Card Set Information

2012-10-28 09:33:31
GSEMSS Airway Paramedic EMT

Airway Test
Show Answers:

  1. movement of air into and out of the lungs
  2. aka laryngopharynx, lowest portion of pharynx, opens into the larynx anteriorly and the esophagus posteriorly
  3. frontal and maxillary sinsus are known as
  4. CSF leakage from nose, ears
    rhinorrhea, otorrhea
  5. spasmodic closure of the vocal cords
  6. the essential/functional elements of an organ (i.e. lung - bronchioles/alveoli)
  7. collapse of the alveoli
  8. increased CO2 in the blood
  9. what separates the upper and lower airways
  10. larynx (considered part of lower)
  11. bony shelves in the nasal passageway that warm, filter, and humidify air
  12. where are the facial sinuses located
    frontal, ethmoid, sphenoid, and maxillary bones
  13. the function of these prevent contaminants from entering the respiratory tract and act as turbinates for fluid to and from eustachian tubes and tear ducts
  14. the gums in the mouth
  15. where is the frenulum
    under the tongue
  16. most common airway obstruction in unconscious pt
  17. laryngeal prominence
    adam's apple
  18. what structures attach to the hyoid bone
    tongue, jaw, epiglottis, and thyroid cartilage
  19. Glossal- and ling- refer to what structure
  20. the ______ is an extension of the soft palate
  21. the lower airway starts at approx. what level of the cervical vertebrae
  22. the adam's apple is a prominence of what structure
    throid cartilage
  23. the ______ cartilage is the first ring of the trachea and the lowest portion of the larynx
  24. where is the glottic opening
    space between the vocal cords
  25. where is the epiglottis
    superior portion of the glottis
  26. between the base of the tongue and the epiglottis is a space or pocket called the ________
  27. the trachea extends to which vertebrae in the adult
  28. what is the function of the goblet cells
    produce mucous
  29. what habit can damage the cilia of the airway
  30. beta-2 stimulation causes what effect in the bronchial tubes
  31. the point of entry of blood vessels, nerves, and bronchi into each lung
  32. what phospho-lipid keeps alveoli expanded
  33. the ________ tighten or slack to give pitch to the voice
    arytenoid cartilages
  34. aka throat
  35. what structure wraps around the alveoli
    pulmonary capillaries
  36. actual exchange of O2 and CO2 in the alveoli and tissues of the body
  37. physical act of moving air into/out of the lungs
  38. process of loading O2 molecules onto hemoglobin molecules in the bloodstream
  39. _______ a passive process in a healthy person
  40. what shape is the larynx in a child?
  41. epiglottis?
  42. omega-shaped
  43. because of the relatively large occiput, the head of a young child is normally ________ when in the supine position. What would you do?
    Flexed, Place towel under the shoulders
  44. because the thoracic cavity can't contribute to lung expansion in infants, they are known as....
    belly breathers
  45. what nerve innervates the diaphragm
  46. list two accessory muscles of breathing
    sternocleidomastoid, trapezius
  47. the amount of gas in air or fluid, such as blood, measured in mmHg (mercury) or Torr
    partial pressure
  48. ventilation with a BVM is called _______ pressure ventilation
  49. portion of tidal volume that doesn't reach alveoli
    dead space
  50. what is the normal tidal volume for an adult? infants/children?
