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Spring '14 Advanced Health Assessment > Airway Assessment > Flashcards

Airway Assessment Flashcards

1
Q
A
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2
Q

Name these structures.

A
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3
Q

Give 6 indications for intubating a patient.

A
  • Airway protection (protect from gastric secretions, etc)
  • Maintenance of patent airway
  • Application of positive pressure ventilation
  • Maintenance of adequate oxygenation
  • Deliver predictable FiO2
  • Provide PEEP
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4
Q

List 6 good reasons to use just a mask for a case.

A
  • It is good because no instrumentation of the airway is required, therefore you avoid trauma and CV stimulation.
  • Difficult airway not present
  • Sugeon does not to access head and neck
  • No airway bleeding/ secretions
  • Case is short in duration
  • No table position change/ head available
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5
Q

What has to be present for a good mask ventilation?

A

You must be able to make a good seal between the mask and the face to overcome upper airway obstruction. Any obstruction should be easily relieved by airway/ chin lift.

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6
Q

Give 6 good airway assessment questions you should ask your patient?

A
  • Previous anesthesia Hx with airway management
  • Difficulty with prior anesthetics/ intubations
  • Past awake or fiberoptic intubation
  • Severe sore throat or dental damage
  • Co-existing disease (goiter, ever had a tracheostomy, ever had a neck dissection)
  • surgical history that may affect airway management
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7
Q

List 11 co-morbidities a patient may have that would affect airway management.

A
  • Lesions of the larynx
  • Thyroid disease
  • Cancer
  • GERD
  • Diabetes
  • Sleep Apnea
  • Obesity
  • Genetic disorders
  • Rheumatoid arthritis
  • Musculoskeletal
  • Scleroderma
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8
Q

T or F. If a patient has had a tracheostomy there is always some stenosis and fibrosis of the airway.

A

True

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9
Q

Name 4 past surgeries that may affect airway management.

A
  • Tracheostomy or scar
  • Neck dissection
  • UVPP
  • Cervical neck instrumentation (fusion)
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10
Q

What is Standard I of the AANA?

A

A practitioner should perform a thorough and complete pre-anesthesia assessment.

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11
Q

What is Standard III of the AANA?

A

The practioner formulates a patient specific plan for anesthesia care.

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12
Q

Which airway measurement is directly related to the size of the tongue?

A

Mallampati score

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13
Q

Mandibular Protrusion Test. This is an example of which class?

A
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14
Q

Mandibular Protrusion Test. This is an example of which class?

A
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15
Q

Mandibular protrusion test. Which class is this?

A
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16
Q

How would you test neck range of motion in your pre-op patient?

A

Full ROM should be 90-165 degrees

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17
Q

How many teeth do we have?

A

We have 32 teeth. 16 on top and 16 on the bottom. Start counting from Right upper jaw and around and then down in a circle.

18
Q

What 6 things do you want to assess in the dental assessment?

A
  • poor dentition
  • loose teeth
  • chipped teeth
  • capped
  • removable bridges
  • dentures
19
Q

What information does the Mallampati exam give us?

A

It relates the size of the base of the tongue to the oral cavity

20
Q

The Mallampati test gives us visualization of:

A
  • pharyngeal structures
  • soft palate
  • fauces
  • uvula and pillars
21
Q

How do you perform the Mallampati exam?

A

Pt sitting up with head in a neutral positon opens mouth wide, but does not say AHHHHH (phonation can inappropriately elevate the soft palate)

22
Q

What Mallampati class is this airway?

A

Class 1. The entire uvula, pillars, fauces, and soft and hard palate are visible.

23
Q

What Mallampati class is this airway?

A

Class 2. Only part of the uvula, fauces, and soft and hard palate are still visible.

24
Q

What class is this airway?

A

Class 3. Only the base of the uvula is visible. along with the soft and hard palates. no fauces or pillars visible.

25
Q

What Mallampati class is this airway?

A

Class 4. Only the hard palate is visible.

26
Q

What Mallampati score is this airway?

A

Grade 1

27
Q

What Mallapati class is this airway?

A

Grade 2

28
Q

What Mallampati class is this airway?

A

Grade III

29
Q

What Mallampati class is this airway?

A

Class 4

30
Q

What are the 3 axis’ shown here?

A
31
Q

What are the 3 axis’ shown here?

A
32
Q

What are the 3 axis’ shown here?

A
33
Q

There is no ‘ideal’ assessment for predicting a difficult airway, but these 5 things are strong predictors of a difficult airway.

A
  • Obesity
  • Decreased head and neck movement
  • Decreased jaw movement
  • Receding mandible
  • “buck” teeth
34
Q

At what phase in the anesthetic process, do we see the most incidence of difficult airway ?

A

66% of difficult airway issues occur during induction

35
Q

What percentage of general anesthetics in general become a difficult airway?

A

1-7%

36
Q

What percentage of difficult airways issues occur during the perioperative period?

A

15%

37
Q

What percentage of difficult airway issues present at extubation?

A

11%

38
Q

What percentage of difficult airway issues occur in the PACU?

A

5%

39
Q

What percentage of difficult airway issues occur at the pre-induction phase?

A

3%

40
Q

Name 7 things that you need for your airway set up.

A
  • Laryngoscope/ blades (2 types)
  • Oral/ nasal airways (several sizes)
  • Tongue depressor
  • ET tubes/ 2 sizes, with stylets and syringe on cuff
  • Suction
  • Ambu bag
  • LMA
41
Q

What sort of airway documentation should you chart?

A
  • Pre-op:
    dental, cerivical range of motion, Mallampati class, TM distance, mouth opening
  • After intubation:
  • visualization, trauma, equipment used, hemodynamic or respiratory changes.
  • After extuabation:
  • loose teeth intact, airway patency, adjuncts, airway maneuvers used

Spring '14 Advanced Health Assessment (5 decks)

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