Airway Flashcards
(116 cards)
1
Q
Pharynx
(anatomy and location)
A
extends from choanae to esophagus
(base of skull to cricoid cartilage and C6)
- contains Naso-, Oro-, and Larnygo-
- narrowest at esophagus and widest at Hyoid
- 10-15 cm long
2
Q
Tongue
(sensory innervation)
A
lingual anterior 2/3 (V3) and Glossopharyngeal posterior 1/3
Chorda Tympani of VII for taste
3
Q
Tongue
(motor Innervation)
A
Hypoglossal (XII)
4
Q
Larynx
(anatomy and location)
A
hollow cartilage structure containing ligaments, membrane and muscles
C3 - C6
5
Q
Larynx
(function)
A
guards entrance to trachea and produces sound
6
Q
A
7
Q
Hyoid Bone
A
suspended U-shaped bone that anchors larynx
connected to thyrohyoid ligament and articulates with superior horn of the thyroid cartilage
8
Q
A
9
Q
Function of Sternohyoid
A
indirect depressor of the larynx
10
Q
Innervation of Sternohyoid
A
Cervical plexus
11
Q
Function of Sternothyroid and Thyrohyoid
A
depresses larynx
12
Q
innervation of sternothyroid
A
cervical plexus
13
Q
innervation of thyrohyoid
A
cervical plexus and hypoglossal nerve
14
Q
innervation of thyroepiglottic
A
recurrent laryngeal nerve
15
Q
innervation of stylopharyngeus
A
glossopharyngeal
16
Q
function of inferior pharyngeal constrictor
A
assists in swallowing
17
Q
innervation of inferior pharyngeal constrictor
A
vagus
18
Q
which intrinsic muscle of the larynx is not innervated by the recurrent laryngeal?
A
cricothyroid
19
Q
sensory and motor functions of the larynx are branches of the _____ nerve
A
vagus
20
Q
sensory below the vocal cords is innervated by _____
A
recurrent laryngeal nerve
21
Q
laryngospasms are a reflex due to stimulation of which nerve?
A
superior laryngeal
22
Q
Simple Mask
[overview]
A
- no reservoir for O2
- mixture of pure oxygen and room air
- variable FiO2
23
Q
minimum fresh gas flow in simple mask to avoid rebreathing CO2
A
5 L/min
24
Q
Venturi Masks
[overview]
A
- high air flow
- better control of FiO2
25
FiO2 of nasal cannula at 3 L/min
0.27 - 0.34
26
FiO2 of nasal cannula at 5 L/min
0.32 - 0.44
27
FiO2 of nasal cannula at 1 L/min
0.21 - 0.24
28
FiO2 of simple mask at 5-6 L/min
0.30 - 0.45
29
FiO2 of simple mask at 7-8 L/min
0.40 - 0.60
30
FiO2 of partial rebreathing mask at 7 L/min
0.35 - 0.75
31
FiO2 of partial rebreathing mask at 15 L/min
0.65 - 1.00
32
FiO2 of non-rebreathing mask at 7-15 L/min
0.40 - 1.00
33
Guedel Airway
34
Berman Airway
* I-Beam shape with center support
35
Contraindications to Nasal Airway (6)
* hemorrhagic disorders
* anti-coagulation therapy
* sepsis
* basilar skull fractures
* history of epistaxis
* nasal packing
36
ETT are typically made of \_\_\_\_\_
polyvinyl chloride (PVC)
* will support combustion
37
On which side of the ETT is the murphy eye?
right
38
Purpose of murphy eye on ETT
if main lumen is blocked by secretions, some ventilation may be possible out Murphy eye
39
Bevel opening on an ETT faces \_\_\_\_\_
left
40
Nasal RAE Tubes
| (types and/or other names)
Ring, Aldair, Elwyn
41
inner and outer wraps in LASER tubes
aluminum and Teflon
42
Laser flex tube
fill distal cuff with saline and proximal cuff with methylene blue
43
adult sizes of oral airways
9, 10, and 11
44
a Mac blade lifts the epiglottis anteriorly and tenses the _____ ligament
hyoepiglottic
45
BURP
Back Upwards Right Pressure
46
ideal positioning of ETT is ____ cm above carina
2-4 cm
47
ETT cuff typically holds ____ mL of air
5 - 6
* seal until you do not get a leak at 20 cmH2O
* 22-32 cmH2O pressure in cuff
48
If ETT is in trachea and no CO2 waveform is seen, what could be the problem?
