Quiz 1 Flashcards

1
Q

Name the cartilages of the larynx

A

3 Unpaired:
Thyroid
Cricoid
Epiglottis

3 Paired:
Arytenoid
Cuniform
Corniculate

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2
Q

Which cartilage of the trachea is the only complete ring?

A

Cricoid

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3
Q

Who founded the 1st anesthesia school & where/year?

A

Agatha Hodgins founded the Lakeside Hospital, School of Anesthesia in 1915
Cleveland, Ohio

She was also the 1st AANA President

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4
Q

What is the Thyro-Mental distance/measurements?

A

Measurement from upper edge of thyroid to chin with the head fully extended

A short thyromental distance= an anterior larynx
>7cm = usually easy intubation
<6cm= difficult airway

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5
Q

Mallampati Class 1

A

Full view of soft palate: uvula, tonsillar pillars, soft/hard palate

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6
Q

Mallampati Class 2

A

Full/partial view of uvula, soft and hard palate

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7
Q

Mallampati Class 3

A

Base of uvula only, soft and hard palate

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8
Q

Mallampati Class 4

A

Hard palate only

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9
Q

Name the 3 primary valves on the AGM

A

1) Ball and Spring Valve
2) Free Floating Valve
3) Diaphragm Valve

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10
Q

What is the PSI of oxygen and what color is the cylinder?

A

Green

1900-2200 PSI

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11
Q

What is the cylinder capacity of Oxygen?

A

660L

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12
Q

What is the PSI of Nitrous Oxide and what color is the cylinder?

A

Blue

745 PSI

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13
Q

What is the cylinder capacity of Nitrous Oxide?

A

1600L

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14
Q

What is the PSI of Air and what color is the cylinder?

A

Yellow

1800 PSI

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15
Q

What is the cylinder capacity of Air?

A

600L

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16
Q

LMA Size 1

Patient Guidelines and Cuff Inflation Volume?

A

Neonates/infants up to 5kg

4mL max

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17
Q

LMA Size 1.5

Patient Guidelines and Cuff Inflation Volume?

A

Infants 5-10kg

7mL max

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18
Q

LMA Size 2

Patient Guidelines and Cuff Inflation Volume

A

Infants/Children 10-20kg

10mL max

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19
Q

LMA Size 2.5

Patient Guidelines and Cuff Inflation Volume

A

Children 20-30kg

14mL max

20
Q

LMA Size 3

Patient Guidelines and Cuff Inflation Volume

A

Children 30-50kg

20mL max

21
Q

LMA Size 4

Patient Guidelines and Cuff Inflation Volume

A

Adults 50-70kg

30mL max

22
Q

LMA Size 5

Patient Guidelines and Cuff Inflation Volume

A

Adults 70-100kg

40mL max

23
Q

LMA Size 6

Patient Guidelines and Cuff Inflation Volume

A

Adults over 100kg

50mL max

24
Q

ASA Class I

A

Healthy patient, no disease

25
ASA Class II
Mild to moderate systemic disturbance- well controlled disease of ONE BODY SYSTEM such as: - Heart disease that slightly limits physical activity - HTN- controlled - Diabetes- controlled* - Chronic bronchitis - Anemia - Morbid obesity - Smoker/ frequent social drinker - Age extremes*
26
ASA Class III
Severe systemic disease that limits activity (or >1 controlled disease): - Heart or chronic pulmonary disease that limits activity - HTN- uncontrolled - Diabetes- uncontrolled (with vascular c/o)* - Angina pectoris - Hx of previous MI - Pacemaker
27
ASA Class IV
Severe systemic disease that is a constant threat to life* - CHF - Persistent angina pectoris - Advanced pulmonary, renal, or hepatic dysfunction
28
ASA Class V
Near death patient, undergoing surgery as resuscitative effort, despite limited change of survival - Uncontrolled hemorrhage from ruptured AAA - PE - Head injury with increased ICP
29
ASA Class VI
Declared brain dead patient- retrieval for organ donation
30
Emergency Operation (E)
Emergency surgery required | -Otherwise healthy 30y/o D&C for moderate persistent hemorrhage
31
Following an airway assessment what are the 3 options for intubation?
1) Awake intubation 2) "A quick look" 3) Induction and paralysis
32
Why would an awake intubation be performed?
For a difficult airway, if there is a significant risk of complications if sedatives and/or muscle relaxants are given prior to airway control
33
What is a "quick look?"
The patient may be sedated for an attempt at direct laryngoscopy WITHOUT muscle relaxation Because there is some risk with failed laryngoscopy, but a low risk of failed mask ventilation
34
Under what conditions would a traditional intubation after induction and paralysis be selected?
The patient must be assessed as having a low risk of difficult laryngoscopy and/or mask ventilation
35
What should be done throughout the process of difficult airway management (Step 2)?
Actively pursue opportunities to deliver supplemental oxygen
36
ASA Difficult Airway Algorithm, Step 1: | Assess the likelihood and clinical impact of what 4 basic management problems?
1) Difficult Ventilation 2) Difficult Intubation 3) Difficulty with Patient Cooperation or Consent 4) Difficult Tracheostomy
37
What should be done if you suspect a cricothyroidotomy is going to be difficult?
The cricothyroid membrane should be marked BEFORE an intervention is undertaken
38
What are the 2 techniques for pre-oxygenation?
1) Tidal volume breathing for 3-5 minutes 2) 4x deep breaths in 30 seconds Both are equally effective in increasing PaO2
39
What is invasive airway access?
Surgical or percutaneous tracheostomy or cricothyroidotomy
40
After a failed attempt at awake non-invasive intubation, what are the options?
1) Cancel the case/ awaken patient 2) Invasive airway access 3) Consider other options: - face mask or LMA anesthesia - local anesthesia or regional nerve blockade (IF mask ventilation not problematic)
41
If intubation is unsuccessful after induction of general anesthesia, what are the 3 things to consider?
1) Call for help 2) Return to spontaneous ventilation 3) Awaken the patient *meanwhile, mask ventilate
42
In the Difficult Airway Algorithm, if mask ventilation (or SGA) is adequate, which pathway is followed?
Nonemergency Pathway - if you can ventilate your patient, it's not a true emergency - utilize difficult airway cart
43
What do you do if mask ventilation is not adequate?
Consider/attempt a supraglottic airway (SGA) | - LMA
44
What if mask ventilation AND SGA is not adequate/feasible?
Follow Emergency Pathway - Emergency non-invasive airway ventilation - Call for help - Emergency invasive airway access (trach/cric/jet/ retrograde intubation)
45
What is in the gallery of tools?
- LMA/SGA - Different laryngoscope blades - LMA as intubation conduit - Fiberoptic intubation - Intubating stylet - Tube change- bougie - Light wand - Blind oral/nasal intubation - Invasive airway access: jer, perc/surgical airway, retrograde intubation