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Airway Mngt & Resp.
Caroline Ch 13 PCP310
| Term | Definition |
|---|---|
| abdominal thrust manoeuvre | Abdominal thrusts performed to relieve a foreign body airway obstruction; also called the Heimlich manoeuvre. |
| accessory muscles | Muscles not normally used during normal breathing; include the sternocleidomastoid muscles of the neck. |
| acetylcholine (ACh) | Chemical neurotransmitter of the parasympathetic nervous system. |
| adenoids Lymphatic | Lymphatic tissues located on the posterior nasopharyngeal wall that filter bacteria. |
| adventitious | Abnormal. |
| agonal respirations | Slow, shallow, irregular respirations or occasional gasping breaths; results from cerebral anoxia. |
| alveolar volume | Volume of inhaled air that reaches the alveoli and participates in gas exchange; equal to tidal volume minus dead space volume and is approximately 350 mL in the average adult. |
| alveoli | Balloon like clusters of single-layer air sacs that are the functional site for the exchange of oxygen and carbon dioxide in the lungs. |
| anatomic dead space | Includes the trachea and larger bronchi. The air remaining in these areas is the result of residual gas in the upper airway at the end of inhalation. |
| anoxia | An absence of oxygen. |
| antegrade amnesia | The inability to create new memories. |
| aphonia | Inability to speak. |
| apneustic centre | Portion of the brainstem that influences the respiratory rate by increasing the number of inspirations per minute. |
| apneustic respirations | Prolonged gasping inspirations followed by extremely short, ineffective expirations; associated with brainstem insult. |
| arytenoid cartilages | Pyramid-like cartilaginous structures that form the posterior attachment of the vocal cords. |
| aspiration | Entry of fluids or solids into the trachea, bronchi, and lungs. |
| asymmetric chest wall movement | When one side of the chest moves less than the other; indicates decreased airflow into one lung. |
| atelectasis | Collapsing of the alveoli. |
| atlanto-occipital joint | Joint formed at the articulation of the atlas of the vertebral column and the occipital bone of the skull. |
| bag-mask device | Manual ventilation device that consists of a bag, mask, reservoir, and oxygen inlet; capable of delivering up to 100% oxygen; removal of the mask for bag ventilation is used when attached directly to a tracheal tube. |
| barotrauma | Trauma resulting from excessive pressure. |
| benzodiazepines | Sedative-hypnotic drugs that provide relaxation and mild sedation; includes drugs such as midazolam (Versed) and diazepam (Valium). |
| bimanual laryngoscopy | An effective technique to improve laryngoscopic view of the vocal cords by external manipulation of the larynx. |
| Biot respirations | Irregular pattern, rate, and depth with intermittent periods of apnea; results from increased intracranial pressure. |
| bougie | Also called the Eschmann stylet; a flexible device that is inserted in between the glottis under direct laryngoscopy. The tracheal tube is then threaded over the device, facilitating its entry into the trachea. |
| Bourdon-gauge flowmeter | An oxygen flowmeter that is commonly used because it is not affected by gravity and can be placed in any position. |
| bronchioles | Subdivision of the smaller bronchi in the lungs; made of smooth muscle and dilate or constrict in response to various stimuli. |
| BURP manoeuvre | Acronym as it relates to laryngoscopy for Backward, Upward, Rightward Pressure. |
| capnographer | Device that attaches in between the tracheal tube and bag-mask device; contains colourimetric paper, which should turn yellow during exhalation, indicating proper tube placement. |
| capnometer | Device that attaches in the same way as a capnographer, but provides a light-emitting diode (LED) readout of the patient’s exhaled carbon dioxide. |
| carbon monoxide (CO) oximeter | A device that measures absorption at several wavelengths to distinguish oxyhemoglobin from carboxyhemoglobin. |
| carboxyhemoglobin (COHb) | Abnormal hemoglobin that is formed by the attachment of carbon monoxide to the hemoglobin molecule. |
| carina | Point at which the trachea bifurcates (divides) into the left and right mainstem bronchi. |
| cerebrospinal otorrhea | Cerebrospinal fluid (CSF) drainage from the ears. |
| cerebrospinal rhinorrhea | Cerebrospinal fluid (CSF) drainage from the nose. |
| chemoreceptors | Monitor the levels of O2 and co2 in the blood, and the pH of the cerebrospinal fluid, and then provide feedback to the respiratory centres to modify the rate and depth of breathing based on the body’s needs at any given time. |
| Cheyne-Stokes respirations | Gradually increasing rate and depth followed by a gradual decrease with intermittent periods of apnea; associated with brainstem insult. |
| colourimetric carbon dioxide detector | A device that attaches between the tracheal tube and ventilation device; uses special paper that should turn from purple to yellow during exhalation, indicating the presence of exhaled carbon dioxide. |
