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Comprehensive Exam > Airway > Flashcards

Airway Flashcards

1
Q

Pharynx

(anatomy and location)

A

extends from choanae to esophagus

(base of skull to cricoid cartilage and C6)

  • contains Naso-, Oro-, and Larnygo-
  • narrowest at esophagus and widest at Hyoid
  • 10-15 cm long
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2
Q

Tongue

(sensory innervation)

A

lingual anterior 2/3 (V3) and Glossopharyngeal posterior 1/3

Chorda Tympani of VII for taste

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3
Q

Tongue

(motor Innervation)

A

Hypoglossal (XII)

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4
Q

Larynx

(anatomy and location)

A

hollow cartilage structure containing ligaments, membrane and muscles

C3 - C6

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5
Q

Larynx

(function)

A

guards entrance to trachea and produces sound

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6
Q
A
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7
Q

Hyoid Bone

A

suspended U-shaped bone that anchors larynx

connected to thyrohyoid ligament and articulates with superior horn of the thyroid cartilage

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8
Q
A
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9
Q

Function of Sternohyoid

A

indirect depressor of the larynx

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10
Q

Innervation of Sternohyoid

A

Cervical plexus

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11
Q

Function of Sternothyroid and Thyrohyoid

A

depresses larynx

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12
Q

innervation of sternothyroid

A

cervical plexus

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13
Q

innervation of thyrohyoid

A

cervical plexus and hypoglossal nerve

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14
Q

innervation of thyroepiglottic

A

recurrent laryngeal nerve

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15
Q

innervation of stylopharyngeus

A

glossopharyngeal

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16
Q

function of inferior pharyngeal constrictor

A

assists in swallowing

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17
Q

innervation of inferior pharyngeal constrictor

A

vagus

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18
Q

which intrinsic muscle of the larynx is not innervated by the recurrent laryngeal?

A

cricothyroid

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19
Q

sensory and motor functions of the larynx are branches of the _____ nerve

A

vagus

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20
Q

sensory below the vocal cords is innervated by _____

A

recurrent laryngeal nerve

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21
Q

laryngospasms are a reflex due to stimulation of which nerve?

A

superior laryngeal

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22
Q

Simple Mask

[overview]

A
  • no reservoir for O2
  • mixture of pure oxygen and room air
  • variable FiO2
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23
Q

minimum fresh gas flow in simple mask to avoid rebreathing CO2

A

5 L/min

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24
Q

Venturi Masks

[overview]

A
  • high air flow
  • better control of FiO2
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25
Q

FiO2 of nasal cannula at 3 L/min

A

0.27 - 0.34

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26
Q

FiO2 of nasal cannula at 5 L/min

A

0.32 - 0.44

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27
Q

FiO2 of nasal cannula at 1 L/min

A

0.21 - 0.24

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28
Q

FiO2 of simple mask at 5-6 L/min

A

0.30 - 0.45

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29
Q

FiO2 of simple mask at 7-8 L/min

A

0.40 - 0.60

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30
Q

FiO2 of partial rebreathing mask at 7 L/min

A

0.35 - 0.75

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31
Q

FiO2 of partial rebreathing mask at 15 L/min

A

0.65 - 1.00

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32
Q

FiO2 of non-rebreathing mask at 7-15 L/min

A

0.40 - 1.00

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33
Q
A

Guedel Airway

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34
Q
A

Berman Airway

  • I-Beam shape with center support
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35
Q

Contraindications to Nasal Airway (6)

A
  • hemorrhagic disorders
  • anti-coagulation therapy
  • sepsis
  • basilar skull fractures
  • history of epistaxis
  • nasal packing
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36
Q

ETT are typically made of _____

A

polyvinyl chloride (PVC)

  • will support combustion
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37
Q

On which side of the ETT is the murphy eye?

A

right

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38
Q

Purpose of murphy eye on ETT

A

if main lumen is blocked by secretions, some ventilation may be possible out Murphy eye

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39
Q

Bevel opening on an ETT faces _____

A

left

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40
Q

Nasal RAE Tubes

(types and/or other names)

A

Ring, Aldair, Elwyn

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41
Q

inner and outer wraps in LASER tubes

A

aluminum and Teflon

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42
Q
A

Laser flex tube

fill distal cuff with saline and proximal cuff with methylene blue

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43
Q

adult sizes of oral airways

A

9, 10, and 11

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44
Q

a Mac blade lifts the epiglottis anteriorly and tenses the _____ ligament

A

hyoepiglottic

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45
Q

BURP

A

Back Upwards Right Pressure

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46
Q

ideal positioning of ETT is ____ cm above carina

A

2-4 cm

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47
Q

ETT cuff typically holds ____ mL of air

A

5 - 6

  • seal until you do not get a leak at 20 cmH2O
  • 22-32 cmH2O pressure in cuff
48
Q

If ETT is in trachea and no CO2 waveform is seen, what could be the problem?

