Airway Management, Ventilation, and Respiration

Comprehensive vocabulary flashcards covering upper and lower airway anatomy, the physiology and pathophysiology of respiration, patient assessment tools, airway maneuvers, suctioning standards, supplemental oxygen devices, and advanced ventilation techniques.

Upper Airway

All anatomic airway structures located above the vocal cords, consisting of the nose, mouth, oral cavity, pharynx, and larynx, whose major functions are to warm, filter, and humidify air entering the body.

Nasopharynx

The superior section of the pharynx, lined with a ciliated mucous membrane that filters out dust and small particles, which warms and humidifies air as it enters the body.

Oropharynx

The posterior portion of the oral cavity, extending from the soft palate to the epiglottis.

Larynx

A complex structure formed by independent cartilaginous structures that marks the boundary where the upper airway ends and the lower airway begins.

Thyroid Cartilage

The prominent cartilaginous structure of the larynx that forms a V shape anteriorly, commonly referred to as the Adam's apple.

Cricoid Cartilage

A firm, complete ring of cartilage located inferior to the thyroid cartilage that forms the first ring of the trachea.

Cricothyroid Membrane

The elastic fibrous tissue that connects the thyroid cartilage superiorly to the cricoid ring inferiorly.

Glottis

The space between the vocal cords, representing the narrowest portion of the adult airway.

Epiglottis

A leaf-shaped cartilaginous structure superior to the larynx that helps prevent food and liquid from entering the larynx and trachea during swallowing.

Lower Airway

The airway structures below the vocal cords responsible for delivering oxygen to the alveoli, including the trachea, bronchi, bronchioles, and alveoli.

Trachea

The conduit for air entry into the lungs that begins directly below the cricoid cartilage and descends down the midline of the neck into the thoracic cavity.

Carina

The point in the thoracic cavity where the trachea branches into the right and left mainstem bronchi.

Bronchioles

Smaller airway branches made of smooth muscle that dilate and constrict as oxygen passes through them, connecting directly to alveoli.

Alveoli

Millions of microscopic, thin-walled, balloon-like sacs surrounded by pulmonary capillaries where oxygen and carbon dioxide exchange occurs.

Visceral Pleura

The thin serous membrane that covers the outer surface of the lung tissue.

Parietal Pleura

The thin serous membrane that lines the inside of the thoracic cavity.

Mediastinum

The central space between the lungs containing the heart, great vessels (aorta and vena cava), esophagus, trachea, major bronchi, and nerves.

Phrenic Nerves

Nerves originating in the neck and coursing through the thorax that allow the diaphragm to contract downward, which is necessary for breathing.

Ventilation

The physical act of moving air into and out of the lungs, which is necessary for oxygenation and respiration to occur.

Inhalation

The active, muscular phase of breathing during which the diaphragm and intercostal muscles contract, creating negative pressure within the thorax that allows air to enter the body.

Negative-Pressure Ventilation

The physiologic process where expansion of the thoracic cage decreases air pressure within the thoracic cavity, creating a slight vacuum that pulls air in through the trachea.

Partial Pressure

The amount of gas in the air or dissolved in fluid, such as blood, measured in millimeters of mercury ($\text{mm Hg}$).

Tidal Volume

A measure of the amount of air in milliliters moved into or out of the lungs during a single breath, averaging approximately $500\,\text{mL}$ in an adult.

Dead Space

The portion of inspired air that fails to reach the alveoli for gas exchange.

Exhalation

The normally passive process of breathing during which the diaphragm and intercostal muscles relax, decreasing the size of the thorax and pushing air out through the trachea.

Hypoxia

A dangerous condition in which the tissues and cells of the body do not get enough oxygen.

Hypoxic Drive

A backup respiratory drive that senses dissolved oxygen levels rather than carbon dioxide to regulate breathing, typically found in patients with end-stage COPD.

Oxygenation

The process of loading oxygen molecules onto hemoglobin molecules in the bloodstream.

Respiration

The actual physical exchange of oxygen and carbon dioxide in the alveoli as well as the tissues of the body.