    Adults: 5-7mL/kg (500mL avg.) Infants/Children: 6-8mL/kg
  51. Tidal Volume (TV) x Respiratory Rate (RR) = _________
    minute volume
  52. what is the physiologic dead space
    the alveoli that have collapsed (atelectasis) due to disease or by obstructions
  53. how does the apneustic center in the brain receive signals from stretch receptors in the lungs
    VAGUS nerve
  54. this reflex terminates inhalation thus preventing over-expansion of lungs
    Hering-Breuer reflex
  55. A rise in pCO2 causes the pH to ________
  56. two parts of brain stem that are involved in controling breathing
    pons and medulla
  57. where are chemoreceptors located
    carotid bodies, aortic arch, central (medulla)
  58. what nerves send the signals received from the chemoreceptors to the respiratory center
    nerves 9 (glossopharengeal) and 10 (vagus)
  59. pts with COPD routinely have increased levels of _______
  60. _______ventilation causes acidosis
  61. what is wrong with this pt.? pH= <7.35 PaCO2= >45 HCO3 = 22-26
    Respiratory Acidosis
  62. what type of pts will have the hypoxic drive as the primary motivation to breath
    end-stage COPD pts
  63. respiratory rate of a pt with a fever will be _________
  64. meds that depress the CNS cause a _______ in respiratory rate
  65. % of O2 in inhaled air
    FIO2, Atmosphere = 21% O2, so... FIO2 = 0.21
  66. List the normal adult H and H values
    Male = 14-16g/dL Female = 12-14g/dL
  67. one hemoglobin combines with ____ oxygen molecules
  68. absence of oxygen
  69. shortness of breath
  70. list early s/s of hypoxia
    restlessness, irritability, apprehension, tachycardia, anxiety
  71. decrease in arterial O2 level
  72. tissues/cells dont receive enough O2
  73. toxin produced in cell when O2 is not present
    lactic acid
  74. what "cycle" produces ATP
    aerobic metabolism/respiration
  75. aka pulmonary respiration, exchange of O2/CO2 between alveoli and blood in pulmonary capillaries
    external respiration
  76. aka cellular respiration, exchange of O2/CO2 between systemic circulation and cells in the BODY
    internal respiration
  77. byproduct of aerobic cellular metabolism
  78. amount of O2 dissolved in blood plasma
  79. t or f: SpO2 and SaO2 are the same thing
  80. oxygen saturation abbreviation if measured by a pulse ox
  81. oxygen saturation abbreviation if measured by ABGs
  82. _________ factors that cause airway obstruction from allergy, infection, tongue blockage
  83. __________ factors that cause airway obstruction from trauma, foreign body airway obstruction
  84. T or F: all factors affecting pulmonary ventilation are caused by problems with the A and P of the respiratory system
    FALSE - some are CNS or PNS
  85. pt with numerous rib fractures breathes more shallow on purpose to alleviate pain caused by the injury. this is called.....
    splinting (of the chest)
  86. ____________ usually causes an increase in pCO2 and a decrease in pH
  87. does CO2 have a greater or lesser affinity for hemoglobin in comparison to oxygen
