AIRWAY INFECTIONS, BURNS, RELATED BONE AND JOINT DISEASES

Question 1

name 4 upper airway infections common in children

Answer 1

acute epiglottitis

croup

laryngotracheobronchitis

tonsilitis

Question 2

what tool would be used for surgery on a peritonsillar abscess?

Answer 2

mcivor mouth gag

Question 3

what would be the airway management plan for a pt with pertonsillar abscess?

Answer 3

general/anode oett

Question 4

definition: spasm of the jaw muscles, causing the mouth to remain tightly closed

Answer 4

trismus

Question 5

what are two complications related to peritonsillar abscess?

Answer 5

partial airway obstruction

trismus

Question 6

what tools should be available for intubation for peritonsillar abscess surgery?

Answer 6

anode ett

+/- FFOB

Question 7

definition: connective tissue infection that occurs on the floor of the mouth under the tongue

Answer 7

ludwig’s angina

Question 8

what is the best course of airway management for Ludwig’s angina?

Answer 8

FFOB NETT sedation

Question 9

what is the appropriate induction plan for Ludwig’s angina?

Answer 9

IV after intubation complete & confirmed

Question 10

what is the most appropriate post-op airway management for ludwig’s angina?

Answer 10

patient will remain intubated

Question 11

what is the appropriate emergence plan for ludwig’s angina?

Answer 11

sedation with propofol infustion

Question 12

definition: (greek - ankhon) strangling

Answer 12

angina

Question 13

what is the appropriate induction plan for a case of pediatric acute epiglottitis?

Answer 13

single-breath sevoflurane induction

Question 14

appropriate postop airway management for pediatric epiglottitis?

Answer 14

patient will remain intubated

Question 15

appropriate emergence plan for pediatric acute epiglottitis?

Answer 15

complete sedation with possible nmb

Question 16

what are the symptoms that present with pediatric acute epiglottitis?

Answer 16

fever, drooling, difficulty swallowing

sitting upright, leaning forward, drooling

Question 17

how does resolution of acute epiglottitis appear?

Answer 17

decreased WBC, fever abates, air leak develops

Question 18

what airway complications present with retropharyngeal abscess?

Answer 18

partial airway obstruction

limited nasopharyngeal access

infection limits topical pharyngeal anesthesia

Question 19

what is the major airway management periop risk associated with surgery for chronoic recurrent tonsillitis?

Answer 19

postop hemorrhage

Question 20

what is the male:female ratio of thermal injury?

Answer 20

69:31

Question 21

what is the survival rate of thermal injuries?

Answer 21

96.6%

Question 22

how many burn centers are there in the US?

Answer 22

62 (in 29 states)

Question 23

what are the two major types of burns?

Answer 23

fire/flame

scalds

Question 24

where do most thermal injuries occur?

Answer 24

72% – home

Question 25

what is the percentage of burn patients that have inhalational injury?

Answer 25

33% of burn pts have inhalational injuries

Question 26

name four types of inhalational injuries

Answer 26

hot, dry gases steam toxic/ chemical/ irritating gases smoke

Question 27

how should the assessment of airway injury be approached?

Answer 27

current vs projected status

Question 28

how should the assessment of the cardiovascular effects be conducted?

Answer 28

current vs. projected cardiovascular effects

Question 29

what is the primary goal of airway management of thermal/chemical injuries?

Answer 29

maintain airway patency and oxygenate

Question 30

what are the related pathophysiologies related to fire-thermal injuries?

Answer 30

CO poisoning CN poisoning aspiration

Question 31

what would be included in current status airway assessment of thermal injury if airway directly involved?

Answer 31

facial, oral, nasal burns singed nasal hairs

Question 32

what would be included in projected status of airway assessment of thermal injuries if airway directly involved?

Answer 32

**laryngeal edema** – rapid loss of airway patency

Question 33

why is tracheostomy contraindicated in thermal injury pts?

Answer 33

risk of wound and mediastinal infection

Question 34

at what pressure at which air leak is audible is discontinuation of airway support acceptable/unacceptable?

Answer 34

5-10cmH2O – acceptable \> 20cmH2O – unacceptable

Question 35

definition: released by cellulosic conflagration: denatures protein; produces pulmonary edema (10ppm)

Answer 35

acrolein

Question 36

released by polyurethane conflagration

Answer 36

CN

Question 37

released by fires and incomplete combustion

Answer 37

CO

Question 38

released by PVC conflagration; severe mucosal burns in airway

Answer 38

HCl

Question 39

what is the goal of initial burn treatment?

Answer 39

debridement and burn dressing changes

Question 40

what is the goal of long-term burn treatment?

Answer 40

plastic/ other surgeries

Question 41

definition: immobility

Answer 41

ankylosis

Question 42

definition: inflammation of joint

Answer 42

arthritis

Question 43

definition: pertaining to vertebra(e) or spine

Answer 43

spondyl(o)-

Question 44

definition: vertebral inflammation

Answer 44

spondylitis

Question 45

definition: partial displacement of a joint

Answer 45

subluxation

Question 46

definition: cervical vertebral fusion + short neck + low hairline; C-spine: 2-7 vertebrae

Answer 46

kippel-feil syndrome

Question 47

definition: small posterior fossa, caudal displacement, hydrocephalus

Answer 47

arnold-chiari malformation

Question 48

definition: inflammatory, multiple organ disease; C-spine, TMJ, cricoarytenoid joint; progressive and devastating

Answer 48

juevenile rheumatoid arthritis

Question 49

definition: an extremely short individual with disproportionate body parts

Answer 49

dwarfism

Question 50

what type of dwarfism is autosomal dominant; development disorder with decreased proliferation of growth plate cartilage

Answer 50

achonddroplastic dwarfism

Question 51

what is the airway complication most often observed in pts with achondroplastic dwarfism?

Answer 51

cervical instability – due to premature fusion of bones at base of skull

Question 52

definition: synovial inflammation and granulation with insidious onset progressing to cartilaginous destruction; presents with morning stiffness

Answer 52

polyarthropy

Question 53

how does rheumatic arthritis affect lower c-spine?

Answer 53

decreased flexion

Question 54

how does rheumatic arthritis affect atlanto-occipital joint?

Answer 54

decrease extension

Question 55

how does rheumatic arthritis affect TMJ movement?

Answer 55

decreased rotation/gliding – decreased mouth opening

Question 56

how does rheumatic arthritis affect cricoarytenoid joints?

Answer 56

decreased rotation/gliding – hoarseness/ stridor/ dyspnea

Question 57

also known as marie-strumpell disease, a progressive arthritis of spine and pelvis; a flexion deformity of the spine with fixed cervical spine

Answer 57

ankylosing spondylitis – spondyloarthropathy

Question 58

degenerative joint disease of TMJ presents how?

Answer 58

degeneration of articular cartilage – limited inflammation and pain with use

Question 59

degenerative joint disease of the cervical spine presents how?

Answer 59

limited movement, pain, paresthesias, motor involvement

Question 60

definition: grating, crackling or popping sounds between bone and cartilage or fractured parts of bone

Answer 60

crepitus