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Apex Review > Airway management 2 > Flashcards

Airway management 2 Flashcards

1
Q

Which congenital conditions are associated with cervical spine anomalies? Select 2
a. Treacher collins
b. Klippel-Feil
c. Goldenhar
d. Pierre Robin

A

B. Klippel-Feil
C. Goldenhar

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2
Q

____________ is the chief concern in the patient with angioedema

A

Upper airway obstruction

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3
Q

Three key causes of angioedema include

A

anaphylaxis, ACE inhibitors, and C1 esterase deficiency

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4
Q

Angioedema caused by anaphylaxis is best treated with

A

epinephrine, antihistamines, & steroids

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5
Q

Angioedema caused by ACE inhibitors or C1 esterase deficiency is best treated with

A

icatibant
ecallantide
FFP
C1 esterase concentrate

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6
Q

______________ is a bacterial infection characterized by a rapidly progressing cellulitis in the floor of the mouth

A

Ludwig’s angina

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7
Q

The most significant concern with Ludwig’s angina is

A

posterior displacement of the tongue resulting in complete, supraglottic airway obstruction

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8
Q

In the patient with Ludwig’s angina, the best methods of securing the airway include

A

awake nasal intubation or awake tracheostomy

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9
Q

Congenital conditions that impact airway management include:

A

Pierre Robin
Treacher Collins
Trisomy 21
Klippel-Feil
Goldenhar
Beckwidth
Cri du Chat

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10
Q

What is the cause of ACE-I angioedema?

A

ACE inhibitors prevent bradykinin breakdown

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11
Q

What is the treatment for hereditary angioedema?

A

C1 esterase concentrate
FFP
ecallantide
icatibant
patients should receive prophylaxis for porceudres that stimulate the upper airway

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12
Q

_________ is contraindicated in patients with an infection above the level of the trachea

A

Retrograde intubation

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13
Q

Which conditions are characterized by a large tongue?

A

“Big Tongue”
Beckwith syndrome
Trisomy 21

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14
Q

Which conditions are characterized by a small/underdeveloped mandible?

A

“Please get that chin”
Pierre Robin
Goldenhar
Treacher collins
Cri du Chat

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15
Q

Which conditions are characterized by a cervical spine anomaly?

A

Kids Try Gold
Klippel-Feil
Trisomy 21
Goldenhar

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16
Q

Pierre robin is characterized by

A

small/underdeveloped mandible (micrognathia or mandibular hypoplasia)
a tongue that falls back and downwards (glossoptosis)
cleft palate
neonate often requires intubation

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17
Q

Treacher Collins is characterized by

A

small mouth
small/underdeveloped mandible
nasal airway blocked by tissue (choanal atresia)
ocular and auricular anomalies

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18
Q

Trisomy 21 is characterized by

A

small mouth
large tongue
atlantoaxial instability
small subglottic diameter (subglottic stenosis)

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19
Q

Klippel-Feil is characterized by

A

congenital fusion of cervical vertebrae–> neck rigidity

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20
Q

Goldenhar is characterized by

A

small/underdeveloped mandible
cervical spine abnormality

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21
Q

Beckwith syndrome is characterized by

A

large tongue

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22
Q

Cri du chat is characterized by

A

small/underdeveloped mandible
laryngomalacia
stridor

23
Q

What is the optimal position for tracheal intubation?
a. cervical flexion only
b. atlanto-occipital joint extension only
c. cervical flexion and atlanto-occipital joint extension
d. cervical extension and atlanto-occipital joint flexion

A

c. cervical flexion & atlanto-occipital joint extension

24
Q

The “sniffing position” consists of

A

cervical flexion and atlanto-occipital extension

25
Q

The sniffing positions aligns the

A

oral, pharyngeal, and laryngeal axes

26
Q

What positioned should be used for morbidly obese patients?

