General Airway + Policy Review Flashcards
How long is the trachea? What is the area of bifurcation called? Where is it positioned to the esophagus?
- Trachea is 10 cm long
- Area of bifurcation is called CARINA
- Trachea lies ANTERIOR to the esophagus
What separates the brain from the nasal cavity?
Cribiform plate (thin layer of bone)
With facial or head trauma, the cribiform plate may fracture. What can happen because of this?
Leakage of CSF into the nose (CSF rhinorrhea).
Any tube inserted in the nose can directly touch the cranium, potentially having major consequences (think NPA)
What are the 4 nasal sinuses?
Frontal
Ethmoidal
Maxillary
Sphenoid
What are 4 important things to know about sinuses?
- Sinus infections can lead to headaches
- Ethmoid sinuses occasionally rupture with pressure changes
- Sinusitis may lead to brain abscess
- Air-fluid level in the sphenoid sinus may indicate a basal skull fracture
If an ethmoid sinus ruptures, what will a patient present with?
Facial subcutaneous emphysema
What are some common problems that disrupts laryngeal function/structure?
- Laryngeal foreign bodies
- Epiglottitis
- Edema (secondary to burns, chemical inflammation, or allergic reaction)
- Trauma (with secondary bleeding or swelling
- Trauma (with gross disruption of laryngeal structure)
How many lobes do the left and right lungs have?
Right - 3 lobes
Left - 2 lobes
If an FBO manages to pass the carina, where would it most likely end up in?
Right mainstem bronchus
- 25 degree angle
- Almost in a direct line with the trachea
- Also happens with ETT if inserted too far
What is hypoxia?
A state of oxygen deficiency OR lack of oxygen.
- Prolonged hypoxia can cause irreversible damage to the cells
Oxygen moves out of the alveoli into the circulation system by?
Diffusion
Oxygen is transported in the circulation primarily by _____?
AND minimally by _____?
1) Combining with hemoglobin
2) Dissolving in plasma
Oxygen release to the tissues occurs when?
O2 concentration in tissues are LOWER than in the blood
What are some factors that affect oxygen release to the tissues?
- pH
- Temperature
- CO2
How many mls can an adult BVM hold?
1500 ml
How many mls can a paediatric BVM hold?
450 ml
How many mls of oxygen does a BVM with two hands deliver?
2 hands = 1100 ml
1 hand = 800 ml
What is the Haldane effect?
Shift LEFT
- Decreased H+
- Decreased CO2
- Decreased 2,3 BPG
- Decreased Temp
- Increased affinity of O2 with Hb
Net result? LOWER O2 DISSOCIATION
What is the Bohr effect?
Shift RIGHT
- Increased H+
- Increased CO2
- Increased 2,3 BPG
- Increased Temp
- Decreased affinity of O2 with Hb
Net result? HIGHER O2 DISSOCIATION
Patho of Pulmonary Embolism (PE)?
Occlusion of pulmonary arteries by thrombi that originate elsewhere (typically from the legs or pelvis)
- Think about people with DVT’s
- S&S include pleuritic chest pain, dyspnea, lightheadedness, and syncope
Patho of Pneumothorax?
When air enters pleural space causing partial or complete lung collapse.
- Intrapleural pressure is normally negative (less than atmospheric pressure)
- This is due to factors such as inward pull from elastic tissue
- Surface tension within pleural cavity also pulls lungs outward
When air enters the pleural space, intrapleural pressure increases and lung volume decreases
When V/Q is >0.8, what does this mean?
Ventilation EXCEEDS perfusion.
Common causes: emphysema, blood clot, heart failure
When V/Q is <0.8, what does this mean?
Perfusion EXCEEDS ventilation.
Common causes: aspiration, FBO, pulmonary edema
Patho of Pneumonia?
Infection that inflames the air sacs in one or both lungs.
- The air sacs can fill with pus or fluid, causing coughs, fever, chills, and difficulty breathing
How does Epinephrine work during anaphylaxis?
Epi stimulates beta-adrenergic receptors (B2).
- Leads to bronchial smooth muscle relaxation
- Can help with bronchospasm, wheezing, and dyspnea
*Ventolin does the same thing
