Chapter 11 Airway Management

Question 1

The space in between the vocal cords that is the narrowest portion of the adult’s airway; also called the glottic opening

Answer 1

glottis

Question 2

insertion of an endotracheal tube directly through the larynx between the vocal cords and into the trachea to maintain and protect an airway

Answer 2

endotracheal intubation

Question 3

The use of muscles of the chest, back, and abdomen to assist in expanding the chest; occurs when air movement is impaired

Answer 3

labored breathing

Question 4

An oygen-delivery device in which oxygen flows through two small, tubelike prongs that fit into the patient’s nostrils; delivers 24% to 44% supplemental oxygen, depending on the flow rate

Answer 4

nasal cannula

Question 5

Thin white bands of tough muscular tissue that are lateral borders of the glottis and serve as the primary center for speech production

Answer 5

vocal cords

Question 6

The volume of air that reaches the alveoli. It is determined by substracting the amount of dead space air from the tidal volume

Answer 6

alveolar ventilation

Question 7

The process of providing oxygen, often in combination with ventilation, prior to intubation in order to raise the oxygen levels of body tissues; a critical step in advanced airway management. This extends the time during which an advanced airway can be placed in an apneic patient, because the more oxygen that is available in the alveoli, the longer the patient can maintain adequate gas exchange in the lungs during the procedure

Answer 7

preoxygenation

Question 8

Movements in which the skin pulls in around the ribs during inspiration

Answer 8

retractions

Question 9

Any portion of the airway that does contain air and cannot participate in gas exchange, such as the trachea and bronchi

Answer 9

dead space

Question 10

A liquid protein substance that coats the alveoli in the lungs, decreases alveolar surface tension, and keeps the alveoli expanded; a low level in a premature infant contributes to respiratory distress syndrome

Answer 10

surfactant

Question 11

Thin membrane that covers the lungs

Answer 11

visceral pleura

Question 12

A hollow, cylindrical device used to remove fluid from the patient’s airway

Answer 12

suction catheter

Question 13

Bypassing of oxygen-poor blood past nonfunctional alveoli to the left side of the heart

Answer 13

intrapulmonary shunting

Question 14

A method of ventilation used primarily in the treatment of critically ill patients with respiratory distress; can prevent the need for endotracheal intubation

Answer 14

continuous positive airway pressure

Question 15

Metabolism that can proceed only in the presence of oxygen

Answer 15

aerobic metabolism

Question 16

The exchange of air between the lungs and the environment; occurs spontaneously by the patient or with assistance from another person, such as an EMT

Answer 16

ventilation

Question 17

An opening through the skin and into an organ or other structure

Answer 17

stoma

Question 18

Airway adjunct inserted into the nostril of an unresponsive patient or a patient with an altered level of consciousness who is unable to maintain airway patency independently

Answer 18

nasopharyngeal airway

Question 19

Subdivision of the smaller bronchi in the lungs; made of smooth muscle and dilate or constrict in response to various stimuli

Answer 19

bronchioles

Question 20

The amount of air that can be forcibly expelled from the lungs after breathing in as deeply as possible

Answer 20

vital capacity

Question 21

Deficient oxygen concentration in the tissues

Answer 21

hypoxia

Question 22

A normal reflex mechanism that causes retching; activated by touching the soft palate or the back of the throat

Answer 22

gag reflex

Question 23

A condition in which air fills the stomach, often as a result of high volume and pressure during artificial ventilation

Answer 23

gastric distention

Question 24

A ventilation device attached to a control box that allows the variables of ventilation to be set. It frees the EMT to perfom other tasks while the patient is being ventilated

Answer 24

automatic transport ventilator

Question 25

The act of air moving into and out of the lungs during chest compressions

Answer 25

passive ventilation

Question 25

The air that remains in the lungs after maximal expiration

Answer 25

residual volume

Question 26

A body part or condition that appears on both sides of the midline

Answer 26

bilateral

Question 27

The biochemical processes that result in production of energy from nutrients within the cells; also called cellular respiration

Answer 27

metabolism

Question 28

A flexible device that is inserted between the glottis under direct laryngoscopy; the endotracheal tube is threaded over the device, facilitating its entry into the trachea

Answer 28

gum elastic bougie

Question 29

Visualization of the vocal cords, and thereby placement of the endotracheal tube, that is facilitated by use of a video camera and monitor

