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1Principles of Anesthesia > Airway Equipment Pt1 (Exam 2) > Flashcards

Airway Equipment Pt1 (Exam 2) Flashcards

1
Q

What pressure should the inflatable seal of a face mask be at?

A

20 - 25 cmH₂O with minimal leak

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2
Q

What connector size does a face mask have?

A

22 mm internal diameter

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3
Q

What risk factors are there for difficult mask ventilation?

A
  • Male
  • > 55 yo
  • Beard
  • Edentulous
  • OSA
  • BMI > 30 kg/m²

O.B.E.S.E

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4
Q

What are some options for overcoming a difficult mask ventilation?

A
  • Oral or nasopharyngeal airway
  • Two-handed technique
  • Cut the beard
  • Tegaderm
  • Difficult airway algorithm
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5
Q

What are most oropharyngeal airways made of?

A

plastic

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6
Q

What is the purpose of placing an oropharyngeal airway?

A

Lift tongue & epiglottis away to ↓ work of breathing during SV

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7
Q

How is the correct oropharyngeal airway size checked?

A

Corner of mouth → angle of jaw or earlobe

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8
Q

When inserting oropharyngeal airways, what reflexes should be depressed?

A

Pharyngeal and laryngeal reflexes should be depressed adequately

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9
Q

Where are bite blocks placed? What situations might require use of a bite block?

A

Between upper and lower teeth and gums

Endoscopy, bronchoscopy, prevent ETT biting

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10
Q

Which artificial airway is tolerated in patients w/ intact airway reflexes?

A

Nasopharyngeal airways (NPA)

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11
Q

What airway is preferable for patients with loose teeth, oral trauma, gingivitis, or limited mouth opening?

A

Nasopharyngeal airway (NPA)

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12
Q

When are Nasopharyngeal airways contraindicated?

A
  • Basilar skull fracture
  • Nasal deformity
  • Hx of epistaxis
  • Pregnancy
  • Coagulopathy
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13
Q

How are Nasopharyngeal airways sized?

A

By outer diameter in the french scale (usually 10-36 fr)

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14
Q

How is the appropriate size NPA measured?

A

bony mandible or nostril → external auditory meatus

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15
Q

What are the possible complications of airways? (6)

A
  • Airway obstruction from incorrect placement
  • Ulceration (nose, tongue, etc.)
  • Dental/oral damage
  • Laryngospasm
  • Latex allergy (older, green NPAs)
  • Retention/swallowing
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16
Q

Who developed Supraglottic airways?

A

Dr. Archie Brain

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17
Q

What airway is intermediate in invasiveness between a face mask and endotracheal tube?

A

Supraglottic airway (LMA, Laryngeal mask airway)

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18
Q

Are supraglottic airways used for spontaneous ventilation or positive pressure ventilation?

A

Can be used for both SV or PPV

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19
Q

Where do LMA classic’s sit after insertion?

A

Hypopharynx surrounding the supraglottic structure.

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20
Q

What LMA size is necessary for adults 50-70 kg?

A

LMA 4

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21
Q

What LMA size is necessary for children 30-50 kg?

A

LMA 3

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22
Q

What size LMA is necessary for adults over 100 kg?

A

LMA 6

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23
Q

What LMA size is necessary for adults 70-100 kg?

A

LMA 5

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24
Q

What LMA size is necessary for neonates and infants up to 5 kg?

A

LMA 1

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25
Q

What LMA size is necessary for infants/children between 10-20 kg?

A

LMA 2

26
Q

What LMA size is necessary for infants between 5-10 kg?

A

LMA 1.5

27
Q

What LMA size is necessary for children between 20-30 kg?

A

LMA 2.5

28
Q

What occurs with an LMA that is too small?

A

Leaking occurs with positive pressure ventilation

29
Q

What occurs with an LMA that is too large?

A
  • Won’t seat on glottis
  • ↑ incidence Sore throat
  • Pressure on nerves
30
Q

What nerves might be compressed with an overly large LMA?

A
  • Lingual
  • Hypoglossal
  • Recurrent Laryngeal
31
Q

Label the following steps of LMA insertion as true or false.

