Unit 12- Airway Flashcards
(93 cards)
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
2
Q
what is pulmonary ventilation
A
exchange of air between lungs and environment
air in and out of lungs
3
Q
what do nasal turbinates do
A
three bony shelves that increase surface area of nasal muscosa, improve filtration, warming, humidification
4
Q
jaw , tongue , epiglottis and thyroid bone attach to
A
hyoid bone
5
Q
what are adenoids
A
lymph tissue at posterior naso wall, filter bacteria and virus
6
Q
major structure of layrnx
A
thyroid cartilage
7
Q
lateral borders of glottis are
A
vocal cords
8
Q
narrowest part of trachea
A
glottic opening
9
Q
trachea divides at ____ to form two ____
A
carina, bronchi
10
Q
external boundaries of lower airway
A
4th cervical vertebrae and xiphoid process
11
Q
how long is trachea
A
10-12 cm
12
Q
what surface substance is found to “lubricate”
A
surfactant
13
Q
area between lungs called
A
mediastinum
14
Q
what does the phrenic nerve do for respiration
A
stimulates diaphragm contraction
15
Q
what is oxygenation
A
process of loading oxygen molecules onto hemoglobin in the blood
16
Q
what is respiration
A
actual exchange of oxygen and CO2 in the alveoli and tissues of body
17
Q
what is tidal volume
dead space
A
measure of depth of breathing
portion that does not reach alveoli to exchange
18
Q
children under 8, narrowest part of airway is
A
cricoid ring
19
Q
partial pressure
A
is amount of gas in air or dissolved in fluid , like blood
20
Q
average tidal volume
average dead space
A
500 ml
150 ml
21
Q
what is vital capacity
A
amount of air that can be forceably expelled from lungs after taking the deepest breath in
22
Q
what is residual volume and how much is usually left
A
amount left after max expiration, 1200 mL
23
Q
another word for cellular respiration
A
metabolism
24
Q
in presence of oxygen , cellular ____ change glucose to energy , this process if known as ___
A
mitchondria, aerobic metabolism
25
what takes over when O2 is missing in cell-
| by which process ,
anaerobic metabolism
| glycosis, less ATP and creates lactic acid
26
the ___ is the primary involuntary respiratory center. It connects to respiratory muscles via the ___
medulla, vagus nerve
27
what do chemoreceptors do
monitor pH of CSF and measure amount of CO2 in blood
28
factors affecting ventilation
airway obstruction
trauma, head / spinal cord or other trauma
CNS depressants
medical condition
29
factors affecting respiration
inadequate 02 in environment
| reduced surface of gas exchange
30
when blood bypasses alveoli and doesnt get oxygenated and returns to heart, this is called
intrapulmonary shunting
31
what two systems maintain homeostasis with pH
respiratory and renal
32
what is a buffer
compound that repeatedly neutralizes excess acids or bases
33
three main components of buffer system
circulating bicarbonate
respiratory
renal
34
fluctuations in pH could lead to which two systems going either direction
respiratory - acidosis/alkalosis
| metabolic- acidosis / alkalosis
35
symptoms of respiratory acidosis ( hypo-ventilation )
```
systematic vasoconstriction
headache
red, flushed skin
CNS drepression
bradypnea
N/V
hypercalcemia
```
36
symptoms of respiratory alkalosis ( hyper-ventilation )
```
decreased cerebral confusion
light headedness
confusion, vertigo
tingling lips/face
hand spasms
hypocalcemia
chest tightness
```
37
possible causes of metabolic acidosis
any acidosis not respiratory is metabolic
lactic acidosis, ketoacidosis, aspririn , alochol, GI lose
38
symptoms of metabolic acidosis
```
systematic vasoconstriction
headache
red, flushed skin
CNS drepression
tachypnea
N/V
hypercalcemia
dysarhythmia
```
39
possible causes of metabolic alkolosis
excessive water intake, excessive antacid intake
| excessive urination , excessive vomit
40
symptoms of metabolic alkolosis
confusion , tremors , hand cramps , bradypnea , hypotension
41
cheyne-stokes breathing, where do we see this
irregular pattern, increasing rate and depth followed by period of apnea
ICP , stroke
42
what are ataxic respirations
irregular , ineffective respirations, may not may not have pattern
43
kussmaul breathing, and where do we see this
deep, gasping respirations
metabolic acidosis
44
agonal gasps
not breathing
45
time limits for suction (3)
adult-15
child- 10
infant -5
46
three common types of air tank sizes and their constants
D- 350 L 0.16
E-650 L 0.28
M- 3000L 1.56
47
what does the pin index system do
make sure you dont hook wrong equipment to the wrong type of cylinder
48
oxygen does not burn or explode but does
support combustion
49
flow rate and oxygen delivered
| NC, Simple Mask, Partial NRB, NRB, BVM, Mouth to Mouth
```
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
main advantage to venturi mask
fine adjustments , long time use
51
when would we likely see the use of oxygen humidifiers
long term, prolonged transport , conditions like croup, epiglottis , broncholitis
52
how much air does a bvm typically hold
1200-1600 mL
53
what is lung compliance
ability of alveoli to expand when air is drawn in during inhalation
54
CPAP may be used for -2
acute pulmonary edema and obstructive pulmonary disease
55
type of multiumen airways
combitube
56
what do multilumen airways have and allow you to do
two tubes, can go into trachea or espohagus
| ventilate correct tube!