    GREATER - 250x more
  88. how does the renal system combat a change in pH
    filters out H+ and retain bicarbonate or vise versa
  89. rales and crackles are ______ breath sounds
  90. aka positional dyspnea
  91. T or F: intrapulmonary shunting causes hypoxemia
  92. portion of chest retracts during inhalation instead of out
    flail chest
  93. one or two word speech
    staccato speech
  94. systolic bp drops >10mmHg during inhalation, with possible pulse change
    pulsus paradoxus
  95. when might you see someone with pulsus paradoxus
    decompensated COPD, pericardial tamponade, tension pneumothorax, severe asthma
  96. increase in severity
  97. Make (a disease or its symptoms) less severe or unpleasant without removing the cause.
  98. Make (suffering, deficiency, or a problem) less severe
  99. who is at high risk for aspiration
    any pt w/o gag or cough reflex
  100. increase respiratory rate, then decreases slowly to a period of apnea (brainstem injury)
  101. deep, rapid, hunger-style respirations (diabetic ketoacidosis)
  102. sudden inhalation due to spasm of the diaphragm, cut short by closure of the epiglottis
  103. T or F: active EXHALATION is pathologic
    TRUE - exhalation should be passive
  104. T or F: inhalation is usually longer than exhalation
    FALSE - inhalation is shorter, I/E ratio = 1/2
  105. define adventitious breath sounds
  106. T or F: wheezing denotes constricted airway
    TRUE - heard mostly during exhalation
  107. T or F: crackles can be heard as collapsed alveoli pop open
  108. T or F: rhonchi tell the provider that the airway is not clear of secretions
  109. is stridor an upper or lower airway sound
  110. a _______ _______ rub may be heard over an inflamed area of lung tissue
    pleural friction
  111. T or F: the pCO2 is one indicator of ventilator status
  112. what is the normal pCO2
    35-45 mmHG
  113. what color means CO2 is present on the colormetric capnography
    YELLOW - (YES) or Gold (GOOD)
  114. Purple (POOR - BAD)
  115. most reliable method of confirming initial and ongoing advanced airway placement
    continuous QUANTITATIVE WAVEFORM capnography
  116. gurgling indicates the need for what
  117. aka tonsil-tip (large diameter rigid catheter)
  118. aka french catheter - soft
  119. T or F: aspiration increases the mortality rate
  120. T or F: suctioning causes hypoxemia and bradycardia
  121. amount of time to limit to when suctioning
    adults - 15s, children - 10s, infants - 5s
  122. T or F: suctioning can cause laryngospasm and/or vomitting
  123. when do you apply suction
  124. as you are withdrawing suction what motion do you make
  125. what class is benzocaine
    anesthetic (numbs)
  126. other names for benzocaine
    hurricaine, cetocaine, endocaine
  127. T or F? An OP airway is appropriate for a patient with a gag reflex.
  128. T or F? A NP or OP airway is a proper substitute for adequate head positioning.
  129. T or F? OP and NP airways make ventilating with a BVM easier and more effective.
  130. The NP and OP airway are intended to keep the tongue off of what structure?
    Posterior Pharyngeal Wall
  131. How is an OP airway sized? NP?
    OP- Earlobe to corner of mouth NP – earlobe to tip of nose
  132. Contrast techniques for insertion of an OP airway in an adult and in an infant
    Use a TONGUE DEPRESSOR in a child because airway is not as developed
  133. List contraindications for NP airway usage
    Pt. Intolerance, Facial/Skull fracture
  134. Define epistaxis
    nose bleeding
  135. T or F? ____ The bevel of the NP airway should face the septum during insertion.
  136. Define dentition
    developing new teeth
  137. T or F? ____ Most patients that are snoring have a partial airway obstruction due to the tongue blocking the pharynx
  138. What does the prefix dys- mean?
  139. Suffix –phonia?
    ability to speak
  140. Suffix -phasia?
    a speech disorder
  141. Suffix -phagia?
  142. List common causes of laryngeal edema
    epiglottitis, anaphylaxis, inhaled injuries (burns)
  143. What does aspiration of blood or vomit do to mortality rate?
    Significantly Increases it
  144. Is the Heimlich maneuver usually effective and indicated for partial airway obstruction?
    No, coughing
  145. How would you note poor lung compliance when “bagging” a patient?
    Increased resistance during ventilation
  146. Are blind finger sweeps indicated in foreign body airway obstruction circumstances?
  147. Define direct laryngoscopy
    Visualization of the airway with a laryngoscope blade
  148. What are Magill forceps used for in the field?
    removing foreign bodies in a pts upper airway
  149. What is the danger in carrying an oxygen cylinder?
    has the properties of a rocket
  150. A patient is on oxygen at home and his relatives are smoking in proximity to the patient. What would you do?
    O2 supports combustion process so don’t smoke near it
  151. When would you replace an O2 tank (psi)?
    200psi or lower
  152. Describe two common types of flow meters
    Bourdon-Gauge: not affected by gravity (cylinder-mounted) Pressure-compensated: incorporates a float ball to measure flow-rate (wall-mounted)
  153. Define stoma
    orifice that connects trachea to outside air
  154. Define laryngectomy
    larynx is removed
  155. Define tracheostomy
    surgical opening in trachea
  156. T or F? When a patient with a tracheostomy becomes dyspneic, airway patency should be assessed
  157. T or F? In-line technique should be considered when intubating patients with facial injuries
  158. List the two main reasons (categories) for advanced airway management
    failure to maintain a patent airway or failure to adequately oxygenate and ventilate
  159. What is a Mallampati classification?
    ability to see posterior pharynx in an open mouth (Class I = fully open | Class IV = Can’t see at all)
