Key Terms Flashcards
What tracheostomy technique is associated with increased incidence of stenosis?
A trach for the 2nd time.
A 64 y/o man with a total laryngectomy goes for a lap chole. What type of ETT should you use?
Anode tube
What device is most appropriate in this type of pulmonary disease? (don’t know what pic is)
ETT Not endobronchial, not LMA, not anode.
What type of poisoning would most likely be associated with a closed-space heater fire with incomplete combustion?
Carbon monoxide (CO)
What airway management is indicated for acute burn patients?
Intubation ASAP and secure the airway
Identify

Laryngoflex
Identify

Anode ETT, wire enforced
What are stay sutures?
They are placed into the tracheal wall to help identify stoma location after a tracheostomy.
How long are stay sutures left in place?
72 hours or 3 days
What would you expect in an achondroplastic dwarf related to his/her cervical spine?
Atlanto occipital subluxation

Label


What disease process is depicted?
What drug is most likely associated?

Ludwig’s angina
ACE inhibitors
What breath sound do you expect to hear with this image?

Rales with increased lung water.

How would you intubate this pt?

Nasal route
What is depicted?

Shiley uncuffed
What is depicted?

Shiley cuffed
What is depicted?

Fenestrated cuffed trach
What cranial nerve and what branches are being monitored?
What type of surgery is being performed?
Facial nerve, temporal, buccal branches
Parotidectomy
What is the incidence of angioedema in the US?
15%
What is depicted?
When is it contraindicated?

