Chapter 15 Paramedic Airway Management, Respiration, and Artificial Ventilation

Upper airway
• all structures above the glottis
• nasopharynx
• frontal, maxillary, ethmoid, sphenoid sinuses
• oropharynx
• laryngopharynx
• larynx
Lower airway
• all structures below the glottis
• trachea
• bronchial tree
• alveoli
• lungs
• ends where the trachea bifurcates into the right and left main bronchi; at the level of the jugular notch
piriform sinus
• a recess located on either side of the larynx
• foreign materials that are swallowed may become lodged in these areas
carina of the trachea
• a downward and backward projection of the last tracheal cartilage
• forms a ridge that seperates the opening of the right and left mainstem bronchus
• occurs at the sternal angle (aka the angle of louis)
bronchial segments
CONDUCTING AIRWAYS
1. right and left main bronchi
2. branch into secondary bronchi
3. they then divide into tertiary segmental bronchi
4. finally terminal bronchioles (smallest airways without alveoli)

RESPIRATORY UNIT
5. terminal bronchioles divide into respiratory bronchioles
6. and then alveolar ducts

ALVEOLI
• functional units of the respiratory system
• make up most of the lung tissue
• together the two lungs have about 300 million alveoli
• the alveoli are coated with pulmonary surfactant (then film produced by the alveolar cells that prevents alveoli from collapsing
mediastinum
• two lungs are seperated by the mediastinum
• the contents of the mediastinum are:
1. heart
2. blood vessels
3. trachea
4. esophagus
5. lymphatic tissue
6. vessels
lobules
• left lung has 2 lobes, right has 3
• each lobe is divided into lobules
• the left has 9, the right has 10 lobules
both lungs are surrounded by a separate …
pleura cavity
• the two laters of the pleura are visceral and parietal
• they are separated by a serous fluid that acts as a lubricant to allow the membranes to slide past each other during breathing
primary function of the lungs…
respiration
ventilation vs respiration
RESPIRATION:
• THE EXCHANGE OF OXYGEN AND CARBON DIOXIDE BETWEEN AND ORGANISM AND THE ENVIRONMENT

VENTILATION:
• MECHANICAL MOVEMENT OF AIR INTO AND OUT OF THE LUNGS

VENTILATION MAKES RESPIRATION POSSIBLE

support structures of the airway
1. thoracic cage
2. phrenic nerve
3. mediastinum
thoracic cage
• protects vital organs
• prevents collapse of thorax during ventilation
• consists of:
1. thoracic vertebrae
2. ribs and their associated costal cartilages
3. sternum
diaphragm
• most important muscle for ventilation
• when the diaphragm contracts:
1. abdominal contents are pushed downward
2. intercostal muscles move the ribs upward and outward
3. increasing the volume and decreasing pressure in the thoracic cavity
phrenic nerve
• composed mostly of motor nerve fibers
• produces contractions of the diaphragm (because of nerve fibers)
• originates from the spinal cord between cervical nerves C3 and C5. Injury to this area may damage nerve cells that stimulate the phrenic nerve which fascilitates contraction of the diaphragm