External Respiration

The exchange of gases between the lungs and the blood, where oxygen diffuses from alveoli into pulmonary capillaries and carbon dioxide moves from the capillaries into alveoli.

Surfactant

A chemical substance that reduces surface tension within the alveoli to keep them expanded, making gas exchange easier.

Internal Respiration

The exchange of oxygen and carbon dioxide between the systemic circulatory system capillaries and the tissue cells of the body.

Aerobic Metabolism

The cellular process in which cells combine glucose and oxygen to produce energy (ATP), producing water and carbon dioxide as primary waste products.

Anaerobic Metabolism

Cellular metabolism that takes place in the absence of adequate oxygen, which cannot meet the cellular metabolic demands and ultimately leads to cell death if uncorrected.

Chemoreceptors

Receptors that monitor levels of oxygen, carbon dioxide, hydrogen ions, and cerebrospinal fluid pH, sending feedback to the medulla and pons to regulate rate and depth of respiration.

Ventilation/Perfusion Mismatch

A condition occurring when air flow into the alveoli and blood flow through the pulmonary capillaries are not directed to the same place at the same time, impairing gas exchange.

Aerosol-Generating Procedures (AGPs)

Interventions including CPR, nebulizer treatments, endotracheal intubation, and CPAP that aerosolize secretions and require rescuers to wear masks and eye protection with shields.

Normal Adult Breathing Rate

A regular respiratory rate of $12\text{--}20\,\text{breaths/min}$ with adequate depth, regular chest rise and fall, and clear, equal bilateral breath sounds.

Tripod Position

An abnormal posture indicating respiratory distress where a patient sits leaning forward with arms outstretched and hands braced on knees or an elevated surface.

Retractions

Visible inward pulling of the skin around the ribs or above the clavicles during inspiration, demonstrating increased effort of breathing.

Agonal Gasps

Occasional, gasping respiratory efforts that can occur after the heart has stopped; these do not represent adequate breathing.

Cheyne-Stokes Respirations

An abnormal breathing pattern marked by an increasing rate and depth of respirations followed by a period of apnea, frequently observed in stroke or head injury patients.

Ataxic Respirations

Irregular, unidentifiable respiratory patterns with no consistent rhythm, which may follow serious brain injuries.

Kussmaul Respirations

Deep, rapid respirations commonly seen in patients experiencing metabolic acidosis.

Pulse Oximetry (Spo2)

An assessment measurement representing the percentage of hemoglobin molecules bound to oxygen in arterial blood, normally greater than $94\%$ on room air.

End-Tidal CO2 (ETCO2)

The maximal concentration of carbon dioxide exhaled at the end of a breath, with a normal physiologic range of $35\text{--}45\,\text{mm Hg}$.

Capnometry

A device-based assessment that provides a digital numeric reading of the end-tidal carbon dioxide level.

Capnography

An assessment method that provides both a numeric reading and a continuous breath-to-breath graphical waveform of end-tidal carbon dioxide.

Tongue Obstruction

The most common airway obstruction in an unconscious patient, occurring when relaxed throat and tongue muscles allow the tongue to fall back into the throat.

Head Tilt–Chin Lift Maneuver

A technique used to open the airway in patients without suspected spinal trauma by applying backward pressure to the forehead while lifting the chin upward.

Jaw-Thrust Maneuver

An airway maneuver used to open the airway when cervical spine injury is suspected, performed by placing fingers behind the angles of the lower jaw and lifting it upward.

Cross-Finger Technique

A technique used to open a patient's mouth by placing index finger on upper teeth and thumb on lower teeth and pushing them past each other in a scissors-like motion.

Tonsil Tips (Yankauer Tips)

Rigid, plastic pharyngeal suction tips with a wide diameter designed to remove thick secretions, vomit, and blood from the mouth.

Whistle-Tip Catheter

A nonrigid plastic catheter (French catheter) used to suction the nose, stomas, or liquid secretions where a rigid catheter cannot be introduced.

Fixed Suctioning Unit

A permanently mounted ambulance suction unit that should generate a vacuum of more than $300\,\text{mm Hg}$ when the tubing is clamped.

