Appropriate airway management - Answer *Steps must be performed in order. Bypass steps that do not apply.* a. Open and maintain a patent airway. b. Recognize and treat airway obstructions. c. Assess ventilation and oxygenation status. d. Administer supplemental oxygen. e.Provide ventilatory assistance. Upper airway - Answer Consists of all anatomic airway structures above the glottic opening. *1. Tongue* a. Must be manipulated b. Tends to fall back into the posterior pharynx in unresponsive patient *2. Pharynx* a. Muscular tube that extends from the nose and mouth to the esophagus and trachea b. Composed of: i. Nasopharynx ii. Oropharynx iii. Laryngopharynx (hypopharynx) Lower airway - Answer Extends from the glottis to the pulmonary capillary membrane. 1. *Larynx* 2. *Thyroid cartilage* 3. *Cricoid cartilage (cricoid ring)* 4. *Cricothyroid membrane* 5. *Glottis* 6. *Trachea* 1. Larynx - Answer -Complex structure formed by many independent cartilaginous structures -Marks where the upper airway ends and lower airway begins 2. Thyroid cartilage - Answer -Shield-shaped structure formed by two plates that join in a "V" shape anteriorly to form the laryngeal prominence i. Known as the Adam's apple ii. More pronounced in men iii. Can be difficult to locate in obese or short-necked patients -Suspended from the hyoid bone by the thyroid ligament -Directly anterior to the glottic opening 3. Cricoid cartilage (cricoid ring) - Answer -Lies inferiorly to the thyroid cartilage -Forms the lowest portion of the larynx -More prominent in females 4. Cricothyroid membrane - Answer -Located between the thyroid and cricoid cartilage Paramedic Airway FISDAP Review Part 1 Rated 100% Correct!! -Site for emergency surgical and nonsurgical access to the airway -Bordered laterally and inferiorly by the highly vascular thyroid gland 5. Glottis - Answer -Narrowest portion of the adult airway -Vocal cords are located at the lateral borders of the glottis. -Epiglottis is located at the superior border of the glottis. -ET intubation requires visualizing the epiglottis, glottis, and vocal cords before inserting the ET tube. 6. Trachea - Answer -Immediately descends into the thoracic cavity -Not a straight tube, which is key to understand when placing an ET tube The respiratory and cardiovascular systems work together to ensure that: - Answer 1. A constant supply of oxygen and nutrients is delivered to every cell. 2. Waste products are removed from every cell. Ventilation - Answer -Physical act of moving air into and out of the lungs 1. *Inhalation* is the active, muscular part of breathing. 2. *Exhalation* is a passive process and does not normally require muscular effort. Oxygenation - Answer -Process of loading oxygen molecules onto hemoglobin molecules in the bloodstream -Requires adequate *FiO2 (Percentage of oxygen in inhaled air)* Respiration - Answer -Process of exchanging O2 and CO2--> 1. *External respiration (Also called pulmonary respiration)*: Process of exchanging O2 and CO2 between the alveoli and blood in pulmonary capillaries. 2. *Internal respiration (Also called cellular respiration)*: Exchange of O2 and CO2 between the systemic circulation and the body's cells. Pathophysiology of Respiration - Answer -Multiple conditions can inhibit the body's ability to effectively provide oxygen to cells. 1. Disruption of pulmonary ventilation, oxygenation, and respiration will cause immediate effects on the body. a. Must be recognized and corrected immediately b. Important to distinguish a primary ventilation problem from a primary oxygenation or respiration problem 2. Every cell needs a constant supply of oxygen to survive. a. Some tissues are more resilient than others. b.Sufficient levels of external respiration and perfusion are required. 3. Hypoxia, ventilation-perfusion ratio and mismatch, factors affecting ventilation, factors affecting oxygenation and respiration, and acid-base balance. 1. Hypoxia - Answer Tissues and cells do not receive enough oxygen --> Death may occur quickly if not corrected.