Answer 29

video laryngoscopy

Question 30

A technique in which oxygen administred via a high-flow nasal cannla is left in place during an intubation attempt, allowing for continuous oxygen delivery into he airways during all phases of the procedure

Answer 30

apneic oxygenation

Question 31

The upper tract or the passage above the larynx, which includes the nose, mouth, and throat

Answer 31

airway

Question 32

Any airway manipulation that induces the production of aerosols that may present a risk for airborne transmission of pathogens, such as CPR

Answer 32

aerosol-generating procedure

Question 33

A cyclical pattern of abnormal breathing that increases and then decreases in rate and depth, followed by a period of apnea

Answer 33

Cheyne-Strokes respirations

Question 34

The term used to describe the amount of gas in air or dissolved in fluid, such as blood

Answer 34

partial pressure

Question 35

The amount of air (in milliliters) that is moved into or out of the lungs during one breath

Answer 35

tidal volume

Question 36

Increased carbon dioxide level in the bloodstream

Answer 36

hypercarbia

Question 37

The process of exchanging oxygen and carbon dioxide

Answer 37

respiration

Question 38

A condition of excessive oxygen consumption resulting in cellular and tissue damage

Answer 38

oxygen toxicity

Question 39

Irregular, infeffective respirations that may or may not have an identifiable pattern

Answer 39

ataxic respirations

Question 40

The use of a capnometer, a device that measures the amount of expired carbon dioxide

Answer 40

capnometry

Question 41

An assessment tool that measures oxygen saturation of hemoglobin in the capillary beds

Answer 41

pulse oximetry

Question 42

The passive part of the breathing process in which the diaphragm and the intercostal mucles relax, forcing air out of the lungs

Answer 42

exhalation

Question 43

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

Answer 43

compliance

Question 44

An accumulation of air or gas in the pleural cavity

Answer 44

pneumothorax

Question 45

A term used to describe the degree of distress in a patient with a mild airway obstruction. If present, the patient often has a weak, ineffective cough, increased difficulty breathing, or possible cyanosis and may produce a high-pitched noise during inhalation (stridor)

Answer 45

poor air exchange

Question 46

The volume of air that moves in and out of the lungs per minute; calculated by multiplying the tidal volume and respiratory rate; also called minute ventilation

Answer 46

minute volume

Question 47

Technique to open the airway by placing the fingers behind the angle of the jaw and brining the jaw forward; used for patients who may have a cervical spine injury

Answer 47

jaw-thrust maneuver

Question 48

A harsh, high-pitched respiratory sound, generally heard during inspiration, that is caused by partial blockage or narrowing of the upper airway; may be audible without a stethoscope

Answer 48

stridor

Question 49

The two nerves that innervate the diaphragm; necessary for adequate breathing to occur

Answer 49

phrenic nerves

Question 50

A surgical procedure to create an opening (stoma) into the trachea; a stoma in the neck connects the trachea directly to the skin

Answer 50

tracheostomy

Question 51

A term used to distinguish the degree of distress in a patient with a mild airway obstruction. If present, the patient is still conscious and able to cough forcefully, although wheezing may be heard

Answer 51

good air exchange

Question 52

The volume of air moved through the lungs in 1 minute minus the dead space; calculated by multiplying tidal vlume (minus dead space) and respiratory rate.

Answer 52

Alveolar minute volume

Question 53

Shortness of breath or difficulty breathing

Answer 53

dyspnea

Question 54

The part of the pharynx that lies above the level of the roof of the mouth, or palate

Answer 54

nasopharynx

Question 55

A condition in which chronically low levels of oxygen in the blood stimulate the respiratory drive; seen in patients with chronic lung diseases

Answer 55

hypoxic drive

Question 55

A tubular structure that extends vertically from the back of the mouth to the esophagus and trachea

Answer 55

oropharynx

Question 56

Absence of spontaneous breathing

Answer 56

apnea

Question 57

A protective item, such as a pocket mask with a valve, that limits exposure to a patient's body fluids

Answer 57

barrier device

Question 58

The process of replacing nitrogen in the lungs with oxygen to maintain a normal oxygen saturation level during advanced airway management

Answer 58

denitrogenation

Question 59

A noninvasive method to quickly and efficiently provide information on a patient's ventilatory status, circulation, and metabolism; effectively measures the concentration of carbon dioxide in expired air over time

