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BradyPmed1, 13
Volume 1, Chapter 13
| Question | Answer |
|---|---|
| What is a Ventilation? | the mechanical process that moves air into and out of the lungs. |
| Brain injury or death occurs in how long? | 6-10 mins. |
| what are the components of the upper airway? | Nasal cavity, oral cavity, and the Pharynx. |
| What is the eusachian tubes? | a tube that connects the ear to the nasal cavity. |
| What are nasolacrimal ducts? | Tubular vessels that drain tears and debris from the eyes into the nasal cavity. |
| What are the components of the Lower Airway? | the trachea, bronchi, alveoli, lung parenchyma, and the pleura |
| What is the pressure exerted by each componnet of a gas mixture, such as O2, and CO2, called? | Partial Pressure (PaO2, PaCO2) |
| What takes control to ensure the continuation of respiration, if the medulla fails? | The apneustic center, and a third center the pneumotaxic center, both located in the pons. |
| What is the Total Lung capacity? | The toatl amount of air contained in the lung at the end of maximal inspiration, approximately 6 Liters |
| What is the average volume of gas inhaled or exhaled in one repiratory cycle called? | Tidal volume, approximatley 500mL |
| What is Alveolar Volume? | the amount of gas in the tidal volume that reaches the alveoli for gas exchange, approximately 350mL. |
| What is Minute Volume? | The amount of gas moved in and out of the respiratory tact in 1 minute. |
| What is a liplike opening between the vocal cords? | The Glottis. |
| What is cricoid pressure? | pressure applied ina posterior direction to the anterior cricoid cartilage. |
| What does applying cricoid pressure do? | Occludes the esophagus and prevents aspiration. |
| What does the Epiglottis do? | Prevents food from entering the trachea and also prevents aspiration. |
| The exchange between O2 and CO2 is called what? | Respiration |
| What is a 10-12 cm long tube that connects the larynx to the two mainstem bronchi? | The Trachea |
| What is a result of inserting the ET tube to far? | Right mainstem intubation. |
| What is the normal PaO2 (partial pressure of O2)? | 13.7% or 104.0 torr |
| The most common cause of airway obstruction is? | The Tongue |
| What are some common causes for airway obstruction in peds? | the tongue is raltively larger due to a smaller jaw, the epiglottis is much floppier and rounder, and the larynx is more superior and anterior. |
| The movement of a gas from an area of higher concentration to lower concentration is called? | Diffusion |
| What can occur if surfactant is insufficient or if the alveoli are not inflated? | Atelectasis (Alveolar collapse) |
| Excessive pressure of CO2 in the blood is called? | Hypercarbia |
| What is the Hering-Breuer Reflex? | prevents overexpansion of the lungs allowing the stretch receptors to relax |
| What is the hypoxic drive? | A mechanism that increases the respiratory stimulation when PaO2 falls and inhibits respiratory stimulation when PaO2 climbs. |
| What are cheyne-Stokes respirations? | Progressively deeper, faster breathing alternation gradual with shallow, slower breathing, indication brainstem injury. |
| Deep, slow or rapid, gasping breathing, commonly found in DKA are called? | Kussmaul's Respirations |
| What is a type of abnormal respiration's associated with increase ICP? | Biot's Respirations |
| A partial obstruction of the upper airway by the tongue is called? | Snoring |
| What is a harsh, high-pitched sound heard on inhalation, associated with laryngeal edema or constriction? | Stridor |
| What is Wheezing? | a musical, squeaking, or whistling sound heard upon inspiration or expiration, ass. with bronchiloar constriction. |
| A fine, bubbling sound heard on inspirations, associated with fluid is called? | Crackles or Rails |
| A drop in BP of greater than 10mmHG during inspiration is termed? | Pulsus Paradoxus |
| What does a colorimetric device detect? | CO2 by the paper changing color to yellow. |
| What are the four phases of a Capnogram? | Phase I--the respiratory baseline Phase II--the respiratory upstroke Phase III--The respiratory plateau Phase IV--the inspiratory phase. |
| What are the different levels of Hypoxia? | Normal--95-100%, Mild Hypoxemia--91-94%, Moderate Hypoxemia--86-90%, and severe hypoxemia-->85% |
| What are some basic airway maneuvers? | Head-tilt chin lift, jaw-thrust, modified jaw-thrust, and cricoid pressure. |
| In what situations may ETCO2 levels be low? | Cardiac Arrest |
| What is the recommened GCS for intubation of a pt? | GCS of 8 or less |
| An OPA does what? | Prevents the tongue from obstructing the glottis. |
| When may you use an NPA? | In the presence of a gag relfex, and when the pt's teeth are clenched. |
| What is the most preferred method of advanced airway management in the prehospital setting? | ET Tube intubation |
