Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anesthesia Exam 1 > Airway > Flashcards

Airway Flashcards

1
Q

What spinal cord level is the larynx located at?

A

C3-C6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are three functions of the larynx?

A

Airway protection, respiration and phonation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

From where to where is the larynx located?

A

From the epiglottis to the cricoid cartilage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the paired cartilages of the larynx?

A

Arytenoid, corniculate and cuneiform.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the unpaired cartilages of the larynx?

A

Cricoid, thyroid and epiglottis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the narrowest point of the pediatric airway?

A

Cricoid cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What nerve supplies most of the intrinsic laryngeal muscles?

A

The recurrent laryngeal nerve (a branch of the vagus nerve)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What nerve supplies the cricothyroid muscle?

A

The external branch of the superior laryngeal nerve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the intrinsic muscles that adduct or close the glottis?

A

Lateral cricoarytenoid and Arytenoids.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the intrinsic muscle that abducts the vocal cords?

A

Posterior cricoarytenoid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What intrinsic laryngeal muscle elongates or puts tension on the vocal cords?

A

The cricothyroid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What two intrinsic laryngeal muscles shorten and relax the vocal cords?

A

Vocalis and thyroarytenoid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the 4 extrinsic muscles of the larynx?

A

Sternohyoid, thyrohyoid, omohyoid, and sternothyroid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some questions to consider during an airway evaluation/history?

A 
Radiation of burn to head/neck?
C-spine pain or LROM?
TMJ pain?
Rheumatoid arthritis?
Ankylosing spondylitis?
Abscess or tumor?
Prior intubation or tracheotomy?
Snoring or sleep apnea?
Dysphagia or stridor?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What can you see with Mallampati class I, 2, 3 and 4?

A

1: Facil pillars, soft palate, uvula.
2: Uvula masked by tongue
3: Soft palate, uvula base
4: Only hard palate seen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the thyromental distance?

A

Distance from lower border of mandible to the thyroid notch with neck fully extended.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the normal thyromental distance? What length indicates a difficult intubation?

A

6-6.5cm or 4 finger-breaths. Less than 3 fingers indicates difficult intubation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What 3 axis are aligned in the sniffing position?

A

Oral, pharyngeal and laryngeal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the goal of pre-oxygenation?

A

Increased oxygen concentration in functional reserve volume and decreased nitrogen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How many minutes of tight face mask should be used for pre-oxygenation and how many minutes of apnea can a healthy patient tolerate after this? What is the alternative to this method and how many minutes of apnea can a patient tolerate with that method?

A

3-5 minutes tight face mask with 100% O2, a healthy patient can tolerate up to 10 minutes of apnea. Four vital capacity breaths in 30 seconds allows a healthy patient to tolerate up to 5 minutes of apnea.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the elements of an airway setup?

A
  • Laryngoscope-2 types of blades
  • Oral/nasal airways in several sizes
  • Tongue depressor
  • ETT 2 sizes
  • Suction
  • Ambu-bag
  • Stylet
  • LMA (difficult airway) #4
22
Q

What size ETT do you generally use for adult males?

For adult females?

A

Males: 7.5 & 8.0

Females 6.5 & 7.0

23
Q

What is the desirable position for the ETT?

What measurement on the ETT does this correlate to for males and females?

A

2 cm below the vocal cords and 4cm above the carina.

Males 23 cm Females 21 cm.

24
Q

What sensory nerves stimulate the airway?

A

Glossopharyngeal, internal branch of the superior laryngeal and the recurrent laryngeal.

25
Q

What motor nerves stimulate the airway?

A

External branch of the superior laryngeal and the recurrent laryngeal.

26
Q

What nerve innervates the posterior 1/3 of the tongue and the oroppharnyx to the vallecula?

A

Glossopharyngeal (CN9)

27
Q

What branch of the vagus supplies sensory to the vocal cords and above?

A

Interior superior laryngeal

28
Q

What nerve supplies the mucosa below the vocal cords?

A

The recurrent laryngeal (branch of vagus)

29
Q

What nerve supplies the cricothyroid muscle?

A

External branch of the superior laryngeal.

30
Q

What nerve supplies all intrinsic muscles of the larynx except for the cricothyroid muscle?

A

Recurrent Laryngeal.

31
Q

What are some systemic effects that tracheal intubation can cause?

A

Cardiac: hypertension and tachycardia, myocardial ischemia

Respiratory: laryngospasm and bronchospasm

32
Q

What are some complications of tracheal intubation?

A
  • Trauma to airway structures
  • esophageal intubation
  • endobronchial intubation
  • endotracheal tube ignition
  • Sore throat
  • Laryngospasm
  • Croup
33
Q

What are some general indications for airway blocks?

A
  • to abolish or blunt reflexes

- To provide patient comfort and airway anesthesia during the performance of these procedures.

34
Q

What are some complications from airway blocks?

A

Systemic toxicity and hematoma formation.

35
Q

What are the indications for a transtracheal block?

A
  • blocks the recurrent laryngeal nerve for awake laryngoscopy, fiberoptic and or retrograde intubation
  • Abolition of the gag reflex or hemodynamic response to laryngoscopy or bronchoscopy
  • results in anesthesia of the trachea below the vocal cords
  • the injection of local anesthetic usually stimulates the cough reflex
36
Q

Where is local anesthetic injected during a transtracheal block?

A

Cricothyroid membrane after a skinwheel.

37
Q

What guage needle is used during a transtracheal block and how many mls are injected?

A

a 23-24g needle and 3-4ml of lidocaine.

38
Q

What is visualized to verify placement during a transtracheal block?

A

Air bubbles.

39
Q

What nerve does a superior laryngeal block target?

A

The internal branch of the superior laryngeal nerve.

40
Q

What are some indications for a glossopharyngeal nerve block?

A

-need for abolition of the gag reflex or hemodynamic response to laryngoscopy

41
Q

What muscle elongates and puts tension on the vocal cords?

A

Cricothyroid.

42
Q

What muscles shorten the vocal cords?

A

Vocalis and thyroarytenoid.

43
Q

What muscles close the glottis?

A

Arytenoids, lateral cricoarytenoid.

44
Q

What muscles open the glottis?

A

Posterior cricoarytenoid.

45
Q

How many mls is injected on each side for a superior laryngeal block?

A

2mls

46
Q

Describe the technique for a superior laryngeal block.

A
  • hyoid bone displaced laterally towards the side to be displaced
  • inferior border of the cornu is palpated
  • 23 g 2.5cm needle inserted perpendicular to the skin 1/4 inch below and 1/4 inch medial to the inferior cornu and is walked off the greater cornu of the hyoid bone inferiorly- 1-2 ml of LA can be injected here
  • Needle passes through thyrohyoid membrane, loss of resistance is felt, aspirate (no blood or air) and inject 2ml of LA
  • block is repeated on the opposite side.
47
Q

What nerve is blocked during a transtracheal block?

A

Recurrent laryngeal nerve

48
Q

What guage needle do you use during a transtracheal block?

A

23G 3/4 inch

49
Q

How many mls of LA are injected during a transtracheal block?

A

3-5ml.

50
Q

What equipment is needed for a cricothyrotomy?

A
  • 14 G IV catheter or cricothyrotomy kit
  • High pressure ventilation system
  • Protective equipment
  • Face shield
  • Chlorhexidine
51
Q

How long ca a cricothyrotomy be left in place?

A

72 hours or less.

52
Q

What are some risks of a cricothyrotomy?

A
  • Esophageal perforation
  • Subcutaneous emphysema
  • Excessive bleeding or hemorrhage if a vessel is ruptured

Anesthesia Exam 1 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions