Airways A Final Flashcards
1
Q
Name of sinus located behind the conchae
A
Sphenoidal sinus
2
Q
What vertebral level is the hyoid bone
A
C3
3
Q
What vertebral level is the thyroid cartilage
A
C4-C5
4
Q
What vertebral level is the cricoid cartilage
A
C6
5
Q
Which bones suspend the larynx
A
Skull and mandible
6
Q
Which bones stabilize the larynx
A
Sternum and scapulae
7
Q
What are the tubercles directly lateral to the interarytenoid incisure
A
Corniculate
8
Q
What are the tubercles lateral to the corniculate tubercles
A
Cuneiform
9
Q
What position are the vocal cords in during phonation and effort closure
A
Midline
10
Q
What position are the vocal cords in when a patient is anesthesized
A
Paramedian
11
Q
What position are the vocal cords in during maximum inspiration
A
Lateral
12
Q
Whats the most common reason for airway obstruction in an anesthesized patient
A
Tongue falling against the posterior pharyngeal wall
13
Q
Which vertebral level is the major carina located
A
T6
14
Q
What is the inner diameter of a face mask
A
22mm
15
Q
What is the outer diameter of the ETT connector
A
15mm
16
Q
What is the outer diameter of the elbow
A
22mm
17
Q
What is the inner diameter of the elbow
A
15mm
18
Q
What is the definition of risk
A
The probability of injury or loss; the likelihood of doing harm
19
Q
What happens to the lower C spine during DL alignment
A
Flexes
20
Q
What happens to the atlanto-occipital joint during DL aligmnment
A
Extends
21
Q
What is the appropriate inter-incisor distance for managing the airway
A
Equal to or greater than 4cm
22
Q
What can you see in a MAL1 view
A
Tonsils, uvula, both palates
23
Q
What can you see in a MAL2 view
A
Uvula, both palates
24
Q
What can you see in a MAL3 view
A
Both palates
25
What can you see in a MAL4 view
Hard palate
26
What are the motions of the TMJ
Rotate and glide
27
What is the appropriate thyromental distance for managing the airway
6.5cm
28
What is the appropriate mandibular length for managing the airway
Greater than or equal to 9cm
29
What is the medical term for nose bleed
Epistaxis
30
What muscle do you test to assess motor function of CN VII
Orbicularis oculi
31
What is the fulcrum point for the larynx
Hyoid bone
32
What are the suspenders and stabilizers of the larynx
Extrinsic laryngeal muscles
33
What are the 2 suspension points of the larynx
Mastoid and styloid processes
34
What are the 2 stabilization points of the larynx
Sternum and scalpula
35
What is the large muscle that makes up the floor of the mouth
Mylohyoid
36
What is macrogenia
Large chin
37
What is micrognathia
Small jaw
38
What is macrognathia
Large jaw
39
What is mandibular prognathism
Jaw jets out in front of upper teeth
40
Where do I place my fingers during jaw thrust maneuver
Behind the angle of the mandible
41
Where do I not place my fingers during jaw thrust maneuver
Submental space
42
How many phases of swallowing are there
3
43
What is the purpose of swallowing
To move solids and liquids to the stomach
44
What are the 3 phases of swallowing (deglutition)
Oral, pharyngeal, esophageal
45
Which arches relax during the oral phase of swalling
Palatoglossal
46
Whats the last step of the oral phase of deglutition
Food bolus moves into the oropharynx
47
What occludes during the pharyngeal phase of swallowing
Nasopharynx
48
What closes during the pharyngeal phase of swallowing to prevent aspiration
Larynx
49
What is the vocal cord action to prevent aspiration
Adduct
50
What is the aryepiglottic fold action to prevent aspiration
Adduct
51
What does the epiglottis do to prevent aspiration
Fold over the glottis
52
What aerodigestive activities are inhibited during the pharyngeal phase of swallowing
Breathing, coughing, sneezing, vomiting
53
What elevates during pharyngeal phase of swallowing to receive food bolus
Hypopharynx
54
What action moves the food bolus toward the esophagus during the pharyngeal phase of swallowing
Pharyngeal peristalsis
55
What 3 structures constrict during the pharyngeal phase of swallowing to produce pharyngeal peristalsis
Superior, middle, and inferior pharyngeal constrictor
56
What moves food bolus into the stomach during the esophageal phase of deglutition
Esophageal peristalsis
57
What positions are pharynx and larynx in during esophageal phase of deglutition
Rest
58
During what phase of breathing does deglutition occur
Expiration
59
What vertebral levels does the esophagus extend to
C6-T11
60
What are the 4 layers of the esophagus
Muscosa, submucosa, muscular layer, fibrous layer
61
What is achalasia
Increased tone at LES, incomplete relaxation of LES
62
What are the 3 signs and symptoms of achalsia
1) Progressive dysphagia
2) Noctural regurgitation
3) Aspiration
63
What can a diverticulum impede the placement of
NG/OG tube
64
What's another name of Zenker's Diverticulum
Pharyngoesophageal diverticulum
65
What is Zenker's Diverticulum
Outpouching of esophageal mucosa between the cricopharyngeus muscle and inferior pharyngeal constrictor
66
What is the ratio of M:F for Zenker's Diverticulum
1.5 Males:1 Female
67
Does Zenker's Diverticulum occur more in older or younger patients?
