Airway Management

Question 1

Congénital causes of difficult airway

Answer 1

Pierre Robin syndrome
Treacher Collins syndrome
Goldenhars syndrome
Down syndrome
Klipper feil syndrome

Question 2

Risk factors showing potential acquired conditions leading to difficult airway

Answer 2

Hx of difficult intubation
Obstructive sleep apnea
Pregnancy
Infections
Trauma
Foreign body
Tumors around head and neck
T2 diabetes

Question 3

Iatrogenic causes of difficult airway

Answer 3

Neck , oral, pharyngeal radiotherapy / irradiation

Temporomandibular joint fusion / surgery

Question 6

LEMON mnemonics for physical exam in anaesthesia assessment

Answer 6

Look
Evaluate - 332 rule
Mallampati
Obstruction
Neck mobility

Question 7

What to look for in physical exam

Answer 7

Facial trauma
Short bull neck
Obesity
Limitation of mouth opening
Receding mandible
Health of Teeth
Large tongue
Soft tissue swelling of neck
Deviation of larynx , trachea
Beard

Question 8

Mallampati score

Answer 8

Class I - soft palate , uvula , faucet and pillars visible
Class II - soft palate , uvula and fauces
Class III - soft palate , base of uvula
Class IV - soft palate not visible at all

Question 10

Causes of obstruction

Answer 10

Impacted objects
Blood
Vomitus
Teeth
Epiglottis
Dentures
Tumors

Question 11

Neck mobility

Answer 11

C spine immobilization
C spine surgery
Rheumatoid arthritis
Ankylosing spondylitis
Diabetes
Radiation stiffness

Question 12

What is the thyromental distance / patil test

Answer 12

Normal more than 7cm
If less than 6cm -> difficult intubation possible

Question 14

What is the sternomental distance / savvatest

Answer 14

Distance less than 12 predictive of difficult intubation

Question 16

Investigations in airway assessment

Answer 16

Neck xray - lateral (compression) , PA (deviation)
Chest xray - retrosternal extensions
Ct scan

Question 17

Alternative airway techniques

Answer 17

Oropharyngeal airway
Nasopharyngeal airway
LMA
ETT
Stylette and bougie
Video laryngoscope
Fiber optic intubation

Question 18

Answer 18

Nasopharyngeal tube

Question 19

Answer 19

Oropharyngeal airway

Question 21

Answer 21

Laryngeal mask airway LMA

Question 22

Answer 22

Preformed LMA

Question 23

Answer 23

Pediatric ETT

Question 24

Answer 24

Precurved north facing ETT ( nasoTT)

Question 25

Answer 25

Precurved south facing ETT (oroTT)

Question 26

Answer 26

Reinforced ETT

Question 27

Answer 27

Stylet for ETT , useful to guide ETT into trachea

Question 28

Answer 28

Bougie

Question 29

Answer 29

Laryngoscope and blades

Question 30

Spo2 level in hypoxia

Answer 30

Less than 95%

Question 31

Causes of hypoxia

Answer 31

Hypoxemia Anaemia Impaired circulation (HF,sepsis, hypovolemia , anaphylaxis ) Impaired cellular metabolism

Question 32

Indications for oxygen therapy

Answer 32

Hypoxia <92% Hypoxemia Peri or post cardiac/respiratory arrest Shock Low CO, severe Metabolic acidosis Respiratory failure Seizures, convulsions Sepsis MI GA and peri operative High altitude

Question 33

Oxygen toxicity symptoms

Answer 33

Hypoxemia acidosis, death Retinal damage Renal damage Erythrocytes hemolysis Myocardial Damage Hepatic damage Convulsion

Question 34

Nasal prongs characteristics

Answer 34

Low flow delivery system Variable FiO2 Flow rate 1-6L/min FiO2 - 24-44% Advatanges - well tolerated , can eat and talk Disadvantages.- nasal irritation, mucosal drying, Indication - minimal or no respiratory distress

Question 35

Simple face mask characteristics

Answer 35

Low flow Variable FiOO2 40-60%

Question 36

Venturi mask characteristics

Answer 36

Fixed delivery system Uses Bernoulli’s principle Indication - COPD High flow 4-12L/min 24, 28, 31, 35, 40

Question 38

Partial rebreather mask characteristics

Answer 38

Simple mask with reservoir bag, has holes which allows escape and mixing of oxygen with air 8-12L 60% o2

Question 39

Non rebreather mask

Answer 39

High flow Flow rate 6-10L 50-70% Indication - spontaneously breathing patient who requires higher possible o2 Issue-carbon monoxide poisoning , trauma