EMT Chp. 11

Question 1

What is the process called for gas exchange in the lungs?

Answer 1

External respiration.

Question 2

List the anatomic structures of the upper airway.

Answer 2

Nasopharynx, nasal air passage, pharynx, oropharynx, mouth, epiglottis, larynx.

Question 3

List the structures of the lower airway.

Answer 3

Trachea, apex of the lung, bronchioles, carina, main bronchus.

Question 4

Where is the mediastinum located?

Answer 4

Between the lungs.

Question 5

What structures are located in the mediastinum?

Answer 5

Heart, great vessels, esophagus, trachea, major bronchi, and many nerves.

Question 6

Define ventilation.

Answer 6

The physical act of moving air into and out of the lungs.

Question 7

Define oxygenation.

Answer 7

The process of loading oxygen molecules onto hemoglobin molecules in the bloodstream.

Question 8

Define respiration.

Answer 8

The actual exchange of oxygen and carbon dioxide in the alveoli as well as the tissues of the body.

Question 9

Is inhalation an active or passive process?

Answer 9

Active.

Question 10

What occurs during inhalation?

Answer 10

The diaphragm and intercostal muscles contract, allowing air to enter the body and travel to the lungs.

Question 11

Define tidal volume.

Answer 11

The amount of air (in mL) that is moving into or out of the lungs during one breath.

Question 12

Define hypoxia.

Answer 12

Failure to meet the body’s need for oxygen.

Question 13

Explain the hypoxic drive.

Answer 13

Secondary control of breathing based on the levels of oxygen dissolved in the plasma.

Question 14

List the late signs of hypoxia.

Answer 14

Mental status changes, weak (thready) pulse, cyanosis.

Question 15

Where can ventilation without oxygenation occur?

Answer 15

In places where oxygen levels in the breathing air have been depleted.

Question 16

Define metabolism.

Answer 16

Cells taking energy from nutrients through a series of chemical processes.

Question 17

What is the purpose of surfactant?

Answer 17

It reduces surface tension within the alveoli and keeps them expanded.

Question 18

Describe internal respiration.

Answer 18

The exchange of oxygen and carbon dioxide between the systemic circulatory system and the cells of the body.

Question 19

Define aerobic metabolism.

Answer 19

In the presence of oxygen, cells convert glucose into energy.

Question 20

Define anaerobic metabolism.

Answer 20

Without adequate oxygen, cells do not completely convert glucose into energy, leading to lactic acid accumulation.

Question 21

What do central chemoreceptors in the medulla respond to?

Answer 21

Slight elevations in carbon dioxide level or decrease in the pH of the CSF.

Question 22

What is an example of ventilation/perfusion (V/Q) mismatch?

Answer 22

Pulmonary Embolism.

Question 23

What is the normal respiratory rate range for an adult?

Answer 23

12-20 breaths per minute.

Question 24

What are the signs of adequate breathing for adult patients?

Answer 24

Normal rate (12-20 breaths/min), regular pattern, clear lung sounds, regular chest rise and fall, adequate depth.

Question 25

What types of patients are Cheyne-Stokes respirations seen?

Answer 25

Stroke and patients with serious head injuries.

Question 26

Describe Cheyne-Stokes respirations.

Answer 26

Irregular respiratory pattern with increasing rate and depth followed by apnea.

Question 27

How do you assess airway and breathing on a patient found in a prone position?

Answer 27

Patients must be repositioned to allow airway and breathing.

Question 28

What is the most common airway obstruction in a patient?

Answer 28

Tongue.

Question 29

What is the preferred way to open the airway of a patient with no suspected cervical spinal injury?

Answer 29

Head tilt-chin lift maneuver.

Question 30

What is the preferred way to open the airway of a patient with a cervical spinal injury?

Answer 30

Jaw Thrust Maneuver.

Question 31

What should you do if you hear gurgling in a patient?

Answer 31

Suction the patient.

Question 32

When suctioning with a rigid catheter, what should you avoid touching?

Answer 32

The back of the airway.

Question 33

What is the most significant complication associated with oropharyngeal suctioning?

Answer 33

Vomit.

Question 34

What are the indications for inserting an oral airway?

Answer 34

Unresponsive patients without a gag reflex, apneic patients being ventilated.

Question 35

What are the contraindications for inserting an oral airway?

Answer 35

Conscious patients, any patient with an intact gag reflex.

Question 36

What could happen if you try to insert an oral airway in a patient with a gag reflex?

Answer 36

Vomiting or a spasm.

Question 37

What should you do if the patient starts to gag while attempting to insert an oral airway?

