Name the structures and anatomical boarders of the upper airway!!
- Anterior to C1
- Contains base of skull and soft pallet, eustachian tubes, adenoids.
- Accounts for 2/3 the upper airways resistance
- Sensory innervated by the maxillary and trigeminal nerves
- Anterior to C2-3
- Soft palette to epiglottis
- Posterior to larynx, epiglottis, cricord cartilage
- C3-4 to C6
- Epiglottis and cricoid cartilage
- Protects the airway, provides airflow, cough and gag reflex, and produced phonation
Name the structures and anatomical borders of the glottis region.
Base of tongue to the corniculate cartilage
Epiglottis, true and false cords and glottis
Muscles involved in Laryngospasm?
Describe the superficial Vasculature of the neck
EXTERNAL CAROTID → Superior thyroid → superior Laryngeal → supplies the supraglottic region of larynx
INFERIOR THYROID ARTERY→ inferior laryngeal → supplies the infraglottic region
What is Stridor? What is stertor? what is teh difference b/t them?
- Stridor- Partial obstruction of Larynx, trachea, or bronchi and is heard on both inspiration and expiration
- Stertor- Obstruction above the larynx and is only heard on inspiration (snoring)
- Differences- both are due to turbulent airflow of the respiratory tract due to partial obstruction
What are the types of stridor?
- Inspiratory- @ or above cords
- Biphasic- inspiratory and expiratory in the subglottic or trachea
- Expiratory- Small bronchioles (asthma)
What is Wheezing? Where does it occur vs Stridor?
- Obstruction of the lower smaller airways
- Stridor is obstruction of the upper airway up to the layrynx
Explain Law of LaPlace?
Pressure needed to expand an alveolus if directly proportional to the surcase tension and inversly proportional to the radius
So larger alveoli need less pressure to stay open than smaller alveoli
Describe Bernouilis Principle!
Flow through a constricted tube increases it's velocity and decreases it's pressure on the walls
Name the branches of the trigeminal nerve
Opthalmic→ ciliary → Ethmoid → forame rotudom → maxillary → infraorbital → foramen ovale → mandibular → lingual and inferior aveolar
Name the branches of the Facial nerve
Temporal facial division → temporal, zygomatic cervical facial division → bucal, marginal, cervical
mcg/kg/min X 60gtt/min X kg
Name local Maxes
- Plain 2.8mg/kg or 175 max
- W/epi 3.2mg/kg or 225 max
- Plain 4.5mg/kg or 300 max
- W/epi 7mg/kg or 500mg max
Name the Epi strengths in mcgs
1:100,000 = 10 mcgs
1:200,000 = 5 mcgs
1:400,000 = 2.5 mcgs
Name local Strengths in mg
1% = 10mg
0.5% = 5 mg
0.25% = 2.5 mg
Talk about Ancef!!
- inhibits cell wall synthesis
- Gram + staph and strep
- Gram - ecoli
- 1st generation Cephalosporin
- 30 min onset
Talk about clindamycin
- inhibits protein synthesis @ the ribosomal subunit
- Gram + cocci and Anerobes
- Max 40mg/kg
what is high output faliure
Seen in trauma, sepsis
increase CO more than normal which overloads pulmonary system causes pulm edema secondary to an increased diastolic pressure in the left ventricle