Airway in the context of Endotracheal intubation


Airway in the context of Endotracheal intubation

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⭐ Core Definition: Airway

The respiratory tract is the subdivision of the respiratory system involved with the process of conducting air to the alveoli for the purposes of gas exchange in mammals. The respiratory tract is lined with respiratory epithelium as respiratory mucosa.

Air is breathed in through the nose to the nasal cavity, where a layer of nasal mucosa acts as a filter and traps pollutants and other harmful substances found in the air. The turbinates increase the nasal cavity, helping it warm, humidify, and filter the incoming air (Sobiesk & Munakomi, 2023). Next, air moves into the pharynx, a passage that contains the intersection between the esophagus and the larynx. The opening of the larynx has a special flap of cartilage, the epiglottis, that opens to allow air to pass through but closes to prevent food from moving into the airway.

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Airway in the context of Exhalation

Exhalation (or expiration) is the flow of the breath out of an organism. In animals, it is the movement of air from the lungs out of the airways, to the external environment during breathing.This happens due to elastic properties of the lungs, as well as the internal intercostal muscles which lower the rib cage and decrease thoracic volume. As the thoracic diaphragm relaxes during exhalation it causes the tissue it has depressed to rise superiorly and put pressure on the lungs to expel the air. During forced exhalation, as when blowing out a candle, expiratory muscles including the abdominal muscles and internal intercostal muscles generate abdominal and thoracic pressure, which forces air out of the lungs.

Exhaled air is 4% carbon dioxide, a waste product of cellular respiration during the production of energy, which is stored as ATP. Exhalation has a complementary relationship to inhalation which together make up the respiratory cycle of a breath.

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Airway in the context of Mannequin

A mannequin (sometimes spelled as manikin and also called a dummy, lay figure, or dress form) is a doll, often articulated, used by artists, tailors, dressmakers, window dressers and others, especially to display or fit clothing and show off different fabrics and textiles. Alternatively the term refers, or referred to, a live human fashion model.

Life-sized mannequins with simulated airways are used in the teaching of first aid, CPR, and advanced airway management skills such as tracheal intubation. During the 1950s, mannequins were used in nuclear tests to help show the effects of nuclear weapons on humans. Also referred to as mannequins are the human figures used in computer simulation to model the behavior of the human body.

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Airway in the context of Apnea

Apnea (also spelled apnoea in British English) is the temporary cessation of breathing, which may be voluntary or involuntary. During apnea, there is no movement of the muscles of inhalation, and the volume of the lungs initially remains unchanged. Depending on how blocked the airways are (patency), there may or may not be a flow of gas between the lungs and the environment. If there is sufficient flow, gas exchange within the lungs and cellular respiration would not be severely affected. Voluntarily doing this is called "holding one's breath".Apnea may first be diagnosed in childhood, and it is recommended to consult an ear-nose-throat specialist, allergist or sleep physician to discuss symptoms when noticed; malformation and/or malfunctioning of the upper airways may be observed by an orthodontist.

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Airway in the context of Tracheal intubation

Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway or to serve as a conduit through which to administer certain drugs. It is frequently performed in critically injured, ill, or anesthetized patients to facilitate ventilation of the lungs, including mechanical ventilation, and to prevent the possibility of asphyxiation or airway obstruction.

The most widely used route is orotracheal, in which an endotracheal tube is passed through the mouth and vocal apparatus into the trachea. In a nasotracheal procedure, an endotracheal tube is passed through the nose and vocal apparatus into the trachea. Other methods of intubation involve surgery and include the cricothyrotomy (used almost exclusively in emergency circumstances) and the tracheotomy, used primarily in situations where a prolonged need for airway support is anticipated.

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Airway in the context of Tracheotomy

Tracheotomy (/ˌtrkiˈɒtəmi/, UK also /ˌtræki-/), or tracheostomy, is a surgical airway management procedure which consists of making an incision on the front of the neck to open a direct airway to the trachea. The resulting stoma (hole) can serve independently as an airway or as a site for a tracheal tube (or tracheostomy tube) to be inserted; this tube allows a person to breathe without the use of the nose or mouth.