| Combitube Multilumen | Multilumen airway device that consists of a single tube with two lumens, two balloons, and two ventilation ports; an alternative device if tracheal intubation is not possible or has failed. |
| continuous positive airway pressure (CPAP) | A form of noninvasive ventilation in which the patient exhales against positive pressure via a tight-fitting face mask; used to treat patients with cardiogenic pulmonary edema. |
| Cormack-Lehane classification | A system used to predict intubation difficulty based on the airway structures observed during laryngoscopy. |
| cricoid cartilage | Forms the lowest portion of the larynx; also referred to as the cricoid ring; the first ring of the trachea and is the only upper airway structure that forms a complete ring. |
| cricoid pressure | The application of posterior pressure to the cricoid cartilage to reduce the risk of gastric distention and regurgitation during positive pressure ventilation; also called the Sellick manoeuvre. |
| cricothyroid membrane | A thin, superficial membrane located between the thyroid and cricoid cartilages that is relatively avascular and contains few nerves; the site for emergency surgical and nonsurgical access to the airway. |
| curved laryngoscope blade | Also called the Macintosh blade; designed to fit into the vallecula, indirectly lifting the epiglottis and exposing the vocal cords. |
| cyanosis | Blue or purple skin; indicates inadequate oxygen in the blood. |
| dead space | Any portion of the airway that does not contain air and cannot participate in gas exchange. |
| depolarizing neuromuscular blocking agents | Competitively bind with the acetylcholine receptor sites but are not affected as quickly by acetylcholinesterase; includes drugs such as succinylcholine. |
| diaphragm | The major muscle of breathing. It is the anatomic point of separation between the thoracic cavity and the abdominal cavity. |
| diffusion | Movement of a gas from an area of higher concentration to an area of lower concentration. |
| digital intubation | Method of intubation that involves directly palpating the glottic structures and elevating the epiglottis with the middle finger while guiding the tracheal tube into the trachea by feel. |
| direct laryngoscopy | Visualization of the airway with a laryngoscope. |
| dysphonia | Difficulty speaking. |
| dyspnea | Any difficulty in respiratory rate, regularity, or effort. |
| end-tidal carbon dioxide (etco2) detectors | Devices that detect the presence of carbon dioxide in exhaled air. |
| epiglottis | Leaf-shaped, cartilaginous structure that closes over the trachea during swallowing. |
| esophageal detector device | Bulb or syringe that is attached to the proximal end of the tracheal tube; a device used to confirm proper tracheal tube placement. |
| etomidate | A nonnarcotic, non-barbiturate hypnotic-sedative drug; also called Amidate. |
| exhalation | Passive movement of air out of the lungs; also called expiration. |
| expiration | Passive movement of air out of the lungs; also called exhalation. |
| expiratory reserve volume | The amount of air that you can exhale following a normal exhalation; average volume is approximately 1,200 mL. |
| external respiration | The exchange of gases between the lungs and the blood cells in the pulmonary capillaries; also called pulmonary respiration. |
| extubation | The process of removing the tube from an intubated patient. |
| fasciculations | Characterized by brief, uncoordinated twitching of small muscle groups in the face, neck, trunk, and extremities; caused by the administration of depolarizing neuromuscular blocking agents (eg, succinylcholine). |
| fraction of inspired oxygen (Fio2) | The percentage of oxygen in inhaled air. |
| functional residual capacity | The amount of air that can be forced from the lungs in a single exhalation. |
| gag reflex | Automatic reaction when something touches an area deep in the oral cavity; helps protect the lower airway from aspiration. |
| gastric distention | Inflation of the patient’s stomach with air. |
| gastric tube | A tube that is inserted into the stomach to remove its contents. |
| glottis | The space in between the vocal cords that is the narrowest portion of the adult’s airway; also called the glottic opening. |
| head tilt–chin lift manoeuvre | Manual airway manoeuvre that involves tilting the head back while lifting up on the chin; used to open the airway of an unresponsive nontrauma patient. |
| hemoglobin | An iron-containing protein within red blood cells that has the ability to combine with oxygen. |
| Hering-Breuer reflex | A protective mechanism that terminates inhalation, thus preventing overexpansion of the lungs. |
| hilum | Point of entry of all of the blood vessels and the bronchi into each lung. |
| Hi-Ox mask | A mask that allows the patient to inhale oxygen from a reservoir bag via a one-way valve and exhale breath through another one-way valve through a high-efficiency filter before exiting the mask. |
