Airway Fisdap Questions
Respiratory System Essentials
I. Fundamental Concepts of Ventilation
Tidal Volume: The amount of air inhaled or exhaled during a normal
breath. In an average adult, this is approximately 500 ml.
Alveolar Volume: The volume of air that reaches the alveoli for gas
exchange during normal breathing is about 350 ml.
Dead Space Volume: The air that remains in the conducting airways
(trachea, bronchi) and does not participate in gas exchange. This volume is
approximately 150 ml in an adult.
Minute Ventilation: The total volume of air inhaled or exhaled per minute
(Respiratory Rate × Tidal Volume). The normal adult respiratory rate is 12-
20 breaths per minute.
II. Common Respiratory Conditions and Presentations
A. Chronic Bronchitis
Suspect in: A patient with a history of heavy smoking, consistent cough,
and frequent respiratory infections. Auscultation may reveal bilateral
rhonchi (low-pitched rattling sounds).
Explanation: Chronic bronchitis involves long-term inflammation of the
bronchioles, leading to excessive mucus and pus production, which
obstructs the airways. The persistent cough is a compensatory mechanism to
clear this obstruction.
B. Respiratory Failure
Suspect in: An unresponsive patient with a significantly low respiratory rate
(e.g., 6 breaths per minute), altered mental status (e.g., sleepy, difficult to
arouse), and signs of poor perfusion (e.g., cool, pale, diaphoretic).
Immediate Intervention: Assisting ventilations with a bag-valve mask
(BVM) is crucial to increase respiratory rate and ensure adequate
oxygenation.
, C. Pneumonia
Suspect in: A febrile patient presenting with shortness of breath, dull chest
pain, and a cough producing "rusty" sputum.
Explanation: Pneumonia is an infection of the lung tissue. The rusty
sputum indicates a lower airway infection, and fever is a systemic response
to the infection. Dull chest pain is common at the site of infection.
D. Upper Airway Obstruction
Sign: Stridor, a harsh, high-pitched sound during inspiration, often indicates
an obstructed upper airway.
Common Cause: In an unresponsive, supine patient, the tongue is the most
frequent cause of airway obstruction as it relaxes and falls back into the
pharynx. The pharynx itself is the most common location for airway
obstruction in general due to its shared function with the digestive system.
E. Labored Breathing
Signs: Use of accessory muscles (neck, shoulders), nasal flaring, and
initially an increased respiratory rate and heart rate. As the patient tires,
respiratory rate and quality will decline.
Indication: Suggests the patient is working harder than normal to breathe,
often due to underlying respiratory distress.
F. Asthma Attack
Initial Concern: In a conscious patient with an asthma attack presenting
with wheezing and a mid-90s pulse oximetry, the primary concern is
diminishing pulmonary function potentially leading to respiratory failure.
G. Airway Occlusion
Consequences: Even with attempted breathing against a partially occluded
airway, inadequate air movement to the alveoli can lead to hypoxia
(insufficient oxygen to the tissues) or hypercapnia (excessive carbon
dioxide in the blood).
Altered Mental Status: For any patient with an altered mental status, the
most significant airway concern is the tongue relaxing and obstructing the
airway.
Respiratory System Essentials
I. Fundamental Concepts of Ventilation
Tidal Volume: The amount of air inhaled or exhaled during a normal
breath. In an average adult, this is approximately 500 ml.
Alveolar Volume: The volume of air that reaches the alveoli for gas
exchange during normal breathing is about 350 ml.
Dead Space Volume: The air that remains in the conducting airways
(trachea, bronchi) and does not participate in gas exchange. This volume is
approximately 150 ml in an adult.
Minute Ventilation: The total volume of air inhaled or exhaled per minute
(Respiratory Rate × Tidal Volume). The normal adult respiratory rate is 12-
20 breaths per minute.
II. Common Respiratory Conditions and Presentations
A. Chronic Bronchitis
Suspect in: A patient with a history of heavy smoking, consistent cough,
and frequent respiratory infections. Auscultation may reveal bilateral
rhonchi (low-pitched rattling sounds).
Explanation: Chronic bronchitis involves long-term inflammation of the
bronchioles, leading to excessive mucus and pus production, which
obstructs the airways. The persistent cough is a compensatory mechanism to
clear this obstruction.
B. Respiratory Failure
Suspect in: An unresponsive patient with a significantly low respiratory rate
(e.g., 6 breaths per minute), altered mental status (e.g., sleepy, difficult to
arouse), and signs of poor perfusion (e.g., cool, pale, diaphoretic).
Immediate Intervention: Assisting ventilations with a bag-valve mask
(BVM) is crucial to increase respiratory rate and ensure adequate
oxygenation.
, C. Pneumonia
Suspect in: A febrile patient presenting with shortness of breath, dull chest
pain, and a cough producing "rusty" sputum.
Explanation: Pneumonia is an infection of the lung tissue. The rusty
sputum indicates a lower airway infection, and fever is a systemic response
to the infection. Dull chest pain is common at the site of infection.
D. Upper Airway Obstruction
Sign: Stridor, a harsh, high-pitched sound during inspiration, often indicates
an obstructed upper airway.
Common Cause: In an unresponsive, supine patient, the tongue is the most
frequent cause of airway obstruction as it relaxes and falls back into the
pharynx. The pharynx itself is the most common location for airway
obstruction in general due to its shared function with the digestive system.
E. Labored Breathing
Signs: Use of accessory muscles (neck, shoulders), nasal flaring, and
initially an increased respiratory rate and heart rate. As the patient tires,
respiratory rate and quality will decline.
Indication: Suggests the patient is working harder than normal to breathe,
often due to underlying respiratory distress.
F. Asthma Attack
Initial Concern: In a conscious patient with an asthma attack presenting
with wheezing and a mid-90s pulse oximetry, the primary concern is
diminishing pulmonary function potentially leading to respiratory failure.
G. Airway Occlusion
Consequences: Even with attempted breathing against a partially occluded
airway, inadequate air movement to the alveoli can lead to hypoxia
(insufficient oxygen to the tissues) or hypercapnia (excessive carbon
dioxide in the blood).
Altered Mental Status: For any patient with an altered mental status, the
most significant airway concern is the tongue relaxing and obstructing the
airway.
