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FISDAP_Airway_Exam_2022.docx, Exams of Advanced Education

Virginia Union University (VUU)Advanced Education

FISDAP_Airway_Exam_2024.docx exam

Typology: Exams

2024/2025

Available from 06/06/2025

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FISDAP Airway Exam 2022 โ€“ Questions And
Answers (100% Corect)
From the atmosphere, what structures does air pass through during
ventilation? Correct ans - Starts in atmosphere, then nose,
nasopharyngeal space/orophargyneal space (if mouth breather), then
pharynx, larynx, trachea, bronchi, bronchioles, alveoli
What is the purpose of the nasal passages and nasopharynx? Correct
ans - To warm/humidify air as it passes through
What is the difference between respiration and ventilation? Correct ans
- Respiration refers to the exchange of gases in the alveoli, ventilation refers
to the movement of air into the lungs. Respiration is needed to provide O2 to
cells and remove waste products. Also regulates pH of blood.
What are the structures of the upper airway? Correct ans - nose,
mouth, tongue, jaw, pharynx and larynx
What structure is considered a landmark that divides the upper airway from
lower? Correct ans - The larynx, anything above is upper. The larynx
and below are lower.
What are the structures of the lower airways? Correct ans - larynx
(includes adam's apple/thyroid cartilage, cricothyroid membrane, cricoid
cartilage), trachea, bronchi, bronchioles, alveoli
Describe the anatomy of the larynx. Correct ans - From superior to
inferior. Thyroid cartilage, cricothyroid membrane, and cricoid membrane.
The thyroid cartilage and cricoid cartilage are anterior to the larynx, and the
cricothyroid membrane is posterior to both structures.
True or false: the lungs are completely equal in the midsaggital plane.
Correct ans - False, right lungs has 3 lobes, left lung only has 2 lobes.
Together they have 5 total. Also, the right bronchi is inferior to the left
bronchi.
What are the structures of the lungs in order of ventilation? Correct ans
- bronchioles, and alveoli
True or false: the lungs use muscles found in the lateral lobes to expand and
contract? Correct ans - False: the lungs are hollow organs and contain
no muscles. When the diaphragm contracts it expands the thoracic cavity.
The pleural space has a negative pressure and the lungs expand. This results
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Download FISDAP_Airway_Exam_2022.docx and more Exams Advanced Education in PDF only on Docsity!

FISDAP Airway Exam 2022 โ€“ Questions And

Answers (100% Corect)

From the atmosphere, what structures does air pass through during ventilation? Correct ans - Starts in atmosphere, then nose, nasopharyngeal space/orophargyneal space (if mouth breather), then pharynx, larynx, trachea, bronchi, bronchioles, alveoli What is the purpose of the nasal passages and nasopharynx? Correct ans - To warm/humidify air as it passes through What is the difference between respiration and ventilation? Correct ans

  • Respiration refers to the exchange of gases in the alveoli, ventilation refers to the movement of air into the lungs. Respiration is needed to provide O2 to cells and remove waste products. Also regulates pH of blood. What are the structures of the upper airway? Correct ans - nose, mouth, tongue, jaw, pharynx and larynx What structure is considered a landmark that divides the upper airway from lower? Correct ans - The larynx, anything above is upper. The larynx and below are lower. What are the structures of the lower airways? Correct ans - larynx (includes adam's apple/thyroid cartilage, cricothyroid membrane, cricoid cartilage), trachea, bronchi, bronchioles, alveoli Describe the anatomy of the larynx. Correct ans - From superior to inferior. Thyroid cartilage, cricothyroid membrane, and cricoid membrane. The thyroid cartilage and cricoid cartilage are anterior to the larynx, and the cricothyroid membrane is posterior to both structures. True or false: the lungs are completely equal in the midsaggital plane. Correct ans - False, right lungs has 3 lobes, left lung only has 2 lobes. Together they have 5 total. Also, the right bronchi is inferior to the left bronchi. What are the structures of the lungs in order of ventilation? Correct ans
  • bronchioles, and alveoli True or false: the lungs use muscles found in the lateral lobes to expand and contract? Correct ans - False: the lungs are hollow organs and contain no muscles. When the diaphragm contracts it expands the thoracic cavity. The pleural space has a negative pressure and the lungs expand. This results

in a slightly negative pressure (compared to the atmosphere) and air rushes in. True or false: Air rushes into the lungs because of negative pressure. Correct ans - True, when the lungs expand, they are creating a vacuum because they are expanding the volume of the container. This increase in volume causes influx of air into the container until the pressure is equalized with the atmosphere. True or false: The parietal pleura lines the lungs and the visceral pleura lines the lungs. The space between is called the anterior pleura. Correct ans