A

HELP position (head elevated laryngoscopy position)
when patient lies supine, excess adipose on the neck, shoulders, and back place the chest higher than the head

27
Q

For the morbidly obese patient, putting the bed in __________ unloads the diaphragm and may prolong the time between apnea and desaturation

A

reverse Trendelenburg

28
Q

How does lateral rotation of the head affect the ETT?

A

ETT tip moves away from carina (risk of extubation)

29
Q

How does the nose away from chest position affect the ETT?

A

ETT tip moves away from the carina (risk of extubation)

30
Q

How does the nose to chest position affect the ETT?

A

ETT tip moves towards the carina (risk of endobronchial intubation)

31
Q

Optimal position for laryngoscopy of the obese patient is achieved when the

A

sternum and the external auditory meatus are in the same horizontal plane

32
Q

What are nerve injuries related to airway management?

A

aggressive jaw thrust
face mask strap is too tight
endotracheal tube connector resting on the patient’s face

33
Q

An aggressive jaw thrust can cause injury to the

A

facial nerve

34
Q

Presentation of injury to the facial nerve as a result of an aggressive jaw thrust includes

A

the affected side of the face may sag, the patient may drool, and chewing will be affected

35
Q

A face mask strap that is too tight can compress the

A

buccal branch of the facial nerve (CN7)

36
Q

Nerve injury as a result of a too tight face mask can present as

A

the patient will have difficulty opening and closing lips (orbiculares oris muscle function is impaired)

37
Q

An endotracheal tube connector resting on the patient’s face may cause

A

damage to the supraorbital nerve

38
Q

Presentation of damage to the supraorbital nerve appears as

A

eye pain, forehead numbness, photophobia

39
Q

What axes are aligned when the head is lying flat on the bed and extended?

A

laryngeal & pharyngeal

40
Q

Contraindications to the use of a nasopharyngeal airway include: (select 2)
a. dental trauma
b. coagulopathy
c. Pierre robin syndrome
d. Le Fort 2 fracture

A

b. coagulopathy
d. Le Fort 2 fracture

41
Q

An oro or nasopharyngeal airway is used to

A

relieve upper airway obstruction
opens the airway by displacing the tongue and epiglottis from the posterior wall of the pharynx

42
Q

How should you size an OPA?

A

measure from the corner of the mouth to the earlobe or the angle of the mandible

43
Q

How should you size a NPA?

A

measure from the nare to the earlobe or the angle of the mandible

44
Q

Placing an oral airway into a lightly anesthetized patient can precipitate

A

vomiting or laryngospasm

45
Q

A __________ is usually better tolerated in a lightly anesthetized patient

A

nasal airway

46
Q

Contraindications for a NPA include

A

cribriform plate injury (LeFort 2 & 3 fracture), coagulopathy, nasal fracture, previous Caldwell-Luc procedure, previous transphenoidal hypophysectomy

47
Q

A cribiform plate injury presents as

A

LeFort 2 or 3 fracture, basilar skull fracture, CSF rhinorrhea, racoon eyes, periorbital edema

48
Q

What complications may arise from use of an OPA?

A

dental injury
vomiting
oropharyngeal trauma
ischemia (compresses blood flow to affected areas)

49
Q

An OPA that is ___________ can obstruct the airway by causing the tongue to kink against the roof of the mouth

A

too short

50
Q

An OPA that is _________ can obstruct the patient’s airway by displacing the epiglottis towards the glottis, It can also cause trauma

A

too long
a too long NPA can also do the same

51
Q

What are the types of oropharyngeal airways?

A

Guedel
Berman
WIlliams
Ovassapian

52
Q

Specific uses for the Ovassapian OPA is

A

fiberoptic intubation

53
Q

Specific uses for the Williams OPA include

A

blind orotracheal intubation
fiberoptic intubation

54
Q

What is the cribiform plate?

A

a boney structure that separates the nasal cavity from the anterior cranial fossa; injury to this structure can allow an NPA or nasal ETT to enter the brain

Apex Review (224 decks)

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