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APA/Foundations 1 > Quiz 1 > Flashcards

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
Q

ASA Class II

A

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
Q

ASA Class III

A

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
Q

ASA Class IV

A

Severe systemic disease that is a constant threat to life*

  • CHF
  • Persistent angina pectoris
  • Advanced pulmonary, renal, or hepatic dysfunction
28
Q

ASA Class V

A

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
Q

ASA Class VI

A

Declared brain dead patient- retrieval for organ donation

30
Q

Emergency Operation (E)

A

Emergency surgery required

-Otherwise healthy 30y/o D&C for moderate persistent hemorrhage

31
Q

Following an airway assessment what are the 3 options for intubation?

A

1) Awake intubation
2) “A quick look”
3) Induction and paralysis

32
Q

Why would an awake intubation be performed?

A

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
Q

What is a “quick look?”

A

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
Q

Under what conditions would a traditional intubation after induction and paralysis be selected?

A

The patient must be assessed as having a low risk of difficult laryngoscopy and/or mask ventilation

35
Q

What should be done throughout the process of difficult airway management (Step 2)?

A

Actively pursue opportunities to deliver supplemental oxygen

36
Q

ASA Difficult Airway Algorithm, Step 1:

Assess the likelihood and clinical impact of what 4 basic management problems?

A

1) Difficult Ventilation
2) Difficult Intubation
3) Difficulty with Patient Cooperation or Consent
4) Difficult Tracheostomy

37
Q

What should be done if you suspect a cricothyroidotomy is going to be difficult?

A

The cricothyroid membrane should be marked BEFORE an intervention is undertaken

38
Q

What are the 2 techniques for pre-oxygenation?

A

1) Tidal volume breathing for 3-5 minutes
2) 4x deep breaths in 30 seconds

Both are equally effective in increasing PaO2

39
Q

What is invasive airway access?

A

Surgical or percutaneous tracheostomy or cricothyroidotomy

40
Q

After a failed attempt at awake non-invasive intubation, what are the options?

A

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
Q

If intubation is unsuccessful after induction of general anesthesia, what are the 3 things to consider?

A

1) Call for help
2) Return to spontaneous ventilation
3) Awaken the patient

*meanwhile, mask ventilate

42
Q

In the Difficult Airway Algorithm, if mask ventilation (or SGA) is adequate, which pathway is followed?

A

Nonemergency Pathway

  • if you can ventilate your patient, it’s not a true emergency
  • utilize difficult airway cart
43
Q

What do you do if mask ventilation is not adequate?

A

Consider/attempt a supraglottic airway (SGA)

- LMA

44
Q

What if mask ventilation AND SGA is not adequate/feasible?

A

Follow Emergency Pathway

  • Emergency non-invasive airway ventilation
  • Call for help
  • Emergency invasive airway access (trach/cric/jet/ retrograde intubation)
45
Q

What is in the gallery of tools?

A
  • 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

APA/Foundations 1 (9 decks)

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