  • False: the visceral pleura lines the lungs, the parietal pleura lines the body cavity and the pleural space is the space in between both where body fluid allows for both to smoothly glide. What muscles are involved in inhalation? Correct ans - The diaphragm, cervical muscles (neck), intercostals, abdominal muscles, and pectoral muscles. What muscles are involved in expiration? Correct ans - none, expiration (if done passively) is achieved by the relaxation of the diaphragm. What is the primary driver of respiration? (Why would we increase/decrease RR?) Correct ans - The CSF in the brain has chemoreceptors sensitive to CO2. When there is too much CO2. The pH changes. These sensors feed back to the medulla oblongata, which stimulates the phrenic nerve which innervates the diaphragm. They cause an increase in activity of the diaphragm. This increases the RR which causes us to increase tidal volume. This means more CO2 is exhaled. And brings our pH back to normal. We also have the less sensitive hypoxic drive What is hypoxic drive? Correct ans - Backup system to control respiration. Chemoreceptors in brain, aorta, and carotid arteries. But they are "satisfied" by a small amount of O2, which means it is not as sensitive as pH control of CO What two areas of the brain are involved in respiration? Correct ans - medulla-controls rhythm, initiates inspiration, sets base pattern for respirations, and stimulates diaphragm to contract. pons-changes depth of inspiration, expiration or both. True or false: arteries bring oxygenated blood to organs/capillaries Correct ans - True in most cases with one exception. Arteries (away) bring blood away from the heart. Usually this is oxygenated blood. But the
  1. pale/cyanotic skin
  2. cool, damp, clammy skin
  3. tripod position Chapter 10
  4. 12< or 20>
  5. irregular rhythm
  6. diminished, absent or noisy auscultated breath sounds
  7. reduced flow of expired air at nose/mouth
  8. unequal or inadequate chest expansion
  9. labored breathing
  10. shallow depth
  11. pale, cyanotic, cool or moist skin
  12. retractions around ribs or above clavicles What are agonal gasps? What should you do if a pt has agonal gasps? Correct ans - Pt in cardiac arrest has occasional gasping breaths because respiratory center in brain continues to send signals to breathing muscles. Artificial ventilations and chest compressions. Where are the alpha-1 receptors located? What is their effect? Correct ans - location-blood vessels constricted blood vessels, skin is pale, cool, clammy They essentially increase BP Where are the Beta-1 receptors located? What is their effect? Correct ans - location-heart effect- increased HR, increased force of contraction They essentially increase CO since CO = HR x SV Where are the Beta-2 receptors located? What is their effect? Correct ans - location - lungs (beta-2 is beta-tube) effect - bronchodilation (more air enters lungs) Where are the muscarinic receptors located? What is their effect? Correct ans - location - heart effect - decreased HR, decreased force of contraction Muscarinic is parasympathetic system and do complete opposite of Beta- which is sympathetic

What hormones activate the sympathetic nervous system? Correct ans

  • Epineprhine and norepineprhine, which are released from he adrenal gland after stimulation by the sympathetic nervous system. These hormones stimulate heart and blood vessels. What is pathophysiology? Correct ans - Study of how normal physiologic processes are affected by disease What is respiratory compromise? Correct ans - Inability of body to move gas effectively. Can result in decreased O2 (hypoxia) and increased CO2 (hypercarbia) What factors can impair ventilation? Correct ans - 1. Obstruction a. foreign objects - toys, food, teeth tongue etc b. physiological - induced by asthma, allergic rxns, infection
  1. Impairment a. brain injury - to medulla/pons b. breathing muscles - diaphragm, c. nerves - neuromuscular disease like cerebral palsy can affect phrenic nerve
  2. Other factors a. drugs - opioids can reduce RR b. loss of consciousness - can cause impaired ventilation c. trauma to chest wall - impair expansion of lungs What factors can impair respiration? Correct ans - 1. air (too little O2, too much CO2, toxins like CO)
  3. impaired movement of gas across cell membrane (due to fluid in alveoli, mucus or other secretions)
  4. Blood vessels become clogged (pulmonary embolism) What is the V/Q ratio? Correct ans - How much gas is being moved effectively, versus how much blood is flowing around the alveoli where gas exchange (perfusion occurs) example - pt w/ pulmonary embolism might have regular ventilation, but blockage might impair exchange or perfusion. So Q is compromised. What happens in the body when there is respiratory compromise? Correct ans - 1. O2 levels fall and CO2 levels rise
  5. Brain detects increase in CO
  6. Body increases RR to try to manage CO2 levels
  7. If increased respiration does not clear CO2, then blood is acidic
  1. tachycardia
  2. anxiety Late
  3. mental status changes
  4. weak (thready) pulse
  5. cyanosis
  6. Dyspnea Cellular respiration (Metabolism)? Correct ans - Cells take energy from nutrients through series of chemical processes. What is the difference between external and internal respiration? Correct ans - External - process of breathing fresh air into respiratory system and exchanging O2 and CO2 between alveoli and blood in pulmonary capillaries internal - exchange of oxygen and CO2 between systemic circulatory systems and cells of body What are the critical periods in which a cell needs O2? Correct ans - 0- 1 minute: cardiac irritability 0-4 minute: brain damage not likely 4-6 minute: brain damage possible 6-10 minute: brain damage likely more than 10: irreversible brain damage What is intrapulmonary shunting? What is the cause of it? Correct ans - It's when blood enters lungs from right side of heart bypasses alveoli and return to left side of heart in unoxygenated state. Can be caused by nonfunctional alveoli due to diseases What factors can lead to hypoxia due to circulatory compromise? Correct ans - 1. obstruction of blood flow due to a. pulmonary embolism b. pneumothorax c. heart failure d. cardiac tamponade
  7. Decreased ability of blood to carry O a. blood loss b. anemia c. shock (vasodilatory shock) What is labored breathing? How do you tell someone has it? Correct ans
  • Pt with inadequate breathing may appear to be working hard to breathe.

