The windpipe; the main conduit for air passing to and from the lungs
Tracheostomy tube
A tube inserted through the hole created by a tracheostomy
Turbinates
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)
Vasodilatory shock
A type of shock related to relaxation of the blood vessels, allowing blood to pool and impair circulation
Ventilation
The physical movement of air into the lungs
Visceral pleura
Thin membrane that covers the lungs
Vital capacity
The amount of air that can be forcibly expelled from the lungs after breathing in as deeply as possible
Voluntary
Wheezing
A high-pitched, whistling breath sound that is prominent on expiration, and suggests an obstruction or narrowing of the lower airways (bronchoconstriction)
Rhonchi
Lung sound:
- Thick mucous
- Asthma
- Chronic Bronchitis
- COURSE CRACKLES
Wheezes
Lung sound:
- Polyphonic –> Bronchospasms
- Monophonic –> Inflammation & chronic sound
Crackles / Rales
Lung sound:
- Fine crackles
- –> Pulmonary Effusion (fluid around the alveoli)
- Pulmonary Edema (bubbles)
Pleural Friction Rub
Lung sound:
- Inflammation
- Rubbing balloons