  160. T or F? LEMON is an acronym used to predict difficult intubations.
    FALSE - helps start intubation process
  161. List at least 4 complications of intubation, in addition to improper placement
    Bleeding, hypoxia, laryngeal swelling, and laryngospasm
  162. T or F? ____ Intubation is a definitive means of achieving complete control of the airway.
  163. What are the usual size ET tubes for an adult man and a woman?
    women = 7.0 – 8.0 Men = 7.5 – 8.5
  164. You have begun to ventilate a patient that is not intubated. The chest is not rising as much as you would like. What actions might you take to improve chest rise?
    reposition head, intubate or OPA/NPA
  165. Define barotrauma
    increase in intrathoracic pressure
  166. What is a tension pneumothorax?
    air in the pleural space that can’t escape causing increased pressure
  167. What is an ATV? Per our SOPs, should they be used on peds patients? Trauma patients?
    Automatic Transport Ventilator – Contact Medical Control for Peds – NEVER for TRAUMA pt
  168. What is the general formula for estimating TV in an adult?
  169. What does our SOP (ATV) say to use as a formula to set tidal volume? Rate?
    10ml/kg – when in doubt round downRate = 8-10/min, may increase to 12-20 if perfusing rhythm returns
  170. T or F? The EC clamp should be used when ventilating pediatric patients.
  171. T or F? A good seal is important for CPAP.
  172. Why might a patient have CPAP at home?
    CHF, COPD, Asthma, Sleep Apnea
  173. List the actions of CPAP (why it’s beneficial and for whom)
    Increases pressure in lungs, opens collapsed alveoli, forces interstitial fluid back into pulmonary circulation
  174. ONLY USED ON alert, oriented, respiratory distress Pts
  175. T or F? A patient must be breathing (and at adequate depth) for CPAP to be utilized.
  176. Define PEEP
    Positive-End Expiratory Pressure = resistance when pt exhales
  177. List three uses for an NG tube
    feeding, administer drugs, emptying stomach
  178. How is an NG tube is measured prior to insertion?
    nose to ear to xiphoid process
  179. T or F? CPAP delivers the same concentration of oxygen as a NRB.
  180. T or F? CPAP can cause gastric distention and lowered BP?
  181. How can a provider lessen the incidence of gastric distention during ventilation?
    reposition airway, limit to 1 second ventilations
  182. How would you confirm placement of an NG tube?
    auscultate epigastric region while injecting 30-50ml/air or observe gastric contents in the tube by aspirating
  183. When the diaphragm contracts during breathing, what happens to the size of the thorax?
  184. Compare and contrast O2 delivery devices and the % age of oxygen delivered What liter flow is appropriate for each?
    NC 1-6L = 24-44%, NRB 15L = 90-100%, BVM 15L = nearly 100%, Mouth-to-Mask 15L = nearly 55%
  185. Who might a Venturi mask help in particular?
    Long range transport of COPD pts
  186. What is the formula for cardiac output?
    CO = SV x HR (amount of blood ejected from left ventricle in one minute)
  187. Why is two-person “bagging” preferred over one-person?
    One maintains seal while other ventilates
  188. Effectiveness of ventilation is best determined by
    Watching chest rise and fall and feeling for resistance
  189. T or F? Hyperventilation with a BVM increases the risk of aspiration
  190. How much gas does an adult-sized BVM hold?
  191. Describe the EC clamp
    C-shape with thumb and pointer finger – E-shape with other three fingers under the boney portion of pts chin pulling pt face into the mask
  192. Where should your fingers NOT rest during the EC clamp?Why?
    Soft space under chin – chokes pt
  193. T or F? Ventilation rates should be determined by the patient’s age.
  194. If a healthcare provider is assisting ventilation in a breathing patient, he/she should compress the bag when the patient inhales/exhales.