Answer 59

capnography

Question 60

The process of delivering oxygen to the blood by diffusion from the alveoli following inhalation into the lungs

Answer 60

oxygenation

Question 61

Abnormal breathing pattern characterized by slow, gasping breaths, sometimes seen in patients in cardiac arrest

Answer 61

agonal gasps

Question 62

A system established for portable cylinders to ensure that a regulator is not connected to a cylinder containing the wrong type of gas

Answer 62

pin-indexing system

Question 63

Large, semi-rigid suction tips recommended for suctioning the pharynx

Answer 63

tonsil tips

Question 64

Point at which the trachea bifurcates (divides) into the left and right main stem bronchi

Answer 64

carina

Question 65

Open, clear of obstruction

Answer 65

patent

Question 66

The amount of carbon dioxide present at the end of an exhaled breath

Answer 66

end-tidal CO2

Question 67

Metabolism that takes place in the absence of oxygen; the main by-product is lactic acid

Answer 67

anaerobic metabolism

Question 68

A collection of blood in the pleural cavity

Answer 68

hemothorax

Question 69

A combination of two movements to open the airway by tilting the forehead back and lifting the chin; not used for trauma patients

Answer 69

head tilt-chin lift maneuver

Question 70

A safety system for large oxygen cylinders, designed to prevent the accidental attachment of a regulator to a cylinder containing the wrong type of gas

Answer 70

American Standard Safety System

Question 71

A high-pitched, whistling breath sound that is most prominent on expiration, and which suggests an obstruction or narrowing of the lower airways; occurs in asthma and bronchiolitis

Answer 71

wheezing

Question 72

A device with a one-way valve and a face mask attached to a ventilation bag; when attached to a reservior and connected to oxygen, it delivers more than 90% supplemental oxygen

Answer 72

bag-mask device

Question 73

In the context of the airway, the introduction of vomitus or other foreign material into the lungs

Answer 73

aspiration

Question 74

The active, muscular part of breathing that draws air into the airway and lungs; a medication delivery route

Answer 74

inhalation

Question 75

A side-lying position used to maintain a clear airway in unresponsive patients who are breathing adequately and do not have suspected injuries to the spine, hips, or pelvis

Answer 75

recovery position

Question 76

Thin membrane that lines the chest cavity

Answer 76

parietal pleura

Question 77

Monitor the levels of oxygen, carbon dioxide, and pH of the cerebrospinal fluid and then provide feedback to the respiratory centers to modify the rate and depth of breathing based on the body's needs at any given time.

Answer 77

chemoreceptors

Question 78

The exchange of gases between the blood cells and the tissues

Answer 78

internal respiration

Question 79

Space within the chest that contains the heart, major blood vessels, vagus nerve, trachea, major bronchi, and esophagus; located between the two lungs

Answer 79

mediastinum

Question 80

A complex structure formed by many independent cartilaginous structures that all work together; where the upper airway ends and the lower airway begins; also called the voice box

Answer 80

larynx

Question 81

An accumulation of air or gas in the pleural cavity that progressively increases pressure in the chest and that interferes with cardiac function, with potentially fatal results

Answer 81

tension pneumothorax

Question 82

Visualization of the airway with a laryngoscope

Answer 82

direct laryngoscopy

Question 83

Airway adjunct inserted into the mouth of an unresponsive patient to keep the tongue from blocking the upper airway and to facilitate suctioning the airway, if necesary

Answer 83

oropharyngeal airway

Question 84

A combination mask and reservior bag system that is the preferred way to give oxygen in the prehospital setting; delivers up to 90% inspired oxygen and prevents inhaling the exhaled gases (carbon dioxide)

Answer 84

nonrebreathing mask

Question 85

Movement of a gas from an area of higher concentration to an area of lower concentration

Answer 85

diffusion

Question 86

The exchange of gases between the lungs and the blood cells in the pulmonary capillaries; also called pulmonary respiration

Answer 86

external respiration

Question 87

Occurs when a foreign body partially obstructs the patient's airway. The patient is able to move adequate amounts of air, but also experiences some degree of respiratory distress

Answer 87

mild airway obstruction

Question 88

Improper placement of an advanced airway device into the esophagus rather than into the trachea

Answer 88

esophageal intubation

Question 89

Occurs when a foreign body completely obstructs the patient's airway. The patient cannot breathe, talk, or cough

Answer 89

severe airway obstruction