Adult Suctioning Limit

The guideline recommending that each suctioning attempt in an adult patient should be limited to $10\,\text{seconds}$ to avoid hypoxia.

Oropharyngeal Airway (OPA)

A semicircular curved plastic airway adjunct indicated for unresponsive patients without a gag reflex to keep the tongue off the posterior pharynx.

Nasopharyngeal Airway (NPA)

A soft, flexible tube inserted through the naris indicated for semiconscious or unconscious patients who have an intact gag reflex.

Recovery Position

A lateral position used to maintain a patent airway and prevent aspiration in an unconscious, uninjured patient breathing spontaneously with adequate tidal volume.

Pin-Indexing System

A safety system for portable medical gas cylinders that uses specific pin configurations to prevent connecting an incompatible regulator to an oxygen cylinder.

American Standard Safety System

A safety system with varied internal and external threading patterns used on large compressed gas cylinders to prevent regulator mismatches.

Pressure Regulator

A device that attaches to high-pressure oxygen cylinders to reduce gas pressure to a therapeutic working range of $40\text{--}70\,\text{psi}$.

Bourdon-Gauge Flowmeter

A flowmeter calibrated to read flow rates in liters per minute that is not affected by gravity and can operate in any physical position.

Pressure-Compensated Flowmeter

A calibrated upright glass flowmeter containing a float ball that measures gas flow rate and must remain vertical because it is gravity-dependent.

Oxygen Toxicity

Damage to cellular tissue caused by excessive blood oxygen levels, resulting in oxygen free radical production that injures or destroys cells.

Nonrebreathing Mask

An oxygen delivery mask with a reservoir bag and one-way valves that delivers up to $95\%$ inspired oxygen at flow rates of $10\text{--}15\,\text{L/min}$.

Nasal Cannula

A lightweight device delivering $24\%\text{--}44\%$ oxygen via two small nasal prongs at flow rates of $1\text{--}6\,\text{L/min}$.

Venturi Mask

A face mask equipped with interchangeable, color-coded entrainment adapters that precisely regulate delivered oxygen concentrations between $24\%$ and $40\%$.

Tracheostomy Mask

A specialized mask shaped to fit over a surgical neck stoma and secured around the neck with an elastic strap to deliver supplemental oxygen.

Positive-Pressure Ventilation

The artificial delivery of air forced into the lungs, which elevates intrathoracic pressure and can reduce venous return to the heart and diminish cardiac output.

Apneic Adult Ventilation Rate

The artificial ventilation rate for an adult patient with a pulse who is not breathing, defined as $1\,\text{breath every } 6\,\text{seconds}$.

Apneic Pediatric Ventilation Rate

The artificial ventilation rate for an infant or child with a pulse who is not breathing, defined as $1\,\text{breath every } 2\text{--}3\,\text{seconds}$.

Gastric Distention

The inflation of the stomach with air during positive-pressure ventilation, most often caused by excessive volume, rapid ventilations, or an obstructed airway.

Automatic Transport Ventilator (ATV)

A mechanical resuscitator attached to a control box that delivers set ventilation volumes and rates automatically, allowing the rescuer to maintain mask seal and patency.

Continuous Positive Airway Pressure (CPAP)

Noninvasive positive-pressure therapy delivered through a sealed face mask throughout the respiratory cycle to treat severe respiratory distress in COPD or pulmonary edema.

Alveolar Recruitment

The process by which continuous positive airway pressure opens collapsed alveoli and prevents atelectasis during exhalation.

Tracheostomy Tube

An artificial tube inserted through a neck stoma to maintain airway patency, consisting of an outer cannula with flange, an inner cannula, and a removable obturator.

Passy-Muir Valve

A one-way valve attached to a tracheostomy tube that allows a patient to inhale through the stoma and exhale past the vocal cords to enable speech.

DOPE Mnemonic

An assessment mnemonic used when an intubated or tracheostomy patient deteriorates: Displaced tube, Obstructed tube, Pneumothorax, and Equipment failure.

Supraglottic Airway

An advanced airway device (such as a King LT or i-gel) that is blindly inserted to rest above the glottis to provide a seal and ventilate the lungs without entering the trachea.