Look for use of accessory muscles which are not used during normal breathing What are Cheyne-Stokes Respirations? What do they indicate? Correct ans - Irregular respiration where pt breathes w/ increasing rate/depth that is followed by apnea, followed again by period of increasing rate/depth of respiration. Can occur in people with strokes/head trauma What are ataxic respirations? Correct ans - When pt has irregular ineffective respirations that may or may not have identifiable pattern What are Kussmaul respirations? What do they indicate? Correct ans - Deep, rapid respirations Seen in pt's with metabolic acidosis, or those with diabetes You arrive on scene with a pt that is conscious but experiencing respiratory distress. What are two devices that can assess their respiration? Correct ans - 1. Pulse oximetry (measures O2 bound to hemoglobin)

  1. Capnography device (measures end tidal CO2) How would you use a pulse oximeter? Correct ans - 1. clean pt's finger, and remove nail polish as needed. Place finger into probe and turn on.
  2. Palpate radial pulse to ensure accuracy and correlation w/ pulse ox Normal reading between 98-100. Less than 90% pt requires treatment unless chronic condition. Oxygen applied when SPO2 drops below 94% What can cause an inaccurate pulse ox? Correct ans - 1. Hypovolemia
  3. Severe peripheral vasoconstriction (chronic hypoxia, smoking or hypothermia)
  4. Time delay in detecting respiratory insufficiency
  5. Dark/metallic nail polish
  6. Dirty fingers
  7. CO poisoning You encounter an unconscious pt. They have a pulse but inadequate breathing. What should you do if they are a) found in their bed or b) found underneath a tree? Correct ans - You need to open the airway. If head trauma is suspected, use a jaw thrust. If head trauma is not suspected, use a head-tilt-chin-lift maneuver

Carbon Monoxide Poisoning Correct ans - 1. flu like symptoms

  1. headache
  2. dizziness
  3. fatigue
  4. nausea
  5. vomiting
  6. chest pain remove them from scene, administer high flow o2 by nonrebreathing mask. May need full airway control w/ airway adjunct and bvm ventilation CHF Correct ans - 1. Dependent edema
  7. Crackles (pulmonary edema)
  8. Orthopnea
  9. Paroxysmal nocturnal dyspnea Common Cold Correct ans - 1. cough
  10. runny/stuffy nose
  11. sore throat COPD Correct ans - slow process of dilation/disruption of airways/alveoli caused by chronic bronchial obstruction Croup Correct ans - 1. fever
  12. barking cough
  13. stridor
  14. mostly seen in pediatric patients inflammation/swelling of pharynx, larynx and trachea. Typically seen in young children Treat w/ humidified O Diphtheria Correct ans - 1. difficulty breathing/swallowing
  15. sore throat
  16. thick gray buildup in throat/nose
  17. fever Emphysema Correct ans - 1. barrel chest
  18. pushed lip breathing (pink puffers)
  19. dyspnea on exertion
  20. cyanosis
  21. wheezing/decreased breath sounds Most common form of COPD. Loss of elastic material in lungs

