Anesthesia Equipment Part I (Ericksen) Exam 2 Flashcards
What is one of the primary purposes of using face masks in anesthesia?
A. To administer oral medication
B. To administer gas without anything in the patient’s mouth
C. To monitor airway pressure from the mouth
D. To measure oxygen saturation
B. To allow gas administration from the breathing system without any apparatus in the patient’s mouth
Which process do face masks help with in anesthesia? Select 2
A. Denitrogenation
B. Defibrillation
C. Preoxygenation
D. Intubation
E. Ventilation
A. Denitrogenation
C. Preoxygenation
Face masks can be used for:
A. Only the beginning of an anesthetic procedure
B. Only the end of an anesthetic procedure
C. The entire anesthetic procedure
D. Only during surgical procedures
C. The entire anesthetic procedure
Ear tube surgery - 10min
Elderly patients - ear wax removal - 5min case
Non-invasive, no ETT or LMA. We are required to do these cases. Mostly in peds
True or False
Face masks provide positive airway pressure and gas movement through a patients protected airway
False. Fase masks provide positive aiway pressure and gas movement through an unprotected the airway.
Still possible to vomit and aspirate. There is nothing in the vocal cords to prevent aspiration. Patients LIE, could have eaten or full belly
How do you know if you are successfully bag masking your patient?
A. EtCO2
B. Chest rise
C. Tidal Volume
D. O2 saturation
E. No excessive gas leak
F. All the Above
F. All the Above
You should not have an excessive gas leak, having a good seal of the mask on the nose and mouth. The pneumatic cuff is there to keep that good seal
What is a characteristic of the body of the face mask?
A. Opaque and provides shape
B. Transparent and provides shape
C. Colored and rigid
D. Soft and scented
B. Transparent and provides shape
What is the function of the seal on the face mask?
A. To provide structural integrity
B. To monitor the patient’s breathing
C. To connect to the oxygen supply
D. Cushion and minimal leak
D. Inflatable cushion and have a minimal leak
The seal of the face mask is an inflatable cushion that creates a minimal leak at ________ to ________cm H₂O.
A. 15 to 20
B. 20 to 25
C. 25 to 30
D. 30 to 35
B. 20 to 25cm H₂O
There is no perfect seal, will have a leak, but ok if it is at this pressure
The connector of the face mask has a ________ mm internal diameter and a circular ring with prongs for straps.
A. 18 mm
B. 20mm
C. 22 mm
D. 25 mm
C. 22 mm
Face mask with prongs for mask straps
Face masks may have additional features such as pacifier, ________, or scent.
A. ports
B. fresh gas inlet
C. built-in filters
D. temperature sensors
A. ports - for bronchoscopy or endoscope for pulmonology
Grape scent is bad, bubblegum or cherry is good
What bag mask method is this picture demonstrating?
One-handed method
What bag mask method is this picture demonstrating?
Two handed method used for bigger face, adipose tissue or endentulous
Someone else is bagging for you
Which of the following are factors contributing to difficult mask ventilation? (Select 6)
A. Female gender
B. Male gender
C. Age over 55
D. Presence of a beard
E. Having all teeth
F. Edentulousness
G. BMI < 30 kg/m²
H. BMI > 30 kg/m²
I. OSA/snoring
B. Male gender
C. Age over 55
D. Presence of a beard - a beard
F. Edentulousness - no teeth
H. BMI > 30 kg/m²
I. OSA/snoring -sometimes pt don’t know
The presence of ________ can make mask ventilation more difficult.
A. a beard
B. clean-shaven
C. long hair
D. botox lips
A. a beard
For patients with a beard, it may be necessary to ________ the beard to improve mask ventilation.
A. style
B. braid
C. cut
D. glue
C. cut
You can also use a tegaderm and cut a hole in it where the mouth is
To overcome difficult mask ventilation, one may use an oral airway or a ________ airway.
