mod 3 air way cht 10
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| pulmonary ventilation | mechanical process air moves in and out of the lungs, air is pulled in, pushed out the chest cavity
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| External Respiration | Gas exchange between alveoli and pulmonary capillaries
Oxygenates and removes carbon dioxide from the lungs
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| Internal Respiration | Gas exchange between the systemic capillaries and cells.
Delivery of oxygen to cells and removal of carbon dioxide
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| Aerobic Metabolism (Cellular Respiration) | Aerobic metabolism need O2 to break down glucose, make ATP
By products of aerobic metabolism are WATER and CARBON DIOXIDE
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| Upper Airway | Extends from the nose and mouth to cricoid cartilage( above vocal cords) at inferior edge of larynx
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| Epiglottis | Protects lungs, may fail to close in unresponsive patients,
in altered mental status, muscle relaxation can cause epiglottis to obstruct larynx
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| Bronchioles | Contain smooth muscle, which can contract and narrow the air passage.
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| Parietal | Back of ribs surrounds lungs
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| Viscerail | Is actually on the surface of the lungs
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| Diaphragm | Provides 60% to 70% of the effort of breathing (biggest muscle for breathing.
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| Inhalation | External intercostal muscles & Diphram contract. - Chest cavity increases in size - pressure in the chest cavity decreases- air is drawn in through the nose and mouth. (this requires energy)
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| Exhalation | External intercostal muscles & diaphragm relax - Chest cavity Decreases in size - Pressure in the chest cavity Increases - air is pushed out through the nose and mouth
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| Brainstem | Recive input from chemoreceptors about the levels of oxygen, carbon dioxide and pH
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| Respiration | Is the p[recess of gas exchange
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| Oxygenation and removal of carbon dioxide | occur as result of external and internal respiration
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| Hypoxemia | Is a low oxygen content in arterial blood that may occur.
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| Hypoxia | Inadequate oxygen is being delivered to the cells. it may occur from airway obstruction inadequate breathing andf shock
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| Alveolar/Capillary exchange | Gases move from areas of higher concentration to areas of lower concentration. Carbon Dioxide diffuses from capillaries into alveoli
oxygen diffuses from the alveoli into the blood and is bound to hemoglobin
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| Capillary/ cellular exchange | Blpood entering capillaries is high in oxygen, which diffuses into cells.
Cells are high in carbon dioxide, which diffuses into the blood.
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| Anerobic metabolism results in | Insufficient energy production
Buildup of lactic acid
Cell Dysfunction
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| Pulmonary Ventilation may be impaired by | Interruption of nervous control
Damage to thorax
Increased airway resistance
Loss of airway patency
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| Gas exchange may be impaired by | Decreased ambient oxygen content
Lung disease, drowning
Toxic gases
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| Poor perfusion also leads to cellular hypoxia | Obstructed forward movement of blood,
Hypovolemia
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| Signs of an open airway | Air can be felt and heard moving in and out of the mouth and nose
The patient is speaking in full sentences or with little diffucilty
THe sound of the voice is normal for the patient
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| Signs of a blocked or inadequate airway | Abnormal upper airway sound
An awake patient who is unable to speak
Evidence of a foregn body airway obstruction ( tongue, food, vomit, blood, or teeth in the upper airway, mouth or nose
Swelling to the mouth, tongue or oropharynx
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| Upper airway sounds | Snoring, crowing, gurgling, stridor
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| Opening the airway | Manual maneuvers, suction, mechanical airways
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| Head- tilt chin- lift maneuver | Used when NO spinal is suspected
used in unresponsive patients, cardiac arrest
Must be supplemented with a mechanical airway of ineffective on its own
( fixs snoring)
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| Jaw thrust maneuver | Used when spincal injury IS suspected
Allows neck to remain in neutral, in- line position
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| Recovery position | Used if a patient has an altered mental status and is at risk of aspiration
contraindicated in suspected spinal injury and patients who need posititive pressure ventilation
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| Suction | Gurgling indicates liquid in the airway
use suction to remove blood, vomitus, secretions, and any other liquids, food particles, or objects from the mouth and airway
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| Standard precautions during suctioning | Protective eyewear, mask, gloves, N-95 or HEPA respirator for suspected tuberculosis
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| Suction equipment | Maybe be mounted in the ambulance or portable
Must generate enough vacum and airflow to clear the airway
must have wide-bore, thick tubing, a collection bottle, and water supply
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