Older
68
What side does Zenker's Diverticulum occur in most often
Left side, 90%
69
What is the most common hiatal hernia
Axial (sliding) - 95%
70
What are the two types of hiatal hernias
Axial (sliding) and nonaxial (paraesophageal)
71
Patients with hiatal hernias are at high risk for what?
Aspiration
72
What are the 4 main risk factors for aspiration
Full stomach, GERD, hiatal hernia, upper GI diverticula
73
What is the bony protrusion from bones in the oral cavity
Torus
74
What is the posterior process on the axis
Dens
75
What is the large hole in the bottom of the skull
Foramen magnum
76
Which vertebrae have vertebral foramen
Cervical
77
What facets are on the atlas and axis
Superior and inferior facets
78
What is the condyle on the base of the skull
Occipital condyle
79
At what vertebral level are the vocal cords located
C4/C5
80
What vertebral level should the tip of the ET tube end
T2
81
What are the orders of axial alignment for a DL
Laryngeal, pharyngeal, oral
82
How do you bring the laryngeal axis into alignment for a DL
Folded sheets
83
How do you bring the pharyngeal axis into alignment for a DL
Atlanto-occipital extension
84
Where do the gas exchange airways begin
Respiratory bronchioles
85
Where to the upper conducting airways begin and end
Nose--->glottis
86
Where do the lower conducting airways end
Terminal bronchioles
87
What cranial nerve innervates the trachea
Vagus
88
What nerve innervates the sensory portion of the RLN
Vagus
89
What landmark do you use to assess the major carina ventrally in a physical exam
Sternal angle
90
What is the landmark for the dorsal portion of the major carina
T5-T7 in Xray of upright adult
91
What procedure requires anesthesia of the major carina
FFOB
92
At what angle does the right mainstem bronchus branch at in adults and infants
20 degrees in adults
| 30 degrees in infants
93
RUL takes off within how many centimeters of mainstem origin
2cm
94
At what angle does the left mainstem bronchus at in adults and infants
40 degrees in adults
| 47 degrees in infants
95
How long is the left mainstem bronchus
5cm
96
What is physiologic deadspace
Total deadspace in the patient
97
What is anatomic deadspace
Volume of the conducting airways
98
What is alveolar deadspace
Exchange airways that are not being perfused
99
What is normal per kilo amount of dead space
2.2ml/kg or 1ml/pound
100
Anatomical dead space is decreased by what
ETT tube, tracheostomy, laryngectomy
101
Which dead space is increased by the volume of the tube
Physical dead space
102
How much does intubation decrease anatomical dead space
By half
103
How do you calculate physical deadspace of an ETT
pi*r^2*h
104
How do you calculate net change in deadspace with an ETT
Anatomical deadspace/2 + physical deadspace of ETT
105
What are the 4 functions of the larynx
1) Air passage into and out of the lungs
2) Protect lungs from solids and liquids
3) Phonation
4) Effort closure
106
What 4 actions cause effort closure of the larynx
1) Coughing
2) Lifting
3) Defecation
4) Parturition
107
From a lateral view of oral muscles, what muscle under the tongue appears to fan out
Genioglossus
108
From a lateral view of oral muscles, what 2 muscles are inferior to the genioglossus muscle
Geniohyoid and mylohyoid
109
From a lateral view of oral muscles, what large muscle extends vertically from the tongue to the hyoid
Hyoglossus muscle
110
From a side view of oral muscles, what muscle branches off the hyoglossus muscle posteriorly and connects to the styloid process of the skull
Styloglossus muscle
111
What muscle attaches to the hyoid bone and styloid process and appears diagonal in a lateral view of oral muscles
Stylohyoid muscle
112
From a lateral view of the muscles of the neck region, what is the order from posterior to anterior of the muscles that stabilize the larynx (TOS)
Thyrohyoid, omohyoid, sternohyoid
113
What 4 muscles suspend the larynx
Digastric, mylohyoid, stylohyoid, geniohyoid
114
Which 3 extrinsic laryngeal muscles, all connected to the hyoid, form the floor of the mouth
Mylohyoid, digastric, stylohoid
115
What is the name for the horns of the hyoid bone
Cornua (greater and lesser)
116
Why are the greater cornua important anatomic landmarks for an airway exam