Williams airway
Anode ETT
What type of spinal anesthetic should be used for hip surgery in lateral decubitus position?
hypobaric tetracaine
What is the tracheostomy inner cannual circuit connection?
15mm
What sinus is involved in a blowout fracture?
Maxillary sinus
What is depicted?
What antihypertensive is most frequently associated with this condition?
Angioedema produced arteriolar dilation, venular inflammation. Located below the DERMIS
Ace inhibitors
What is depicted?
What type of surgery will this require?
Squamous cell carcinoma
Total laryngectomy
What is the inheritance pattern for achondroplastic dwarfism?
autosomal dominant
How do you induce a child with a foreign body in the airway?
What must you have available? (2)
Heliox and Sevo inhalational induction
Magill forceps and Atropine!
What is the spinal deformity with Marie-Strumpell disease?
Spondlyoarthropathy, fixed cervical spine
Aka, ankylosing spondylitis. It is a rheumatoid arthritis of the extremeties.
What are the most prevalent etiologies for angioedema?
Drug related (90%)
Inheritance, autosomal dominant
Females > males
What is the pathophysiology of angioedema?
Vasoactive mediators such as histamine, serotonin, and bradykinins cause angioedema.
Produces arteriolar dilation, venular inflammation, vascular leakage
What are the normal body components of an achondroplastic dwarf?
Normal trunk
Also have normal intelligence, longevity, and reproduction
What are abnormal body components of achondroplastic dwarf? (5)
- Large head
- Large mandible
- Short maxilla
- Premature c-spine fusion
- Cervical instability
What is depicted?
What is the treatment?
Severe vocal cord granulomata
Laser surgery?
What condition would you expect pre-op hoarseness?
How would you manage the pt’s airway?
Acromegaly
Hoarseness due to decreased rotation and gliding or cricoarytenoid joints.
Do not upsize the tube for the trachea will be normal in size.
What laryngeal structures are made of hyaline cartilage?
Cricoid, Arytenoid, Thyroid
What surgical areas require one lung management in thoracic surgery? (4)
Lungs
Bronchi
Pulmonary vessels
Chest wall–trauma, mediastinum, tumors
What are non-thoracic surgerical areas requiring one lung management? (3)
Spine
Aorta
GI–esophagus, gastroesophageal junction
What diseases require one lung management? (4)
Infection
Hemorrhage
Parenchyma
Interrupted airways–bronchopleural fistula
What allows atlanto-occipital extension?
Pharyngeal alignment by tilting the head.
How do you calculate lung compliance?
C = Tidal volume / (Paw - Ppleura)
How do you calculate thoracic compliance?
Vt / (Ppleura - Patm)
How do you calculate total lung-thorax compliance?
Vt / (Pend expiration - P end inspiration)
How do CLT, CL, and CT relate to one another?
What are normal values for each?
1/ CLT = 1/CL + 1/CT
CLT = 100
CL = 200
CT = 200
How do you calculate percent transmission of intrathoracic vascular pressures?
CL / (CL + CT)
What action is most likely to produce iatrogenic retropharyngeal abscesses?
Failed NGT placement
What is the age for end of development in humans?
7 y/o
What ages result in the highest incidence of foreign body aspiration?
2-3 y/o
FRC is decreased in geriatrics. True or false?
False.
How do you examine the airway of post-irradiation patients?
Manual exam of larynx with swallowing
Where does the eustachian tube drain?
nasopharynx
What muscle of the tongue is responsible for depressing and protruding the tongue?
genioglossus
What is depicted?
Name the parts.
Waldeyer’s ring
Palantine tonsils
Lingual
Adenoids
Nasopharyngeal
What is the airway managment of a tonsillar abscess drainage?
GETA
Short acting NMB
Anode tube
How do you manage a known case of angioedema?
Steroids 10 - 14 days
FFB w/in 24 hours of surgery
If undiagnosed, FFP ASAP!
What sound is produced by an orificial airway lesion?
Stridor
What sound is produced in asthma?
Wheezes
Where is the glottis in an infant vs. an adult?
C3- C4
The cricoid is the narrowest part in child until ___ y/o.
7
What are complications associated with nasotracheal intubation? (7)
Infection
Sinusitis
Perichondritis
Epistaxis
Abrasion
Chondritis
Hemorrhage
What are acute airway management complications?
Catheter placement was not confirmed (50%)
Began HPOV with misplaced catheter (25%)
Catheter was directed to the head.
What are intermediate airway management complications?
Inadequate O2
Failed to recognize inadequate O2
Tried to perform HPOV with breathing circuit
Failed to maintain catheter position
What is a long term airway management complication?
Barotrauma.
What is a primary tracheostomy?
Done initially or within 24 hours of intubation.
What is the incidence of hoarseness associated with intubation?
When is spontaneous resolution?
When should you follow up?
3%
1-3 days
1 week
When do the following events occur due to prolonged intubation?
Ulceration
Granulomata
Cisatrical stenosis
> 72 hours
3-21 days
> 2 weeks
What is this?
TMJ DJD
What’s this?
Tonsillar abscess
What’s this?
Retropharyngeal abscess
How do you manage post-laryngectomy case?
Suture in laryngectomy tube, pt SV
What should FiO2 be for laser surgery?
< 30%
What laser is more superficial? Deep?
CO2
YAG
What is the motor threshold for nerve stimulation?
15mA
_____ RLN passes under aorta and hoarseness can occur w/ an aortic aneuysm
Left
What is the most common cause of stridor in 2 y/o?
laryngomalacia
What is compromised with poor head and neck alignment during lateral decubitus?
Vascularity is compromised.
What is the pathophysiology of TMJ DD?
How do you intubate?
Pain during activity with limited mouth opening
Nasal intubation
What is the airway management risk of neurofibromatosis?
Neuromas can be highly vascular.
Also alveolitis in 20%
What’s this?
gingival hyperplasia with dilantin therapy
What’s this?
Gingivitis
What’s this?
Peridontitis
What is normal thyromental distance?
> 6.5 cm
What does the proximal limb of a montgomery t-tube do?
Distal?
Laryngeal, provides airflow
Tracheal, serves as a stent
It is used for long term airway managment giving stomal and suction access and phonation.
What’s this?
leukoplakia
Where will the vocal cords be with RLN injury?
Interruption?
Hoarseness toward midline
Paramedian
What is the action of the tranverse arytenoideus?
ADduction