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Principles > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Mouth opening: an incisor distance of ____ or greater is desirable in an adult

A

3cm

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2
Q

Primary symptom of unilateral recurrent laryngeal nerve injury

A

Hoarseness, but may lose protective role of larynx in preventing aspiration

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3
Q

The laryngeal skeleton consists of ___ cartilages. ___ paired and ___ unpaired

A

9; 3; 3

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4
Q

Move the larynx as a whole

A

Extrinsic muscles

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5
Q

Move various cartilages in relation to one another

A

Intrinsic muscles

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6
Q

The entire palatial arch, including the bilateral faucial pillars, is visible down to the bases of the pillars

A

Mallampati Class I

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7
Q

The upper part of the faucial pillars and most of the uvula are visible

A

Mallampati Class II

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8
Q

Only the soft and hard palates are visible

A

Mallampati Class III

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9
Q

Only the hard palate is visible

A

Mallampati Class IV

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10
Q

The distance b/w the mentum (chin) and the superior thyroid notch. What distance is desirable?

A

Thyromental distance. > 3 fingerbreadths

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11
Q

A neck circumference > than ____ is associated w/ difficulties in visualization of the glottis openings

A

17 inches

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12
Q

Relative alignment of the oral and pharyngeal axes is achieved by having the pt in what position?

A

The “sniffing” position

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13
Q

The preoxygenated pt may have a ______ oxygen reserve

A

5 - 8 min

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14
Q

Which muscles cause vocal cords to abduct? adduct?

A 
abduct= posterior cricoarytenoid (pull apart);
adduct= lateral cricoarytenoid (Lets close the airway)
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15
Q

CricoThyroid & ThyroaRytenoid

A

Cords Tense; They Relax

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16
Q

Laryngospasm tx

A 
Positive pressure (increase APL valve to 15-20);
Low dose sux;
Jaw lift;
Turn gas on/deepen anesthetic;
100% O2
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17
Q

Thyromental distance tells you?

A

Submandibular space

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18
Q

What conditions would impair the sniffing position?

A

Cervical spine; DJD; RA; Burns; Trauma- halo; Down syndrome

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19
Q

Risk for difficult mask ventilation (BONES)

A 
Beards;
Obesity;
No teeth;
Elderly;
Snoring
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20
Q

Risk for difficult intubation

A

Mallampati 3-4; Recess chin/anterior airway; small mouth opening; Thyromental distance < 4 fingerbreadths; no neck; can’t extend/flex neck

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21
Q

Factors for difficult LMA placement

A

Limited mouth opening (burns), obstruction/trauma

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22
Q

When would you opt to have a knife nearby?

A

Hx of difficult airway or trach

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23
Q

When can you not use a nasal airway?

A

Basal head injury (bruising behind ears, around eyes, edema on eyes, leaking of CSF ears/nose)

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24
Q

Most common eye injury

A

Corneal abrasion

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25
Q

What is the most common cause of vision loss

A

Increased pressure causing ischemic neuropathy

26
Q

Link peripheral nerve to spinal cord

A

First order neurons

27
Q

Link spinal cord or brainstem to the subcortical structure

A

Second order neurons

28
Q

Links subcortical structure to cerebral cortex

A

Third order neurons

29
Q

______ column is more evolved

A

Dorsal

30
Q

Fine touch, proprioception. Large and myelinated

A

Dorsal column

31
Q

More primitive. Pain, temp. Smaller and slow conducting fibers

A

Anterolateral system

32
Q

What 3 drugs can be used to tx post op shivering?

A

Oral clonidine, Demerol, & precedex

33
Q

Shivering increases O2 consumption by ______, increasing ischemia

A

400%

34
Q

Top 3 intraop causes of anaphylaxis

A
  1. Sux;
  2. Latex;
  3. Antibiotics
35
Q

Tx for intraop anaphylaxis

A 
Stop causative agent;
100% O2;
Steroids;
H2 antagonist (ranitidine) & H1 antagonist (Benadryl);
Epi (5, 10, 20 mcg);
Fluids;
Albuterol;
Vasopressin
36
Q

What pts are high risk for latex allergy?

