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Flashcards > Induction & Airway Block > Flashcards

Induction & Airway Block Flashcards

0
Q

Goal of pre-oxygenation

A
  • increase O2 concentration in FRC with 100% oxygen and get rid of nitrogen (79% nitrogen, 21% oxygen in RA)
  • admin 100% O2 at 8-10L of flow
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1
Q

The “sniffing” position aligns what 3 axises

A

-oral, pharyngeal, laryngeal

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2
Q

A healthy patient recieveing pre-oxygention can tolerate how many minutes of apnea?

A

10 minutes

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3
Q

How many vital capacity breath are given in 30 seconds?

A

4 breaths

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4
Q

How many minutes can a healthy patient tolerate after 4 vital capacity breaths?

A

5 minutes

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5
Q

When is vital capacity breaths necessary?

A
  • when a patient is a crash C section

- ruptured abdominal aorta (RSI)

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6
Q

Airway Setup

A
  • laryngoscope/blade 2 types
  • oral/nasal airways several sizes
  • tongue depressor
  • ETT: 2 sizes
  • suction
  • ambu-bag
  • stylet
  • LMA (difficult airway)
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7
Q

ALL cases need to have what # LMA nearby? Why?

A
  • # 4

- it allows practitioner to place a 6.0 ETT in an emergency

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8
Q

What size ETT does an intubating LMA allow a practitioner place?

A

-8.0 ETT

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9
Q

Complications of an oral airway?

A
  • LARYNGOSPASM
  • bleeding
  • soft tissue damage
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10
Q

Nasal airway/trumpet

A

provides passageway from nose to pharynx beneath the relaxed and obstructing tongue

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11
Q

Nasal airway length is measured from:

A

-nares to meatus of ear

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12
Q

Complications/Precautions of nasal airways:

A

-epitaxis, nasal or basal skull fracture, adenoid hypertrophy, anticoagulants

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13
Q

Laryngoscope and name of blades:

A
  • Mac (1-4): curved blade

- Miller (0-4) straight blade

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14
Q

Mac blade does what?

A

-blade fits into veleculla and pulls tongue forward

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15
Q

Miller blade does what?

A

-picks up epiglottis

16
Q

Typical adult ETT sizes for men and women?

A
  • females: 7.0 and 6.5

- males: 7.5 and 8.0

17
Q

Desirable position of an ETT? Typical placement from men and women?

A
  • 4cm above the carina and 2cm below the vocal cords
  • males approx 23cm
  • females approx 21cm
18
Q

Airway innervation: Sensory

A
  • glossopharyngeal
  • internal branch of superior laryngeal (vagus)
  • recurrent laryngeal
19
Q

Airway innervation: Motor

A
  • external branch of superior laryngeal

- recurrent laryngeal

20
Q

Sequence of steps prior to intubating someone:

A
  • admin induction drug
  • lash reflex
  • test ventilate
  • then intubate
21
Q

Sensory innervation of the larynx:

A
  • glossopharyngeal
  • interior (internal) superior laryngeal
  • recurrent laryngeal
22
Q

Glossopharyngeal (CN 9) innervates:

A

-posterior 1/3 of tongue and oropharynx to vallecula

23
Q

Internal Superior Laryngeal nerve (branch of vagus) innervates:

A

-supplies sensory to vocal cords and above

24
Q

Recurrent Laryngeal nerve (branch of vagus) supplies:

A

-supplies mucosa below vocal cords

25
Q

Motor innervation of Larynx

A
  • external branch of superior laryngeal nerve (vagus)

- recurrent laryngeal

26
Q

External branch of superior laryngeal nerve (vagus) supplies:

A

-supplies the cricothyroid muscle- puts tension on VCs

27
Q

The recurrent laryngeal nerve (vagus) supplies:

A

-supplies ALL intrinsic muscle of larynx EXCEPT the cricothyroid membrane

28
Q

Complications of tracheal intubation:

A
  • trauma to airway structures
  • esophageal intubation
  • endobronchial intubation
  • endotracheal tube ignition
  • sore throat
  • laryngospasm
  • croup
29
Q

Indications for airway blocks:

A
  • abolish or blunt reflexes

- provide patient comfort and airway anesthesia during performance of procedures

30
Q

Complications of airway blocks:

A
  • systemic toxicity

- hematoma formation

31
Q

Indications for a transtracheal block:

A
  • block the recurrent laryngeal nerve (for awake laryngoscopy etc.)
  • abolition of the gag reflex or hemodynamic responses to laryngoscopy and brochoscopy
32
Q

Transtracheal block results in anesthesia:

A
  • anesthesia of the trachea and below the vocal cords

- (the injection of local anesthesia stimulates the cough reflex which spreads the lidocaine above the vocal cords)

33
Q

For the transtracheal block the needle is injected caudad in what membrane?

A

-cricothyroid membrane

34
Q

Indications for superior laryngeal block:

A
  • blocks the internal (sensory) branch of SLN
  • blocks the supraglottic region
  • results in abolition of the gag reflex or hemodynamic responses to larygoscopy or bronchoscopy
35
Q

Indications for the glossopharyngeal nerve block

A
  • lingual branch of glossopharyngeal nerve supplies sensory to the back of the tongue
  • abolition of the gag reflex or hemodynamic response to laryngoscopy
  • when topical application is not effective
36
Q

For an airway block, which 3 blocks need to be done?

A
  • transtracheal block
  • superior laryngeal nerve block
  • glossopharyngeal block
37
Q

The thyromental distance is assessing what axises?

A

-pharyngeal and laryngeal axis

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