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EMT Module #2
| Question | Answer |
|---|---|
| The trachea divides into the right and left mainstem bronchi at the ___________. | Carina |
| Normal tidal volume for an adult is? | 500mL (5-7mL/kg) |
| Approximately how much air is filtered, warmed and humidified by the adult respiratory system each day? | 10,000 liters |
| What are Cilia? | Cilia are fine, fingerlike projections that have the ability to contract in a single direction. |
| The trachea is approximately ____ cm in length and is composed of a series of C-shaped cartilaginous rings. | 11 |
| Approximately how many alveoli are contained in the adult lungs? | 300 million |
| The alveoli are moistened and kept open because of the presence of an important chemical called __________. | Surfactant |
| The right lung contains ___ major divisions or lobes and the left lung has ___. | The right lung has 3 and the left has 2 |
| What are the three important processes that allow gas exchange to occur? | Ventilation, Diffusion and Perfusion |
| What is Ventilation? | Ventilation is the mechanical process of moving air in and out of the lungs. |
| What is the Diaphragm? | The Diaphragm is a big dome-shaped muscle that separates the thorax and the abdomen. Nerve impulses from the phrenic nerve stimulates the diaphragm to contract. |
| How do we breathe? | During inspiration, the diaphragm contracts & flattens, the intercostal muscles contract producing an expansion in the chest cavity. These 2 actions cause an expansion in the chest volume, which produces a decrease of 1-2 mmHg below atmospheric pressure |
| What is the Total Lung Capacity of the adult? | Approx. 6,000 mL. (6 liters) |
| The respiratory membrane, which normally measures ___ to ___ in thickness, must remain intact for gas exchange to occur. | 0.5 - 1.0 micrometer |
| What is the most important determinant of the ventilatory rate? | Arterial PCO2 |
| What are Kussmaul's Respirations? | Kussmaul's Respirations are deep, rapid breaths that result as a corrective measure against conditions such as diabetic ketoacidosis that produce metabolic acidosis |
| What are Cheyne-Stokes Respirations? | These respirations have a pattern with progressively increasing tidal volume, followed by a declining volume, separated by periods of apnea at the end of expiration. This pattern is typically seen in older patients with terminal illness or brain injury |
| What is Central Neurogenic Hyperventilation? | Central neurogenic hyperventilation also produces deep, rapid respirations that are caused by strokes or injury to the brainstem. In this case, there is loss of normal regulation of ventilatory controls and respiratory alkalosis is often seen |
| What are Ataxic (Biot's) Respirations? | Ataxic (Biot's) Respirations are characterized by repeated episodes of gasping ventilations separated by periods of apnea. This pattern is seen in patients with an increase in ICP |
| What are Apneustic Respiration? | Apneustic Respirations are characterized by long, deep breaths that are stopped during the inspiratory phase and separated by periods of apnea. This pattern is usually a result of a stroke or severe CNS disease |
| What is paroxysmal nocturnal dyspnea (PND)? | It is a sudden episode of difficult breathing that occurs after lying down; most commonly caused by left-heart failure |
| What is orthopnea? | Difficulty breathing while lying supine |
| What is hemoptysis? | Coughing up of blood |
| What is tachypnea? | Tachypnea describes a respiratory pattern with a rate that exceeds 20 breaths per minute |
| What is bradypnea? | Bradypnea describes a respiratory pattern with a rate slower than 12 breaths per minute |
| Excess oxygen can result in the formation of toxic chemicals called ___________. | Free radicals |
| What does PEEP stand for? | Positive End-Expiratory Pressure |
| ____________ risk factors are those that are influenced by or are from within the patient. | Intrinsic |
| The ____________ airway extends from below the larynx to the alveoli. | Lower |
| The ____________ airway extends from the mouth and nose to the larynx. | Upper |
| _______________ is the exchange of gases between the alveoli and the red blood cells. | Pulmonary or external respiration |
| _______________ is the exchange of gases between the red blood cells and the various body tissues. | Cellular or internal respiration |
| Normal inspired air contains what percentage of oxygen? | 21% |
| What is the normal dead space volume for an average adult? | 150 mL |
| How can you calculate how long your oxygen will last using a "D" cylinder? | D Cylinder = psi x 0.16 / lpm |
