76 Questions
What is the percentage of anesthetic deaths in the U.S. attributed to difficult and failed airway management?
2.3%
What is the narrowest portion of the adult airway?
Glottis
Why is it difficult to 'sweep' the tongue out of the way in children?
Because the tongue is very large compared to the oral cavity
What is the age range during which the epiglottis is larger and stiffer in children?
Until about 2 years of age
What is the significance of the ROM sign of retraction?
It is a sign of obstruction
What is the primary objective of the LMA Fastrach?
To allow for blind intubation through LMA
What is the maximum pressure recommended for LMA?
20 mmH20
Which of the following is a complication associated with improper placement of LMA?
All of the above
What is the size of the LMA mask for a normal adult weighing less than 70 kg?
Mask size 4
What is the role of the second lumen in the LMA ProSeal?
It acts as an esophageal vent
What is the primary indication for awake fiber optic intubation?
Anticipated difficult tracheal intubation/ventilation
What is the purpose of the translaryngeal block?
It anesthetizes below the cords
What is the use of the lighted stylet?
It visualizes the tracheal position through the skin of the neck
What is the purpose of the bougie?
It helps in epiglottis-only view (grade 3)
What is the advantage of the Glidescope?
It is useful in patients with limited neck extension or anterior airways
What is the orientation of the probe/image in a long axis view?
Parallel to the desired structure
What is the primary goal of hemodynamic monitoring?
To ensure adequate perfusion for delivery of O2 to tissues
What is a limitation of noninvasive blood pressure (NIBP) measurement?
Improper cuff sizing
What is the Penaz technique used for?
To analyze waveforms and provide dynamic vital signs
What is the purpose of hydraulic coupling in the transducer system?
To create a voltage differential
What is the effect of overdamping in a transducer system?
Loss of fine detail and underestimated SBP
Why is proper leveling of the transducer important?
To negate the effects of hydrostatic pressure
What is the conversion factor for 1 inch of height difference in hydrostatic pressure measurement?
0.74 mmHg
What is the purpose of documenting blood pressure, heart rate, and respiration in anesthesia care?
To fulfill AANA standards of practice
What is the consequence of a pinched phenomenon in a transducer system?
Loss of fine detail and absent dicrotic notch
What is the primary advantage of using invasive monitoring in anesthesia care?
Continuous monitoring of vital signs
What is the primary indication for performing a surgical cricothyrotomy?
Cannot intubate, cannot ventilate situation
What is the advantage of surgical cricothyrotomy compared to tracheotomy?
The membrane is relatively avascular
What is the purpose of the pressure valve in percutaneous translaryngeal jet ventilation (PTJV)?
To allow for passive egress of air
What is the primary indication for using a double-lumen tube?
Prevention of damage to the healthy lung
What is the correct technique for placing a left-sided double-lumen tube?
Pass the tube through the glottis with the distal curvature facing anteriorly
What is the confirmation of a properly positioned left-sided double-lumen tube?
Visualization of the rim of the blue-bronchial cuff through the bronchoscope
What is the management of a right-sided isolation scenario with a double-lumen tube?
Clamp the tracheal lumen and close the cap on the bronchial side
What is a relative contraindication for using a double-lumen tube?
All of the above
What is the threshold for expecting a difficult airway based on thyromental distance?
Less than 3 fingers (< 6.5 cm)
What is the goal of pre-oxygenation before intubation?
ETO2 > 90
What is the recommended angle for the needle during the infraclavicular approach for CVC placement?
10-15 degrees
What is the approximate catheter length to the caval-atrial junction for a left SC insertion?
19 cm
What is the waveform characteristic of atrial contraction in a CVP waveform?
A wave
What is the concern if the catheter tip is too short during CVC placement?
Increased venous thrombosis risk
What is the normal range for LVEDP?
4-12 mmHg
What is the purpose of the NAVL pneumonic?