You can use them to palpate and move the hyoid
117
What membrane attaches to the hyoid bone
Thyrohyoid membrane
118
What ligament attaches to the hyoid bone
Hyoepiglottic ligament
119
What are 3 examples of hyaline cartilage in the larynx (CAT)
Cricoid, arytenoid, thyroid
120
What are 3 examples of elastic cartilage in the larynx
Epiglottis, corniculate tubercles, cuneiform tubercles
121
What is the general shape of the thyroid cartilage
Shield
122
What are the wings of the thyroid cartilage called
Alae
123
What is the midline fusion of alae called (2 names)
Prominentia laryngis/Adam's apple
124
What is the cephalad attachment of the thyroid cartilage
Thyrohyoid membrane
125
What is the caudad attachment on the thyroid cartilage
Cricothyroid membrane
126
Where are the vocal cords located in relation to the thyroid cartilage
Midline, interior
127
What are the 2 functions of the thyroid cartilage
1) Protect larynx
| 2) Suspends 7 of the 8 laryngeal folds
128
What suspends the thyroid cartilage from the hyoid bone
Superior cornu
129
What suspends the cricoid cartilage from the thyroid cartilage
Inferior cornu
130
What type of cartilage is cricoid cartilage
Hyaline
131
What is the general shape of the cricoid cartilage
Signet ring
132
What are the 2 functions of the cricoid cartilage
1) Supports arytenoid cartilages
| 2) Tilts for tensing VCs
133
How do you locate the cricoid cartilage on a physical ecam
It is the midline, rounded prominence below the prominentia laryngis
134
What is the cephalad attachment of the cricoid cartilage
Cricothyroid membrane
135
What is the caudad attachment of the cricoid cartilage
Trachea
136
What type of cartilage is arytenoid cartilage
Hyaline
137
What is the general shape of arytenoid cartilage
Pyramid
138
What is a unique aspect of arytenoid cartilages
They are the action center of the larynx
139
What is the attachment of the muscular process of the arytenoid cartilage
Cricoarytenoid muscles
140
What is the attachment of the vocal process of the arytenoid cartilage
Vocal cords
141
What are the 4 functions of the arytenoid cartilages
1) Movement of vocal cords
2) Rotates on vertical axis
3) Glides or slides on base
4) Intermediary for vocal cord tensing
142
What type of cartilage is the epiglottis
Elastic
143
What is the function of the epiglottis
Folds to help protect laryngeal adieus
144
What type of cartilage is corniculate cartilage
Elastic
145
What is a unique aspect of the corniculate cartilages
Cartilages of Santorini
146
What is the function of the corniculate cartilages
Spring-like action produces recoil assistance with seperation of arytenoids and reopening of the glottis
147
What type of cartilage is cuneiform cartilage
Elastic
148
What is a unique aspect of the cuneiform cartilages
Cartilages of Wrisberg
149
What are the 2 functions of the cuneiform cartilages
1) Stiffens aryepiglottic folds
| 2) Spring-like action facilitates reopening of the glottis
150
What type of joints are in the larynx
Synovial
151
What are the 2 joint pairs in the layrnx
Cricothyroid joints, cricoarytenoid joints
152
What are the 2 movements of the cricothyroid joint
Rotate and glide
153
What are the actions of the cricothyroid joint
1) Cricoid cartilage rotates
| 2) Gliding produces cricoid cartilage shift on thyroid cartilage
154
What are the 2 movements of the cricoarytenoid joints
Rotate and glide
155
What does lateral gliding of the cricoarytenoid joint cause
Lateral rotation and forward, downward movement
156
What does medial gliding of the cricoarytenoid joint cause
Medial rotation
157
What type of tissue is the vocal ligament
Elastic
158
What are the 2 muscles of the vocal cords
Vocalis muscle and thryoarytenoid muscle
159
What type of cells make up the vocal cords
Stratified squamous epithelium
160
What are the 4 actions of the vocal cords
Abduction, adduction, shortening, tensing
161
What actions does the Recurrent Laryngeal Nerve produce
Adduction, abduction, shortening
162
What action is the Superior Laryngeal Nerve responsible for
Tensing
163
What is the only intrinsic laryngeal muscle that is not a pair
Transverse arytenoid muscle
164
What is the only instrinsic laryngeal muscle that is innervated by the Superior Laryngeal Nerve
