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Appropriate airway management - ✔✔*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 - ✔✔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*
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,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 - ✔✔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 - ✔✔-Complex structure formed by many independent
cartilaginous structures
-Marks where the upper airway ends and lower airway begins
2. Thyroid cartilage - ✔✔-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
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,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) - ✔✔-Lies inferiorly to the thyroid cartilage
-Forms the lowest portion of the larynx
-More prominent in females
4. Cricothyroid membrane - ✔✔-Located between the thyroid and cricoid
cartilage
-Site for emergency surgical and nonsurgical access to the airway
-Bordered laterally and inferiorly by the highly vascular thyroid gland
5. Glottis - ✔✔-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 - ✔✔-Immediately descends into the thoracic cavity
-Not a straight tube, which is key to understand when placing an ET tube
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, The respiratory and cardiovascular systems work together to ensure that: -
✔✔1. A constant supply of oxygen and nutrients is delivered to every cell.
2. Waste products are removed from every cell.
Ventilation - ✔✔-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 - ✔✔-Process of loading oxygen molecules onto hemoglobin
molecules in the bloodstream
-Requires adequate *FiO2 (Percentage of oxygen in inhaled air)*
Respiration - ✔✔-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 - ✔✔-Multiple conditions can inhibit the
body's ability to effectively provide oxygen to cells.
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