Airway

Question 1

5 Questions for Airway Approach Algorithm?

Answer 1

1. is airway management required?
2. might laryngoscopy be difficult?
3. will supra-laryngeal vent be possible?
4. is the stomach empty?
5. will the pt tolerate a judgement error or apnea period?

Question 2

Oral Airway

Answer 2

should reach base of tongue & hold tongue dowwn

may stimulate airway reflexes

Question 3

when to avoid nasal airway?

Answer 3

coagulopathy, epistaxis, anticoagulation

Question 4

LMA Sizing

Answer 4

5: large adult
4: adult
3: 30 kg to small adult
2. 5: 20 - 30kg
2: 10-20kg
1. 5: 5-10kg
1: under 5kg

Question 5

LMA max cuff pressure & air in cuff size

Answer 5

60 cm H2O

5: 40 ml
4: 30 ml
3: 20 ml
2. 5: 14 ml
2: 10 ml
1. 5: 7 ml
1: 4ml

Question 6

LMA position

Answer 6

over pharynx, tip sits in the esophagus at cricopharyngeous muscle

Question 7

ET tube max cuff pressure

Answer 7

< 30 cm H2O

Question 8

Laryngoscope Sizing

Answer 8

Adult: 3-5
Neonate: 0-1
6 m - 1yr: 1-2

Question 9

sniffing position

Answer 9

aligns pharyngeal-laryngeal axes

Question 10

Mac V. Miller Blade

Answer 10

Mac - curved - into vallecula

Miller - straight - lifts epiglottis up

Question 11

Signs of accurate ETT placement

Answer 11

• bilateral breath sounds
• chest rise
• absent epigastric sounds
• ETCO2
• mist in the ETT
• CXR/fiberoptic

Question 12

Laryngospasm

Answer 12

tight closure of adductor muscles - lateral cricothyroid + thyroarytenoid
higher risk with light anesthesia, hypocapnia and underlying irritable airway
Larsens maneuver and PPV with bag/mask

Question 13

Local Anesthesia for Airway

Answer 13

trans tracheal block
superior laryngeal nerve block
glossopharyngeal nerve block
topical lidocaine

Question 14

indications for fiberoptic bronchoscope use

Answer 14

upper airway obstruction: abcess, tumor, prior surgery, trauma
mediastinal mass
subglottic stenosis
congenital airway abnormalities
immovable cervical vertebrae

Question 15

Extubation Criteria

Answer 15

can protect airway
oxygenate
includes muscle strength - respiratory drive, LOC - VC 15cc/kg - insp force -30 to -40 cm H2O

Question 16

Difficult Mask Vent

Answer 16

B - beards 
O - obesity & obstructions
N - no teeth 
E - elderly
S - snores

Question 17

Carina Location

Answer 17

T5-T7

Question 18

Larynx Location

Answer 18

C5-C6 in adult

ETT should sit 5 cm above carina***

Question 19

Primary & Accessory Inspiratory Muscles

Answer 19

Primary: external intercostals & diaphragm
Accessory: scalene, sternocleidomastoid, pec minor

Question 20

FRC & TLC

Answer 20

FRC 2-3L (RV + ERV) —- 35 ml/kg

TLC 5-6L (RV+ERV+IRV)

Question 21

Vital Capacity

Answer 21

65-75 ml/kg

Question 22

Glottis

Answer 22

the true vocal cords

the narrowest part of the adult airway