A. pharyngeal
B. tracheal
C. nasopharyngeal
D. esophageal
C. nasopharyngeal Dr. Ericksen loves these
True or false
The two-handed technique is a way of overcoming difficult mask ventilation.
True - have someone bag for you
If traditional mask ventilation methods fail, one should refer to the ________ airway algorithm.
A. regular
B. difficult
C. standard
D. emergency
B. difficult
When do we like to use mask straps? Select 4
A. Small hands with big faces
B. Big hands with small faces
C. Endentulous faces
D. Large beards
E. Hands free while pt is SPV
F. Facial reconstruction
A. Small hands with big faces
C. Endentulous faces
D. Large beards
E. Hands free while pt is SPV
*Make sure patient is asleep or comfortable/sedated because they can be claustrophobic. *
What is the primary function of an oropharyngeal airway (OPA)? (pick 2)
A) To provide mechanical ventilation
B) To keep the tongue from blocking the upper airway
C) To keep the tonsils from blocking the upper airway
D) To keep the epiglottis from blocking the upper airway
B) To keep the tongue from blocking the upper airway
D) To keep the epiglottis from blocking the upper airway
Lifts the tongue and epiglottis away from the posterior pharyngeal wall to relieve obstruction that may occure and open up the airway
When should an oropharyngeal airway (OPA) NOT be used?
A) In an unconscious patient without a gag reflex
B) In a conscious patient
C) During resuscitation
D) In conjunction with a bag-valve mask
B) In a conscious patient
Not comfortable
True or False
You can let the PACU nurses remove the OPA when the patient is still sleeping so they don’t wake up agitated.
FALSE
When the patient is awake enough to reach up and try and remove the OPA, that shows you they can support their airway. Then you can remove the OPA
What is the correct method to measure the appropriate size of an oropharyngeal airway?
A) From the corner of the mouth to the earlobe
B) From the tip of the nose to the jawline
C) From the middle of the tongue to the back of the throat
D) From the corner of the mouth to the chin
A) From the corner of the mouth to the earlobe or to the angle of the JAW LINE
Putting a OPA that is too small is dangerous because pt can swallow it. Size appropriatley
True or False
An OPA helps decrease the work of breathing during spontaneous ventilation (SV).
True
You can place after propofol and trying to mask ventilate and you notice they are obstructing even with repositioning the head/neck. Helps facilitate masking
What material are most oropharyngeal airways (OPA) made of?
A) PVC
B) Plastic
C) Rubber
D) Silicone
B) Plastic
Why must the bite portion of an oropharyngeal airway be firm?
A) To ensure flexibility with insertion
B) To prevent the patient from closing the lumen by biting
C) To allow easy insertion into the oropharynx
D) To prevent patient from collapsing their airway
B) To prevent the patient from closing the lumen by biting
Make sure they have GOOD teeth, if they have bad teeth (meth mouth) do NOT put an OPA in.
How are oropharyngeal airways (OPA) typically color-coded?
A) By the length of the airway
B) By the manufacturer
C) By the size designated in millimeters
D) By the type of material used
C) By the size designated in millimeters
Not always color coded. Size is important.. 🤭
Which reflexes should be depressed before inserting an oropharyngeal airway?
A) Pharyngeal and cough reflexes
B) Gag and swallow reflexes
C) Pharyngeal and laryngeal reflexes
D) Laryngeal and gag reflexes
C) Pharyngeal and laryngeal reflexes
Don’t need to be paralyzed, can do it with induction agent or enough narcotic on board
If the pharngeal and laryngeal reflexes are still intact while placing an OPA due to inadequate anesthetics on board, what can be a consequence?
A. Vomiting
B. Coughing
C. Spit out the OPA
D. Aspirate
E. Laryngospasm
F. Bronchospasm
G. All of the above
G. All of the above
Will not see any of these problem when the patient is emerging from anesthesia. Only when inducing
What are the two ways of inserting OPAs? Select 2
A. Inserting right side up and invert as you advance
B. Inserting upside down and invert as you advance
C. Scissor mouth and invert as you advance
D. Two fingers in the nose and lift
E. Insert upside down and sweep tongue to the left
F. Tongue depressor method
B. Inserting upside down and invert as you advance
F. Tongue depressor method
A bite block is placed between the upper and lower ________ and ________.