57
indication of multilumen airway
contra
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
two pressures of multilumen airway
100 mL and 15 mL
59
what is a king LT airway
what determines size
blind insert, 2 inflatable cuffs inserted into esophagus
size and weight of pt
60
some contraindications of king LT
does not protect against aspiration or vomit
over 4' tall pt
ingested caustic substance
esophagus disease
61
what is a laryngeal mask airway ( LMA )
risks
contraindicated
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
If the amount of alveoli pulmonary surfactant is decreased:
alveolar surface tension will increase.
63
Continuous positive airway pressure (CPAP) is indicated for patients with:
pulmonary edema.
64
Cellular function deteriorates and death occurs when the pH:
drops below 6.9 or rises above 7.8.
65
The anterior portion of the cricoid ring is separated from the thyroid cartilage by the:
cricothyroid membrane.
66
Slow, shallow, irregular respirations or occasional gasps are MOST indicative of:
cerebral anoxia.
67
Intrapulmonary shunting occurs when:
nonfunctional alveoli inhibit the diffusion of oxygen and carbon dioxide.
68
What are the pyriform fossae?
Hollow pockets along the lateral borders of the larynx
69
Tidal volume minus dead space volume is called:
alveolar ventilation.
70
The pyramid-like cartilaginous structure that forms the posterior attachment of the vocal cords is called the:
arytenoid cartilage.
71
What structure is located in the posterior aspect of the nasal cavity?
Nasopharynx
72
Patients receive the MOST benefit from continuous positive airway pressure (CPAP):
during the exhalation phase.
73
The narrowest portion of the adult's trachea is the:
glottic opening
74
when you have a advanced extraglottic airway in, what should you ventilate at , 2 condtions
6 a min OR
| till adequate end tital C02
75
when someone has ICP, what do you want the end tital c02 to be between
30-35 mmHg
76
what is the calculation to get adequate tidal volume for a pt
5 ml/kg
77
name of best 2 hand 2 person BVM mask hold
TE
| thenar eminence
78
acronym for issues with extraglottic or advanced airway adjunct
D-displaced
O-Obstruction
P- poor compliance ( difficult to ventilate)
E- equipment
79
acronym for issues with BVM mask seal
```
M- mask seal
O- obesity/ obstruction
A- age 55+
N- no teeth
S- stiff lungs
```
80
2 contraindicators of extraglottic airway
lower airway obstruction, gag reflex
81
what is the name of the maneuver for putting pressure on cricoid ring
sellicks
82
difference between capnography and capnometry
graph vs number
83
healthy gradient between P02 and ETC02
2-5 mmHg
84
what is the collape or reduction of lung / alveoli
atelectasis
85
acronym for difficulty with entry of airway adjunct
R- restricted mouth
O- obstruction below
D- disruption
S- stiff
86
ligament that attaches hyoid bone to epiglottis
hypoepiglottic ligament
87
what is the name of process to evaluate and look at uvula to assessment mouth entry
melanpatti
88
what are the two sizes of combi tubes
adult male and female
89
how do we size LMA ( laryngeal mask airway)
and 3 main sizes and air prssure
how far down do we put LMA
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
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
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
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
listen bilateral bases and bilateral apices for air movement in lungs not stomach
back out the king and re-auscultate
92
Cheyne stokes breathing is what and can be seen when
Biot pattern
increase and decrease breathing pattern with period of apnea
ICP
rapid gasping followed by apnea
93
kassmual breathing
Diabetic Ketoacidosis
deep gasping respirations