| ET tube intubation requires what? | direct visualization of the vocal cords. |
| Where is the Macintosh blade (curved) supposed to fit? | Into the vallecula. |
| Where is the Miller blade (straight) supposed to fit? | Under the epiglottis. |
| What are the sizes of prosimal end of an ET tube? | 15mm inside diameter/22mm outside diameter |
| What are the advantages of ET tube intubation? | Isolates the trachea and permits complete control of the airway, impedes gastric distention, and offers a direct route for suctioning of respiratory passages. |
| What are some disadvantages of ET tube intubation? | Requires direct visualization of the vocal cords, and bypasses the upper airway's function of warming, filtering, and humidifying the inhaled air. |
| What is the max flow rate of a nasal cannula? | 2-6L per minute |
| The flow rate of a protable suction device should be set to what %? | 30-40% |
| The most preferred neuromuscular blocking agent for emergency RSI is? | Succinylcholine |
| What are some advantages of Nasotracheal Intubation? | The head and neck can remain in neutral position, does not produes as much gag response, can be tolerated by an awake pt, can be secured more easily than an orotracheal tube, and pts cannot bite the ETT. |
| Some disadvantages of nasotracheal Intubation are? | more difficult and time consuming, may kink of clog more easily, and a greater risk of infection |
| When is a Nasotracheal intubation not recommended? | possible nasal and basilar skull fx's, deviated nasal septum, and cardiac or respiratory arrest. |
| What is a dual-lumen airway with a ventilation port for each lumen called? | Esophageal Tracheal Combitube |
| What is a Pharyngotracheal Lumen Airway or PtL? | A two tube system, in which a large cuff encircles the tubes lower third, and when inflated seals the entire oropharynx. |
| What has an inflatable distal end (similar to a face mask) which is placed in the hypopharynx and inflated, when tracheal intubation is unsuccessful? | The Laryngeal mask airway (LMA) |
| A surgical airway technique that inserts a 14 gauge needle into the trachea at the cricothyroid membrane is called? | Needle circothyrotomy |
| What is a surgical airway techniques that places and ET or trach tube directly into the trachea through a surgical incision? | Open circothyrotomy |
| When should you use surgical airway procdures? | After you have exhausted your other airway skills and no other means will establish an airway. |
| A situation where proper insertion of an ET tube requires more that 3 attempts, or last more than ten mintues is called? | A difficult intubation |
| What are the different classes of the mallampati classification system? | class 1--entire tonsil clearly visible, class 2--upper half of tonsil fossa visible, class 3--soft and hard palate clearly visible, and class 4--Only hard palate visible |
| What are the different classifications of the Cormack and LeHane System? | Grade 1--entire glottic opening and vocal cords may be seen, Grade 2-- epiglottis may be seen with a partial view of vocal cords, Grade 3--Only epiglottis seen, Grade 4-- Neither epiglottis or glottis seen |
| Which classification system uses a percentage of the glottis that can be visualized ranging from 0 (none visualized) to 100 (vocal cords fully visualized)? | POGO Classification system |
| When ventilating a pt with a stoma, what might occlude the airway? | organized secretions forming a mucous plug. |
| When inserting a ET tube into a stoma how far should you insert the tube? | 1-2cm beyond the distal cuff |
| Suctioning may cause what, causing bradycardia and hypotension? | Stimulation of the vagus nerve. |
| How many liters are contained in a D cylinder? | 400L |
| How many liters contained in a E cylinder? | 660L |
| How many liters contained in a M cylinder? | 3,450L |
| What is a high-flow face mask that delivers realtively precise O2 concentrations, regardless of the pt's rate and depth of breathing, primarily used for COPD pts? | A Venturi Mask |
| What percentage of O2 does a simple face mask deliver? | 40-60% O2 @ around 6-10L per minute |
| Which mask is indicated for pt's required moderate to high O2 concentration when results are not obtained by a simple face mask? | Partial rebreather, with a max flow of 10L/min |
| A mask that has a one qay sided ports, as well as a reservoir bag, delivering 80-95% @ 15L/min? | Nonrebreather mask |
| A BMV with an O2 reservoir bag attached to high flow O2 @ 15L/min delivers what % of O2 to the pt? | 90-95% |
| Which type of BVM ventilation is the most efficient method? | Two-person BVM ventilation |
| A ventilation device that is manually operated by a push button or lever, delivering 100% O2 @ 40L/min is called? | A demand valve device |
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