| How can you calculate how long your oxygen will last using a "E" cylinder? | E Cylinder = psi x 0.28 / lpm |
| How can you calculate how long your oxygen will last using a "M" cylinder? | M Cylinder = psi x 1.56 / lpm |
| The average volume of gas inhaled or exhaled in one respiratory cycle is the: | Tidal volume |
| The ______________ is the most superior part of the airway. | Nasal cavity |
| The ______________ is the only bone in the axial skeleton that does not articulate with any other bone. | Hyoid |
| The _______________ is the amount of gas in the tidal volume that remains in the air passageways unavailable for gas exchange. | Dead-space volume |
| The _______________ comprise(s) the key functional unit of the respiratory system. | Alveoli |
| What drug is an antagonist for an opiate overdose? | Narcan |
| You arrive on scene with a patient in moderate to severe respiratory distress and you notice the patient is breathing with pursed lips. What does this finding tell you? | Pursed lip breathing is the patients attempt to auto PEEP. |
| What abnormal sound can usually be heard without a stethoscope and is found on the inhalation phase of the respiratory drive – it is also classified as an “extra-thoracic sound.” | Stridor |
| What accessory muscles can be utilized by the body in an effort to compensate for a severe respiratory problem? | Scalene and Sternocleidomastoid muscles (SCM’s) |
| Where on a hemoglobin molecule does oxygen bind to? | On one of the four heme sites. |
| _____________ is the mechanical process of moving air in and out of the lungs. | Ventilation |
| What are the three important processes that allow gas exchange to occur? | Ventilation, Diffusion and Perfusion |
| What structures make up the upper airway? | Nasal cavity, pharynx and the larynx. |
| What causes a patient to exhibit a pink like skin characteristic with emphysema? | Polycythemia (an excess of red blood cells resulting in an abnormally high hematocrit). |
| What is the maximum pressure setting that you would use with your CPAP device? | No more than 10 cm H20 pressure |
| What is phonation? | Phonation is speech – or sounds made by air passing through the vocal cords |
| On average, how long is the trachea in an adult patient? | 11 cm |
| How many main divisions or lobes are found in the left and right lungs? | Left 2, Right 3 |
| The most important determinant of the ventilation rate of a patient is the _________. | Arterial PCO2 |
| What is the “Hypoxic Drive?” | Hypoxic drive happens in patients with COPD – they will breathe off of the level of O2 detected in the arterial blood by receptors in the aortic arch. – Measured PO2 levels between 50 and 60 mmHg are not uncommon in these patients. |
| How many molecules of oxygen can a single hemoglobin carry? | 4 |
| What is the dividing point between the upper and lower airway of an adult? | The larynx |
| What type of cell in the alveoli is responsible for the production of surfactant? | Type II cells |
| What is considered to be the "SA Node" of the respiratory drive? | The Pre-Botzinger Complex |
| Which process of ventilation is always an active process? | Inhalation (inspiration) |
| If a patient is said to be breathing from a hypoxic drive, what triggers them to breathe? | Low levels of O2 |
| What are the three important processes that allow gas exchange to occur in the human body? | Ventilation, Diffusion, and Cardiac Perfusion |
| What color of skin might you see with a patient suffering from a severe carbon monoxide poisoning? | Cherry Red |
| A PE that blocks both the left and right main pulmonary artery is called a: | Saddle Clot |
| What is the goal in the management of a patient that is severely hyperventilating? | The goal is to increase the PCO2 in the body - The best way to accomplish this is to "coach" the patient to slow down their respiratory drive |
| What is Paroxysmal Nocturnal Dyspnea (PND)? | It is a sudden episode of difficult breathing that occurs after lying down; most commonly caused by left-heart failure. |
| _________________ risk factors are those that are influenced by or are from within the patient. | Intrinsic |
| What is the medical word for the Adam’s apple? | Thyroid cartilage |
| What are agonal respirations? | Gasping-type respirations that have no pattern and occur very infrequently |
| What is Alveolar volume? | The amount of inspired air that reaches the alveoli of the lungs |
| What are Alveoli? | The air sacs of the lungs |
| What is an Automatic Transport Ventilator (ATV) | It is a positive pressure ventilation device that delivers ventilations automatically |
| What is a Bag-Valve-Mask (BVM) device? | It is a positive pressure ventilation device that consists of a bag with a valve and a mask. The bag-valve device is connected to the mask or other airway. The bag is squeezed to deliver a ventilation to the patient. |
