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R.Scott PMA Midterm 2 > Unit 12- Airway > Flashcards

Unit 12- Airway Flashcards

1
Q

what does upper airway consist of
where is the separating line
and primary function

A

nose , mouth, jaw, throat, larynx
larynx
warm , filter , humidify air into body

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2
Q

what is pulmonary ventilation

A

exchange of air between lungs and environment

air in and out of lungs

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3
Q

what do nasal turbinates do

A

three bony shelves that increase surface area of nasal muscosa, improve filtration, warming, humidification

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4
Q

jaw , tongue , epiglottis and thyroid bone attach to

A

hyoid bone

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5
Q

what are adenoids

A

lymph tissue at posterior naso wall, filter bacteria and virus

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6
Q

major structure of layrnx

A

thyroid cartilage

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7
Q

lateral borders of glottis are

A

vocal cords

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8
Q

narrowest part of trachea

A

glottic opening

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9
Q

trachea divides at ____ to form two ____

A

carina, bronchi

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10
Q

external boundaries of lower airway

A

4th cervical vertebrae and xiphoid process

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11
Q

how long is trachea

A

10-12 cm

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12
Q

what surface substance is found to “lubricate”

A

surfactant

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13
Q

area between lungs called

A

mediastinum

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14
Q

what does the phrenic nerve do for respiration

A

stimulates diaphragm contraction

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15
Q

what is oxygenation

A

process of loading oxygen molecules onto hemoglobin in the blood

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16
Q

what is respiration

A

actual exchange of oxygen and CO2 in the alveoli and tissues of body

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17
Q

what is tidal volume

dead space

A

measure of depth of breathing

portion that does not reach alveoli to exchange

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18
Q

children under 8, narrowest part of airway is

A

cricoid ring

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19
Q

partial pressure

A

is amount of gas in air or dissolved in fluid , like blood

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20
Q

average tidal volume

average dead space

A

500 ml

150 ml

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21
Q

what is vital capacity

A

amount of air that can be forceably expelled from lungs after taking the deepest breath in

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22
Q

what is residual volume and how much is usually left

A

amount left after max expiration, 1200 mL

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23
Q

another word for cellular respiration

A

metabolism

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24
Q

in presence of oxygen , cellular ____ change glucose to energy , this process if known as ___

A

mitchondria, aerobic metabolism

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25
Q

what takes over when O2 is missing in cell-

by which process ,

A

anaerobic metabolism

glycosis, less ATP and creates lactic acid

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26
Q

the ___ is the primary involuntary respiratory center. It connects to respiratory muscles via the ___

A

medulla, vagus nerve

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27
Q

what do chemoreceptors do

A

monitor pH of CSF and measure amount of CO2 in blood

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28
Q

factors affecting ventilation

A

airway obstruction
trauma, head / spinal cord or other trauma
CNS depressants
medical condition

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29
Q

factors affecting respiration

A

inadequate 02 in environment

reduced surface of gas exchange

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30
Q

when blood bypasses alveoli and doesnt get oxygenated and returns to heart, this is called

A

intrapulmonary shunting

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31
Q

what two systems maintain homeostasis with pH

A

respiratory and renal

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32
Q

what is a buffer

A

compound that repeatedly neutralizes excess acids or bases

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33
Q

three main components of buffer system

A

circulating bicarbonate
respiratory
renal

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34
Q

fluctuations in pH could lead to which two systems going either direction

A

respiratory - acidosis/alkalosis

metabolic- acidosis / alkalosis

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35
Q

symptoms of respiratory acidosis ( hypo-ventilation )

A 
systematic vasoconstriction
headache
red, flushed skin
CNS drepression
bradypnea
N/V
hypercalcemia
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36
Q

symptoms of respiratory alkalosis ( hyper-ventilation )

A 
decreased cerebral confusion
light headedness
confusion, vertigo
tingling lips/face
hand spasms
hypocalcemia
chest tightness
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37
Q

possible causes of metabolic acidosis

A

any acidosis not respiratory is metabolic

lactic acidosis, ketoacidosis, aspririn , alochol, GI lose

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38
Q

symptoms of metabolic acidosis

A 
systematic vasoconstriction
headache
red, flushed skin
CNS drepression
tachypnea 
N/V
hypercalcemia 
dysarhythmia
39
Q

possible causes of metabolic alkolosis

A

excessive water intake, excessive antacid intake

excessive urination , excessive vomit

40
Q

symptoms of metabolic alkolosis

A

confusion , tremors , hand cramps , bradypnea , hypotension

41
Q

cheyne-stokes breathing, where do we see this

A

irregular pattern, increasing rate and depth followed by period of apnea

ICP , stroke

42
Q

what are ataxic respirations

A

irregular , ineffective respirations, may not may not have pattern

43
Q

kussmaul breathing, and where do we see this

A

deep, gasping respirations

metabolic acidosis

44
Q

agonal gasps

A

not breathing

45
Q

time limits for suction (3)

A

adult-15
child- 10
infant -5

46
Q

three common types of air tank sizes and their constants

A

D- 350 L 0.16
E-650 L 0.28
M- 3000L 1.56

47
Q

what does the pin index system do

A

make sure you dont hook wrong equipment to the wrong type of cylinder

48
Q

oxygen does not burn or explode but does

A

support combustion

49
Q

flow rate and oxygen delivered

NC, Simple Mask, Partial NRB, NRB, BVM, Mouth to Mouth

A 
NC - 1-6 LPM - 24-44 %
Simple Mask - 8-10 LPM 40-60%
Partial NRB 6-10 LPM 35-55 %
NRB- 10-16 LPM - 90 %
BVM- 15 LPM - nearly 100 %
mouth to mouth- 15 LPM- Nearly 55 %
50
Q

main advantage to venturi mask

A

fine adjustments , long time use

51
Q

when would we likely see the use of oxygen humidifiers

A

long term, prolonged transport , conditions like croup, epiglottis , broncholitis

52
Q

how much air does a bvm typically hold

A

1200-1600 mL

53
Q

what is lung compliance

A

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

54
Q

CPAP may be used for -2

A

acute pulmonary edema and obstructive pulmonary disease

55
Q

type of multiumen airways

A

combitube

56
Q

what do multilumen airways have and allow you to do

A

two tubes, can go into trachea or espohagus

ventilate correct tube!

