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Respiratory system

Respiratory system (still in progress)

Without oxygen, brain tissue will begin to die within how many minutes? Four to six
Nasopharynx Pathway for air from the nose to the larynx
Oropharynx Pathway for air and food from the mouth to the larynx
Pharynx Includes: Area extending from the nose and mouth to the esophagus and trachea Nasopharynx Oropharynx
Larynx Formed by several structures of cartilage below the pharynx
Epiglottis Tissue that can prevent food and liquid from entering the trachea
Thyroid cartilage Where is it? What are its characteristics? Forms what is also known as the "adams apple" Large cartilage in the larynx V shape in the front, inferior to the Epiglottis
Cricoid cartilage Where is it? What are its characteristics? Lowest portion of the larynx Inferior to the Thyroid cartilage Forms a ring above the trachea
Trachea Begins below the cricoid cartilage
Bronchi Divides from the trachea into two main stems
Bronchioles Smaller branches from the main bronchi, ending with sacks of alveoli
Alveoli Where the blood in capillaries picks up oxygen and nutrients exchanges it with carbon dioxide and waste
The mediastinum contains Heart, great vessels, esophagus, trachea, major bronchi, many nerves
Ventilation EMT example: Physical act of moving air into the lungs Using a BVM to push air into the lungs
Diaphragm Muscle below the lung that increases/decreases the pressure with contraction and relaxation
Inspiration/inhalation Delivers oxygen to alveoli
Tidal volume Measure of depth of breathing
Dead space Portion of inspired air that fails to reach any alveoli
Expiration/exhalation Air leaves the lungs through the trachea
Hypoxia When tissues and cells do not get enough oxygen
COPD (Chronic Obstructive Pulmonary Disease) Difficulty eliminating carbon dioxide Chronic Bronchitus and Emphysema
Pneumonia Lung inflammation caused by bacterial or viral infection, alveoli fill with fluid
Acute pulmonary edema Symptoms: DO NOT: Fluid backing up into the lungs from congestive heart failure Low blood pressure, chest pain, dyspnea, pedal adema, tachycardia DO NOT administer medications or place patient in fowlers position
Pulmonary embolism The blockage of the pulmonary artery by a blood clot
Simple or tension pneumothorax When air enters the pleural space but cannot exit, increasing the pressure and collapsing the lung
Open pneumothorax Pleural space increases with air because of a hole or wound
Hemothorax Blood in the pleural cavity
Hemopneumothorax Blood accumulating in the pleural cavity, increasing the pressure and collapsing the lung
Regular or adequate breathing 12-20 breaths/min Regular inhalation/exhalation Bilateral clear and equal lung sounds Equal chest rise and fall Adequate depth (tidal volume)
Abnormal breathing Less than 12 breaths/min, more than 20 breaths/min Irregular rhythm Diminished, absent or noisy auscultated breath sounds Reduced flow of expired air at nose and mouth Unequal chest expansion Shallow depth
Agonal gasps Breathing after the heart has stopped
Cheyne-Stokes Often seen in patients with stroke or head injury
Ataxic respirations irregular or unidentifiable pattern May follow serious head injuries
Kussmaul respirations Deep, rapid respirations Common in patients with metabolic acidosis
Best practices for suctioning Never ________ Never suction the mouth or nose for more than 15 seconds - adults 10 seconds - children 5 seconds - infants
Best practices for suctioning Suctioning can result in _______ Suctioning can result in hypoxia
Oropharyngeal airway device Appropriate for ______ Contranindications _______ Unresponsive patients without gag reflex Apneic patients with BVM Concious patients Any patient with intact gag reflex
Nasopharyngeal airway device Appropriate for ________ Contraindications _______ Unresponsive patients Patient with intact gag reflex Patient unable to maintain their airway spontaneously Sever head injury with blood in nose History of fractured nasal bone
Nonrebreathing masks Best for: Can provide: __%, ___ lpm Patients who are breathing adequately but are suspected of having hypoxia 80 % to 90 %, 12-15 lpm
