Airway Management - Anatomy & Physiology Flashcards
(123 cards)
1
Q
The upper airway consists of all anatomic airway structures above the level of the ___
A
Vocal cords
2
Q
Upper airway structures
A
- Nose
- Mouth
- Jaw
- Oral cavity
- Pharynx
- Larynx
3
Q
The major function of the upper airway
A
To warm, filter, and humidify air as it enters the body through thr mouth and nose
4
Q
A muscular tube that extends from the nose and mouth to the level of the esophagus and trachea
A
Pharynx (throat)
5
Q
The pharynx is composed of ___
A
- Nasopharynx
- Oropharynx
- Laryngopharynx
6
Q
The laryngopharynx is also called the ___
A
Hypopharynx
7
Q
Lowest portion of the pharynx
A
Laryngopharynx
8
Q
At the base, the laryngopharynx ___
A
Splits into two lumens, the larynx (and ultimately the trachea) anteriorly and the esophagus posteriorly
9
Q
The nasopharynx is lined with ___
A
A ciliated mucous membrane that keeps contaminants such as dust out of the respiratory tract
10
Q
The mucous membranes in the nose ___ air as it enters the body, in addition to filtering it
A
Warm and humidify
11
Q
After air enters the nose, it passes into the ___
A
Nasopharynx
12
Q
Forms the posterior portion of the oral cavity
A
Oropharynx
13
Q
The oral cavity is bordered by ___
A
- Superiorly by the hard and soft palates
- Laterally by the cheeks
- Inferiorly by the tongue
14
Q
Helps separate the digestive system from the respiratory system
A
Epiglottis
15
Q
The epiglottis is located ___
A
Superior to the larynx
16
Q
When swallowing occurs, the larynx is ___ and the epiglottis ___
A
- Elevated
- Folds over the glottis to prevent aspiration of contents into the trachea
17
Q
The larynx is a complex structure formed by ___
A
Many independent cartilaginous structures
18
Q
The thyroid cartilage is ___
A
A shield-shaped structure formed by two plates that join in a V shape anteriorly to form the laryngeal prominence known as the Adam’s apple
19
Q
The cricoid cartilage, or cricoid ring, lies ___
A
Inferiorly to the thyroid cartilage
20
Q
Forms the lowest portion of the larynx
A
Cricoid cartilage
21
Q
First ring of the trachea
A
Cricoid cartilage
22
Q
The only lower airway structure that forms a complete ring
A
Cricoid cartilage
23
Q
The elastic tissue that connects the thyroid cartilage superiorly to the cricoid ring inferiorly
A
Cricothyroid membrane
24
Q
The space between the vocal cords and the narrowest portion of the adult’s airway
A
Glottis
25
The glottis is also called the ___
Glottic opening
26
The lateral borders of the glottis are the ___
Vocal cords
27
These white bands of thin muscle tissue are partially separated at rest and serve as the primary center for speech production
Vocal cords
28
Vocal cords defense reflexes
Protect the lower airway, causing a spasmodic closure to the lower airway to prevent substances from entering the trachea
29
The function of the lower airway
Deliver oxygen to the alveoli
30
External boundaries of the lower airway
4th cervical vertebra and the xiphoid process
31
Internally the lower airway spans the ___
Glottis to the pulmonary capillary membrane
32
Conduit for air entry into the lungs
Trachea (windpipe)
33
The trachea is a ___
Tubular structure about 4 to 5 inches long and consists of C-shaped cartilaginous rings
34
The trachea begins ___ and descends ___
1. Directly below the cricoid cartilage
2. Anteriorly down the midline of the neck into the thoracic cavity
35
Once in the thoracic cavity, the trachea ___
Divides at the level of the carina into the two main stem bronchi (right & left)
36