Cricothyroid muscle
165
What 3 intrinsic laryngeal muscles adduct the vocal cords
Lateral cricoarytenoid, oblique arytenoid, transverse arytenoid
166
What instrinsic laryngeal muscle abducts vocal cords
Posterior cricoarytenoid
167
What intrinsic laryngeal muscle tenses the vocal cords
Cricothyroid
168
What 2 intrinsic laryngeal muscles shorten the vocal cords
Thyroarytenoid, vocalis
169
What 2 intrinsic laryngeal muscles close the glottis
Aryepiglottic, thryoepiglottic
170
What action of the cricoid cartilage do the cricothyroid muscles produce
Tip and move cricoid cartilage posteriorly
171
What nerve provides supraglottic sensory innervation to the cricothyroid muscle
Internal branch of the Superior Laryngeal Nerve
172
What nerve provides motor innervation to the cricothyroid muscle
External branch of the SLN
173
What is the landmark for blocking the SLN
Superior horn of the hyoid bone
174
What 2 muscles oppose the action of the cricothyroid muscle
Vocalis and thyroarytenoid muscles, they contract and pull arytenoids and shorten the vocal cords
175
What muscle extends from the oblique arytenoids to the lateral epiglottis
Aryepiglottic muscle
176
What artery does the Right RLN travel around
Subclavian
177
What artery does the Left RLN travel around
Aortic arch
178
What membrane is pierced by the internal branch of the SLN
Thyrohyoid
179
Is the internal branch of the SLN sensory or motor
Sensory
180
What region does the internal branch of the SLN innervate
Supraglottic region
181
Is the external branch of the SLN sensory or motor
Motor
182
What muscles do the external branch of the SLN innervate
Cricothyroid muscles
183
How do you confirm oxygen is flowing in a hand-operated, self-inflating bag
Listen to the distal end
184
How do you confirm oxygen is flowing in an oxygen source with a reservoir
Reservoir bag fills up
185
How do you confirm that you can manually ventilate before attaching the patient to the device
Occlude patient port and squeeze bag so you can generate and hold positive pressure
186
What ventilatory rate do you provide patients during transport from the ICU?
6-8 breaths/minute for effective alveolar ventilation without hyperventilation
187
What can happen to the brain if you hyperventilate your patient during transport from the ICU
Hyperventilation will drive the CO2 down which decreases cerebral blood flow and increases chance of cerebral ischemia
188
What can happen to the brain if you hypoventilate your patient during transport from the ICU
Hypoventilation will drive the CO2 up and increase cerebral blood flow, thus increasing chance for edema in the brain
189
What is the prevalence of anisocoria
40%
190
What is acromegaly
Abnormally large head and neck features
191
What are the largest salivary glands
Parotid
192
What glands should be examined during airway exam
Lacrimal, parotid, submandibular, sublingual, thyroid
193
What is another name for parotid duct
Stensen duct
194
What is another name for submandibular duct
Wharton's duct
195
What is a treatment of dry eyes
Punctal plugs
196
What does PERLA stand for regarding an eye examination
Pupils Equal and Reactive to Light and Accommodation
197
What is exophthalmus
Bulging eyes, may not close completely
198
What causes bilateral exophtalmus
Hyperthyroidism
199
What causes unilateral exophthalmus
Orbital tubor
200
What is ptosis
Drooping of the eyes
201
What types of edema can occur with the eyes
Periorbital edema, conjunctival edema, scleral edema
202
What is angle of the atlanto-occipital gap
35 degrees
203
What is leukoplakia
White patches inside the mouth
204
What is the condition where the pharyngeal arches and wall are severely swollen and red
Pharyngitis
205
What is the condition where the palatine tonsils are coated with a liquidy white substance
Exudate
206
What is the condition where the gums grow over the teeth
Gingival hyperplasia
207
What is the therapy for gingival hyperplasia
Dilantin
208
What is the condition where the gums appear red and irritated
Gingivitis
209
What condition results in receding gums
Peridontitis
210
What is the I:E ratio of a normal flow-volume loop
I:E equal, 50:50
211
What is the I:E ratio of a flow-volume loop with extrathoracic variable obstruction