  195. T or F? Goggles and or a face mask should be used during suctioning and intubation attempts.
  196. T or F? A small amount of sterile saline may be placed down a stoma prior to suctioning attempts to liquefy secretions.
  197. T or F? When bagging a patient with well-fitting dentures, it is best to leave them in place during ventilations.
  198. T or F? With airway management, it is best to quickly perform ALS maneuvers instead of wasting time with BLS maneuvers.
    FALSE – start with BLS then work up to ALS
  199. Where is Murphy’s eye on an ET tube?
    Distal end of the tube after the cuff
  200. Where is the narrowest portion of the pediatric airway?
    Funnel-shaped cricoid ring
  201. How would you estimate the proper ET tube size in a pediatric patient?
    Internal diameter of nostril or diameter of the little finger or size of the thumbnail
  202. Discuss types of laryngoscope blades, including where they are placed in the airway
    Straight = Miller/Wisconsin –lifts up the epiglottis, Curved = Macintosh – fits in the vellecula to lift up the epiglottis indirectly
  203. What is the value of a stylet?
    Enables you to guide the ET tube into the glottis opening even if you can’t see it
  204. Into what shape should you mold an ET tube prior to insertion?
    Hockey Stick
  205. According to the words of wisdom, for how many minutes should a provider ventilate prior to intubation?
    2-3 Minutes
  206. During intubation, why must you move the patient’s tongue from right to left?
    so you can see past it
  207. How does, “walking the blade down the airway” help during the intubation process?
    so you don’t accidently go to deep
  208. T or F? During intubation attempts, you must see the ET tube tip pass the vocal cords in all cases.
  209. T or F? The laryngoscope is designed so that the tube runs down the barrel of the laryngoscope during insertion.
  210. Describe BURP
    Backwards, Upward, Rightward Pressure of lower third of the thyroid cartilage (Sellick’s Maneuver)
  211. What is the proper ventilation rate for an apneic adult? Child? Infant?
    Adult = 10-12 breaths/min (5-6 seconds), Child/Infant = 12-20 breaths/min (3-5 seconds), Cardiac Arrest = 8-10 breaths/min (6-8 seconds)
  212. T or F? Once the cuff is inflated on a placed ET tube, the provider’s hand can be removed from the tube safely.
  213. T or F? Nasotracheal intubation must be performed on a spontaneously breathing patient.
  214. List contraindications to nasotracheal intubation
    Respiratory or Cardiac Arrest, Head/Face Trauma
  215. What is trismus and how does it complicate intubation attempts?
    Clenched Teeth
  216. ___________ is the most common complication of NT intubation.
  217. A NT tube is advanced when the patient inhales/exhales.
  218. Why would you want to be sure to follow the floor of the nasal passage closely when inserting a NT or NG tube?
    Can damage turbinates
  219. Trans-illumination intubation is….
    Placing a light in the trachea
  220. Retrograde intubation….
    needle is placed through the skin into trachea fed up through mouth and hooked to et tube to guide into the trachea
