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ANES 512b Midterm > Chapter 32: Endobronchial Tubes + Bronchial Blockers > Flashcards

Chapter 32: Endobronchial Tubes + Bronchial Blockers Flashcards

1
Q

Three principle surgical uses for use of endobronchial tube + blockers?

A

Thoracic surgery
Non-thoracic surgery
Bronchopulmonary lavage

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2
Q

What is bronchopulmonary lavage?

A

The irrigation or washing out of the bronchi and bronchioles to remove pulmonary secretions

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3
Q

Which pulmonary surgeries might require an endobronchial tube?

A

Segmental resection, lobectomy, pneumonectomy

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4
Q

Which bronchial surgeries might require an endobronchial tube/

A

Resection, repair

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5
Q

Thoracic surgeries that may require an endobronchial tube include:

A

Lungs
Bronchi
Pulmonary vessels
Chest wall

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6
Q

Non-thoracic surgeries that may require an endobronchial tube include:

A

Spine
Vascular
GI

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7
Q

In which vascular surgery might you use an endobronchial tube?

A

Aorta

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8
Q

Which GI surgeries may require an endobronchial tube?

A

Esophagus

GE junction

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9
Q

Reasons you may use an endobronchial tube during surgery?

A

Infection, hemorrhage (disease or trauma) call for the isolation of the right + left lungs
Parynchema: provide unilateral support (oxygenation + ventilation to one lung)

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10
Q

Example of disease in lungs that would require endobronchial tube:

A

Bronchopleural fistula

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11
Q

Which lung is easier to mainstem?

A

Right side

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12
Q

What is the angled takeoff of the right main bronchus?

A

20*

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13
Q

What is the angled takeoff of the left main bronchus?

A

40*

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14
Q

Length of right main bronchus before RUL takeoff?

A

2.5 cm

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15
Q

Length of left main bronchus before LUL takeoff?

A

5 cm

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16
Q

Which lung has two lobes?

A

Left

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17
Q

Which lung has three lobes?

A

Right

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18
Q

Line that separates RUL + RML?

A

Horizontal fissure

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19
Q

Line that separates RML + RLL?

A

Oblique fissure

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20
Q

Line that separates LUL + LLL?

A

Oblique fissure

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21
Q

Which lung has a horizontal fissure?

A

Right lung

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22
Q

Anatomical position of the LLL in relation to the LUL?

A

LLL is posterior to LUL

23
Q

In which CXR view can you best visualize the RML?

A

Posterior + lateral

24
Q

Name three devices that we use in one-lung ventilation:

A

Endobronchial tube
Integrated ETT-bronchial blocker
ETT + bronchial blocker

25
Q

A univent ETT is an example of:

A

an integrated ETT-bronchial blocker

26
Q

Example of integrated ETT-bronchial blocker?

A

Univent ETT

27
Q

Two examples of bronchial blockers that are to be used in conjunction with (but are not integrated parts of) an ETT?

A

Arndt device

Rusch endobronchial blocker

28
Q

Arndt device + Rusch endobronchial blocker are two examples of:

A

ETT + bronchial blocker

29
Q

What aspect of the double lumen tube separates the lungs from the environment?

A

Tracheal cuff

30
Q

Purpose of tracheal cuff?

A

Separates the lungs from the environment

31
Q

Purpose of endobronchial cuff?

A

Separates the two lungs from each other

32
Q

What aspect of the double lumen tube separates the two lungs from each other?

A

Endobronchial cuff

33
Q

Distinguishing feature of Right-sided double lumen ETT?

A

It has a ventilation slot for the RUL (make sure it is placed at the level of the RUL).

34
Q

In a double lumen tube, what is the purpose of one lumen ending in the trachea + the other in a single lung?

A

We can control whether or not we ventilate both lungs at once (trachea) or one lung at a time (lung).

35
Q

Method of visualization when placing EBT?

A

FFOB

36
Q

Double lumen tubes are sized based on:

A

height

37
Q

How do you confirm that you have successful placed a double lumen tube without the use of FFOB?

A

Clamp one lung off; when you ventilate, you should hear breathing sounds on one side but not the other

38
Q

Which endobronchial tube has a clear lumen and a blue lumen? Which is the blue lumen?

A

Broncho-Cath

Blue = bronchial

39
Q

What color is the proximal balloon on a Broncho-Cath?

A

Clear

40
Q

What color is the distal balloon on a Broncho-Cath?

A

Blue

41
Q

What is a univent?

A

A conventional ETT with integrated bronchial blocker

42
Q

The OD of a normal ETT is reflected in what aspect of a Univent?

A

OD

43
Q

On a Univent, which balloon is blue?

A

The pilot balloon of the tracheal cuff.

44
Q

Which endobronchial tube has a distal end with an ETT cuff and two lumens?

A

Univent (integrated ETT + bronchial blocker)

45
Q

The ETT proximal end of a Univent has:

A

15 mm circuit connector
ETT cuff inflation system
Blocker port

46
Q

The bronchial blocker proximal end of a Univent has:

A

Blocker inflation system
Blocker port
Blocker locking mechanism

47
Q

Which endobronchial tube requires the use of a fiberoptic scope as an introducer?

A

Arndt endobronchial blocker

48
Q

How does the Ardnt endobronchial blocker relate to an ETT?

A

It has a special connector that is compatible with the ETT: use that connector as a port of sorts to thread the Arndt device along with the fiberoptic scope.

49
Q

Which endobronchial blocker has two proximal balloons, a radiopaque shaft, and bifurcated distal extensions/

A

Rusch endobronchial blocker

50
Q

The distal end of which endobronchial blocker is Y-shaped?

A

Rusch

51
Q

Which endobronchial blocker has a camera and light source, thereby eliminating the need for FFOB assistance?

A

ETView Medical VivaSight

52
Q

Air volume required to inflate bronchial cuff?

A

6-7 cc

53
Q

When you switch from one-lung ventilation to two-lung ventilation, what are some changes you should make to your ventilation settings?

A

Change your rate and tidal volumes (therefore minute ventilation) to prevent volutrauma.

54
Q

If a patient starts to desaturate during one-lung ventilation, what are some things you can do?

A

100% O2

Apply CPAP to non-ventilated lung.

ANES 512b Midterm (12 decks)

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