Chapter 9 Airway, Oxygenation and Ventilation

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Chapter 9 Airway, Oxygenation and Ventilation
2014-02-12 17:26:36
Chapter Airway Oxygenation Ventilation

Chapter 9 Airway, Oxygenation and Ventilation
Show Answers:

  1. Brain tissue will begin to die within _ to _ minutes.
    4 to 6
  2. The upper airway consists of all anatomic airway structures above the ____ cords.
  3. Six parts of the upper airway:
    • Nose
    • Mouth
    • Jaw
    • Oral cavity
    • Pharynx
    • Larynx
  4. Muscular tube extending from nose and mouth to the level of esophagus and trachea
  5. Three parts of the pharynx:
    • nasopharnyx
    • oropharynx
    • laryngopharynx
  6. -Formed by union of facial bones
    -Lined with ciliated mucous membrane that filters out dust and small particles
    -Warms and humidifies air as it enters the body
  7. -Posterior portion of the oral cavity
    -Lips and mouth form the entrance to oral cavity.  Entrance for respiratory and digestive system
    -Superior to the larynx is the epiglottis which helps prevent food and liquid from entering the larynx during swallowing
  8. Complex structure formed by many independent cartilaginous structures and marks where upper airway ends and lower airway begins
  9. ____ ____ of the larynx forms a “V” shape anteriorly—the Adam’s apple.
    Thyroid cartilage
  10. ____ cartilage (or ____ ring) forms lowest portion of larynx.
  11. ____ is the area between the vocal cords and is the narrowest part of an adult’s airway
  12. White bands of thin muscle tissue that are partially separated at rest, produce speech, and protect trachea from the entry of substances like water and vomitus
    Vocal cords
  13. This is the conduit for air entry into the lungs which begins directly below the cricoid cartilage
    Trachea (windpipe)
  14. In the thoracic cavity, the trachea divides at the ____ into two main stem bronchi, right and left.
  15. Lung tissue is covered with the ____ pleura, a slippery outer membrane.  The ____ pleura line the inside of the thoracic cavity.
    • visceral
    • parietal
  16. Bronchioles are made of ____ ____; they dilate and constrict as oxygen passes through them.
    smooth muscle
  17. The ____ is the area between the lungs.
  18. Six things within the mediastinum:
    • Heart
    • Great vessels
    • Esophagus
    • Trachea
    • Major bronchi
    • Many nerves
  19. The phrenic nerve is also found in the ____ and it allows the ____ to contract
    • thorax
    • diaphragm
  20. The amount of gas in air or dissolved in fluid, such as blood.
    Partial pressure
  21. The amount of gas in the oxygen (partial pressure) that resides in the alveoli is ___ mm Hg.
  22. Carbon dioxide enters alveoli from the blood and causes a carbon dioxide partial pressure of  __ mm Hg.
  23. The body attempts to ____ the partial pressure, which results in oxygen diffusion across the membrane into the blood.
  24. The amount of air in milliliters that is moved into or out of the lungs during a single breath.
    Tidal volume
  25. Average tidal volume is ___ mL.
  26. The portion of tidal volume that does not reach the alveoli and does not participate in gas exchange.
    Dead space
  27. The amount of air moved through the lungs in 1 minute minus the dead space.
    Minute ventilation (minute volume)
  28. The amount of air that can be forcibly expelled from the lungs after breathing deeply.
    Vital capacity
  29. Refers to air that remains after maximal expiration.
    Residual volume
  30. Regulation of ventilation is primarily by the pH of ____ ____, which is directly related to the amount of carbon dioxide dissolved in the plasma portion of the blood.
    cerebrospinal fluid
  31. Patients with chronic obstructive pulmonary disease (COPD) have difficulty eliminating ____ ____ through exhalation.
    carbon dioxide
  32. In COPD patients, the body uses a “backup system” known as the ____ ____ to control breathing.
    hypoxic drive
  33. Caution should be taken when administering high concentrations of oxygen to patients with:
    obstructive pulmonary disease.
  34. ____ keeps alveoli expanded, making it easier for gas exchange.
  35. cardiac irritability occurs:
    0 to 1 minute
  36. brain damage is not likely:
    0 to 4 minutes
  37. brain damage is possible
    4 to 6 minutes
  38. brain damage is very likely
    6 to 10 minutes
  39. irreversible brain damage occurs
    Over 10 minutes
  40. Adenosine triphosphate (ATP) is produced through processes known as the ____ ____ and ____ ____.
    • Krebs cycle
    • oxidative phosphorylation
  41. A failure to match ventilation and perfusion is the cause of most abnormalities of oxygen and carbon dioxide exchange.  This is called:
    V/Q ratio mismatch.