  • Insert well lubricated w/ the cuff facing up
  • Hold like a pencil
  • Upward against the hard palate
  • Follow the anterior pharyngeal wall
  • Feel curve downward into airway then come to a stop.
A
  • Insert well lubricated w/ the cuff inflated (False, cuff should be faced down)
  • Hold like a pencil (True)
  • Upward against the hard palate (True)
  • Follow the anterior pharyngeal wall (False, follow the posterior pharyngeal wall)
  • Feel curve downward into airway then come to a stop. (True)
32
Q

What anatomic technique would one use for a difficult LMA insertion?

A
  • Jaw lift
  • Pull tongue forward
  • Slightly inflate balloon
33
Q

How does an LMA Unique compare to an LMA classic?

A
  • Stiffer (made of PVC)
  • Less compliant cuff

*both disposable
*insertion is the same

34
Q

What are the characteristics of an LMA Proseal?

A
  • Shorter than Classic
  • Reinforced w/ wire
  • Access to Esophagus for gastric tube (2nd gen)
35
Q

Which LMA type has no cuff to seal around the supraglottic opening and is made of medical-grade thermoplastic elastomer?

A

i-gel LMA’s

36
Q

Which LMA’s provide access to the esophagus through a built in opening?

A
  • LMA Proseal
  • i-gel LMA’s
  • (2nd gen LMA’s)
37
Q

What are the characteristics of I-gel LMA’s?

A
  • No cuff (non-inflatable anatomic seal)
  • Gastric channel
  • Can intubate through
38
Q

What are the advantages of LMAs? (5)

A
  • Easy and speedy placement
  • Improved hemodynamic stability
  • Reduced anesthetic requirements
  • No muscle relaxation needed
  • Tracheal intubation risks avoided
39
Q

Which LMA allows for intubation through the LMA itself?

A

i-gel LMA’s (typically)

40
Q

Would an LMA or an ETT be better for hemodynamic stability?

A

LMA

41
Q

Which LMA’s offer the best protection from gastric regurgitation and aspiration?

A

LMA’s offer little protection from aspiration.

Best protection: i-gel and 2nd generation LMA’s with gastric port.

42
Q

Would an LMA or ETT be better for protection from Laryngospasm?

A

ETT

LMA’s offer no protection from laryngospasm

43
Q

What size Mac blades are used for adult laryngoscopy?

A

3 and 4

44
Q

What size Miller blades are used for adult laryngoscopy?

A

2 and 3

45
Q

Which intubating blade style is generally better for smaller mouths and longer necks?

A

Miller

46
Q

Which intubating blade causes more cervical spine movement with its use?

A

Mac

47
Q

Which laryngoscopy blade is inserted into the vallecula?

A

Mac

48
Q

What imaginary line is created when placing a patient in the sniffing position?

A

Horizontal line connecting external auditory meatus and sternal notch.

49
Q

Is a laryngoscopy blade inserted into the right or left of the mouth?

A

Right

50
Q

How much cervical flexion and head extension are present in the sniffing position?

A
  • 35° lower cervical flexion
  • 80-90° head extension
51
Q

How is the larynx externally displaced to provide a better intubating view?

A

BURP technique

Backward
Upward
Rightward
Pressure

52
Q

What laryngoscopic positioning is useful for obese patients?

A

Ramped Position
(with Troop pillow or folded blankets)

53
Q

What is a Shikani Optical Stylet?

A

Stylet contraption with eyepiece for visualization and oxygen insufflation while intubating

54
Q

What are the disadvantages to the optical stylet?

A
  • Longer intubation time
  • No nasal intubations
  • No malleable stylet for precise directing.
55
Q

What are the benefits of the optical stylet?

A
  • Visualized trachea
  • ↓ sore throat incidence
  • ↓ c-spine movement
56
Q

What are the strongest predictors of failure of video laryngoscopy?

A

Presence of altered neck anatomy with:
* Surgical scar
* Radiation changes
* Mass

57
Q

What are the biggest advantages to using video laryngoscopy? (3)

A
  • Operator and assistant can visualize
  • ↓ C-spine movement
  • Can perform further from pt face (infectious pt)
58
Q

What are overall limitations of video laryngoscopes? (3)

A
  • Video system required
  • Limited portability
  • Can fail w/ anatomic abnormalities
59
Q

Label each of the following types of video laryngoscopes

A
60
Q

What is the most frequent anesthesia-related claim?

A

Dental injury

1Principles of Anesthesia (26 decks)

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