Airway Assessment by AI Flashcards
What is the anatomy of the airway?
Includes the mouth, pharynx, larynx, trachea, and associated structures
The airway anatomy is crucial for understanding intubation and airway management.
What are the components of the mouth in airway anatomy?
Roof, floor, tongue, mandible, teeth
The mouth plays a vital role in airway assessment and management.
What is the length of the trachea in adults?
10 to 15 cm
The trachea extends from the inferior cricoid membrane to the carina.
What is the primary function of the larynx?
Phonation and airway protection
The larynx connects the pharynx to the trachea.
What are the unpaired laryngeal cartilages?
Thyroid, cricoid, epiglottis
The thyroid is the largest cartilage.
What are the paired laryngeal cartilages?
Arytenoid, corniculate, cuneiform
The arytenoid cartilages are where the vocal cords attach.
Where are the true vocal cords located?
They attach to the arytenoids and the thyroid notch on thyroid cartilage
The true vocal cords are essential for sound production.
What is a significant predictor of difficult intubation?
Past difficult intubation
Other factors include excessive sore throat and recent onset of hoarseness.
What does the STOP BANG questionnaire assess?
Risk factors for obstructive sleep apnea
It includes questions about snoring, tiredness, observed apnea, blood pressure, body mass index, age, neck circumference, and gender.
What is the Mallampati classification used for?
To assess the visibility of oropharyngeal structures
It ranges from Class I (most visible) to Class IV (only hard palate visible).
What does the ‘C’ in the ‘LEMONS’ intubation assessment stand for?
Criteria associated with difficult airway
This includes evaluating the patient’s face and neck for abnormalities.
What does the ‘B’ in the ‘BOOTS’ predictor for difficult BMV stand for?
Beard
The ‘BOOTS’ acronym includes other factors like Obesity, Older age, and Toothless.
What is the significance of the sniffing position?
Aligns the oral, pharyngeal, and laryngeal axis
This positioning aids in intubation.
What is the preferred inter-incisor distance for easy intubation?
> 6 cm (3 finger breadths)
Adequate mouth opening is crucial for successful intubation.
What is the purpose of laryngeal manipulation (BURP)?
To optimize the view of the glottis during intubation
It involves backward, upward, and rightward pressure on the larynx.
What is the preferred thyromental distance for easy intubation?
> 6.5 cm (3 finger breadths)
This measurement helps assess airway anatomy.
What does the term ‘difficult airway’ refer to?
Challenges in intubation or ventilation
Factors include anatomical variations and patient history.
What is the role of nebulized lidocaine in airway management?
To provide local anesthesia before intubation
It helps minimize discomfort during the procedure.
What are the criteria associated with difficult mask ventilation?
Obesity, Beard, Edentulous, Snorer, Elderly, Mallampati score 3 or 4
These factors can complicate ventilation during anesthesia.
What is the significance of the ‘3-3-2 rule’ in airway assessment?
Assessing mouth opening, mandible, and thyroid notch distance
Each measurement helps predict intubation difficulty.
What is the expected course of a patient with difficult airway features?
Potential need for awake intubation or alternative airway strategies
Early decision-making is vital in these cases.
What is the primary use of propofol in rapid sequence intubation?
Sedation and induction agent
Propofol is used for its rapid onset and short duration.
What are the two main paralytic agents mentioned?
Rocuronium and Succinylcholine
Rocuronium is preferred in certain clinical situations.
What condition can predispose patients to malignant hyperthermia?
Existing muscular dystrophies or inherited myopathies
Malignant hyperthermia is a serious reaction to certain anesthetics.
What is the onset time for intubating conditions with rocuronium?
40 seconds
Compared to succinylcholine, which has a quicker onset.
Fill in the blank: The duration of action for succinylcholine is _______.
5-10 minutes
True or False: Rocuronium has a longer duration of action than succinylcholine.
True
Rocuronium lasts 30-90 minutes.
What should be the target SBP before intubation if possible?
≥140 mmHg
This helps ensure better perfusion during the procedure.
What is the induction agent of choice in shock patients?
Ketamine
Ketamine provides both sedation and sympathetic stimulation.
What is the recommended initial intervention for patients with high aspiration risk?
Intubate in semi-upright position
This reduces the risk of aspiration during intubation.
What should be done if oxygen saturation cannot reach ≥95%?
Consider lung shunt physiology
Conditions like pulmonary edema or pneumonia may be affecting saturation.
What are the physiological killers mentioned?
- Hypotension
- Hypoxemia
- Metabolic Acidosis
What is the significance of using a PEEP valve during intubation?
It helps maintain positive pressure in the airway
This can prevent atelectasis and improve oxygenation.
What does the acronym NO DESAT stand for?
Nasal Oxygen During Efforts Securing A Tube
What is the recommended dose of ketamine for procedural sedation?
0.5-1 mg/kg
This dosage provides adequate sedation for preoxygenation.
What should be included in the plan for failed intubation?
Rescue maneuvers like ventilation and cricothyrotomy
Early initiation of rescue maneuvers is crucial for patient safety.
What is the role of the bougie in intubation?
Facilitates passage of the endotracheal tube
Incorporating bougie use into routine can aid in difficult intubations.
Fill in the blank: The cribriform plate is part of the _______.
Nasal anatomy
What is the effect of increased circulating CO2 in patients with metabolic acidosis?
It can worsen acidosis and lead to arrhythmias
Monitoring CO2 levels is important in managing acidosis.
What are the two recommended approaches for preoxygenation in patients with difficulty breathing?
- Nasal Cannula at 15LPM + BVM 15LPM + PEEP Valve
- SIMV + PSV with VT 8ml/kg Predicted Body Weight
WHat are turbinates?
Thin structures in the nasal cavilty that bleed easily
The lateral wall of the nasal passages is characterized by the presence
to avoid bleeding push the nose into a pig nose state and push the NPA straight down
How do you avoid bleeding when placing an NPA?
Cocaine soaked gauze, Afrin (neo nasal spray), lidocaine
What scan do you do to get the best view of the tongue?
MRI/CT
WHat is the primary cause of upper airway obstruction
Loss of pharyngeal muscle tone is one of the primary causes of upper airway obstruction during anesthesia
chin lift with mouth closure increases longitudinal tension in the pharyngeal muscles, counteracting the tendency of the pharyngeal airway to collapse
Nasopharynx ends at the _____
Soft Palate
The nasopharynx ends at the soft palate; this region is termed the velopharynx and is a common site of airway obstruction in both awake and anesthetized patients
The pharynx joins the ___ and ______
larynx and esophagus