| hyoid bone | A small, horseshoe-shaped bone to which the jaw, tongue, epiglottis, and thyroid cartilage attach. |
| hypercapnia | Increased co2 content in arterial blood. |
| hyperventilation | Occurs when co2 elimination exceeds co2 production. |
| hypocapnia | Decreased carbon dioxide content inarterial blood. |
| hypoventilation | Occurs when carbon dioxide production exceeds the body’s ability to eliminate it by ventilation. |
| hypoxemia | A decrease in arterial oxygen levels. |
| hypoxia | A lack of oxygen to the body’s cells andtissues. |
| hypoxic drive | Secondary control of breathing that stimulates breathing based on decreased Pao2 levels. |
| I-gel | A supraglottic airway device that uses a non-inflatable, gel-like mask to isolate the larynx and facilitate ventilation. |
| inspiration | The active process of moving air into the lungs; also called inhalation. |
| inspiratory reserve volume | The amount of air that can be inhaled after a normal inhalation; the amount of air that can be inhaled in addition to the normal tidal volume. |
| intercostal nerves | Nerves that innervate the external intercostal muscles, the muscles between the ribs. |
| internal respiration | The exchange of gases between the blood cells and the tissues; also called cellular respiration. |
| intrapulmonary shunting | Bypassing of oxygen-poor blood past nonfunctional alveoli. |
| jaw-thrust manoeuvre | Manual airway manoeuvre that involves stabilizing the patient’s head and thrusting the jaw forward; the preferred method of opening the airway of an unresponsive trauma patient. |
| jaw-thrust manoeuvre with head tilt | Manual airway manoeuvre that involves thrusting the jaw forward while tilting back on the head. |
| ketamine | A drug with sedative, analgesic, and hypnotic properties; created in the laboratory from phencyclidine (PCP). |
| King LT airway | A single-lumen airway device that is blindly inserted into the esophagus; when properly placed in the esophagus, one cuff seals the esophagus, and the other seals the oropharynx. |
| Kussmaul respirations | Deep, gasping respirations; common in ketoacidosis (diabetic coma). |
| laryngeal mask airway (LMA) | Device that surrounds the opening of the larynx with an inflatable silicone cuff positioned in the hypopharynx; an alternative device to bag-mask ventilation. |
| laryngectomy | A surgical procedure in which the larynx is removed. |
| laryngoscope | Device that is used in conjunction with a laryngoscope blade in order to perform direct laryngoscopy. |
| laryngospasm | Spasmodic closure of the vocal cords. |
| larynx | A complex structure formed by many independent cartilaginous structures that all work together; where the upper airway ends and the lower airway begins. |
| lung compliance | The ability of the alveoli to expand when air is drawn into the lungs, either during negative pressure ventilation or positive pressure ventilation. |
| Magill forceps | A special type of forceps that is curved, thus allowing the paramedic to manoeuvre it in the airway. |
| methemoglobin (metHb) | A compound formed by oxidation of the iron on hemoglobin. |
| minute alveolar volume | The amount of air that actually reaches the alveoli per minute and participates in gas exchange. |
| minute volume | The amount of air that moves in and out of the respiratory tract per minute. |
| multilumen airway | Airway device with a single long tube that can be used for esophageal obturation or endotracheal tube ventilation, depending on where the device comes to rest following blind positioning. |
| Murphy eye | An opening on the side of a tracheal tube at its distal tip that enables ventilation to occur even if the tip becomes occluded by blood, mucus, or the tracheal wall. |
| narcotic | From the Greek word for stupor, referring to an agent that dulls the senses and relieves pain. More commonly, it refers to both opium-derived drugs (morphine, codeine) and the related synthetic agents (fentanyl, alfentanil). |
| nasal cannula | A device for delivering oxygen by was of two small tubes that are inserted into the nares. |
| nasal septum | A rigid partition composed of bone and cartilage; divides the nasopharynx into two passages. |
| nasogastric (NG) tube | Gastric tube is inserted into the stomach through the nose. |
| nasopharyngeal (nasal) airway | A soft rubber tube approximately 15 cm long that is inserted through the nose into the posterior pharynx behind the tongue, thereby allowing passage of air from the nose to the lower airway. |
| nasopharynx | The nasal cavity; formed by the union of the facial bones. |
| nasotracheal intubation | Insertion of a tracheal tube into the trachea through the nose. |
| nebulizer | Device used primarily to deliver aerosolized medications. Oxygen enters an aerosol chamber that contains 3 to 5 mL of fluid. The pressurized oxygen in this chamber aerosolizes the medication for inhalation. |