| What does bilaterally mean? | On both sides |
| Bradypnea is defined as a breathing rate that is? | A breathing rate that is slower than the normal rate |
| What are the bronchi? | They are the two main branches leading from the trachea to the lungs |
| What are the bronchioles? | They are smaller branches of the bronchi. They connect the bronchi to the alveoli. |
| What do chemoreceptors monitor in our body? | Receptors that constantly monitor the arterial content of oxygen, carbon dioxide, and the blood pH and stimulate a change in respiratory rate and depth. See also central chemoreceptors and peripheral chemoreceptors |
| What is Continuous Positive Airway Pressure (CPAP) | A form of noninvasive positive pressure ventilation. The CPAP device delivers a continuous flow of air under pressure |
| What is the cricoid cartilage? | It is the most inferior portion of the larynx and the only full cartilaginous ring of the upper airway. It is felt immediately below the thyroid cartilage |
| What is the crossed-fingers technique? | It is a technique in which the thumb and index finger are crossed with the thumb on the lower incisors and the index finger on the upper incisors. The fingers are moved in a snapping or scissor motion to open the mouth |
| What is crowing? | It is a sound similar to that of a cawing crow that indicates that the muscles around the larynx are in spasm and beginning to narrow the opening into the trachea |
| What is cyanosis? | It is a blue-gray color of the mucous membranes and/or skin, which indicates inadequate oxygenation or poor perfusion |
| What is dead space in your airway? | It is the anatomical areas in the respiratory tract (outside the alveoli) where air collects during inhalation but no gas exchange occurs |
| What does the term "deoxygenated" mean? | It means containing low amounts of oxygen, as with venous blood. |
| What is the diaphragm? | It is the major muscle of respiration that separates the chest cavity from the abdominal cavity. It is responsible for approximately two-thirds of our breathing. |
| What is the epiglottis? | It is a small, leaf-shaped flap of cartilaginous tissue, located immediately posterior to the root of the tongue, that covers the opening of the larynx to keep food and liquid from entering the trachea and lungs. |
| What is the esophagus? | It is the passageway at the lower end of the pharynx that leads to the stomach |
| What is exhalation? | It is the passive process of breathing air out of the lungs (aka expiration). This occurs when the diaphragm and chest muscles relax. |
| What is external respiration (pulmonary respiration)? | It is the gas exchange process that occurs between the alveoli and the pulmonary capillaries |
| What is a Flow-restricted, oxygen-powered ventilation device (FROPVD)? | It is a device that consists of a ventilation valve and trigger or button and is driven directly by oxygen. It is used to provide positive pressure ventilation. |
| What is a french suction catheter? | It is a flexible tubing that is part of a suctioning system. It is also known as a whistle tip or soft suction catheter. |
| What is gastric distention? | It is the inflation of the stomach. This can occur when someone ventilates a patient incorrectly by using too much force during ventilation or giving too many breaths per minute. |
| What is gurgling? | It is a gargling sound that indicates a fluid is in the mouth or pharynx. If a patient presents with this you must suction their airway clear! |
| What is a yankauer suction catheter? | It is a rigid plastic tube that is part of a suctioning system, commonly referred to as a tonsil tip or tonsil sucker. |
| What is the head-tilt, chin-lift maneuver? | It is the manual technique used to open the airway. The head is tilted back by one hand. The tips of the fingers of the other hand are placed under the chin and used to lift the mandible up and forward |
| What is hemoglobin? | It is a protein molecule found on the surface of the red blood cell that is responsible for carrying a majority of oxygen in the blood |
| What is a high-pressure regulator? | It is an oxygen regulator that is used to power the flow-restricted, oxygen-powered ventilation device. The flow rate cannot be adjusted. |
| What is hypoperfusion? | It is the insufficient delivery of oxygen and other nutrients to some of the body’s cells and inadequate elimination of carbon dioxide and other wastes that results from inadequate circulation of blood |
| What is hypoxemia? | It is low oxygen content in arterial blood |