E > I
212
What shows up on the flow-volume loop when there is an extrathoracic variable obstruction
Inspiratory plateau
213
What shows up on the flow-volume loop when there is an intrathoracic variable obstruction
Expiratory plateau
214
What is the I:E ratio of a flow-volume loop with intrathoracic variable obstruction
I > E
215
What shows up on the flow-volume loop when there is a fixed obstruction
Inspiratory and expiratory plateaus
216
What is on X axis of flow volume loop
Time
217
What is on Y axis of flow volume loop
Flow
218
What surgeries can fix a partial airway obstruction
Tracheostomy
| Cricothryotomy (emergency only)
219
What would you hear during auscultation of a patient with a partial airway obstruction
Inspiratory and expiratory stridor
220
What observations would you make on a patient with partial airway obstruction
Dyspnea, stress, breathing pattern, retractions
221
Pharmacologic support of a partial airway obstruction must acheive what
Improved flow across an orificial lesion
222
What nonsurgical techniques could help manage a partial airway obstruction
Intubation or other physical airway device
223
What is the change in flow when going from air to 100% O2
90%
224
What is the change in flow when going from 100% O2 to 70% heliox
260%
225
What is the change in flow when going from 100% O2 to 80% heliox
330%
226
What is the flow volume loop pattern of a goiter
Fixed
227
What is the flow volume loop pattern of a tracheal obstruction
Fixed
228
What is the flow volume loop pattern of subglottic stenosis
Fixed extrathoracic (maybe variable?)
229
What is the flow volume loop pattern of glottic SCCa
Fixed
230
Who invented the LMA
Brain
231
What are some advantages of an LMA
Less stimulating, no muscle relaxant required, less increase in intrathoracic, intra-abdominal, and intraocular pressures, less CV stimulation, provides post op airway
232
What are some disadvantages of an LMA
Failure rate, complications and adverse events
233
Where does the LMA seat
Above the larynx (supraglottic seal)
234
What material is an LMA made of
Silicone
235
What's the angle between the airway tube and body of the mask
30 degrees
236
OD of the LMA connector
15mm
237
What are some contraindications for LMA use
GERD, not NPO, hiatal hernia, obesity, pregnancy, bowel obstruction, acute pancreatitis, high resistance/low compliance respiratory disease, patient positioned with limited airway access, upper airway pathology
238
How can you prevent torque when securing an LMA
Tape to zygomatic region, use circuit tree
239
What cathether on an LMA can facilitate endotracheal intubation
Aintree
240
What nerves can be stimulated with an LMA
IX and X
241
What are some acute risks that could occur with LMA use
Failure to acheive a good seal, failure to provide safe PPV, hypoxemia, hypoventilation
242
What does ACDF stand for
Anterior cervical discectomy and fusion
243
What is the endpoint for fiberoptic airway procedures
To have a patient answering yes-no questions after the ETT is in place
244
What sedation is used for airway anesthesia
Propofol infusion or a neuroleptic technique with fentanyl and droperidol
245
What anesthetic method is directly applied for anesthesia of the oral cavity and oropharynx
Topical spray - Lidocaine 4%
246
What anesthetic method is indirectly applied for anesthesia of the oral cavity, nasal passage, pharynx, larynx, and trachea
Aerosol - use an aerosol generator (particles 10-100 microns) with heliox and Lidocaine 4%
247
What anesthetic method is directly applied for anesthesia of the VCs, trachea, and carina
FFOB injection via suction port or injection port - Lidocaine 4%
248
What anesthetic method is indirectly applied for anesthesia of the supraglottic region
Transtracheal injection
249
What is transtracheal injection
Using a 20 gauge catheter to inject ~5mL of Lidocaine 4% through the cricothyroid membrane
250
How much Lidocaine 4% is used for a transtracheal injection
5mL
251
What membrane is pierced during a transtracheal injection
Cricothyroid membrane
252
What area is anesthesized with a Superior Laryngeal Nerve Block
Supraglottic region
253
What muscle can you block with an SLN block
Cricothyroid
254
What drug do you use with an SLN block and how much do you use
