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NREMT Review > respiratory and airway > Flashcards

respiratory and airway Flashcards

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1
Q

perfusion

A

circulation of blood through lungs

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2
Q

diffusion

A

gas exchange co2 and o2

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3
Q

where is respiratory center housed

A

brainstem specifically medulla

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4
Q

wheezing

A

lower airways (bronchioles0

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5
Q

Stridor

A

upper airway obstruction ( subglottic)

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6
Q

rhonchi

A

secretions in broncial airways

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7
Q

eupnea

A

normal respirations

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8
Q

cheyne stokes breahtign

A

periods of breahting with periods of apnea

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9
Q

biots respirations

A

regular deep respirations followed by periods of apnea

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10
Q

apneustic respirations

A

deep gasping inspirations
associated with stroke or trauma

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11
Q

kussmals

A

rapid and deep

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12
Q

nasal cannula LPM and concentration

A

1-6 24-44%

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13
Q

nebulizer LPM

A

4-6 handheld and 6-8 mask

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14
Q

NRB LPM and concentration

A

12-15 80-100%

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15
Q

BVM LPM, tidal volume, BPM

A

at least 15
adult 1 sec, 500ml tidal volume
dead space 150 ml
12 adults
20 peds

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16
Q

CPAP indications

A

F’N CPAP
flail chest
near drowning
copd
pulmonary edema/embolixm
asthma
pneumonia

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17
Q

miller blade goes where

A

directly to epiglottis

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18
Q

endotrol tube

A

used in nasotracheal intubation

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19
Q

Ped tube formula

A

(16+age)/4

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20
Q

PH

A

7.35-45

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21
Q

Co2 ABG

A

35-45

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22
Q

bicarb

A

22-26

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23
Q

ABG in respiratory acidosis

A

PH down
paco2 up
hco3 normal

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24
Q

abg in respiratory alkaloiss

A

ph up
paco2 down
hco3 normal

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25
Q

abg in metabolic acidosis

A

ph down
paco2 normal
hco3 down

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26
Q

abg in metabolic alkalosis

A

ph up
paco2 normal
hco3 up

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27
Q

ROME acronym

A

respiratory opposite metabolic equal

respiratory
ph decreases co2 increases

metabolic
ph down, hco3 down

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28
Q

respiratory acidsois cause

A

hypoventialtion (retaining to much co2)

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29
Q

respiratory alkalosis cause

A

hyperventilation ( blowing off to much co2)

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30
Q

metabolic acidosis cause

A

build up of lactic acid ex
lactic acidosis, dka, renal failure, sepsis, toxins

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31
Q

metabolic acidosis treatment

A

respiratory rate, fluid, bicarb

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32
Q

metabolic alkalosis cause

A

loss of hydrogen ions (rare)
vomiting, suctioning, large amounts of baking soda or antacids

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33
Q

phases of etco2

A

phase 1- respiratory baseline, late phase of inspiration

phase 2- respiratory upstroke, exhalation of dead space gasses and gasses from alveoli

phase 3- respiratory plateau
airflow through alveoli with nearly constant co2 level

phase 4 - inspiratory phase, sudden downstroke on waveform

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34
Q

CPR etco2

A

10-15 mmhg
change cpr if less than 10

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35
Q

sharkfin etco2

A

prolonged expiratory phase,
asthma, copd, anaphylaxix, fabo, treat this with bronchodilators

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36
Q

rising baseline etco2

A

pt is rebreathing co2. check equipment for o2 flow, allow more time for exhalation, ensure cuff has good seal

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37
Q

prolonged waveform higher than 45mmhg

A

hypoventilation

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38
Q

shortened waveform less than 35 mmhg

A

hyperventilation.
consider dka, sepsis, tca od, methanol ingestion

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39
Q

breathing around ett etco2

A

angled sloped downstroke means cuff is to small or wrong size

40
Q

curare cleft

A

dip on the plataeu, neuromuscular blockade is wearing off. pt is able to take a small breath at the top

41
Q

what is COPD

A

umbrella term that covers chronic bronchitis and emphysema

42
Q

chronic bronchitis

A

“blue bloater”
overweight
productive cough
coarse rhonchi
chronic cyanosis
resistance on inspiration and expiration

43
Q

emphysema

A

pink puffer
thin
barrel chested
nonproductive cough
wheezing and rhonchi
dyspnea on exertion
pursed lip breathing
clubbing on fingers

44
Q

what is asthma

A

bronchoconstriction and inflammation.