A) teeth, gums
B) lips, cheeks
C) tongue, roof of the mouth
A) teeth, gums
One of the primary uses of a bite block is to prevent biting on a ____________. Select 3
A) Endotracheal tube
B) Endoscope
C) Laryngoscope
D) Tracheoscope
E) Bronchoscope
A) Endotracheal tube
B) Endoscope
E) Bronchoscope
True of False
You put the bite block in the patient after they go to sleep because its easier to get in the mouth.
FALSE
Place it BEFORE they go to sleep, while they are awake. *When the patient goes to sleep, its like jaws of life, you are trying to pry their mouth open. The “propofol yawn” will be the last chance you get to try and stick it in. *
What is one advantage of using a nasopharyngeal airway (NPA) over an oropharyngeal airway (OPA)?
A) Tolderated with loose teeth
B) Easier to insert
C) Less risk of infection
D) More suitable for unconscious patients
A) Better tolerated in patients with loose teeth or oral trauma
Ericksen’s favorite
Which of the following is NOT a contraindication for using a nasopharyngeal airway (NPA)?
A) Basilar skull fracture
B) Nasal deformity
C) Epilepsy
D) History of epistaxis
C) Epilepsy
In which condition is the use of a nasopharyngeal airway (NPA) preferable?
A) Patients with an intact airway reflex
B) Patients with nasal obstruction
C) Patients with a basilar skull fracture
D) Patients with a history of nosebleeds
A) Patients with an intact airway reflex
NPAs are preferable in patients with loose teeth, oral trauma, gingivitis, or ________ mouth opening.
A) limited
B) wide
C) obstructed
D) normal
A) limited
NPAs are contraindicated in patients with nasal deformity, history of epistaxis, pregnancy, and ________.
A) hypertension
B) coagulopathy
C) diabetes
D) asthma
B) coagulopathy
Definitely a no. History of a nosebleed is not necessarily an absolute contraindication. Need more information from the patient
Pregnancy - very vascular patients, avoid anything that cause additional bleeding
Nasopharyngeal airways (NPA) resemble a shortened ________ tube.
A) tracheal
B) esophageal
C) nasal
D) bronchial
A) tracheal
The flange at the outer end of an NPA is designed to prevent complete ________ through the nasal cavity
A) bypass
B) blockage
C) passage
D) removal
C) passage
NPAs are ________ stimulating than OPAs.
A) more
B) equally
C) less
D) not
C) less
NPAs are sized by the outer diameter in the ________ scale.
A) metric
B) French
C) imperial
D) English
B) French
Anywhere from 10-36 french
The correct size of an NPA is determined by measuring from the bony mandible or nostril to the ________.
A) external auditory meatus
B) tip of the nose
C) corner of the mouth
D) angle of the jawline
A) external auditory meatus
Before insertion, an NPA should be ________ thoroughly.
A) cleaned
B) lubricated
C) sanitized
D) bent
B) lubricated
Can’t have too much lube. But don’t force it down
When a NPA is fully inserted it is approximately ________mm above the epiglottis
A) 5
B) 10
C) 15
D) 20
B) 10mm
Which of the following is a potential complication of incorrect placement of an airway device?
A) Enhanced breathing
B) Airway obstruction
C) Increased comfort
D) Improved oxygenation
B) Airway obstruction - seen more with OPAs, pushed in too far. Size matters, don’t size down
What material in older NPAs can cause allergies in some patients?
A) Plastic
B) Silicone
C) Latex
D) Metal
C) Latex -older NPAs, usually green in color
Which of the following are complications of airway devices? (Select 5)
A) Airway obstruction
B) Improved oxygenation
C) Ulceration of nose
D) Dental damage
E) Enhanced breathing
F) Oral damage
G) Ulceration of the tongue
A) Airway obstruction
C) Ulceration of nose
D) Dental
F) Oral damage
G) Ulceration of the tongue
Who is credited with the invention of supraglottic airways such as LMAs or IGELs?