A

cardiac arrest or pulmonary embolus

49
Q

force in cricoid pressure

A

20 newtons

then 30N when patient is asleep

50
Q

Tube of LMA connected to mask at _____ degree angle

A

30

51
Q

the classic LMA can be used up to ____ times

A

40

52
Q

LMA Supreme

A
  • separate conduit to permit gastric fluid
  • may use higher peak airway pressures
    • up to 30 cmH2O
53
Q

LMA ProSeal

A
  • built in bite block
  • salem pump can pass into stomach
    • less than 16 Fr
  • higher seal pressures
54
Q

LMA in patient under 5 kg

A

1

(maximum cuff volume 4 mL)

55
Q

LMA in patient 10-20 kg

A

2

(maximum cuff volume 10 mL)

56
Q

LMA in patient 30-50 kg

A

3

(maximum cuff volume 20 mL)

57
Q

LMA in patient 50-70 kg

A

4

(maximum cuff volume 30)

58
Q

LMA in patient 70-100 kg

A

5

(maximum cuff volume 40 mL)

59
Q

tidal volumes should be limited to _____ mL/kg if using an LMA

A

8 mL/kg

(limit pressures to 20 cmH2O unless using supreme)

60
Q

LMAs should not be used if the case lasts longer than _____ hours

A

3

consider using Supreme and suctioning gastric contents if longer

61
Q

Cuff pressure in LMA should be less than _____

A

60 cmH2O

62
Q

2 sizes of Combitube

A

37 (4-6 ft) and 41 (>6 ft)

63
Q
A

Combitube

64
Q

Distal cuff of Combitube

A

seals upper esophagus

white pilot balloon

fill with 10 mL of air

65
Q

Proximal cuff of Combitube

A

seals oro and nasopharynx

blue pilot balloon

fill with 85-100 mL air

66
Q

Confirmation of Combitube position

A

ventilate through blue first

if no breaths ounds, then ventilate through distal lumen

67
Q

Combitubes can have mechanical ventilation pressures up to _____

A

50 cmH2O

68
Q
A

King Laryngeal

69
Q

Differences between King laryngeal and Combitube

A

combitube has one pilot balloon and has pediatric sizes

70
Q

King laryngeal cuff needs ____ for adult sizes and ___ for pediatrics

A

60 mL for adults

35 mL for pediatrics

71
Q

proximal cuff of a King Laryngeal tube should lie in the _____

A

hypopharynx

72
Q

Distal cuff of a King Laryngeal tube sholud lie in the _____

A

esophagus

73
Q
A

McCoy blade

74
Q
A

Polio Blade

  • used when A/P diameter precludes use of conventional handle
75
Q
A

Wisconsin

76
Q
A

Wis-Hipple

  • designed for use in infants
77
Q
A

Snow

78
Q
A

Phillips

79
Q
A

Bullard

80
Q
A

Upsher

81
Q
A

Wu

82
Q

(3) Types of Rigid Fiberoptics

A

Bullard, Upsher, and Wu

83
Q

distal angle of Glidescope

A

60o

84
Q
A

AirTraq

85
Q

AirTraq sizes

A

infant (2.5 - 3.5)

pediatric (4.0 - 5.5)

small (6.0 - 7.5)

regular (7.0 - 8.5)

86
Q

Aintree Intubation Catheter

A

designed for use with fiberoptic

  • can ventilate
  • ETT 7.0 or larger
87
Q

Trachlight Preparation

A

cut ETT to 26cm

88
Q

MOANS

A

factors predicting difficult BMV

  • mask seal
    • beards, blood on face
  • Obese
    • BMI > 30
  • Age > 55
  • No teeth
  • Snores or Stiff
89
Q

Grade III Cormack and Lehane

A

visualization of only the epiglottis

90
Q

Grade IV Cormack and Lehane

A

visualization of only the soft palate

91
Q

TMD less than ____ suggests a difficult intubation

A

6 cm

92
Q

contraction of posterior cricoarytenoid muscles cause _____ of vocal cords

A

abduction

93
Q

contraction of lateral cricoarytenoid muscle causes _____ of vocal cords

A

adduction

94
Q

trachea bifurcates at the carina at level _____

A

T5

95
Q

prayer test

A

limited joint mobility

especially in diabetics

96
Q

extrathoracic obstructions are mostly noted during the _____ phase

A

inspiratory

97
Q

intrathoracic obstructions are most noted during the _____ phase

A

expiratory

( + intrathoracic pressure)

98
Q

FiO2 range of nasal cannula

A

22 - 50%

99
Q

FiO2 range in simple mask

A

35 - 60%

100
Q

Avoid airway pressure greater than _____ in resusitation bags

A

20 cmH2O

101
Q

ETT for < 1 kg

A

2.5

102
Q

ETT for 2-3kg

A

3.5

103
Q

(5) straight blades

A
  • miller
  • wisconsin
  • wis-hipple
  • snow
  • seward
104
Q

(2) indirect video laryngoscopes

A

Glidescope and McGarth

105
Q

Klippel-Feil

A

congential fusion of 2+ cervical vertebrae

  • neck rigidity
  • awake intubation if possible
106
Q

Apert’s Syndrome

A

hypoplastic mandible with craniosyntosis

  • exopthalmos
  • high arched palate
107
Q

Treacher Collins

A

micrognathia and microstomia

  • aplastic zygomatic arches
  • choanal atresia
108
Q

Pierre-Robin

A

cleft palate and micrognathia

  • backward tongue movement and pharyngeal wall collapse
109
Q

Dose of Succinylcholine for Laryngospasm

A

IV 0.25 - 1 mg/kg

or

IM 1 - 1.5 mg/kg

110
Q

Dose of Atropine for Laryngospasm

A

IV 0.01 mg/kg

or

0.02 mg/kg

111
Q

pulmonary sounds in Pulmonary Edema

A

rales and rhonchi

112
Q

nerves in gag reflex

A

glossopharyngeal

113
Q

nerve in laryngospasm

A

superior laryngeal

114
Q

nerve in cough

A

vagus

115
Q

Transtracheal block

A

penetrate cricothyroid membrane

4mL of 4% lidocaine followed by cough

116
Q

Bupivacaine

maximum total dosage

A

Comprehensive Exam (6 decks)

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