A

Have procedures often, healthcare workers, allergic to foods (mango, kiwi, chestnut, bananas, avocado, passion fruit), spinabifida & myelomeningocele

37
Q

How does position change effect ET tube?

A

Neck flexion- will go deeper; Neck extension- comes out further (tube goes where neck goes)

38
Q

2 ways to check for patent airway/edema to extubate

A

Deflate cuff (leak test); video laryngoscope

39
Q

Stretch > than ______ degrees will cause stretch injury

A

90

40
Q

Would you use shoulder braces when positioning?

A

NO

41
Q

Where is axilla roll placed?

A

Distal (caudad) to axilla

42
Q

If axilla roll is placed in axilla, what can happen? How can you check?

A

Neuromuscular compression. Place pulse ox on dependent arm

43
Q

Risk factors for ulnar nerve injury

A

Male, Long bed rest, high BMI

44
Q

Risk for median nerve injury

A

AC IV

45
Q

Risk factors for radial nerve injury

A

Art line, BP cuff, tucked too tightly

46
Q

What position most likely to see air embolism?

A

Sitting position (neurosurgery)

47
Q

Involve antigens that cross-link IgE antibodies, triggering the release of inflammatory mediators from mast cells.
Immediate.
Atopy, urticaria/angioedma, anaphylaxis

A

Type I reaction

48
Q

Complement-fixing (C1-binding) IgG antibodies bind to antigens on cell surfaces, activating the classic complement pathway and lysing the cells.
Cytotoxic.
Hemolytic transfusion rxns, autoimmune hemolytic anemia, HIT

A

Type II reaction

49
Q

Occur when antigen-antibody (IgG or IgM) immune complexes are deposited in tissues, activating complement and generating chemotactic factors that attract neutrophils to the area.
Immune complex.
Arthu’s rxn, serum sickness, acute hypersensitivity pneumonitis

A

Type III reaction

50
Q

Referred to as delayed hypersensitivity rxns, mediated by CD4 T lymphocytes that have been sensitized to a specific antigen by prior exposure.
Delayed, cell-mediated.
Contact dermatitis, TB-type hypersensitivity, chronic hypersensitivity pneumonitis

A

Type IV reaction

51
Q

Type I hypersensitivity reactions are classified as _____ or _____. ______ disorders typically affect the skin or respiratory tract & include allergic rhinitis, atopic dermatitis, and allergic asthma

A

Atopic; nonatopic; atopic

52
Q

Sulfa drugs include:

A

Sulfonamide abx, furosemide, HCTZ, & captopril

53
Q

2 types of acute pain

A

Somatic & visceral

54
Q

Sharp pain often described as a stabbing sensation that is either localized to the area around the organ or referred to a distant site

A

Parietal

55
Q

Unpleasant of abnormal sensation w/ or w/o stimulus

A

Dyesthesia

56
Q

Increased response to mild stimulation

A

Hyperesthesia

57
Q

The ______________, which is classically considered the major pain pathway, lies anterolaterally in the white matter of the spinal cord

A

Spinothalamic tract

58
Q

Produce analgesia by inhibition of COX

A

Aspirin, acetaminophen, NSAIDs

59
Q

Peripheral mechanisms that cause phantom pain

A

Neuromas, an increase in C-fiber activity, and Na channel activation

60
Q

Central mechanisms that cause phantom pain

A

Abnormal firing of spinal internuncial neurons and supraspinal involvement secondary to the development of new synaptic connections in the cerebral cortex

61
Q

4 elements of pain processing

A
  1. Transduction;
  2. Transmission;
  3. Modulation;
  4. Perception

Principles (4 decks)

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