To remember the order of structures in the infraclavicular approach
What is the significance of the X descent in a CVP waveform?
Systolic collapse in atrial pressure
What is the recommended method for estimating catheter length?
Measuring the distance from the needle insertion point and the third rib
What is the characteristic of the PA waveform in a PA catheter?
A diastolic step up from the RV waveform
What is the purpose of the PAWP?
To assess LV preload indirectly
What is the effect of a 10-inch difference in height between the external auditory canal and the blood pressure cuff on the arm?
MAP at EAC would be 20 mmHg lower than the MAP at the arm
What is the significance of the damping coefficient in a transducer system?
It prevents the system from over-responding to changes in pressure
What is the orientation of the probe/image in a short-axis view?
The probe/image is perpendicular to the desired structure
What is the purpose of the Wheatstone bridge in a transducer system?
It undergoes hydraulic coupling to measure pressure changes
What is the effect of an underdamped system on the waveform?
It appears as exaggerated peaks and troughs
What is the characteristic of the korotkoff sounds used in sphygmomanometry?
They are created by turbulent flow due to partial collapse of the constricted artery
What is the purpose of the oscillometry technique in non-invasive blood pressure measurement?
It measures the pressure fluctuations due to pulsations transmitted to solid-state transducers
What is the effect of a 1-cm difference in height on the hydrostatic pressure measurement?
It increases the pressure by 0.74 mmHg
What is the primary goal of hemodynamic monitoring in anesthesia care?
To ensure adequate perfusion for delivery of oxygen to tissues
What is the limitation of non-invasive blood pressure measurement using the oscillometry technique?
It is affected by the cuff size and placement
What is the estimated distance from the needle insertion point to the caval-atrial junction for a Right IJ approach?
16 cm
Which of the following anatomical locations is associated with the highest risk of venous thrombosis if the catheter tip is too short?
Azygous vein
What is the characteristic of the diastolic pressure in the pulmonary artery (PA) waveform?
Increased pressure during diastole
What is the primary purpose of the NAVL pneumonic in the infraclavicular approach for CVC placement?
To preserve the anatomical order of nerves, arteries, veins, and lymphatics
What is the significance of the X descent in a CVP waveform?
Systolic collapse in atrial pressure
What is the estimated distance from the needle insertion point to the caval-atrial junction for a Left SC approach?
19 cm
What is the characteristic of the PA waveform in a patient with mitral regurgitation?
Increased diastolic pressure
What is the anatomical location of the caval-atrial junction in relation to the thoracic vertebrae?
At the level of the carina, at thoracic vertebrae 4-5
What is the primary purpose of the CVP waveform analysis?
To monitor the right atrial pressure
What is the significance of the Y descent in a CVP waveform?
Diastolic collapse in atrial pressure
Which artery is the primary source of hand blood flow?
Brachial artery
What is the characteristic of the arterial pressure waveform in a patient with aortic stenosis?
Small amplitude and slow-rising systolic upstroke
Which artery is preferred for arterial cannulation due to its easy access and compressibility in case of arterial puncture?
Femoral artery
What is the significance of pulse pressure variation ≥ 13%?
The patient is likely to benefit from a fluid challenge
Which vein is the first choice for central venous cannulation?
Internal jugular vein
What is the Windkessel model used for?
To calculate stroke volume
Which site is preferred for arterial cannulation due to its lack of collateral circulation?
Brachial artery
What is the significance of a wide pulse pressure in a patient with aortic regurgitation?
Pulsus bisferiens
Which artery has collateral circulation with the PT artery?
DP artery
What is the goal of goal-directed fluid therapy?
To guide individualized patient fluid administration
Learn about the unique challenges of managing pediatric airways, including congenital disorders that increase difficulty. Understand the importance of a comprehensive history and physical examination in identifying potential airway problems. Discover the anatomical differences in pediatric airways, such as a larger and stiffer epiglottis and a relatively large tongue.
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