A) Dr. Archie Bain
B) Dr. Archie Brain
C) Dr. Jane Smith
D) Dr. Alan Jones
B) Dr. Archie Brain
The LMA Classic is shaped like a tracheal tube (TT) ________.
A) distally
B) proximally
C) medially
D) entirely
B) proximally
Matching
LMA Size 1 - E) Neonates/infants up to 5 kg
LMA Size 1.5 - C) Infants between 5-10 kg
LMA Size 2 - G) Infants/children btw 10-20 kg
LMA Size 2.5 - F) Children between 20-30 kg
LMA Size 3 - A) Children 30-50 kg
LMA Size 4 - H) Adults 50-70 kg
LMA Size 5 - B) Adults 70-100 kg
LMA Size 6 - D) Adults over 100 kg
ONLY 2 with HALF SIZES (test question), 1.5 and 2.5
When inserting the LMA, you should feel it curve around downward in the airway and then ________.
A) come to a stop
B) start to inflate
C) begin to vibrate
D) conitnue through
A) come to a stop
It comes to a stop and can’t go any further
What is a visible sign that the LMA is correctly positioned when the balloon is inflated?
A) The patient’s eyes blink
B) The neck bulges
C) The patient coughs
D) The balloon deflates
B) The neck bulges and the LMA may “rise” slightly
What material is the LMA Unique made of?
A) Silicone
B) PVC
C) Rubber
D) Metal
B) PVC
What type of access does the LMA Proseal provide that the Classic LMA does not?
A) Tracheal access
B) Gastric access
C) Nasal access
D) Esophageal access
B) Gastric access
** second generation dt gastric access tube*
The iGel LMA is made from ________-grade thermoplastic elastomer.
A) Silicone
B) PVC
C) Medical
D) Rubber
C) Medical
They really really really protect the airway
The iGel LMA is noninflatable and creates an anatomical seal around the pharyngeal , ________, and ________ structures.
A) Perilaryngeal/Hypoglossal
B) Oropharynx/Perilaryngeal
C) Laryngeal/Hypoglossal
D) Laryngeal/ Perilaryngeal
D) Laryngeal/ Perilaryngeal
IGEL LMAS (NO CUFF)
Which of the following are true about the handle of the larygoscope? (Select 3)
A) Part held in hand
B) Power for the light
C) Forms a right angle to the blade
D) Contains the light source
A) Part held in hand - non dominant
B) Provides power for the light
C) Forms a right angle to the blade when ready for use
What type of blade is A and B?
A) Mac blade
B) Miller blade
You can use them interchangebly in different anatomies. Whatever works for you to see the cords
Most alterations change the angle from the ________ to the ________ and they are differences as noted how they are used.
A) blade, handle
B) light, handle
C) tongue, handle
D) mouth, handle
C) tongue, handle
After the epiglottis is visualized, the tip of the Macintosh blade is advanced into the ________ to move the ________ forward.
A) vallecula, larynx
B) trachea, tongue
C) vallecula, epiglottis
D) esophagus, uvula
C) vallecula, epiglottis
The blade of the Miller lifts the ________.
A) tongue
B) epiglottis
C) uvula
D) larynx
B) epiglottis
What does the acronym BURP stand for in the context of displacing the larynx?
A. Backward, Upward, Rightward, Pressure
B. Backward, Upward, Rotational, Pressure
C. Backward, Upward, Rightward, Placement
D. Backward, Upward, Rotational, Placement
A. Backward, Upward, Rightward, Pressure
What is required for obese patients during laryngoscopy to improve positioning?
A. Elevation of the shoulders and legs
B. Elevation of the shoulders and upper back
C. Elevation of the shoulders and lower back
D. Elevation of the shoulders and arms
B. Elevation of the shoulders and upper back
