AIRWAY MANAGEMENT Flashcards
1
Q
- What is the definition of difficult mask ventilation?
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2
Q
- What is the incidence of difficult mask ventilation?
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3
Q
- What is the definition of difficult tracheal intubation/laryngoscopy?
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4
Q
- What is the incidence of difficult tracheal intubation/laryngoscopy?
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5
Q
- What is the incidence of failed tracheal intubation?
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6
Q
- How does resistance to airflow through the nasal passages compare to that through
the mouth?
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7
Q
- How does resistance to airflow through the nasal passages compare to that through
the mouth?
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8
Q
- What nerves innervate the hard and soft palate?
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9
Q
- What nerve provides sensation to the anterior two thirds of the tongue?
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10
Q
- What nerve innervates the posterior third of the tongue, the soft palate, and the
oropharynx?
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11
Q
- What are the three components of the pharynx?
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12
Q
- What nerves innervate the pharynx?
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13
Q
- Complete the following table: (223, Table 16-1, Motor and Sensory Innervation
of Larynx
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14
Q
- Where is the narrowest part of the adult airway?
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15
Q
- What is special about the cricoid cartilage compared with the other tracheal cartilages?
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16
Q
- What is the purpose of the Mallampati classification system?
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17
Q
- Describe the observer/patient position during Mallampati classification.
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18
Q
- Describe the Mallampati classes.
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19
Q
- What is the purpose of the Cormack and Lehane score?
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20
Q
- Describe the Cormack and Lehane grades.
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21
Q
- What is the purpose of the upper lip bite test (ULBT)?
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22
Q
- Describe the upper lip bite test (ULBT) classes.
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23
Q
- What three axes must be aligned to obtain a line of vision during direct
laryngoscopy? How is this accomplished? What is this final position called?
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24
Q
- What is the concern with a “short” thyromental distance?
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25
Q
- What is the concern with a decreased submandibular compliance?
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26
Q
- What position is associated with improved alignment of the three axes to obtain a
line of vision during laryngoscopy in obese patients?
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27
Q
- What maneuver facilitates identification of the cricoid cartilage in patients who do
not have a prominent thyroid cartilage?
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28
Q
- What is “preoxygenation” prior to the induction of anesthesia? What is its value?
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29
Q
- How is preoxygenation accomplished?
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30
Q
- Name ten independent variables that are associated with difficult facemask
ventilation.
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31
Q
- Why is it important to limit ventilation pressure to less than 20 cm H2O during
facemask ventilation?
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32
Q
- What are contraindications to nasal airway placement?
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33
Q
- What are some indications for endotracheal intubation?
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34
Q
- What is another name for cricoid pressure and how is it performed?
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35
Q
- What is the purpose of cricoid pressure?
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36
Q
- Describe the proper placement of the tip of a curved (Macintosh) laryngoscope blade
versus that of a straight (Miller) laryngoscope blade for exposure of the glottic
opening during laryngoscopy.
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37
Q
- Describe the OELM and BURP maneuvers. What is their purpose?
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38
Q
- How are endotracheal tubes sized?
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39
Q
- Why are endotracheal tubes radiopaque and transparent
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40
Q
- Why are low-pressure, high-volume cuffs on endotracheal tubes preferred?
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41
Q
- What are some serious complications attributable to endotracheal cuff pressures?
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42
Q
- Name some stylets that can be used to facilitate endotracheal intubation.
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43
Q
- What are some methods to confirm the correct placement of an
endotracheal tube?
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44
Q
- When is an awake fiberoptic endotracheal intubation most frequently chosen?
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45
Q
- Why is fiberoptic endotracheal intubation recommended for patients with unstable
cervical spines?
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46
Q
- Why is fiberoptic endotracheal intubation recommended for patients who have
sustained an injury to the upper airway from either blunt or penetrating trauma?
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47
Q
- What is an absolute contraindication to fiberoptic endotracheal intubation?
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48
Q
- What are some relative contraindications to fiberoptic endotracheal intubation?
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49
Q
- What are some advantages and disadvantages of nasal fiberoptic endotracheal
intubation?
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50
Q
- Why should an antisialagogue be given before fiberoptic endotracheal intubation?
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51
Q
- On what basis is the choice of sedation for an awake fiberoptic tracheal intubation
made?
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52
Q
- Describe preparation of the nose and nasopharynx for nasal fiberoptic tracheal
intubation.
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53
Q
- Describe preparation of the tongue and oropharynx for nasal or oral fiberoptic
tracheal intubation.
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54
Q
- Describe preparation of the larynx and trachea for nasal or oral fiberoptic tracheal
intubation.
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55
Q
- Why is lidocaine the preferred airway topical local anesthetic?
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56
Q
- Name two blocks that can be performed to topicalize the larynx and trachea.
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57
Q
- How can the risks of mucosal trauma or submucosal bleeding with nasal
endotracheal intubation be minimized?
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58
Q
- What advantages does inflation of the endotracheal tube cuff during advancement
with the fiberoptic scope offer?
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59
Q
- How is endotracheal tube depth verified during fiberoptic intubation?
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60
Q
- What are possible causes of resistance when removing the fiberoptic
bronchoscope?
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61
Q
- What is the utility of oral intubating airways during oral fiberoptic endotracheal
tracheal intubation?
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62
Q
- Why is visualization more difficult during fiberoptic endotracheal tracheal
intubation in an asleep patient?
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63
Q
- Why is having a second person trained in anesthesia delivery present
recommended for fiberoptic endotracheal tracheal intubation in an asleep patient?