| needle cricothyrotomy Insertion | Insertion of a 14- to 16-gauge over-the-needle IV catheter (angiocath) through the cricothyroid membrane and into the trachea. |
| negative pressure ventilation | Drawing of air into the lungs; airflow from a region of higher pressure (outside the body) to a region of lower pressure (the lungs); occurs during normal (unassisted) breathing. |
| nondepolarizing neuromuscular blocking agents | Binds to acetylcholine receptor sites; however, unlike depolarizing neuromuscular blocking agents, they do not cause depolarization of the muscle fibre; includes drugs such as vecuronium (Norcuron) and pancuronium (Pavulon). |
| nonrebreathing mask | A combination mask and reservoir bag system. Oxygen fills a reservoir bag that is attached to the mask by a one-way valve. This permits the patient to inhale from the reservoir bag but not to exhale back into it. |
| open cricothyrotomy | Also referred to as a surgical cricothyrotomy; an emergent procedure that involves incising the cricothyroid membrane with a scalpel and inserting a tracheal or tracheostomy tube directly into the subglottic area of the trachea. |
| opiates | Potent analgesics that are naturally derived from the opium poppy plant; have sedative properties. Examples include morphine and codeine. |
| opioids | Synthetically derived potent analgesics with sedative properties. Examples include fentanyl (Sublimaze) and alfentanil (Alfenta). |
| orogastric (OG) tube | Gastric tube inserted into the stomach through the mouth. |
| oropharyngeal (oral) airway | A hard plastic device that is curved in such a way that it fits over the back of the tongue, with the tip in the posterior pharynx. |
| oropharynx | Forms the posterior portion of the oral cavity, which is bordered superiorly by the hard and soft palates, laterally by the cheeks, and inferiorly by the tongue. |
| orotracheal intubation | Insertion of a tracheal tube into the trachea through the mouth. |
| orthopnea | Positional dyspnea. |
| oxygen humidifier | Small bottle of water through which the oxygen leaving the cylinder is moisturized before it reaches the patient. |
| oxyhemoglobin (HbO2) | Hemoglobin that is occupied by oxygen. |
| palate | Forms the roof of the mouth and separates the oropharynx and nasopharynx. |
| pancuronium | A non-depolarizing neuromuscular blocking agent; used to maintain paralysis following succinylcholine-facilitated intubation; also called Pavulon. |
| paralytic agents | Also called neuromuscular blocking agents; paralyze skeletal muscles; used in an emergency situation to facilitate intubation. |
| parietal pleura | Thin membrane that lines the chest cavity. |
| partial laryngectomy | Surgical removal of a portion of the larynx. |
| patent | Open. |
| peak expiratory flow | An approximation of the extent of bronchoconstriction; used to determine whether patients are improving with therapy (eg, inhaled bronchodilators). |
| pharynx | Throat. |
| phrenic nerves | Nerves that innervate the diaphragm. |
| physiologic dead space | Additional dead space created by intrapulmonary obstructions or atelectasis. |
| piriform fossae | Two pockets of tissue on the lateral borders of the larynx. |
| pneumotaxic centre | Area of the brainstem that has an inhibitory influence on inspiration. |
| positive end expiratory pressure (PEEP) | Mechanical maintenance of pressure in the airway at the end of expiration to increase the volume of gas remaining in the lungs. |
| pressure-compensated flowmeter | An oxygen flowmeter that incorporates a float ball within a tapered calibrated tube. The float rises or falls according to the gas flow within the tube. Must remain in an upright position to obtain anaccurate flow reading. |
| primary respiratory | drive Normal stimulus to breathe; based on fluctuations in Paco2 and pH of the cerebrospinal fluid. |
| pulse oximeter | Device that measures the amount of saturated hemoglobin in the tissue capillaries non-invasively, by transmitting a beam of light through tissue to a receiver contained in a clip typically attached to the finger or earlobe. |
| pulsus paradoxus | A drop in the systolic blood pressure of 10 mm Hg or more; commonly seen in patients with pericardial tamponade or severe asthma. |
| rapid-sequence intubation (RSI) | A specific set of procedures, combined in rapid succession, to induce sedation and paralysis and intubate a patient quickly. |
| recovery position | Left-lateral recumbent position; used in all unresponsive nontrauma patients, who are able to maintain their own airway spontaneously and are breathing adequately. |
| reduced hemoglobin | The hemoglobin after the oxygen has been released to the cells. |
| reemergence phenomenon | The occurrence of dreams, nightmares, or delirium that can take place during the end of the half-life of ketamine. |
| residual volume | The air that remains in the lungs after maximal expiration. |
| respiration | The exchange of gases between a living organism and its environment. |
| retractions | Skin pulling in between and around the ribs during inhalation. |