  221. A __________ style blade would be used for face-to-face intubation…
  222. Blind or tactile intubation is also called _____ intubation.
  223. What tool will be helpful in Digital intubation?
    Bite block since fingers will be in mouth
  224. T or F? Tracheobronchial suctioning should be a sterile procedure.
  225. T or F? Extubation in the field is rarely if ever done due to potential complications.
  226. T or F? Extubation should be performed as the patient inhales.
  227. T or F? Small children up to 5 years of age have larger occiputs.
  228. T or F? A cuff is necessary on pediatric endotracheal tubes.
  229. T or F? The epiglottis is smaller in young children so a curved blade is best.
  230. T or F? A Broselow tape or similar device is highly necessary during peds resuscitation attempts.
  231. T or F? It is important to document the ET tube number at the teeth after determining proper placement.
  232. What is the formula that is used to determine proper ET tube size in the young child?
    (Age divided by 4) plus 4 or (AGE + 16) Divided by 4
  233. At what age is a cuffed ET tube generally necessary?
    Adolescent (8-10 y/o)
  234. Stimulation of which nervous system causes bradycardia during intubation attempts.
  235. What is the best way to prevent serious bradycardia during intubation attempts?
    Monitor pulse ox
  236. What medication might be used as premedication to prevent bradycardia?
  237. T or F? Tube placement must be reassessed after any patient movement.
  238. What does DOPE stand for?
    Displacement, Obstruction, Pneumothorax, Equipment Failure
  239. After the tube passes the vocal cords, how much farther should it be inserted?
  240. Why is a suction device needed at the head during all intubation attempts?
    aspiration occurs
  241. An attempt at pediatric intubation should not take over ________ seconds.
    20 seconds
  242. Describe the problems of over and under sedation
    Over – respiratory distress, hypotension, complete airway collapse or Under – gagging and incomplete amnesia
  243. T or F? Etomidate is a benzodiazepine.
  244. Define anxiolysis
    relief of anxiety
  245. What is the name of a benzodiazepine antagonist?
  246. What is the risk of using barbiturates to intubate?
    Respiratory depression and (profound) hypotension
  247. T or F? Fentanyl is an opioid that is sometimes used for intubation purposes.
  248. The negative effects of opiates can be reversed with ____________.
  249. Paralytics are ________________-blocking agents. What chemical do they block?
    neuromuscular – block acetylcholine
  250. T or F? Paralytics depress the CNS system and cause sedation.
    FALSE – block neuromuscular junction
  251. T or F? -uronium would alert you to a neuromuscular blocking agent.
  252. T or F? Paralytics should be administered with sedation.
  253. T or F? Amnesia is a desired side effect.
  254. Define fasciculations
    brief muscle twitches
  255. Anectine is
    Succinylcholine Chloride (Depolarizing Neuromuscular blocking agent)
  256. Define RSI
    Rapid Sequence Intubation – aka Pharmocologically assited intubation
  257. T or F? All equipment must be gathered prior to beginning RSI
  258. T or F? The patient should be coached prior to RSI procedures.
  259. T or F? Patients should be on cardiac monitors during intubation attempts.
  260. Why might atropine and/or lidocaine be used prior to intubation attempts?
    Atropine – used to decrease incidence of bradycardia or Lidocaine – used to help closed head injury pt
  261. What three signs are suggested as indication of adequate paralysis?
    Apnea, Laxity of mandible, loss of eyelash reflex
  262. You are trying to intubate. It has been thirty seconds and you cannot get the tube in. What should you do?
    Stop, reoxygenate 30-60s, attempt again
  263. What medication is used for post-intubation sedation in Region 8?
  264. T or F? Combitubes are usually placed into the esophagus.
  265. List contraindications to use of a Combitube
    Children <16 y/o, pts <5’ tall, esophageal trauma, hx of alcoholism
  266. List three complications of Combitube placement
    unrecognized placement in trachea/esophagus, laryngospasm, ballon can obstruct epiglottis
  267. T or F? There are two balloons that must be inflated on a Combitube after insertion.
  268. What is an LMA? Where is the balloon placed/located?
    Laryngeal Mask Airway – placed in the hypopharynx
  269. Does an LMA, properly placed, protect the airway from aspiration?
  270. T or F? The King airway is a multi-lumen airway device similar to the Combitube.
  271. T or F? There are two cuffs or balloons on a King airway.
  272. T or F? The Cobra device lies below the vocal cords if properly placed.
  273. What muscles and vessels are to be considered when performing cricothyrotomies?
    EJ, Carotids, Sternocleidomastoid muscle
  274. How would you control bleeding during a cricothyrotomy procedure?
    light pressure
  275. When might a surgical cricothyrotomy be done? Is it a first choice in airway management?
    Pt older than 12? and needs airway cleared (intubation failed)
  276. T or F? A needle cricothyrotomy is safer than surgical cric for young children under 8 y.o.
  277. Describe subcutaneous emphysema
    Air under the skin
  278. T or F? A hemostat is helpful during a cricothyrotomy.
  279. What is translaryngeal catheter ventilation?
    a method w/needle cric to ventilate pts, requires a high pressure jet ventilator
  280. T or F? The needle should be inserted caudally during a needle cricothyrotomy procedure.
  281. T or F? Lungs must be auscultated after a cricothyrotomy procedure.
  282. T or F? A needle cricothyrotomy, if properly performed, can sustain a patient for long periods of time.
  283. T or F? It is important for a paramedic to observe the chest for overinflation when ventilating through a needle or surgical cricothyrotomy airway.