| What is hypoxia? | It is reduced oxygen delivery to the tissues |
| What is inhalation? | It is the active process of breathing air into the lungs. During inhalation, the diaphragm contracts down and the chest wall muscles contract out. This always uses energy! |
| What are the intercostal muscles | They are the muscles between the ribs |
| What is internal respiration (cellular respiration) | It is the gas exchange process that occurs between the cells and the capillaries |
| What is the jaw-thrust maneuver? | It is a manual technique used to open the airway in the patient with a suspected spinal injury. The fingers are placed at the angles of the jaw and used to lift the mandible up and forward |
| What is a laryngectomy? | It is a surgical procedure in which a patient’s larynx is partially or completely removed. A stoma is created for the patient to breathe through. |
| What is the larynx? | It is the structure that houses the vocal cords and is located inferior to the pharynx and superior to the trachea |
| What is the lower airway? | It is the portion of the respiratory system that extends from the trachea to the alveoli of the lungs |
| What is minute volume or minute ventilation? | It is the amount of air moved in and out of the lungs in one minute. You can calculate this by the following formula: Minuted Volume = Tidal Volume X Ventilation Rate. |
| What are the mucous membrane? | They are a thin layer of tissue that lines various structures within the body |
| What is a nasal cannula? | An oxygen delivery device that consists of two prongs that are inserted into the nose of the patient. The oxygen concentration delivered is from 24–44%. It is the most common used O2 device. |
| What is a Nasopharyngeal Airway (NPA) | It is a curved, hollow rubber tube with a flange or flare at the top end and a bevel at the distal end that is inserted into the nose. It fits in the nasopharynx and extends into the pharynx providing a passage for air. |
| What is the nasopharynx? | It is the portion of the pharynx that extends from the nostrils to the soft palate |
| What is a Non-Rebreather Mask (NRB)? | It is an oxygen delivery device that consists of a reservoir and one-way valve. It can deliver up to 95% to 98% oxygen to the patient. |
| What is an Oropharyngeal Airway (OPA) | It is a semicircular hard plastic device that is inserted in the mouth and holds the tongue away from the back of the pharynx |
| What is the oropharynx? | It is the central portion of the pharynx lying between the soft palate and the epiglottis with the mouth as the opening |
| What is an oxygen humidifier? | It is a container that is filled with sterile water and connected to the oxygen regulator to add moisture to the dry oxygen prior to being delivered to the patient |
| What does the term "oxygenated" mean? | Containing high amounts of oxygen, as with arterial blood. |
| What is oxygenation? | The form of respiration in which oxygen molecules move across a membrane from an area of high oxygen concentration to an area of low oxygen concentration, as when oxygen moves out of a blood vessel into a cell |
| What is the parietal pleura | It is the outermost pleural layer that adheres to the chest wall |
| What does "patent airway" mean? | It means the airway is open and clear of any obstructions |
| What is the pharynx | It is the throat, or passageway for air from the nasal cavity to the larynx and passageway for food from the mouth to the esophagus. |
| What are the pleura? | They are two layers of connective tissue that surround the lungs in the chest cavity |
| What is the pleural space? | It is a small space between the visceral and parietal pleura that is at negative pressure and filled with serous fluid |
| What is Positive Pressure Ventilation (PPV) | It is a method of aiding a patient whose breathing is inadequate by forcing air into his lungs |
| What is residual lung volume? | It is the amount of air remaining in the lungs after a maximal exhalation |
| What does the term "respiration" mean? | It is the exchange of gases between an organism and its environment |
| What is respiratory arrest? | It is when some completely stops breathing (apnea) |
| What is respiratory distress? | It is an increased respiratory effort resulting from impaired respiratory function, while tidal volume and respiratory rate are still adequate. |
| What is respiratory failure? | It is when a patient has insufficient ventilation rate and/or tidal volume. This patient needs you to breathe for them! |
| What is the respiratory (ventilation) rate? | It is the number of breaths taken in one minute |
| What are retractions | It is depressions seen in the neck, above the clavicles, between the ribs, or below the rib cage from excessive muscle use during breathing. It is an indication of respiratory distress. |
