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Airways > Airway Lectures (Hall) > Flashcards

Airway Lectures (Hall) Flashcards

1
Q

2 types of Endotracheal Intubation

A

Orotracheal Intubation

Nasotracheal Intubation

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2
Q

3 types of Laryngoscope Blades

A

Macintosh (Mac)
Miller
D-Blade (video laryngoscope)

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3
Q

Macintosh Blades

A

Curved with the tip placed in the vallecula

typically left handed

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4
Q

Miller Blades

A

Straight with the tip lifting the epiglottis

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5
Q

D-Blades

A

Great curvature, resulting in the lack of direct line of sight of the glottis. Requires the use of an intubating stylet.

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6
Q

Video Laryngoscopes

A 
Equipped With:
Handle
Blade
Light Source
Viewing Screen
Recording System
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7
Q

Conventional Endotracheal Tube (ETT)

A 
Consists of:
Machine end adapter
Tube body
Inflation System
Tip with Bevel and Murphy Eye at distal end
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8
Q

Outside Diameter of ETT machine connector

A

15 mm

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9
Q

Purpose of Murphy Eye

A

Alternate gas pathway in the event that bevel is obstructed by tracheal wall

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10
Q

How to prepare the ETT

A

Seat connector
Check cuff integrity
Deflate cuff
Know how much air is in the syringe (6ml)

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11
Q

Magill Forceps

A

Used for retrieval of foreign bodies and assists with nasotracheal intubation

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12
Q

Introducer tubes

A

Designed to assist with tube placement

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13
Q

Intubating Stylets

A 
Provides rigidity in hockey stick shape
Should not be used unless there is a real need
Risk associated with use:
     puncture
     abrasion
     laceration
     cricoarytenoid dislocation
     failure to intubate
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14
Q

Steps for DL and ET intubation

A 
Obtain correct height of patient
Operator assumes good position
Create axial alignment
Perform DL
Intubate
Confirm intubation
Secure ETT
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15
Q

How to position patient for intubation

A

Patient head at your waist
Your upper arm loosely held at your side
Your lower arm horizontal

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16
Q

Proper intubating positioning allows for

A

Max endurance
Min energy consumption
Optimal depth of field
Visibility of teeth and vocal cords

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17
Q

Proper vector for Laryngoscope during intubation

A

Lift towards the wall/ceiling intersection

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18
Q

Most common error leading to failure to obtain a direct view of the glottis

A

Failure to correctly use towels in head positioning. The use of towels decreases airway patency.

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19
Q

Confirming Endotracheal Intubation

A 
Capnography (repeating wave forms)
Chest Rise
Condensation
Compliance
Auscultation
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20
Q

What not to use to confirm ETT intubation

A

SpO2

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21
Q

Where to listen for Auscultation

A

Farthest from the bronchioles, bilaterally under the arm pits

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22
Q

Functions of the Human Airway

A 
Protection (Aspiration, Microorganisms)
Conduction (O2/CO2 exchange, Anesthetic Gases)
Air Conditioning (heat/humidity)
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23
Q

Proper vector of jaw thrust maneuver

A

90° to the long axis of patient

24
Q

Correct finger positioning of jaw thrust maneuver

A

Fingers behind the angle of the jaw, thumbs on either side of patients nose

25
Q

Muscle that allows jaw thrust maneuver to be effective

A

Genioglossus

26
Q

How does bag and mask ventilation work?

A

Positive pressure flow is directed toward patient by unidirectional valves

27
Q

LMA means?

A

Laryngeal Mask Airway

28
Q

How do LMAs work?

A

Placed into hypopharynx and is inflated to give a seal above the glottis (a blind technique)

29
Q

Proper LMA insertion

A

Deflate cuff
Fill lip of cuff with KY lubricant
Depress tongue with tongue depressor
Pass LMA over tongue and seat it in the hypopharynx
Inflate the cuff and check for capnography waves

30
Q

Why is airway management so important?

A

Provides anesthesia for surgical procedures
Supports resuscitation
Provides long term respiratory care

31
Q

Purpose of preoperative airway examination

A

In order to:
Do no harm during subsequent airway management
Determine airway related risks
Obtain information necessary for bag/mask, DL, LMA
Obtain info needed for post-op management

32
Q

4 key steps to physical examination

A

Palpation
Percussion
Inspection
Auscultation

33
Q

How many plans of action should you have?

A

Always have 5 plans and be prepared to execute 3 of them

34
Q

What are you checking for when conducting a ROM exam?

A

Rotation, Flexion, Extension

Rotation of head from left to right
Flexion of lower c-spine
Extension of atlanto-occipital joint

35
Q

Proper extension of AO joint can be seen as what?

A

“Closure of the gap”

Upper and lower dentition angle should create a 35° angle when going from “horizontal upper to horizontal lower”

36
Q

What is Paresthesias?

A

An abnormal sensation, typically tingling or prickling feeling, caused chiefly by pressure on or damage to peripheral nerves (pins and needles)

37
Q

Things to look for in a Oropharyngeal Examination

A 
Inter-incisor distance
Dentition
Tongue, gums, and floor of mouth
Structures that could cause potential DL difficulty
Asses TMJ
38
Q

TMJ has two actions. What are they?

A

Rotation = 50%

Gliding (sliding) = 50%

39
Q

The inter-incisor distance should be what?

A

Greater than or equal to 4cm

40
Q

When identifying problems with the dentition, always use notation with what?

A

Tooth numbering system

41
Q

What do you expect to see during an OPE?

A 
Hard Palate
Soft Palate
Uvula
Palatine Tonsils or Fossa
Palatoglossal Arches
Palatopharyngeal Arches
42
Q

What is the risk of an incisor opening of less than 4cm ?

A

A conventional DL may not be possible

43
Q

Thyromental Distance

A

Should be greater than or equal to 6.5cm

If less than 6.5cm, a conventional DL may not be possible

44
Q

Mandibular Length from angle to center jaw

A

Should be greater than or equal to 9cm

If less than 9cm, there is limited space for soft tissue displacement and a conventional DL may not be an option.

45
Q

Dysphagia

A

Difficulty Swallowing

46
Q

Prevalence

A

Portion of population that has a condition

47
Q

Incidence

A

Number of new cases occurring in a population in a given time period

48
Q

Where is the Gastroesophageal (GE) junction located?

A

Where the semi-hemispheres of the diaphragm join

49
Q

GE junction opening pressure

A

16 cmH2O = normal
4 cmH2O = Hiatal Hernia
1 cmH2O = GERD

50
Q

Prevalence of Hiatal Hernias

A

20% to 50% of the population
Increases with Age
Majority are Asymptomatic

51
Q

Two types of hiatal hernias

A

Axial (sliding) = 95%

Non-Axial (paraesophageal) = 5%

52
Q

Hiatal Hernia complications

A

Increased risk of aspiration

53
Q

Esophagitis

A

Inflammation of the Esophagus

54
Q

GERD

A

Gastroesophageal Reflux Disease

55
Q

GERD Prevalence and side effects

A

Increases with age
Daily symptoms 7% to 10%
Occasional Symptoms 25% to 40%

Esophagitis
Adenocarcinoma

Airways (1 decks)

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