3mL of 1% Lidocaine
255
Where is the Lidocaine 1% injected during an SLN block
Greater horns of hyoid bone
256
What anesthetic is used for a Sphenopalatine Nerve Block and how much
10mL of Cocaine 4%
257
What topical application is used for a Sphenopalatine Nerve Block
Pledget strips for anesthesia and vasoconstriction of both nasal passages
258
What 2 drugs, when mixed with 4mL of Lidocaine 4%, are used as topical anesthetics and vasoconstrictors for the nasal passages
Oxymetazoline 0.05% (1.5mg or 3mL), Phenylephrine 10% (2000mcg or 0.2mL)
259
What drug is administered preoperatively as an antisialogogue and how is it administered
0.3mg glycopyrrolate intramuscularly
260
What is the preferred technique for anesthesia of the airway
1) Glycopyrrolate injection preop
2) Aerosol lidocaine treatment in POHA
3) Nasal preparation with spray combination
4) Propofol infusion
5) Lidocaine 4% injection through FFOB
261
Who developed early endotracheal equipment
Magill
262
What is the purpose of the bevel on ETTs
Facilitate passage through vocal cords
263
OD of ETT machine connector
15mm
264
What are some benefits of the ETT cuff
Prevent aspiration, PPV, decreased cost of gases
265
What determines ETT size
Patient height
266
What is a Cole ETT
Pediatric - no cuff, has a shoulder, is tapered
267
What volume should be in syringe for ETT cuff inflation
6mL
268
What is stridor
High-pitched, shrill vibrating sound
269
What produces a stridor sound
Orificial partial airway obstruction in the upper conducting airway
270
What does wheezing sound like
High-pitched musical or whistling sound
271
What produces a wheezing sound
Tubular partial airway obstruction in lower conducting airway
272
What is stertor
Snoring sound
273
What produces a stertor
Moveable tissue or loose material in upper conducting airways
274
What does rhonchi sound like
Low-pitched, vibrating
275
What produces rhonchi sounds
Turbulent flow around loose material (mucus) in the larger bronchi
276
What does rales sound like
High-pitched, crackling sound; crepitations
277
What produces rales
Opening of small airways closed by increased lung water, in the lower airways
278
Are rales heard during inspiration, expiration, or both
Inspiration
279
Ruleouts for direct VC involvement in hoarseness
NECK - Recent URI, chronic inflammation, allergy, excessive voice use, malignancy, polyps, VC dysfunction
280
Ruleouts for indirect VC involvement in hoarseness
NECK - Contiguous infection or inflammatory disease, lyphadenopathy, malignancy, thyroid disease
281
What nerves are subject to infectious, inflammatory, or malignant processes
RLN, SLN, Vagus
282
Ruleouts in the chest for hoarseness
Bronchial malignancy, mediastinal mass, TB, aortic arch aneurysm, right subclavian artery disease
283
What artery does the right RLN pass
Subclavian
284
What artery does the left RLN pass
Aortic arch
285
Ruleouts for cricoarytenoid joint disease for hoarseness
Dislocation of joint, arthritis, gout
286
How long must hoarseness last to require otolaryngologic workup
2 weeks
287
Pathophysiology of routine post hoarseness (pharyngitis)
Denudation of epithelium, edema, cricoarytenoid inflammation
288
Incidence of postop pharyngitis
3%
289
Do more males or females complain of postop pharyngitis
More females than males
290
Incidence of postop ulceration
1%, more females than males
291
Incidence of postop granuloma formation
1:10,000, more female than male, 50% bilateral
292
Occurence and onset of cicatricial stenosis
Rare, onset 2+ weeks
293
What percentage of closed claims included death or brain damage
85%
294
What percentage of closed claims included difficult intubation
17% (87 cases)
295
What percentage of closed claims included esophageal intubation
18% (94 cases)
296
Auscultation proved to be unreliable in what percentage of closed claim cases
48%
297
Occurence of anethesia related obstetric mortality
1:500,000
298
Leading cause of obstetric anesthetic mortality
Failure to secure airway, aspiration
299
Name for the medial cleft of upper lip
Philtrum
300
What connects the tongue to the base of the mouth
Lingual frenulum
301
5 branches of the facial nerve
Temporal, zygomatic, buccal, mandibular, cervical
302
