AIRWAY MANAGEMENT Flashcards
1
Q
- What is the definition of difficult mask ventilation?
A
2
Q
- What is the incidence of difficult mask ventilation?
A
3
Q
- What is the definition of difficult tracheal intubation/laryngoscopy?
A
4
Q
- What is the incidence of difficult tracheal intubation/laryngoscopy?
A
5
Q
- What is the incidence of failed tracheal intubation?
A
6
Q
- How does resistance to airflow through the nasal passages compare to that through
the mouth?
A
7
Q
- How does resistance to airflow through the nasal passages compare to that through
the mouth?
A
8
Q
- What nerves innervate the hard and soft palate?
A
9
Q
- What nerve provides sensation to the anterior two thirds of the tongue?
A
10
Q
- What nerve innervates the posterior third of the tongue, the soft palate, and the
oropharynx?
A
11
Q
- What are the three components of the pharynx?
A
12
Q
- What nerves innervate the pharynx?
A
13
Q
- Complete the following table: (223, Table 16-1, Motor and Sensory Innervation
of Larynx
A
14
Q
- Where is the narrowest part of the adult airway?
A
15
Q
- What is special about the cricoid cartilage compared with the other tracheal cartilages?
A
16
Q
- What is the purpose of the Mallampati classification system?
A
17
Q
- Describe the observer/patient position during Mallampati classification.
A
18
Q
- Describe the Mallampati classes.
A
19
Q
- What is the purpose of the Cormack and Lehane score?
A
20
Q
- Describe the Cormack and Lehane grades.
A
21
Q
- What is the purpose of the upper lip bite test (ULBT)?
A
22
Q
- Describe the upper lip bite test (ULBT) classes.
A
23
Q
- What three axes must be aligned to obtain a line of vision during direct
laryngoscopy? How is this accomplished? What is this final position called?
A
24
Q
- What is the concern with a “short” thyromental distance?
A
25
25. What is the concern with a decreased submandibular compliance?
26
26. What position is associated with improved alignment of the three axes to obtain a
line of vision during laryngoscopy in obese patients?
27
27. What maneuver facilitates identification of the cricoid cartilage in patients who do
not have a prominent thyroid cartilage?
28
28. What is “preoxygenation” prior to the induction of anesthesia? What is its value?
29
29. How is preoxygenation accomplished?
30
30. Name ten independent variables that are associated with difficult facemask
ventilation.
31
31. Why is it important to limit ventilation pressure to less than 20 cm H2O during
facemask ventilation?
32
32. What are contraindications to nasal airway placement?
33
33. What are some indications for endotracheal intubation?
34
34. What is another name for cricoid pressure and how is it performed?
35
35. What is the purpose of cricoid pressure?
36
36. Describe the proper placement of the tip of a curved (Macintosh) laryngoscope blade
versus that of a straight (Miller) laryngoscope blade for exposure of the glottic
opening during laryngoscopy.
37
37. Describe the OELM and BURP maneuvers. What is their purpose?
38
38. How are endotracheal tubes sized?
39
39. Why are endotracheal tubes radiopaque and transparent
40
40. Why are low-pressure, high-volume cuffs on endotracheal tubes preferred?
41
41. What are some serious complications attributable to endotracheal cuff pressures?
42
42. Name some stylets that can be used to facilitate endotracheal intubation.
43
43. What are some methods to confirm the correct placement of an
endotracheal tube?
44
44. When is an awake fiberoptic endotracheal intubation most frequently chosen?
45
45. Why is fiberoptic endotracheal intubation recommended for patients with unstable
cervical spines?
46
46. Why is fiberoptic endotracheal intubation recommended for patients who have
sustained an injury to the upper airway from either blunt or penetrating trauma?
47
47. What is an absolute contraindication to fiberoptic endotracheal intubation?
48
48. What are some relative contraindications to fiberoptic endotracheal intubation?
49
49. What are some advantages and disadvantages of nasal fiberoptic endotracheal
intubation?
50
50. Why should an antisialagogue be given before fiberoptic endotracheal intubation?
51
51. On what basis is the choice of sedation for an awake fiberoptic tracheal intubation
made?
52
52. Describe preparation of the nose and nasopharynx for nasal fiberoptic tracheal
intubation.
53
53. Describe preparation of the tongue and oropharynx for nasal or oral fiberoptic
tracheal intubation.
54
54. Describe preparation of the larynx and trachea for nasal or oral fiberoptic tracheal
intubation.
55
55. Why is lidocaine the preferred airway topical local anesthetic?
56
56. Name two blocks that can be performed to topicalize the larynx and trachea.
57
57. How can the risks of mucosal trauma or submucosal bleeding with nasal
endotracheal intubation be minimized?
58
58. What advantages does inflation of the endotracheal tube cuff during advancement
with the fiberoptic scope offer?
59
59. How is endotracheal tube depth verified during fiberoptic intubation?
60
60. What are possible causes of resistance when removing the fiberoptic
bronchoscope?
61
61. What is the utility of oral intubating airways during oral fiberoptic endotracheal
tracheal intubation?
62
62. Why is visualization more difficult during fiberoptic endotracheal tracheal
intubation in an asleep patient?
