Term
| Difficult tracheal intubation is when you have to attempt more than 3 times or spend longer than? |
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Definition
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Term
| The nasopharynx is separated from the oropharynx by the ? |
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Definition
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Term
| the _____ demarcates the border between the oropharynx and hypoharynx |
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Definition
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Term
| The vagus nerve provides sensation to the hypharynx via? |
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Definition
| the internal branches of the superior laryngeal nerve |
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Term
| The larynx sits between cervical __ and __ |
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Definition
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Term
| the vocal cords are formed by the |
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Definition
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Term
| the narrowest portion of the adult airway is? |
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Definition
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Term
| The trachea begins at cervical __ and extends to the carina which is at T? |
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Definition
| C6 starts cervical and extends to the carina which is at T5 |
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Term
| The trachea is ___ cm long and supports by ___ horseshoe shaped cartilages |
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Definition
| Trachea is 10-15 cm long and composed of 16-20 horsehoe cartilages |
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Term
| What mallampati score will the fauces no longer be visible? What else is present for this score? |
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Definition
| A mallampati III the fauces are no longer visible. What you can see is the soft palate, and possible the base of the uvula and hard palate. |
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Term
| Acromegaly patients have a high airway risk for? |
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Definition
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Term
| The shape of the palate may be predictive of airway complications. What findings are you looking for? |
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Definition
1. highly arched palates are bad sign
2. narrow palates are a bad sign |
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Term
| What neck shape may make someone more at risk during your airway assessment? |
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Definition
| Short necks and Thick NeckS! Bad finding |
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Term
| Whats the name for the neck movement needed to get all three axis' in alignment for optimal tracheal intubation |
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Definition
| antlanto-occipital extension |
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Term
| normal atlanto-occipital extension |
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Definition
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Term
| IF you had to do a cricothyroidotomy and the person does not have a pronounced laryngeal prominence then resort to identifying the cricoid cartilage compared to tracheal rings..whats the difference |
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Definition
| Start at the sternal notch and palpate the tracheal cartilage as you work your way up. The cricoid cartilage will be wider and higher compared to tracheal cartilage. |
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Term
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Definition
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Term
| Mallampati class x? is predictive of difficult facemask ventilation |
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Definition
| Mallampatti class III and IV |
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Term
| the minute ventilation for oxygen (MV02) for an adult with an ideal body weight is? |
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Definition
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Term
| What are some good tenchniques to ensure adequate 100% oxygenation of the entire FRC prior to intubation |
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Definition
| 3 minutes of tidal volume breathing 100% or 8 large breaths in 60 seconds is also equivalent. |
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Term
| Limit ventilation pressure of the bag valve mask to less < ___ cm to avoid gastric insufflation |
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Definition
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Term
| An oral airway can cause what bad side effects |
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Definition
1. larygeal spasms
2. gag reflex |
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Term
| nasal airways are contraindicated in what patients 3x |
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Definition
1. basilar skull fractures
2. coagulation abnormalities
3. platelet abnormalities |
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Term
| cricoid pressure for better view is also known as? |
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Definition
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Term
| standard intubating blades for adults for the mac and miller are? |
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Definition
MAC: 3 or 4
Miller: 2 or 3 |
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Term
| what property of the tracheal tube allows it to be seen on xray |
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Definition
| the end is radio opaque for visualization during CXR |
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Term
| How far does the tracheal tube go into the trachea? |
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Definition
| You want the top of the cuff to be at 1-2 cm past the vocal cords. |
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Term
| Where should the tip of the tracheal tube lie? |
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Definition
| half way between the vocal cords and carina |
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Term
| ciliary denudation can occur under the cuff after only how long being intubated |
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Definition
| after only 2 hours of intubation |
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Term
| what kind of patient would you consider using a fiberoptic scope for intubation |
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Definition
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Term
| an absolute contraindication to fiberoptic intubation is? |
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Definition
| TIME. Technique requires time to set up. |
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Term
| What drug is important to give prior to fiberoptic intubation to help prevent disrupting video quality? Describe this class of drugs phsyiology |
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Definition
| give an antisialagogue which will decrease saliva. Atropine can do this. Anticholinergics have this affect as well. Glycopyrloate is another option. |
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Term
| how much glycopyrrolate is given to act as a antisialagogue |
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Definition
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Term
| What is a cornu? give two examples |
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Definition
cornu a structure with a shape likened to a horn, in particular.
a horn-shaped projection of the thyroid cartilage or of certain bones (such as the hyoid and the coccyx). |
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Term
| Describe the procedure for transtracheal block, what equipment needed also |
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Definition
| Need a 20 gauge needle attached to a syringe with 4 mL of a local anesthetic. Find the cricothyroid membrane and begin inserting needle slowly while aspirating to identify if you hit a vessel (bad) or aspirate air (Good! thats the goal) When air is aspirated stop and advance catheter and remove needle. Reattach the LA filled syringe and again reconfirm you are in the trachea (you should be able to aspirate air) then rapidly inject LA |
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Term
| What trick can you do to help facilitate nasal fiberoptic intubation which will have less trauma? What size tube do you choose |
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Definition
| warm the ett prior with water. Use a size tube that is 1.5 mm larger than the diameter of the fiberoptic bronchoscope. |
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Term
| what are three methods for anesthetizing a patients upper airway |
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Definition
1. larynx and trachea local A topicalization
2. Superior laryngeal nerve block
3. transtracheal block |
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Term
| what other device can provide an excellent channel for awake oral fiberoptic intubation |
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Definition
| AN LMA! Since it sits over the larynx it will help facilitate the ETT into the right area. |
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Term
| McGrath scope, glidescope, pentax are examples of what type of laryngoscopes? |
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Definition
| rigid fiberoptic laryngoscopes |
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Term
| The most SNS stimulating thing we do to patients during surgery is? |
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Definition
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Term
| what's the difference between a king airway and combitube |
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Definition
| combitube is two proximal lumens with one distal end that has two lumens (a side port and a distal end) It has two cuffs that need to be inflated. Ventilate through the tube that accesses the lungs. |
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Term
| when do you release cricoid pressure after intubation |
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Definition
| ONLY AFTER TUBE IS CONFIRMED |
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Term
| What ASA classifcation would you give a patient with unstable angina |
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Definition
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Term
| What ASA classifcation would you give a patient with hepato-renal failure |
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Definition
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Term
| What ASA classifcation would you give a patient with mild obesity? How about morbid obesity? |
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Definition
Mild Obesity = ASA 2
Morbid obesity = ASA 3 |
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Term
| What ASA classifcation would you give a patient with pregnancy |
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Definition
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Term
| What ASA classifcation would you give a patient with stable angina |
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Definition
| ASA 3: Stable angina is systemic disease with some functional issues |
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Term
| symptomatic anything with a major disease will result in what ASA class |
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Definition
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