| What is serous fluid, also known as pleural fluid? | It is the fluid that acts as a lubricant to reduce the friction between the parietal and visceral pleura |
| What is snoring? | It is a sound that is heard when the base of the tongue or relaxed tissues in the pharynx partially block the upper airway |
| What is a stoma? | It is a permanent surgical opening into the neck and trachea |
| What is stridor? | It is a harsh, high-pitched sound heard on inspiration that indicates swelling of the larynx or obstruction of the upper airway. |
| What does the word "tachypnea" mean? | It is a breathing rate that is faster than the normal rate |
| That is a therapy regulator? | It is a device that controls the flow and pressure of oxygen from the tank to allow for a consistent delivery of oxygen by liters per minute |
| What is the thyroid cartilage? | It is the bulky cartilage that forms the anterior portion of the larynx. This is also known as the Adam's Apple! |
| What is tidal volume? | It is the amount of air breathed in and out in one normal ventilation. For most adults, that equal 500 mL's of air. |
| What is the trachea? | It is the tubelike structure that leads from the larynx to the lungs. Sometimes also referred to as your windpipe! |
| What is a tracheostomy? | It is the surgical opening in the trachea |
| What is a tracheostomy tube? | It is a hollow tube that is inserted into a tracheostomy to allow the patient to breathe |
| Where does the upper airway start and stop? | The portion of the respiratory system that extends from the nose and mouth to the larynx |
| What does the word "ventilation" mean? | It is the mechanical process by which air is moved in and out of the lungs, primarily caused by changes in pressure inside the chest |
| What is the visceral pleura and where is it found? | It is the innermost layer of the pleura that covers the lung and attaches directly to the lungs. |
| What does the word "auscultation" mean? | It means to listen for sounds within the body with a stethoscope |
| What are baseline vital signs? | They are the first set of vital sign measurements to which subsequent measurements can be compared to during a call. |
| What does a patient's blood pressure represent? | It is the force exerted by the blood on the interior walls of the blood vessels |
| What heart rate is considered bradycardia? | A heart rate less than 60 beats per minute |
| What is capillary refill? | It is the amount of time it takes for capillaries that have been compressed to refill with blood (normal is within 2 seconds) This test should be an "Up-Hill" test! |
| What does "clammy" mean? | It is when the skin is moist and slippery |
| What is a closed-ended question? | It is a question that requires the patient to answer with a “yes” or “no” answer. For example you could ask a patient, can you tell me about your chest pain? |
| What does the word "constricted" mean? | To narrow, or to make smaller. The blood vessels constricted (which means they got smaller) |
| What is cyanosis? | It is a blue-gray coloring of the mucous membranes and/or skin, which indicates inadequate oxygenation or poor perfusion. |
| What does the diastolic blood pressure represent? | It is the amount of pressure exerted against the walls of the arteries when the left ventricle is at rest. |
| What does the word "dilated" mean? | To expand, or make larger. The blood vessels dilated (which means they got larger) |
| What is flushing of the skin? | It is an abnormally red skin color due to vasodilation |
| What is jaundice? | It is a condition characterized by yellowness of the skin, sclera of the eyes, mucous membranes, and body fluids. It typically indicates liver failure or disease |
| What is mottling? | It is a skin discoloration similar to cyanosis but occurring in a blotchy pattern |
| What are open-ended questions? | The are questions that allow the patient to give a detailed response in his own words. For instance, instead of asking a patient if they have chest pain, you would say, can you tell me about what is hurting you today? |
| What does the acronym OPQRST-ASPN stand for? | Onset, Provocation/Palliation, Quality, Radiation, Severity, Time of the complaint, Associated Symptoms and Pertinent Negatives |
| What are orthostatic vital signs? | It the increase in heart rate of 10–20 bpm and/or a decrease in systolic blood pressure of 10–20 mmHg when a patient moves from a supine to an upright or standing position |
| What does the word "Pallor" mean? | Pale or abnormally white skin color |