Vertebral levels of the esophagus
C6-T11
303
What pressure is needed to open the GE junction of someone with a hiatal hernia
4 cmH2O
304
What pressure is needed to open the GE junction of someone with GERD
1 cmH2O
305
What pressure is needed to open GE junction
16 cmH2O
306
What are the 5 different radiodensities
FABBM
| Fat, air, bone, barium, metal
307
Which Lefort fracture still allows you to perform nasal intubation
Lefort 1
308
Where is the anterior commissure
Superior to the cords in a DL view
309
What is otisis media
Inflammation of the middle ear
310
Which vertebrae allows the head to rotate
C1 - atlas
311
Which vertebrae allows the head to move up and rown
C2 - axis
312
What passes through the foramen of the thyrohyoid membrane
Internal superior laryngeal nerve
313
What does BSSO stand for
Bilateral sagittal split osteotomy
314
What is the Valsalva maneuver
Moderately forceful attempted exhalation against a closed airway, usually done by closing one's mouth, pinching one's nose shut while pressing out as if blowing up a balloon. Deviation from normal results indicates problems with vagus reflex
315
Effect of Mueller maneuver
Decreases intrathoracic pressure by breathing against a closed glottis.
316
What is a pathophysiologic effect of a bilateral RLN injury
Stridor
317
What is ankyloglossia?
Stiff tongue
318
How can you calculate the time it will take for an apneic patient to become hypoxic
FRC (35ml/kg)/VO2(kg^0.75*10)
319
What does "RAE" stand for, as in an Oral RAE tube
Ring, Adair, Elwyn
320
The infraorbital nerve provides sensory innervation to which part of the nose?
Vestibules
321
How can you calculate the correct inflation volume for LMAs
5mL x size of LMA
322
How can you confirm proper placement of an LMA
Observe capnogram and auscultate for proper placement
323
Proper action order for RSI
1) Preoxygenate
2) Cricoid pressure (Sellick maneuver)
3) Induction
4) Place tube
5) Confirm
6) Remove cricoid pressure
324
Insufflation pressure for a laparoscopic nephrectomy
15 cmH2O
325
Identification of the arytenoid muscular process
Outside ring
326
Physical attributes of heliox
Increases heat capacity, increases viscosity, decreases density
327
What is the etiology of otitis media with nasotracheal instrumentation
Blockage of eustachian tube
328
What airway generation are the terminal bronchioles
17th
329
How much phenylephrine is required for nasal vasoconstriction
2000mcg
330
How can you manipulate the larynx during a DL
Dorsal depression of the thyroid cartilage
331
What branch do you block with an SLN block
Internal sensory branch
332
What is the definition of abnegation
Denial or refusal
333
Who invented the grade views of the airway
Cormack and Lehane
334
What hemodynamic effects does Mueller manuever cause
It lowers pulmonary blood pressure
335
Indication for ETT introducer
When you don't have a direct visualization of vocal cords
336
What happens to vocal cords immediately following injury to both RLNs
Adduction
337
What happens to vocal cords immediately following interruption of both RLNS
Paralyzed to paramedian position
338
Which lobe of the lungs is most often affected when inadvertent endobronchial intubation occurs
Right upper lobe
339
What does an extra thoracic flow volume loop tell you about the position of your ETT
The tip of the tube is behind the lesion
340
Compared to air and oxygen, what advantages does heliox offer for various airway management situations?
Heliox has less density so it improves gas flow past partial airway obstructions
341
Describe the anterior attachments of the vocal cords
Thyroid cartilage, midline inferior
342
Describe the posterior attachments of the vocal cords
Vocal process of arytenoids
343
TMJ compartment for initial mouth opening
Inferior - 50% - rotate
344
TMJ compartment for late mouth opening
Superior - 50% - gliding
345
How do you measure for the correct nasal airway size
Distance from nares to tragus
346
During which phases of deglutition does peristalsis occur
Pharyngeal and esophageal
347
During which phase of deglutition does larynx closure occur
Pharyngeal
348
During which phase of deglutition does nasopharynx occlusion occur
Pharyngeal
349
What is the true joint of the larynx
Cricoarytenoid