  42. Normal resting minute ventilation is about _ L/min.  One third of this volume fills dead space; therefore, resting alveolar ventilation is about _ L/min.
    6, 4
  43. Pulmonary artery blood flow is approximately _ L/min.
  44. This gives a ventilation to perfusion ratio of _/_ L/min or ___ L/min.
    • 4/5
    • 0.8
  45. abnormal decrease in blood volume
    Hypovolemic shock
  46. abnormal increase in blood vessel diameter, decreasing blood pressure
    Vasodilatory shock
  47. Signs of normal breathing for adults are between 12 and 20 breaths/min
    12 and 20
  48. ____ ____ respirations are often seen in stroke and head injury patients.  Breathing with increasing rate and depth of respirations followed by apnea (spontaneous breathing).
  49. ____ respirations have an irregular or unidentifiable pattern and may follow serious head injuries.
  50. ____ respirations are deep, gasping respirations associated with metabolic or toxic disorders.
  51. ____ ____ and the level of ____ are excellent indicators of respiration.
    Skin color

  52. A ____ ____ measures the percentage of hemoglobin saturation
    pulse oximeter
  53. hemoglobin saturation should be __% to ___% while breathing room air
    98% to 100%
  54. Prevents obstruction of the upper airway by the tongue and allows for passage of air and oxygen to the lungs.
    airway adjunct
  55. ____ airways are used for:
    -Unresponsive patients with a gag reflex
    -Apneic patients being ventilated with a bag-mask device
  56. ____ airways are used with a patient who:
    -are unresponsive or has an altered level of consciousness
    -have an intact gag reflex
    -are unable to maintain his or her own airway spontaneously
  57. Remember this rule: If you hear ____, the patient needs suctioning!
  58. A fixed suctioning unit should generate airflow of more than __ L/min and a vacuum of more than ___ mm Hg when the tubing is clamped.
    40, 300
  59. Plastic, rigid pharyngeal suction tips, are called tonsil tips or ____ tips
  60. Nonrigid plastic catheters, are called French or ____-____ catheters
  61. A ____-____ catheter is the best for suctioning the oropharnyx in adults and is preferred for children.
  62. ____-____ catheters are used to suction the nose and liquid secretions in the back of the mouth and in situations when you cannot use a rigid catheter.
  63. Three situations when you could not use a rigid catheter:
    • -A patient who has a stoma
    • -A patient with clenched teeth
    • -If suctioning the nose is necessary
  64. Never suction the mouth or nose for more than  __ seconds at one time for adult patients, __ seconds for children, and _ seconds for infants.
    15, 10, 5
  65. Suctioning can result in ____.
  66. Composite cylinders are tested every _ years.
  67. Most often the _ (or super _) and _ cylinder sizes will be used.
    D, super D, M
  68. The _ tank remains on board the unit as a main supply tank.
  69. System prevents such mistakes as an oxygen regulator being accidently connected to a carbon dioxide cylinder.
  70. For large cylinders, the safety system is the:
    American Standard System
  71. Pressure regulators reduce the cylinder’s pressure to a useful therapeutic range for the patient—usually __ to __ psi.
    40 to 70
  72. The ____ mask is the preferred way to give oxygen in prehospital setting to patients who are breathing adequately but are suspected of having or showing signs of hypoxia.
  73. With a good mask-to-face seal, the nonrebreathing mask is capable of providing up to __% inspired oxygen.
  74. Adjust the flow rate so the bag on a nonrebreathing mask does not collapse when the patient inhales: usually __ to __ L/min
    10 to 15
  75. A nasal cannula can provide __% to __% inspired oxygen when the flowmeter is set at _ to _ L/min.
    • 24, 44
    • 1, 6
  76. The ____ ____ mask is similar to the nonrebreathing mask, except there is no one-way valve between the mask and the reservoir.  Consequently, patients rebreathe a small amount of their exhaled air.  This is advantageous if the patient is hyperventilating.
    partial rebreathing
  77. With the partial rebreathing mask, the oxygen enriches the air mixture and delivers about __% to __% oxygen and _% to _% carbon dioxide.
    • 80% to 90%
    • 2% to 3%
  78. Mask where a number of settings can vary the percentage of oxygen while a constant flow is maintained from the regulator.