  284. T or F? All EMS systems allow paramedics to perform needle and surgical cricothyrotomies.
  285. make less severe
  286. general discomfort, out of sorts, being unwell
  287. sensitivity to light
  288. double vision
  289. waking up at night to pee
  290. sudden, severe confusion or AMS
  291. IADLs
    (Instrumental) activities of daily living
  292. a tympanic sound would most likely be heard on percussion over a ______ organ
  293. what shape is the bell and diaphragm on a stethoscope and what sounds do they listen for
    bell = cup - deep, low pitch sounds (heart) *place lightly or diaphragm = flat - high pitch (breath, bowel) *firmly placed
  294. coronary arteries fill during ______
  295. BP cuff that is too tight/small will give an artificially _____ reading
  296. what does a pulse ox measure
    arterial O2 saturation (%hemoglobin sat)
  297. reasons for inaccurate pulse ox reading
    hypotensive, hypothermic, sickle cell, anemia, CO poison, fingernail polish
  298. on what is the focus exam often based
    chief complaint
  299. ecchymosis
  300. where to check for tenting(turgor) in the elderly pt
    skin of upper chest
  301. most reliable and consistent method of assessing mental status and neuro function
  302. broken bone sound or subcutaneous emphysema
  303. HEENT
  304. pt with clubbing of the fingertips indicates
    chronic respiratory disease
  305. sign of a pt working to exhale
  306. gives the eye its color
  307. located at the back of the eye
  308. center of the retina that contains the fovea
  309. what is used to check visual acuity
    snell chart - "E" chart
  310. T or F: when you shine a pen light into a pt's left eye, the right eye should react like the left
  311. what does the third cranial nerve have to do with the pupil
    regulates pupil size in opposite eye (oculomotor nerve)
  312. asymmetric pupils in healthy individuals
  313. how do you check a pts six eye musles
    Tracking - H or Z pattern
  314. what is an injected sclera
    red - blood shot eyes
  315. three bones of the ear
    malleus, incus, stapes
  316. what structure does the eustachian tube connect
  317. where would you note the abnormal subcostal retractions in children
  318. bruising and tenderness on mastoid process (below ear)
    battle signs
  319. aka eardrum
    tympanic membrane
  320. cerumen
  321. too much cerumen can cause
    decreased hearing
  322. single most reliable indicator of a spine/spinal cord injury
  323. where is the odontoid process located
    DENS, C-2, superior protuberance
  324. whoose-like sound heard over a narrowed artery
  325. whoosh-like sound heard over heart
  326. humming vibrations (indicates aneurysm or hemodialysis)
  327. aka adventitious
  328. vesicular
  329. stridor is an ______ airway obstruction
  330. atelectasis in one area
  331. hyper and hypo resonance indicate what
    hyper = air or hypo = blood
  332. what organs when damaged give diffuse pain (widespread)
  333. what does a silent chest indicate
    normal OR status asthmaticus
  334. if wheezing is unilateral what would be suspected
    aspirated foreign body or infection
  335. when should you make a transport decision on the pt during the assessment process
    after the E of initial assessment
  336. knowing the protocol but not thinking about what you are doing or whether its working or not
    cookbook medicine
  337. processing the info means
  338. the four cornerstones of paramedic practice are
    gathering, evaluating, synthesizing, developing/implementing pt care plan
  339. what is an emotional state reflected in physical behavior
  340. Six Rs of critical thinking
    Read scene Read pt React Reevaluate Revise plan Review performance
  341. T or F: S3 and S4 may be present in heart failure
  342. what is abnormal for anyone over 35 y/o
  343. what is always abnormal if found in anyone
  344. what is a good position for the pt when you are listening to heart sounds