Answer 37

Immediately remove the adjunct and prepare to suction.

Question 38

When is a nasopharyngeal (NPA) airway better tolerated?

Answer 38

By patients who have an intact gag reflex.

Question 39

What are the indications for a NPA?

Answer 39

Semiconscious or unconscious patients with an intact gag reflex.

Question 40

What are the contraindications for the NPA?

Answer 40

Severe head injury with blood draining from the nose, history of fractured nasal bone.

Question 41

Where should the NPA be inserted?

Answer 41

The nose, larger nostril.

Question 42

Which way should the bevel of the NPA face?

Answer 42

The septum.

Question 43

What is the benefit of placing a patient in the recovery position?

Answer 43

Helps maintain a clear airway in an unconscious patient who is breathing.

Question 44

What is the pressure of the gas in a full oxygen cylinder?

Answer 44

2,000 psi.

Question 45

When should an oxygen tank be taken out of service and refilled?

Answer 45

When it’s 500-1,000 psi.

Question 46

Describe the condition of oxygen toxicity.

Answer 46

Damage to cellular tissue due to excessive oxygen levels in the blood.

Question 47

Before a non-rebreather mask is applied to a patient, what must be ensured?

Answer 47

The bag is full before the mask is placed on the patient.

Question 48

What percentage of oxygen does a patient receive with a non-rebreathing mask set at 15L/min?

Answer 48

90% inspired oxygen.

Question 49

What percentage of oxygen does a nasal cannula deliver?

Answer 49

24-44%.

Question 50

What is the flowmeter set at for a nasal cannula?

Answer 50

1-6 L/min.

Question 51

What is an advantage of using a nasal cannula instead of a non-rebreather mask?

Answer 51

Patients find it more comfortable.

Question 52

What is the consequence of patients that are breathing very rapidly and shallowly?

Answer 52

It moves air primarily in the lower airway passages and does not allow for adequate exchange.

Question 53

What is a disadvantage of positive-pressure ventilation?

Answer 53

Increased intrathoracic pressure affects the return of venous blood to the heart.

Question 54

How do pressure changes affect venous blood return to the heart?

Answer 54

Reduced venous return results in reduced cardiac output.

Question 55

Cardiac output is a function of what?

Answer 55

Stroke volume and heart rate.

Question 56

What is a safer method to prevent possible disease transmission when performing mouth to mask ventilations?

Answer 56

The Bag-Mask device.

Question 57

What should the oxygen flow rate of a bag-mask device with an oxygen reservoir bag be set at?

Answer 57

15 L/min.

Question 58

What percentage of oxygen is delivered with a bag-mask device?

Answer 58

100%.

Question 59

The volume of air delivered to the patient is based on what?

Answer 59

Chest rise and fall.

Question 60

Why is ventilation using a bag-mask device a challenging skill?

Answer 60

It may be difficult to maintain a proper seal while delivering adequate volume.

Question 61

How often should a breath be delivered for patients during one-rescuer bag-mask ventilations?

Answer 61

Every 6 seconds for adults, every 2-3 seconds for infants and children.

Question 62

What is the best way to know that bag-mask ventilations are effective?

Answer 62

Chest rise and fall with each ventilation.

Question 63

How can gastric distension be minimized when ventilating an apneic patient?

Answer 63

Ensure appropriate positioning, rate, and volume.

Question 64

What pressure is created within the chest as it recoils following compressions?

Answer 64

Negative pressure.

Question 65

What conditions in the pre-hospital setting is CPAP a benefit?

Answer 65

Respiratory distress associated with COPD, acute pulmonary edema, and acute bronchospasm.

Question 66

How does CPAP benefit the oxygenation of the patient?

Answer 66

Exhalation not inhalation.

Question 67

What should you do if ventilating a patient with a stoma and hear air escaping from the mouth and nose?

Answer 67

Seal the patient’s mouth and nose to prevent leakage.

Question 68

What is wheezing an indication of?

Answer 68

Mild lower airway obstruction.

Question 69

What should you do if a patient has a foreign body airway obstruction who is conscious and alert?

Answer 69

Ask if they're choking.

Question 70

What is the advantage of leaving dentures in place when providing ventilations?

Answer 70

Provides more structure to the face for a good seal.

Question 71

When should dentures be removed?

Answer 71

When they become dislodged or loose.

Question 72

Describe apneic oxygenation.

Answer 72

Maintain a high-flow nasal cannula during preoxygenation and leave it in place during intubation.

Question 73

What does the technique of apneic ventilation allow for?

Answer 73

Continuous oxygen delivery during all phases of intubation.