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64
Q
- Describe a Patil-Syracuse mask
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65
Q
- Describe an Aintree airway exchange catheter.
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66
Q
- Name some rigid fiberoptic laryngoscopes. When might these laryngoscopes be
useful?
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67
Q
- Describe the retrograde and blind nasal endotracheal intubation techniques and
when they might be useful.
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68
Q
- Describe correct anatomic placement of the laryngeal mask airway (LMA).
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69
Q
- For what purpose was the LMA Fastrach designed?
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70
Q
- When using an ILMA, why are silicone Euromedical endotracheal tubes preferred
over standard endotracheal tubes? What is the disadvantage of these tubes?
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71
Q
- Describe the LMA CTrach
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72
Q
- Describe the ProSeal LMA.
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73
Q
- Describe the esophageal-tracheal Combitube (ETC).
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74
Q
- What is transtracheal jet ventilation and when might it be useful? When is it
contraindicated? What are some potential risks of transtracheal jet ventilation?
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75
Q
- What is a cricothyrotomy and when is it usually performed?
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76
Q
- Why is tracheal extubation during a light level of anesthesia dangerous?
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77
Q
- What is laryngospasm? When is it most likely to occur?
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78
Q
- How should laryngospasm be treated?
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79
Q
- When is deep tracheal extubation contraindicated?
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80
Q
- What are the steps of tracheal extubation?
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81
Q
- What is the most common complication during direct laryngoscopy?
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82
Q
- Describe endotracheal tube movement during head flexion and extension
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83
Q
- What are the two most serious complications after tracheal extubation?
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84
Q
- What is the major complication of prolonged tracheal intubation?
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85
Q
- What are some differences between the infant and the adult airway? At what age
does the pediatric upper airway take on more adultlike characteristics?
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86
Q
- Contrast the location of the larynx in an infant versus an adult. What effect does
this have on the tongue?
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87
Q
- Contrast the size of an infant’s tongue in proportion to the size of the mouth with
that of an adult. What are the consequences of this?
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88
Q
- Contrast an infant’s epiglottis with that of an adult.
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89
Q
- What advantages do straight laryngoscopes offer over curved laryngoscopes when
intubating an infant or small child?
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90
Q
- What is the narrowest portion of an infant’s airway versus an adult airway?
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91
Q
- What is the correct size of an uncuffed endotracheal tube in infants and
children?
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92
Q
- Can cuffed endotracheal tubes be safely used in infants and children? What
if nitrous oxide is used during the anesthetic?
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93
Q
- What are the dangers of an endotracheal tube that is too large for infants and
children?
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94
Q
- Contrast proper head and neck positioning of an adult with that of an infant during
direct laryngoscopy.
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95
Q
- What is different about an infant’s nares compared to an adult’s? Why is this
important?
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96
Q
- Why is a history of snoring important in infants and children?
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97
Q
- What is the dose of oral midazolam for infants or children? What is the maximum
oral dose? What if the child is uncooperative with taking oral midazolam?
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98
Q
- What is the dose of oral midazolam for infants or children? What is the maximum
oral dose? What if the child is uncooperative with taking oral midazolam?
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99
Q
- Describe an inhaled induction in a child. When should the nitrous oxide be
discontinued?
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100
Q
- Describe maneuvers to overcome airway obstruction during mask induction in
infants and children.
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101
Q
- What determines the appropriate size of an LMA for use in infants and
children?
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102
Q
- What is the LMA Flexible? What advantages does it offer?
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103
Q
- What advantage does the Air-Q intubating laryngeal airway (ILA) have over an
LMA?
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104
Q
- What formula is often used to estimate the appropriate-sized endotracheal tubes
for infants and children?
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105
Q
- Is the formula used to estimate the appropriate-sized endotracheal tube for
infants and children applicable for cuffed or uncuffed endotracheal tubes?
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106
Q
- How is the formula used to estimate the appropriate-sized endotracheal tubes for
infants and children adapted for cuffed endotracheal tubes?
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107
Q
- What three advantages do Microcuff endotracheal tubes have over conventional
pediatric cuffed endotracheal tubes?
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108
Q
- Are stylets useful in intubating infants and children?
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109
Q
- What is the disadvantage of a straight laryngoscope blade compared to a curved
blade?
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110
Q
- Describe the most useful sizes of laryngoscope blades according to age.
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111
Q
- What is the most important first step when an unexpected difficult airway occurs in
pediatric patients?
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112
Q
- Why should repeated attempts at direct laryngoscopy be avoided? What should be
done instead?
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113
Q
- Is an awake fiberoptic endotracheal intubation usually an option in managing an
expected pediatric difficult airway?
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114
Q
- What personnel and equipment should be in the operating room before induction
of anesthesia in a pediatric patient with an expected difficult airway?
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115
Q
- What airway devices are available in smaller sizes to facilitate intubation of a child
with a difficult airway?
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116
Q
- Why is tracheal extubation in infants and children riskier than that of adults?
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117
Q
- When does postextubation croup most commonly occur? Why is this important?
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118
Q
- What are the clinical manifestations of postextubation croup?
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119
Q
- How is postextubation croup treated?
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120
Q
- Why is obstructive sleep apnea especially important in infants and children?
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121
Q
- How should opiate therapy be managed in an infant or child with obstructive
sleep apnea?
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122
Q
- Describe tracheal extubation and postoperative monitoring for infants and
children with obstructive sleep apnea.
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123
Q
- How should extubation after a difficult intubation be handled in infants and children?
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