    sitting up slightly forward
  345. how would you instruct the pt to breath when checking heart sounds
    hold breath on inhalation
  346. the "lub" sound of the mitral and tricuspid valves closing starting systolic
  347. the "dub" sound of the pulmonic and aortic valves closing ending systolic
  348. how are murmurs graded
    1 (softest) --> 6 (loudest)
  349. 3 causes of JVD
    right side heart failure, penetrating left chest trauma, cardio shock
  350. what would a bruit over the carotid arteries indicate to you
    turbulent blood flow
  351. where is the PMI
    Point of Maximal Impulse, 5th intercostal space
  352. if pt has an irregular rhythm how long do you assess pulse for
    1 minute
  353. acrocyanosis
    cyanosis of the extremities
  354. visceral pain
    hollow organ, widespread pain
  355. colon pain
  356. -gastric
  357. rigidity
  358. what is a tilt test
    orthostatic vitals
  359. what would indicate a positive finding on a tilt test
    systolic drops 20, diastolic increases 10, HR increases 20
  360. T or F: you should auscultate bowel sounds before palpating ABD
  361. bluish discoloration around the umbilicus
    Cullen Sign
  362. bluish discoloration around the flanks
    Grey-Turner Sign
  363. what is a scaphoid abdomen
    a sunken abdomen
  364. what problems cause pain described as colicky
    hernia, adhesion, bowel obstruction
  365. localized weakening of the abd wall musculature and where are they found
    hernia - found on ventral wall or groin
  366. who has umbilical hernias
  367. olecranon process
  368. prolonged erection indication spinal cord injury
  369. what causes pathologic fractures
    decreased bone density (osteopenia or osteoporosis)
  370. where are mesenteric vessels found
    throughout abd
  371. pain felt when pressure is applied in a certain area
    point tenderness
  372. describe how extremities affected by venous stasis would appear
  373. cramp-like pain in lower legs due to poor circulation or low potassium levels
    intermittent claudication
  374. 4 diseases that increase the rate of peripheral vascular disease
    diabetes, HTN, obesity, tobacco use
  375. 5 P's of arterial blockage or insufficiency
    Pain Pallor Paresis Pulselessness Poikilothermia (inability to maintain a constant core temp
  376. rubor
  377. how is pitting edema rated
    +1 ---> +4 point scale
  378. sideways curve of spine
  379. inward curve at lumbar
  380. outward curve of thoracic spine
  381. sheet-like material covering PERIPHERAL nerves that promotes rapid transmission of impulses
  382. CT that surrounds muscle
  383. what is the cranial nerve that innervates the abd
  384. two primitive reflexes that can be observed in a neonate or infant
    grasping, sucking
  385. T or F: the brain is usually involved in reflexive movements
  386. normal adult response when checking the babinski reflex
    big toe will flex
  387. what is the COASTMAP mnemonic used for
    assessing mental status
  388. ability to perceive position and movement of ones body or limbs
  389. T or F: testing rapid alternating movements can assess a pts coordination
  390. distinct areas of skin that correspond to a specific nerve
  391. T or F: a 2+ deep tendon reflex is considered normal
  392. which is more acute, delirium or dementia
  393. pt right to make own decisions about their medical care
    pt autonomy
  394. performing an exam without consent can lead to what
    assault and battery
  395. absence of a sign/symptom that usually helps ID a pt condition with other s/s
    pertinent negative
  396. loss of control of bodily movements
  397. sustained muscle contractions and abnormal posturing
  398. no language ability
  399. STEMI
    ST elevated MI
  400. a BNP level may be elevated in what type of pts
  401. substances released into blood when heart is damaged or stressed
    cardiac biomarkers
  402. TREAT the _____ and not the ______
    patient and not the Monitor