45
Q

asthma symptoms

A

dyspnea
intercostal retractions
decreasing loc
inability to speak sentances
tachycardia
tachypnea
etco2 above 45 mmhg

46
Q

status asthmaticus

A

severe prolonged asthma attack that has not been stopped by bronchodilators

47
Q

asthma treatment

A

02 and bronchodilators
consider nebulized mag sulfate
steroids
IV fluids
Epi
cpap

48
Q

what is pneumonia

A

infection that causes acute inflammatory response
bacterial, viral, fungal

49
Q

pneumonia symptoms

A

productive cough
pleuritic chest pain tachypnea
wheezing crackles and rhonchi
fever

50
Q

what is ARDS

A

form of hypoxemic respiratory failure

51
Q

what causes ARDS

A

significant pulmonary edema leads to severe hypoxemia,, intrapulmonary shunting, reduced lung compliance and irreversible lung damage

52
Q

Pulmonary embolism risk factors

A

bedridden
long flights
hx of dvt
femal pt on bc
smoking

53
Q

PE ss

A

rapid onset dyspnea
cough
pain
anxiety
hypertension
tachypnea
tachycardia
crackles, wheezes, rhonchi

54
Q

EKG finding PE

A

S1q3t3
Right axis deviation

55
Q

PE obstructive shock

A

pt can enter obstructive shock. give 20 ml/kg fluid repeated as necessary

56
Q

simple pneumothorax

A

presence of air in pleural space
diminshed breath sounds
dyspnea and restlessness
tachypnea

57
Q

tension pneumothorax

A

accumulation of air in pleural space that causes. tension(obstruction)

ss
jvd
hyperresonance
subcutaneous emphysema
late sign will be obstructive shock

58
Q

HAPE:
causes, when it develops, height, symptoms, treatment

A

increased pulmonary artery pressure
symptoms begin 24-72 hours after exposure above 8000 ft
all lung sounds plus tachycardia and cyanosis
treat with o2 and decend altitude

59
Q

AMS causes, symptoms

A

rapidly ascending above 5000 ft
headache, nausea, vomiting, weakness, dizziness, fatigue, tachy or bradycardia, postural hypertension

ataxia marks the change to hace

60
Q

atelectasis

A

collapse of lung tissue (alveoli) makes respiration difficult due to inadequate ability of the alveoli to function

61
Q

carina

A

bifurcation of trachea into right and left bronchus

62
Q

compliance

A

ease of expansion of lungs

63
Q

diaphragm

A

muscular portion that divides lungs and thoracic area

64
Q

expiratory reserve volume

A

amount of gas that can be expelled after a breath. normal is 1,100 ml

65
Q

fick principal

A

oxygen delivered to an organ is equal to the amount of oxygen that is consumed by and carried away from the organ

66
Q

hering breur reflex

A

reflex that prevents overinflation of lungs

67
Q

hypoxic drive

A

stimulus to breathe is from low o2 levels

68
Q

intrapulmonic pressure

A

pressure of gas in alveoli

69
Q

intrathoracic pressure

A

pressure in pleural space or throracic cavity

70
Q

lower airway

A

structures below glottis

71
Q

mediastinum

A

area of body whihc includes trachea, esophagus, heart, great vessles

72
Q

minute volume

A

amount of gas exhaled in 1 min
(rr x tidal volume)
normal is around 5L

73
Q

oxyhemoglobin

A

oxygenated hemoblobin

74
Q

carboxyhemoglobin

A

hemoglobin saturated by co

75
Q

residual volume

A

amount of air in lungs after max exhalation
average is 1200

76
Q

tidal volume normal

A

5-7L

77
Q

total lung capacity

A

5800 ml

78
Q

upper airway

A

area above glottic opening

79
Q

vallecula

A

decompression between epiglottis and base of tongue

80
Q

Vital capacity

A

amount of gas that can move on the deepest inspiration and expiration

81
Q

what lines trachea

A

cilia and goblet cells

82
Q

how many rings on trachea

A

15-20

83
Q

pleural layers

A

visceral- lines the lungs
pleural space
parietal pleura- seperates rib muscle from pleural space

84
Q

phrenic nerve
location and function

A

C3-5
initiates contraction at diaphragm

85
Q

intrapulmonic pressure

A

pressure of gas in alveoli ( a bit above 760 mmhg)

86
Q

intrathoracic pressure

A

pressure in pleural space
(typically below atmospheric pressure around 750

87
Q

Normal breathing uses how much energy? vs abnormal

A

5% 30%

88
Q

Hypoxemia

A

decreased o2 in arterial blood

89
Q

Hypoxia

A

decreased o2 in tissue

90
Q

Chemoreceptors

A

detect changes i co2 and hydrogen levels

91
Q

O2 D cylander PSI/L

A

4000
350L

92
Q

O2 E cylinder PSI/L

A

6000
625L

93
Q

O2 M cylinder PSI/L

A

3450 PSI
3000L

94
Q

H or K O2 cylinder PSI/L

A

4500 PSI
6900 L

95
Q

suction requirements machine
LPM
MMHG
timing

A

intake:30 LPM
300mmhg when clamped
80-100 for adults
adult:15 sec
child:10 Sec
Infant:5 sec

96
Q

management of upper airway obstruction

A

if able to speak encourage to cough
unable to speak= abd thrusts
unconscious = open airway, 2 ventilations, chest compressions
only finger sweep when foreign body is able to be seen, use magills

97
Q

Racemic epi indications

A

croup, asthma, bronchospasm

NREMT Review (12 decks)

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