| What is pulse oximetry and what is considered to be a normal level? | It is the measurement of blood oxygen saturation. Normal is between 94-99. |
| What is a pulse oximeter? | It is an electronic device used to determine the oxygen concentration in arterial blood |
| What is pulse pressure? | It is the difference between the systolic blood pressure and the diastolic blood pressure. A BP of 120/80 would have a pulse pressure of 40. |
| What is pulsus paradoxus? | It is A=a decrease in pulse strength during inhalation |
| What does the acronym "SAMPLE" stand for? | Signs and Symptoms, Allergies, Medications, Pertinent Past History, Last Oral Intake, and Events Leading up to the injury or illness. |
| What is a "sign" when assessing a patient? | Any objective evidence of medical or trauma conditions that can be seen, heard, felt, or smelled in a patient |
| What is the name of the gauge that is used to determine pressure on a BP cuff? | Sphygmomanometer |
| What is a "symptom" when assessing a patient? | Conditions that must be described by the patient because they cannot be observed by another person |
| The systolic blood pressure reading represents what? | The pressure exerted against the walls of the arteries when the left ventricle contracts. |
| Tachycardia describe a heart rate that is greater than? | 100 beats per minute |
| What is the Index of suspicion? | An anticipation that certain types of accidents and mechanisms will produce specific types of injuries |
| What is the Mechanism Of Injury (MOI)? | The factors and forces that cause traumatic injury |
| What is the Nature of illness (NOI)? | The type of medical condition or complaint a patient is suffering from |
| What is Personal Protective Equipment (PPE)? | Equipment worn to protect against injury and disease |
| What is scene safety? | Steps taken to ensure the safety and well-being of the EMT, his partners, patients, and bystanders |
| What is a scene size-up? | An assessment of the scene for safety hazards and to determine the nature of the patient’s problem and the number of patients |
| Apnea is a word used to describe what? | Absence of breathing |
| What is aspiration? | Breathing a foreign substance into the lungs |
| What is AVPU used for and what does it mean? | An acronym to measure the level on consciousness. A for alert, V for responds to verbal stimulus, P for responds to painful stimulus, and U for unresponsive. |
| What does it mean if someone says a patient is suffering from a brain herniation? | Compression and pushing of the brain through the foramen magnum |
| What is Cerebrospinal Fluid (CSF) | A clear fluid that surrounds and cushions the brain and the spinal cord |
| What is the Chief Complaint? | The patient complaint that is the primary reason why the EMS crew was called to the scene |
| How do you position the patient to provide cervical in-line stabilization? | Bringing the patient’s head into a neutral position in which the nose is in line with the navel and the neck is not flexed or extended and holding it there manually |
| What does the word "occluded" mean? | Closed or blocked |
| What is paradoxical movement of the chest" | A section of the chest that moves in the opposite direction to the rest of the chest during the phases of respiration. Typically seen with a flail segment |
| What does the word "patent" mean? | Open |
| What is the primary assessment? | Patient assessment conducted immediately after scene size-up to discover and treat immediately life-threatening conditions, determine whether the patient is injured or ill, and establish priorities for further assessment, care, and transport |
| Rapid secondary assessment | A head-to-toe physical exam that is swiftly conducted on a trauma patient who is unresponsive or who has a significant mechanism of injury, has altered mental status, responds to verbal or painful stimuli, or is unresponsive |
| Reassessment | The continuous assessment that is conducted following the secondary assessment to detect any changes in the patient’s condition, to identify any missed injuries or conditions, and to adjust emergency care as needed |
| What is the secondary assessment? | The portion of patient assessment conducted after the primary assessment, for the purpose of identifying additional serious or potentially life-threatening injuries or conditions and as a basis for further emergency care |
| What patient position is best for evaluating the presence of JVD? | Fowlers (45-60 degrees) |
| How often should you obtain V/S on a critically injured patient? | Every 5 minutes (every 15 for a stable patient) |
| What are the four ways in which you can ventilate a patient (from best to worst)? | Pocket mask, 2-person BVM, FROPVD, 1-person BVM |
Created by:
kevinakers