Epiglottitis Correct ans - 1. Dyspnea

  1. High fever
  2. stridor
  3. drooling
  4. difficulty swallowing
  5. severe sore throat
  6. tripod/sniffing position Life threatening, caused by bacterial infection of epiglottis in children, risk of complete airway obstruction. Try to keep them from crying. Do not put anything in mouths. Provide quick transport to ER, focus on maintaining patent airway Flu Correct ans - 1. cough
  7. fever
  8. sore throat
  9. fatigue Hay Fever Correct ans - coldlike symptoms, caused by allergic response. Hyperventilation Correct ans - over breathing to the point of arterial CO2 falls below normal. Alkalosis of blood occurs.
  10. anxiety
  11. dizziness
  12. numbness
  13. tingling of hands/feet
  14. painful spasms of hand/feet
  15. Pt's feel they cannot catch breathe occurs when someone experiences psychological distress. Maybe be as high as 40 breaths/min or low as 20. Verbally instruct pt to slow breathing, and if that doesn't work, give supplemental O2 and provide transport Pertussis Correct ans - 1. coughing spells
  16. whooping sound
  17. fever airborne bacterial infection, coughing spells can last for a minute where pt turns red. May vomit/want to avoid eat/drink Pleural Effusion Correct ans - collection of fluid outside lung on one or both sides that compresses lung/lungs and causes dyspnea.
  1. neck vein distension
  2. tracheal deviation (late sign)
  3. hypotension, signs of shock (late sign) Respiratory syncytial Virus (RSV) Correct ans - 1. cough
  4. wheezing
  5. fever
  6. dehydration Look for signs of dehydration, infants w/ RSV often refuse liquids. Humidified O2 can be helpful TB Correct ans - 1. cough
  7. fever
  8. fatigue
  9. productive/bloody sputum bacterial infection, can be dormant for years. High prevalence for people living in close contact. Need to wear gloves, eye protection, N-95 respirator How would you differentiate COPD and CHF? Correct ans - COPD emphysema - thin w/ barrel chest, pink puffer, tripod position, flat neck veins, dry lungs, shortness of breath on exertion, rhonchi, wheezing, no mucus bronchitis - obese, difficulty w/ expiration, flat neck veins, blue bloat, lungs wet, shortness of breath on exertion, rhonchi, wheezing, frequent/chronic cough, excessive thick mucous CHF - abdominal distention, edema (sacral/pedal), tachycardia, increased RR, anxiety, inability to lie flat, cyanotic, confused LOC, blue skin, wet lungs, shortness of breath all the time, sudden onset of shortness, crackles, wheezing, coughing may be present, pink frothy sputum What are the types of normal breath sounds? Correct ans - 1. Vesicular
  10. Bronchol-vesicular
  11. Bronchial (tubular) What are vesicular breath sounds? Correct ans - description - soft pitched, low intensity gentle sighing location - over peripheral lung, best heard at base characteristics - best heard on inspiration (5:2) ratio

What are bronchiole-vesicular sounds? Correct ans - description - moderate intensity and moderate pitch blowing sounds, created by air moving through larger bronchi location - between scapula and lateral to sternum characteristics - equal inspiratory and expiratory What are bronchial (tubular) lung sounds? Correct ans - description - high pitched, loud harsh sounds created by air moving through trachea location - anteriorly over trachea, generally not heard over lung tissue characteristics - louder than vesicular sounds, have short inspiratory phase and long expiratory phase (1:2 ratio) What are the types of adventitious lung sounds? Correct ans - 1. crackles (rales)

  1. gurgles (rhonchi)
  2. friction rub
  3. wheeze
  4. stridor What are crackles? Correct ans - description - fine short, interrupted crackling sounds, best approximated by rolling hair between fingers. Best heard on inspiration but can be heard on both. May not be cleared by coughing cause - air passing through fluid/mucous in air passageway location - most often heard in lower lung lobes associated w/ - pulmonary edema, CHF, pneumonia, pulmonary fibrosis, bronchitis What are gurgles (rhonchi)? Correct ans - description - continuous low pitched gurgling sounds w/ moaning/snoring quality. Best heard on inspiration but can be heard on both. Can be altered by coughing. cause - Air passing through narrowed air passages as a result of secretions, swelling, tumors location - Loud sounds can be heard over most lung areas, but predominate over the trachea and bronchi associated w/- Secretions, Obstructions, Pneumonia, Bronchitis, COPD

a. semiconscious/unconscious pt w/ intact gag reflex b. pat's who otherwise will not tolerate OPA contraindications a. severe head injury w/ blood draining from nose b. history of fractured nasal bone What is the recovery position? Correct ans - used to help maintain clear airway in unconscious pt who is not injured and is breathing on his or her own w/ normal respiratory rate and adequate tidal volume Bag Valve Mask Correct ans - use w/ or w/o oxygen. Use for pt's in respiratory arrest, cardiopulmonary arrest, and respiratory failure. CPAP Correct ans - Continous Positive Airway Pressure increases pressure in lungs, opens collapsed alveoli, pushes more oxygen across alveolar membrane, and forces interstitial fluid back into pulmonary circulation. indications - alert pt able to follow commands, obvious signs of moderate to severe respiratory distress, pt is breathing rapidly (over 26 breaths/min), pulse oximetry is less than 90 contraindications - pt who is in respiratory arrest, Si/sx of pneumothorax or chest trauma, pt who has a tracheostomy, active Gi bleeding/vomiting, pt unable to follow verbal commands