63
63. Why is having a second person trained in anesthesia delivery present
recommended for fiberoptic endotracheal tracheal intubation in an asleep patient?
64
64. Describe a Patil-Syracuse mask
65
65. Describe an Aintree airway exchange catheter.
66
66. Name some rigid fiberoptic laryngoscopes. When might these laryngoscopes be
useful?
67
67. Describe the retrograde and blind nasal endotracheal intubation techniques and
when they might be useful.
68
68. Describe correct anatomic placement of the laryngeal mask airway (LMA).
69
69. For what purpose was the LMA Fastrach designed?
70
70. When using an ILMA, why are silicone Euromedical endotracheal tubes preferred
over standard endotracheal tubes? What is the disadvantage of these tubes?
71
71. Describe the LMA CTrach
72
72. Describe the ProSeal LMA.
73
73. Describe the esophageal-tracheal Combitube (ETC).
74
74. What is transtracheal jet ventilation and when might it be useful? When is it
contraindicated? What are some potential risks of transtracheal jet ventilation?
75
75. What is a cricothyrotomy and when is it usually performed?
76
76. Why is tracheal extubation during a light level of anesthesia dangerous?
77
77. What is laryngospasm? When is it most likely to occur?
78
78. How should laryngospasm be treated?
79
79. When is deep tracheal extubation contraindicated?
80
80. What are the steps of tracheal extubation?
81
81. What is the most common complication during direct laryngoscopy?
82
82. Describe endotracheal tube movement during head flexion and extension
83
83. What are the two most serious complications after tracheal extubation?
84
84. What is the major complication of prolonged tracheal intubation?
85
85. What are some differences between the infant and the adult airway? At what age
does the pediatric upper airway take on more adultlike characteristics?
86
86. Contrast the location of the larynx in an infant versus an adult. What effect does
this have on the tongue?
87
87. Contrast the size of an infant’s tongue in proportion to the size of the mouth with
that of an adult. What are the consequences of this?
88
88. Contrast an infant’s epiglottis with that of an adult.
89
89. What advantages do straight laryngoscopes offer over curved laryngoscopes when
intubating an infant or small child?
90
90. What is the narrowest portion of an infant’s airway versus an adult airway?
91
91. What is the correct size of an uncuffed endotracheal tube in infants and
children?
92
92. Can cuffed endotracheal tubes be safely used in infants and children? What
if nitrous oxide is used during the anesthetic?
93
93. What are the dangers of an endotracheal tube that is too large for infants and
children?
94
94. Contrast proper head and neck positioning of an adult with that of an infant during
direct laryngoscopy.
95
95. What is different about an infant’s nares compared to an adult’s? Why is this
important?
96
96. Why is a history of snoring important in infants and children?
97
98. What is the dose of oral midazolam for infants or children? What is the maximum
oral dose? What if the child is uncooperative with taking oral midazolam?
98
98. What is the dose of oral midazolam for infants or children? What is the maximum
oral dose? What if the child is uncooperative with taking oral midazolam?
99
99. Describe an inhaled induction in a child. When should the nitrous oxide be
discontinued?
100
100. Describe maneuvers to overcome airway obstruction during mask induction in
infants and children.
101
101. What determines the appropriate size of an LMA for use in infants and
children?
102
102. What is the LMA Flexible? What advantages does it offer?
103
103. What advantage does the Air-Q intubating laryngeal airway (ILA) have over an
LMA?
104
104. What formula is often used to estimate the appropriate-sized endotracheal tubes
for infants and children?
105
105. Is the formula used to estimate the appropriate-sized endotracheal tube for
infants and children applicable for cuffed or uncuffed endotracheal tubes?
106
106. How is the formula used to estimate the appropriate-sized endotracheal tubes for
infants and children adapted for cuffed endotracheal tubes?
107
107. What three advantages do Microcuff endotracheal tubes have over conventional
pediatric cuffed endotracheal tubes?
108
108. Are stylets useful in intubating infants and children?
109
109. What is the disadvantage of a straight laryngoscope blade compared to a curved
blade?
110
110. Describe the most useful sizes of laryngoscope blades according to age.
111
111. What is the most important first step when an unexpected difficult airway occurs in
pediatric patients?
112
112. Why should repeated attempts at direct laryngoscopy be avoided? What should be
done instead?
113
113. Is an awake fiberoptic endotracheal intubation usually an option in managing an
expected pediatric difficult airway?
114
114. What personnel and equipment should be in the operating room before induction
of anesthesia in a pediatric patient with an expected difficult airway?
115
115. What airway devices are available in smaller sizes to facilitate intubation of a child
with a difficult airway?
116
116. Why is tracheal extubation in infants and children riskier than that of adults?
117
117. When does postextubation croup most commonly occur? Why is this important?
118
118. What are the clinical manifestations of postextubation croup?
119
119. How is postextubation croup treated?
120
120. Why is obstructive sleep apnea especially important in infants and children?
121
121. How should opiate therapy be managed in an infant or child with obstructive
sleep apnea?
122
122. Describe tracheal extubation and postoperative monitoring for infants and
children with obstructive sleep apnea.
123
123. How should extubation after a difficult intubation be handled in infants and children?