The hollow bronchi are supported by ___ and distribute ___
1. Cartilage
2. Air into the right and left lungs
37
Infants and small children have a proportionately larger occiput (posterior portion of the cranium), which causes ___. To mitigate this ___
1. The neck to flex, moving the head forward and backward when supine
2. Place a folded towel under the child's shoulders to maintain a neutral position of the head
38
Children have a proportionately smaller mandible and a proportionately larger tongue. Both factors increase the incidence of ___
Airway obstruction
39
The child's epiglottis is more ___ than an adult's
Floppy and omega-shaped
40
In general, the infant's and child's airway is ___ at all levels
Smaller and narrower
41
The larynx of a child lies ___
More superior and anterior than that of an adult
42
The larynx of a child is ___ shaped due to the ___
1. Funnel
2. Narrow, underdeveloped cricoid cartilage
43
In children younger than 8 years, the narrowest portion of the airway is at the ___
Cricoid ring
44
Children do not have well-developed chest musculature, and their ribs are softer and more pliable than those of an adult. As a result ___
The thoracic cavity cannot optimally contribute to lung expansion, and children rely heavily on the diaphragm for breathing
45
Children and infants are commonly referred to as ___ breathers
Belly
46
The lungs consist of the entire mass of tissue that includes the ___
Smaller bronchi, bronchioles, and alveoli
47
Thin serous membranes that cover the lungs and line the thoracic cavity
Pleurae
48
The visceral pleura covers the ___
Outer surface of the lung tissue
49
The parietal pleura lines the ___
Inside of the thoracic cavity
50
A small amount of ___ is found between the two pleural layers and serves as a ___
1. Fluid
2. Lubricant to prevent friction during breathing
51
On entering the lungs, each bronchus divides into ___, which in turn subdivide into ___
1. Increasingly smaller bronchi
2. Bronchioles
52
The bronchioles are ___
Think hollow tubes made of smooth muscle
53
The tone of the smooth muscles of the bronchioles allows them to ___
Dilate or constrict in response to various stimuli
54
The smaller bronchioles branch into ___ that end at ___
1. Alveolar ducts
2. Alveolar sacs
55
Millions of thin-walled, balloon-like sacs that serve as the functional site for the exchange of oxygen and carbon dioxide
The alveoli
56
Surrounding each alveolar sac is an ___
Intricate bed of blood vessels known as pulmonary capillaries
57
Muscles between the ribs that facilitate normal breathing with the diaphragm
Intercostal muscles
58
Space between the lungs
Mediastinum
59
The mediastinum is surrounded by ___
Tough connective tissue
60
The mediastinum effectively separates the ___
Right and left lungs spaces
61
The phrenic nerves originate from ___
The third, fourth, and fifth cervical nerves
62
What do the phrenic nerves do?
Innervate the diaphragm muscle, allowing it to contract
63
Contraction of the diaphragm occurs in a ___ direction
Downward
64
The physical act of moving air into and out of the lungs
Ventilation
65
The process of loading oxygen molecules onto hemoglobin molecules in the bloodstream
Oxygenation
66
The actual exchange of oxygen and CO2 in the alveoli as well as the tissues of the body
Respiration
67
The active muscular part of breathing
Inhalation
68
What causes air to move into the lungs
Negative pressure from diaphragm contracting downwards, and intercostal muscles contracting, lifting the ribs up and out
69
Why can't the lungs move on their own?