57
Q

indication of multilumen airway

contra

A

deeply apneic, unresponsive, no gag and ET tube failed or not possible

not under 16 years old, has to be between 5-7 ‘ tall
known esophagus issue, ingested caustic , or alcoholism

58
Q

two pressures of multilumen airway

A

100 mL and 15 mL

59
Q

what is a king LT airway

what determines size

A

blind insert, 2 inflatable cuffs inserted into esophagus

size and weight of pt

60
Q

some contraindications of king LT

A

does not protect against aspiration or vomit
over 4’ tall pt
ingested caustic substance
esophagus disease

61
Q

what is a laryngeal mask airway ( LMA )

risks

contraindicated

A

made for operating room
opening is positioned right at glottic opening
inflatable cuff conforms to contours of airway
7 sizes based on weight
supraglottic air way

does not protect against aspiration , actually increases risk , can easily become dislodged as not designed for pts being moved

less effective in obese pt’s, not used in morbid obese
ineffective for pts that need higher pressures

62
Q

If the amount of alveoli pulmonary surfactant is decreased:

A

alveolar surface tension will increase.

63
Q

Continuous positive airway pressure (CPAP) is indicated for patients with:

A

pulmonary edema.

64
Q

Cellular function deteriorates and death occurs when the pH:

A

drops below 6.9 or rises above 7.8.

65
Q

The anterior portion of the cricoid ring is separated from the thyroid cartilage by the:

A

cricothyroid membrane.

66
Q

Slow, shallow, irregular respirations or occasional gasps are MOST indicative of:

A

cerebral anoxia.

67
Q

Intrapulmonary shunting occurs when:

A

nonfunctional alveoli inhibit the diffusion of oxygen and carbon dioxide.

68
Q

What are the pyriform fossae?

A

Hollow pockets along the lateral borders of the larynx

69
Q

Tidal volume minus dead space volume is called:

A

alveolar ventilation.

70
Q

The pyramid-like cartilaginous structure that forms the posterior attachment of the vocal cords is called the:

A

arytenoid cartilage.

71
Q

What structure is located in the posterior aspect of the nasal cavity?

A

Nasopharynx

72
Q

Patients receive the MOST benefit from continuous positive airway pressure (CPAP):

A

during the exhalation phase.

73
Q

The narrowest portion of the adult’s trachea is the:

A

glottic opening

74
Q

when you have a advanced extraglottic airway in, what should you ventilate at , 2 condtions

A

6 a min OR

till adequate end tital C02

75
Q

when someone has ICP, what do you want the end tital c02 to be between

A

30-35 mmHg

76
Q

what is the calculation to get adequate tidal volume for a pt

A

5 ml/kg

77
Q

name of best 2 hand 2 person BVM mask hold

A

TE

thenar eminence

78
Q

acronym for issues with extraglottic or advanced airway adjunct

A

D-displaced
O-Obstruction
P- poor compliance ( difficult to ventilate)
E- equipment

79
Q

acronym for issues with BVM mask seal

A 
M- mask seal
O- obesity/ obstruction
A- age 55+
N- no teeth
S- stiff lungs
80
Q

2 contraindicators of extraglottic airway

A

lower airway obstruction, gag reflex

81
Q

what is the name of the maneuver for putting pressure on cricoid ring

A

sellicks

82
Q

difference between capnography and capnometry

A

graph vs number

83
Q

healthy gradient between P02 and ETC02

A

2-5 mmHg

84
Q

what is the collape or reduction of lung / alveoli

A

atelectasis

85
Q

acronym for difficulty with entry of airway adjunct

A

R- restricted mouth
O- obstruction below
D- disruption
S- stiff

86
Q

ligament that attaches hyoid bone to epiglottis

A

hypoepiglottic ligament

87
Q

what is the name of process to evaluate and look at uvula to assessment mouth entry

A

melanpatti

88
Q

what are the two sizes of combi tubes

A

adult male and female

89
Q

how do we size LMA ( laryngeal mask airway)
and 3 main sizes and air prssure

how far down do we put LMA

A

by weight in KG

size #3 - 30-50 KG - 20 ML
size #4- 50- 70 KG - 30 ML
size #5 - 70+ KG- 40 ML

naturally spots in position

90
Q

how do we size King LTS
and 3 main sizes and air pressure / colour

how far down do we put King LTS, and is there measurement

A

sized by height

size 3 (yellow)-4-5 ft- 45 to 60 ML
size 4 (red) -5-6 ft- 60 to 80 ML
size 5 (purple) 6 + ft -70-90 ML

measurement on tube neck

91
Q

when we insert a extraglottic airway, before we inflate cuff what should we do

if we have weak air entry with king what do we do

A

listen bilateral bases and bilateral apices for air movement in lungs not stomach

back out the king and re-auscultate

92
Q

Cheyne stokes breathing is what and can be seen when

Biot pattern

A

increase and decrease breathing pattern with period of apnea

ICP

rapid gasping followed by apnea

93
Q

kassmual breathing

A

Diabetic Ketoacidosis

deep gasping respirations

R.Scott PMA Midterm 2 (11 decks)

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