cardiac arrest or pulmonary embolus
49
force in cricoid pressure
20 newtons
then 30N when patient is asleep
50
Tube of LMA connected to mask at _____ degree angle
30
51
the classic LMA can be used up to ____ times
40
52
LMA Supreme
* separate conduit to permit gastric fluid
* may use higher peak airway pressures
* up to 30 cmH2O
53
LMA ProSeal
* built in bite block
* salem pump can pass into stomach
* less than 16 Fr
* higher seal pressures
54
LMA in patient under 5 kg
1
| (maximum cuff volume 4 mL)
55
LMA in patient 10-20 kg
2
| (maximum cuff volume 10 mL)
56
LMA in patient 30-50 kg
3
| (maximum cuff volume 20 mL)
57
LMA in patient 50-70 kg
4
| (maximum cuff volume 30)
58
LMA in patient 70-100 kg
5
| (maximum cuff volume 40 mL)
59
tidal volumes should be limited to _____ mL/kg if using an LMA
8 mL/kg
(limit pressures to 20 cmH2O unless using supreme)
60
LMAs should not be used if the case lasts longer than _____ hours
3
consider using Supreme and suctioning gastric contents if longer
61
Cuff pressure in LMA should be less than \_\_\_\_\_
60 cmH2O
62
2 sizes of Combitube
**37** (4-6 ft) and **41** (\>6 ft)
63
Combitube
64
Distal cuff of Combitube
seals upper esophagus
white pilot balloon
fill with 10 mL of air
65
Proximal cuff of Combitube
seals oro and nasopharynx
blue pilot balloon
fill with 85-100 mL air
66
Confirmation of Combitube position
ventilate through blue first
if no breaths ounds, then ventilate through distal lumen
67
Combitubes can have mechanical ventilation pressures up to \_\_\_\_\_
50 cmH2O
68
King Laryngeal
69
Differences between King laryngeal and Combitube
combitube has one pilot balloon and has pediatric sizes
70
King laryngeal cuff needs ____ for adult sizes and ___ for pediatrics
60 mL for adults
35 mL for pediatrics
71
proximal cuff of a King Laryngeal tube should lie in the \_\_\_\_\_
hypopharynx
72
Distal cuff of a King Laryngeal tube sholud lie in the \_\_\_\_\_
esophagus
73
McCoy blade
74
Polio Blade
* used when A/P diameter precludes use of conventional handle
75
Wisconsin
76
Wis-Hipple
* designed for use in infants
77
Snow
78
Phillips
79
Bullard
80
Upsher
81
Wu
82
(3) Types of Rigid Fiberoptics
Bullard, Upsher, and Wu
83
distal angle of Glidescope
60o
84
AirTraq
85
AirTraq sizes
infant (2.5 - 3.5)
pediatric (4.0 - 5.5)
small (6.0 - 7.5)
regular (7.0 - 8.5)
86
Aintree Intubation Catheter
designed for use with fiberoptic
* can ventilate
* ETT 7.0 or larger
87
Trachlight Preparation
cut ETT to 26cm
88
MOANS
factors predicting difficult BMV
* mask seal
* beards, blood on face
* Obese
* BMI \> 30
* Age \> 55
* No teeth
* Snores or Stiff
89
Grade III Cormack and Lehane
visualization of only the epiglottis
90
Grade IV Cormack and Lehane
visualization of only the soft palate
91
TMD less than ____ suggests a difficult intubation
6 cm
92
contraction of posterior cricoarytenoid muscles cause _____ of vocal cords
abduction
93
contraction of lateral cricoarytenoid muscle causes _____ of vocal cords
adduction
94
trachea bifurcates at the carina at level \_\_\_\_\_
T5
95
prayer test
limited joint mobility
especially in diabetics
96
extrathoracic obstructions are mostly noted during the _____ phase
inspiratory
97
intrathoracic obstructions are most noted during the _____ phase
expiratory
| ( + intrathoracic pressure)
98
FiO2 range of nasal cannula
22 - 50%
99
FiO2 range in simple mask
35 - 60%
100
Avoid airway pressure greater than _____ in resusitation bags
20 cmH2O
101
ETT for \< 1 kg
2.5
102
ETT for 2-3kg
3.5
103
(5) straight blades
* miller
* wisconsin
* wis-hipple
* snow
* seward
104
(2) indirect video laryngoscopes
Glidescope and McGarth
105
Klippel-Feil
congential fusion of 2+ cervical vertebrae
* neck rigidity
* awake intubation if possible
106
Apert's Syndrome
hypoplastic mandible with craniosyntosis
* exopthalmos
* high arched palate
107
Treacher Collins
micrognathia and microstomia
* aplastic zygomatic arches
* choanal atresia
108
Pierre-Robin
cleft palate and micrognathia
* backward tongue movement and pharyngeal wall collapse
109
Dose of Succinylcholine for Laryngospasm
IV 0.25 - 1 mg/kg
or
IM 1 - 1.5 mg/kg
110
Dose of Atropine for Laryngospasm
IV 0.01 mg/kg
or
0.02 mg/kg
111
pulmonary sounds in Pulmonary Edema
rales and rhonchi
112
nerves in gag reflex
glossopharyngeal
113
nerve in laryngospasm
superior laryngeal
114
nerve in cough
vagus
115
Transtracheal block
penetrate cricothyroid membrane
4mL of 4% lidocaine followed by cough
116
Bupivacaine
maximum total dosage