They contain no muscle tissue
70
Describes the amount of gas in air or dissolved in fluid, such as blood
Partial pressure
71
Partial pressure is measured in ___
mm/Hg
72
The partial pressure of oxygen in air within the alveoli is ___
104 mm/Hg
73
CO2 entering the alveoli from the blood causes a partial pressure of ___
40 mm/Hg
74
Deoxygenated arterial blood from the right side of the heart has lower levels of ___ than ___. The body attempts to ___
1. Oxygen
2. CO2
3. Equalize the two, resulting in oxygen diffusion across the membrane into the blood and CO2 diffusion in the opposite direction
75
The air pressure outside the body is normally ___ than the air pressure within the thorax
Higher
76
Average tidal volume for an adult man
500 mL
77
The portion of the tidal volume that does not reach alveoli and thus does not participate in gas exchange
Dead space
78
The amount of air (in mL) that is moved into or out of the lungs during one breath
Tidal volume
79
The air that remains in the lungs after maximal expiration
Residual volume
80
The volume of air that reaches the alveoli
Alveolar ventilation
81
How to calculate alveolar ventilation
Subtract the amount of dead space air from the tidal volume
82
The volume of air moved through the lungs in 1 minute
Minute volume
83
How to calculate minute volume
Multiply tidal volume and respiratory rate
84
The volume of air moved through the lungs in 1 minute minus the dead space
Alveolar minute volume
85
How to calculate alveolar minute volume
Multiply tidal volume (minus dead space) and respiratory rate
86
The amount of air that can be forcibly expelled from the lungs after breathing in as deeply as possible
Vital capacity
87
Exhalation does not normally require ___
Muscular effort
88
Exhalation is a ___ process
Passive
89
Clearing the airway means ___
Removing obstructing material, tissue, or fluids from the nose, mouth, and throat
90
Maintaining an airway means ___
Keeping the airway patent
91
Open, free of obstructions
Patent
92
Tissues and cells of the body do not get enough oxygen
Hypoxia
93
The drive to breathe is based on ___
pH changes in the blood and CSF
94
When CO2 levels in the blood increase, the pH of CSF ___
Decreases
95
When the pH of CSF decreases ___
A message is sent to the respiratory centers in the brain, which stimulates breathing
96
COPD
Chronic Obstructive Pulmonary Disease
97
Patients with COPD have difficulty eliminating ___
CO2 through exhalation
98
In patients with COPD, the body uses ___ to control breathing
A backup system called the hypoxic drive
99
The hypoxic drive is based on ___
Levels of oxygen dissolved in plasma
100
Patients who are breathing inadequately will show varying signs and symptoms of ___
Hypoxia
101
The onset and degree of tissue damage caused by hypoxia often depend on the ___
Quality of the ventilations
102
Early signs of hypoxia
1. Restlessness
2. Irritability
3. Apprehension
4. Tachycardia
5. Anxiety
103
Late signs of hypoxia
1. Mental status changes
2. Thready pulse
3. Cyanosis
104
Conscious hypoxia patients will complain of ___
Shortness of breath and may not be able to talk in complete sentences
105
Shortness of breath
Dyspnea
106
The best time to give a patient oxygen
Before signs and symptoms of hypoxia appear
107
Difference between hypoxemia and hypoxia
Hypoxemia: Low level of oxygen in arterial blood
Hypoxia: Low level of oxygen at the cellular level
108
Uncorrected hypoxemia will lead to ___
Hypoxia
109
Oxygenation requires that the air used for ventilation contains an ___
Adequate percentage of oxygen
110
CO affinity for hemoglobin vs oxygen
250 times more
111
Cellular respiration
Metabolism
112
During metabolism, each cell ___
Combines nutrients and oxygen and produces energy and waste products
113
Energy produced in the cells
Adenosine triphosphate
114
Waste products of cells are primarily ___
Water and CO2
115
The process of breathing fresh air into the respiratory system and exchanging oxygen and CO2 between the alveoli and the blood in the pulmonary capillaries
External respiration (pulmonary respiration)
116
Makeup of fresh air
21% oxygen
78% nitrogen
0.3% CO2
117
As the fresh air reaches the alveoli, it comes in contact with a fluid called ___
Surfactant
118
Reduces surface tension within the alveoli and keeps them expanded, making it easier for the gas exchange between oxygen and CO2 to occur
Surfactant
119
Although adequate ventilation is necessary for external respiration to occur, it does not guarantee that ___
External respiration is being achieved
120
Under normal conditions, ___ of the hemoglobin receptor sites contain oxygen
96% to 100%
121
The exchange of oxygen and CO2 between the systemic circulatory system and the cells of the body is called ___
Internal respiration
122
To deliver sufficient oxygen to the tissues of the body, adequate ___ must occur
Ventilation and perfusion
123
With aerobic metabolism, cells convert ___ into energy
Glucose