| rocuronium | A nondepolarizing neuromuscularblocking agent; used to maintain paralysis following succinylcholine |
| safe residual pressure | A term that implies that it is unsafe to continue using an oxygen cylinder with a pressure of less than 200 psi. |
| sedation | Reduction of a patient’s anxiety, induction of amnesia, and suppression of the gag reflex. |
| simple face mask | A full mask enclosure with open side ports. Room air is drawn in through the side ports on inhalation, diluting the concentration of inspired oxygen. Exhaled air is vented through holes on each side of the mask. |
| sinuses | Cavities formed by the cranial bones that trap contaminants from entering the respiratory tract and act as tributaries for fluid to and from the eustachian tubes and tear ducts. |
| stenosis | Narrowing. |
| stoma | The resultant orifice of a tracheostomy that connects the trachea to the outside air; located in the midline of the anterior neck. |
| straight laryngoscope blade | Also called the Miller blade; designed to lift the epiglottis and expose the vocal cords. |
| stylet | A semirigid wire that is inserted into the tracheal tube to mould and maintain the shape of the tube. |
| succinylcholine chloride | A depolarizing neuromuscular blocking agent frequently used as the initial paralytic during rapid |
| surfactant | A proteinaceous substance that lines the alveoli; decreases alveolar surface tension and keeps the alveoli expanded. |
| therapy regulator | Attaches to the stem of the oxygen cylinder, and reduces the high pressure of gas to a safe range (approximately 50 psi). |
| thyroid cartilage | The main supporting cartilage of the larynx; 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. |
| tidal volume | A measure of the depth of breathing; the volume of air that is inhaled or exhaled during a single respiratory cycle. |
| tongue-jaw lift manoeuvre | A manual manoeuvre that involves grasping the tongue and jaw and lifting; commonly used to suction the airway and to place certain airway devices. |
| tonsils | Lymphatic tissues that are located in the posterior pharynx; they help to trap bacteria. |
| tonsil-tip catheter | A hard or rigid suction catheter; also called a Yankauer catheter. |
| total laryngectomy | Surgical removal of the entire larynx. |
| total lung capacity | The total volume of air that the lungs can hold; approximately 6 L in the average adult man. |
| trachea | The conduit for all entry into the lungs; a tubular structure that is approximately 10 to 12 cm in length and is composed of a series of C -shaped cartilaginous rings; also called the windpipe. |
| tracheal intubation | Passing a tracheal tube through the glottic opening and sealing the tube with a cuff inflated against the tracheal wall. |
| tracheal tube | Tube that is inserted into the trachea; equipped with a distal cuff, proximal inflation port, a 15/22-mm adapter, and centimetre markings on the side. |
| tracheobronchial occipital joint | Passing a suction catheter into the tracheal tube to remove pulmonary secretions. |
| tracheostomy | Surgical opening into the trachea. |
| tracheostomy tube | Plastic tube placed within the tracheostomy site (stoma). |
| transillumination intubation | Method of intubation that uses a lighted stylet to guide the tracheal tube into the trachea. |
| translaryngeal catheter ventilation | Used in conjunction with needle cricothyrotomy to ventilate a patient; requires a high -pressure jet ventilator. |
| trismus | Clenched teeth caused by spasms of the jaw muscles. |
| turbinates | Three bony shelves that protrude from the lateral walls of the nasal cavity and extend into the nasal passageway, parallel to the nasal floor; serve to increase the surface area of the nasal mucosa. |
| upper airway | Consists of all anatomic airway structures above the level of the vocal cords. |
| uvula | Tissue structure that resembles a punching bag; located in the posterior aspect of the oral cavity, originating from the soft palate and hanging just above the base of the tongue. |
| vallecula | An anatomic space, or pocket, located between the base of the tongue and the epiglottis; an important anatomic landmark for tracheal intubation |
| vecuronium | A nondepolarizing neuromuscular block ing agent; used to maintain paralysis following succinylcholine-facilitated intubation; also called Norcuron. |
| ventilation | The process of moving air into and out of the lungs. |
| Venturi mask | A mask that has a number of interchangeable adapters that draws room air into the mask along with the oxygen flow; allows for the administration of highly specific oxygen concentrations. |
| visceral pleura | Thin membrane that lines the lungs. |
| vocal cords | White bands of tough tissue that are the lateral borders of the glottis. |
| waveform capnography | A waveform display of exhaled carbon dioxide shown on a portable cardiac monitor/defibrillator. |
| whistle-tip catheters | Soft plastic, nonrigid catheters; also called French catheters. |
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