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Airway in the context of Passive smoking

Passive smoking is the inhalation of tobacco smoke, called passive smoke, secondhand smoke (SHS) or environmental tobacco smoke (ETS), by individuals other than the active smoker. It occurs when tobacco smoke diffuses into the surrounding atmosphere as an aerosol pollutant, which leads to its inhalation by nearby bystanders within the same environment. Exposure to secondhand tobacco smoke causes many of the same health effects caused by active smoking, although at a lower prevalence due to the reduced concentration of smoke that enters the airway.

According to a World Health Organization (WHO) report published in 2023, more than 1.3 million deaths are attributed to passive smoking worldwide every year. The health risks of secondhand smoke are a matter of scientific consensus, and have been a major motivation for smoking bans in workplaces and indoor venues, including restaurants, bars and night clubs, as well as some open public spaces.

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Airway in the context of Respiratory arrest

Respiratory arrest is a serious medical condition caused by apnea or respiratory dysfunction severe enough that it will not sustain the body (such as agonal breathing). Prolonged apnea refers to a patient who has stopped breathing for a long period of time. If the heart muscle contraction is intact, the condition is known as respiratory arrest. An abrupt stop of pulmonary gas exchange lasting for more than five minutes may permanently damage vital organs, especially the brain. Lack of oxygen to the brain causes loss of consciousness. Brain injury is likely if respiratory arrest goes untreated for more than three minutes, and death is almost certain if more than five minutes.

Damage may be reversible if treated early enough. Respiratory arrest is a life-threatening medical emergency that requires immediate medical attention and management. To save a patient in respiratory arrest, the goal is to restore adequate ventilation and prevent further damage. Management interventions include supplying oxygen, opening the airway, and means of artificial ventilation. In some instances, an impending respiratory arrest could be predetermined by signs the patient is showing, such as the increased work of breathing. Respiratory arrest will ensue once the patient depletes their oxygen reserves and loses the effort to breathe.

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Airway in the context of Cricothyrotomy

A cricothyrotomy (also called cricothyroidotomy or laryngotomy) is a medical procedure where an opening is created through the cricothyroid membrane to establish a patent airway during emergency airway management. Cricothyrotomy is primarily performed as the last step in airway management algorithms in cases where an airway cannot be established by other means of nasal or oral tracheal intubation. These situations, often referred to as "cannot intubate, cannot ventilate" (CICV) or "cannot intubate, cannot oxygenate" (CICO), are commonly seen as a result of airway obstruction, angioedema, trauma, burns, or abnormal anatomy.

Multiple types of cricothyrotomy may be considered for emergency surgical airway management, including surgical cricothyrotomy and needle cricothyrotomy. Surgical cricothyrotomy is performed by inserting a large-bore tube through an opening in the cricothyroid membrane created via incision or using the Seldinger technique. Needle cricothyrotomy is performed by inserting a catheter through the cricothyroid membrane and connecting it to a ventilation bag or a high-pressure oxygen source in a process called transtracheal jet ventilation. Various cricothyrotomy techniques have been portrayed in popular media but should only be performed by trained medical professionals.

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Airway in the context of Airway obstruction

Airway obstruction is a blockage of respiration in the airway that hinders the free flow of air. Airway obstructions can occur either in the upper airway or lower airway. The upper airway consists of the nose, throat, and larynx. The lower airway comprises the trachea, bronchi, and bronchioles.

Airway obstruction is a life-threatening condition and requires urgent attention.

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Airway in the context of Wheezing

A wheeze is a clinical symptom of a continuous, coarse, whistling sound produced in the respiratory airways during breathing. For wheezes to occur, part of the respiratory tree must be narrowed or obstructed (for example narrowing of the lower respiratory tract in an asthmatic attack), or airflow velocity within the respiratory tree must be heightened. Wheezing is commonly experienced by persons with a lung disease; the most common cause of recurrent wheezing is asthma, though it can also be a symptom of lung cancer, congestive heart failure, and certain types of heart diseases.

The differential diagnosis of wheezing is wide, and the reason for wheezing in a given patient is determined by considering the characteristics of the wheezes and the historical and clinical findings made by the examining physician.

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