    Venturi mask
  79. The Venturi mask is a medium-flow device that delivers __% to __% oxygen, depending on the manufacturer.  Useful in long-term management of physiologically stable patients
    24% to 40%
  80. Ventilation rates (for apneic patients with a pulse):
    • 1 breath per 5 to 6 seconds
    • 1 breath per 3 to 5 seconds
    • 1 breath per 3 to 5 seconds
  81. To increase the oxygen concentration, administer high-flow oxygen at 15 L/min through the oxygen inlet valve of the pocket mask.  Combined with your exhaled breath, this will deliver about __% oxygen.
  82. With an oxygen flow rate of 15 L/min, a bag-mask device can deliver nearly ___% oxygen.
  83. Bag-mask volumes:
    • 1,200 to 1,600 L
    • 500 to 700 L
    • 150 to 240 mL
  84. These devices, also known as flow-restricted, oxygen-powered ventilation devices, are widely available.  They allow a single rescuer to use both hands to maintain a mask-to-face seal while providing positive-pressure ventilation.
    Manually triggered ventilation devices
  85. Manually triggered ventilation device features a peak flow rate of ___% oxygen at up to __ L/min
    100, 40
  86. Manually triggered ventilation device attached to a control box that allows the variables of ventilation to be set.
    Automatic transport ventilator (ATV)
  87. During the expiratory phase when using CPAP, the patient exhales against a resistance called:
    positive end-expiratory pressure (PEEP).
  88. PEEP values of ___ to ___ cm H2O is generally an acceptable therapeutic range.
    8.0 to 10.0
  89. Shortness of breath or difficulty breathing:
  90. Increased carbon dioxide level in the bloodstream:
  91. Open, clear of obstruction.
  92. A technique that is used with intubation in which pressure is applied to either side of the cricoid cartilage to prevent gastric distention and aspiration and allow better visualization of vocal cords; also called cricoid pressure.
    Sellick maneuver
  93. Bypassing of oxygen poor blood past nonfunctional alveoli to the left side of the heart.
    intrapulmonary shunting
  94. The ability of the alveoli to expand when air is drawn in during inhalation.
  95. The process of exchanging oxygen and carbon dioxide between the alveoli and the blood of the capillaries is called:
    A. cellular metabolism.
    B. external respiration.
    C. alveolar ventilation.
    D. pulmonary ventilation.
    B. external respiration.
    (this multiple choice question has been scrambled)
  96. Which of the following structures is contained within the mediastinum?
    A. esophagus
    B. lungs
    C. bronchioles
    D. larynx
    A. esophagus
    (this multiple choice question has been scrambled)
  97. Which of the following organs or tissues can survive the longest without oxygen?
    A. heart
    B. kidneys
    C. muscle
    D. liver
    C. muscle
    (this multiple choice question has been scrambled)
  98. If administering with supplemental oxygen using a BVM, give ___-___ ml. per ventilation or _-_ ml. / kg.
    • 400-600
    • 6-7
  99. If administering without supplemental oxygen using a BVM, give ___-___ ml. per ventilation or __ ml. / kg.
    • 700-1000
    • 10
  100. A BVM must have a __/__ mm. fitting for face mask
  101. A BVM must accept __ L/min oxygen
  102. A flow-restricted, O2 powered ventilator must provide peak of ___% oxygen at up to 40 L/min
    • 100
    • 40
  103. A flow-restricted, O2 powered ventilator is contraindicated (two things):
    • children
    • spinal or chest trauma
  104. A flow-restricted, O2 powered ventilator must have __ cm (H2O) pressure release valve
  105. Nasal cannula
    Oxygen flow rate:
    Percent oxygen:
    • 1-6 liters / min
    • 24% - 44%
  106. Non-rebreather mask
    Oxygen flow rate:
    Percent oxygen:
    • 10 – 15 liters / min
    • Up-to 90%
  107. Mouth to mask
    Oxygen flow rate:
    Percent oxygen:
    • 15 liters / min
    • 55%
  108. BVM with reservoir
    Oxygen flow rate:
    Percent oxygen:
    • 15 liters / min
    • Between 90 and 100%
  109. Normal Respiratory Ranges
    Adults > 8 y:
    Children 1 – 8 y:
    Infants 1-12 mo.:
    Neonates < 1 mo.:
    • 12 – 20
    • 15 – 30
    • 25 – 50
    • 40 – 60
  110. Which of the following structures is not a part of the upper airway?
    A. nasopharny
    B. epiglottis
    C. trachea
    D. larynx
    C. trachea
    (this multiple choice question has been scrambled)
  111. Properly performed suctioning of a patient may still cause:
  112. Cells need a constant supply of oxygen to survive. Some cells may become severely or permanently damaged after what period of time without  oxygen?
    4-6 minutes