EMT respiratory A&p

ANATOMY

1

For anatomy, you must be able to name, label, pronounce and describe the location and function of the following:

  • Upper airway structures:

    • Nasal cavity

    • Oral cavity

    • Pharynx (nasopharynx, oropharynx, laryngopharynx)

    • Larynx

    • Epiglottis

  • Lower airway structures:

    • Trachea

    • Right and left main bronchi

    • Bronchioles

    • Alveoli

  • Lungs:

    • Right lung (3 lobes)

    • Left lung (2 lobes)

    • Hilum

  • Pleura:

    • Visceral pleura

    • Parietal pleura

    • Pleural space

  • Respiratory muscles:

    • Diaphragm

    • Intercostal muscles

  • Thoracic structures relevant to breathing:

    • Rib cage

    • Mediastinum (conceptually)

  • You must understand the difference between:

    • Upper vs lower airway

    • Conducting zone vs gas exchange zone

    • Ventilation structures vs perfusion structures

For physiology, you should be able to understand the underlying pathophysiology behind:

  • Ventilation mechanics:

    • How the human body knows when to breath in health and with COPD (hypercapnia vs hypoxic drive)

    • Role of diaphragm contraction

    • Inspiration vs expiration

    • Accessory muscle use

  • Gas exchange:

    • Diffusion at the alveolar-capillary membrane

    • Oxygen loading and carbon dioxide unloading

  • Oxygen transport:

    • Haemoglobin binding

    • Oxyhaemoglobin dissociation curve (conceptual only — left/right shift awareness)

  • Carbon dioxide transport (basic overview):

    • Dissolved CO₂

    • Bound to haemoglobin

  • Ventilation–perfusion (V/Q) matching:

    • What happens when ventilation fails

    • What happens when perfusion fails

    • Why both are required

  • Hypoxia vs hypoxaemia:

    • Low tissue oxygen vs low blood oxygen

    • Hypercapnia and respiratory acidosis (basic mechanism)

  • Respiratory failure:

    • Type 1 respiratory failure (low O₂)

    • Type 2 respiratory failure (low O₂ + high CO₂)

  • Obstructive vs restrictive respiratory diseases/injuries:

    • Asthma

    • COPD (emphysema and bronchitis in particular)

    • Anaphylaxis

    • Foreign body obstruction

    • Pulmonary oedema

    • Pneumothorax

    • Tension pneumothorax

    • Pulmonary embolism

    • Pneumonia

  • You must understand the progression of:

    • Airway obstruction → hypoxaemia → hypoxia → organ failure → cardiac arrest

    • Exacerbation of disease → poor ventilation → increased effort of breathing → fatigue → CO₂ retention → decompensation → organ failure → cardiac arrest

    • Respiratory tract Infection → inflammation → consolidation → impaired gas exchange → respiratory failure → organ failure → cardiac arrest

PHYSIOLOGY

2

Why do emt’s need to know this?

3

Shortness of breath is one of the most common ambulance presentations. Without a strong understanding of respiratory anatomy and physiology, assessment becomes guesswork.

  • Airway assessment relies on knowing:

    • Where obstruction can occur

    • How airway positioning improves patency

    • When airway adjuncts are appropriate

  • Breathing assessment depends on understanding:

    • Why respiratory rate changes

    • Why accessory muscles matter

    • Why silent chest in asthma is a red flag

    • Why unequal chest rise suggests pneumothorax

  • Oxygen therapy decisions require insight into:

    • Hypoxia vs hypercapnia

    • When high-flow oxygen is essential

    • Why some COPD patients retain CO₂

    • When ventilatory support is needed rather than just oxygen

  • Recognising life-threatening patterns such as the following requires understanding what is failing; ventilation, perfusion, or both:

    • Tension pneumothorax

    • Severe asthma exhaustion

    • Anaphylaxis airway compromise

    • Pulmonary embolism

    Remember: symptoms such as agitation, confusion and reduced GCS can all be respiratory in origin. Misinterpreting these as purely neurogenic or cardiogenic for example, can delay life-saving airway management and breathing support.

  • Differentiating between:

    • Anxiety hyperventilation

    • Asthma exacerbation

    • Acute pulmonary oedema

    • Sepsis-related tachypnoea

    • Opioid-induced respiratory depression

  • …directly affects whether a patient is:

    • Managed on scene

    • Given immediate drug therapy

    • Ventilated

    • Transported urgently under blue lights

    • Respiratory compromise deteriorates quickly. EMTs must recognise the early physiological warning signs before cardiac arrest occurs.

  • Ultimately, respiratory A&P allows you to answer three critical questions on scene:

    • Is oxygen getting in?

    • Is oxygen getting into the blood?

    • Is oxygen getting to the tissues?

    If you understand those three steps clearly, your respiratory assessment becomes structured, confident and clinically safe.

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