Bag-valve masks Best for: Can provide: __% Patients who cannot breathe on their own Without supplementary oxygen: 21 % with oxygen and no reservoir: 50 % - 60 % With oxygen and reservoir: 90 %
Nasal cannulas Best for: Can provide: __%, ___ lpm Secondary option for spontaneously breathing patients who do not like the nonrebreather. Not a preferred option 24 % to 44 %, 1-6 lpm
Partial rebreathers Best for: Can provide: __%, ___ lpm Hyperventilating patients 40 % to 60 %, 9-10 lpm
Venturi masks Best for: Can provide: __%, ___ lpm Not often used for EMT/prehospital care, adjustable settings 24 % to 40 %
What is positive pressure ventilation? What are the risks/downsides? Ventilation generated by a device (such as a BVM) that forces air into the chest cavity More volume is required to have the same effect as normal breathing Air is forced into the stomach, causing distention
CPAP Benefits: (Continuous Positive Airway Pressure) Increases pressure in the lungs Opens collapsed Alveoli Forces interstitial fluid back into pulmonary circulation
Cyanotic/cyanosis Skin turning blue
Carina The ridge at the base of the trachea before it splits into two
Upper airway components Larynx, pharynx
Lower airway components Trachea, bronchi, bronchioles, alveoli
Intercostal Space or tissue between the ribs
Pleural cavity The small amount of space between the lungs and the ribs
Phrenic nerve Originates from the cervical spine and innervates the diaphragm
Respiration EMT Example: Exchange of gases and waste via the alveoli This is not a something the EMT has tools to solve
Oxygenation EMT Example Attaching oxygen molecules to hemoglobin Using an oxygen tank to provide high concentration of oxygen
When the diaphragm relaxes, pressure ______ When the diaphragm contracts, pressure ______ ^ Increases - Decreases
Primary breathing stimulous is... Elevated CO2 levels in arterial blood
Secondary breathing stimulous is.... Hypoxic drive using arterial O2 levels
Chemoreceptors measure Levels of O2, CO2
V/Q mismatch Ventilation or blood exposure is not compatible (not enough oxygen getting to the blood) (not enough blood getting to the oxygen)
Aerobic metabolism With oxygen glucose turning into energy (ATP)
Anaerobic metabolism Not enough oxygen converts into glucose and leaves lactic acid as byproduct
Normal respirations for Adult Child Infant Adult: 12-20 respiration/min
Types of breathing rhythms Cheyne-Stokes, Kussmaul, Biot's, Ataxic
Types of breathing quality labored/non-labored deep/shallow chest expansion
Lung sounds Apnic, wheezing, stridor, rales, crackling, rhonchi
Lung sounds: Wheezing Example: High pitched sound, lower airway Asthma
Lung sounds: Crackling Bubbling, rice crispy popping sound
Lung sounds: Rhonchi Example: Low pitched vibrations, "snoring" Pneumonia, bronchitus
Lung sounds: Stridor High pitched sound on inspiration, upper airway Can be heard without stethoscope
Lung sounds: Rhonchi Low pitched, rattling sound
Lung sounds: Apnic Example: No sounds, not breathing Respiratory arrest
Chronic Bronchitus Bronchioles are inflamed, increased mucous presence, cilia are unable to filter blood properly *hypoxic drive
Emphysema Alveoli losing its elasticity, "atelectasis". Actual destruction (not just inflammation) in the lungs *hypoxic drive
COPD signs and symptoms Shortness of breath Use of secondary muscles Cyanosis Barrel chest (muscular development from secondary muscles) Small sentences Deep/shallow breath Body positioning (tripod, sitting up)
Asthma Inflammation or swelling of the bronchioles
Tachypnea Fast, shallow breathing
Bradypnea Abnormally slow breathing
Silent chest Extremely severe asthma absent of wheezing
Dyspnea Labored breathing
Lung sounds: Rales Example: Swishing, bubbly sound Acute Pulmonary Edema
Head tilt chin lift vs. Jaw thrust maneuvor Hands on forehead and lower jaw. Superior method of clearing airway vs. Pushing jaw forward with thumbs. Less effective, but protects the neck. Use when there is suspected trauma
Created by: nmatt101
Popular Paramedic/EMT sets




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