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Questions and Answers
What is the primary effect of changing the radius of a catheter on fluid flow rates?
What is the primary effect of changing the radius of a catheter on fluid flow rates?
Which of the following statements about isotonic fluids is true?
Which of the following statements about isotonic fluids is true?
What is a potential risk when using glucose-containing solutions for fluid replacement?
What is a potential risk when using glucose-containing solutions for fluid replacement?
Which factor is indirectly proportional to fluid flow according to Poiseuille's Law?
Which factor is indirectly proportional to fluid flow according to Poiseuille's Law?
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During surgery, what physiological response is likely to occur regarding blood sugar levels?
During surgery, what physiological response is likely to occur regarding blood sugar levels?
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What environmental factor is crucial to consider when managing a patient with sickle cell during anesthesia?
What environmental factor is crucial to consider when managing a patient with sickle cell during anesthesia?
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Which congenital abnormality is most likely to cause projectile vomiting in infants due to gastric outlet obstruction?
Which congenital abnormality is most likely to cause projectile vomiting in infants due to gastric outlet obstruction?
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Which factor most significantly affects heart rate in infants experiencing respiratory distress?
Which factor most significantly affects heart rate in infants experiencing respiratory distress?
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What airway evaluation technique is most critical prior to induction of a patient with severe respiratory distress?
What airway evaluation technique is most critical prior to induction of a patient with severe respiratory distress?
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What is the recommended anesthetic implication for a patient with hyperchloremic metabolic alkalosis?
What is the recommended anesthetic implication for a patient with hyperchloremic metabolic alkalosis?
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How does metabolic alkalosis in preoperative patients affect their response to CO2 levels?
How does metabolic alkalosis in preoperative patients affect their response to CO2 levels?
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In managing postoperative respiratory depression, which complication is most directly linked to preoperative alkalosis?
In managing postoperative respiratory depression, which complication is most directly linked to preoperative alkalosis?
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What is a standard procedure for supervising the placement of a Broviac or Mediport?
What is a standard procedure for supervising the placement of a Broviac or Mediport?
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When dealing with children who are' hyperventilating due to discomfort, what is the key factor to manage their respiratory status?
When dealing with children who are' hyperventilating due to discomfort, what is the key factor to manage their respiratory status?
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In emergency cases of severe dehydration from vomiting, which electrolyte imbalance should be addressed first?
In emergency cases of severe dehydration from vomiting, which electrolyte imbalance should be addressed first?
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What is a key reason for managing oxygen levels in pediatric patients during anesthesia?
What is a key reason for managing oxygen levels in pediatric patients during anesthesia?
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Which intervention is least effective for managing upper airway obstruction in pediatric patients?
Which intervention is least effective for managing upper airway obstruction in pediatric patients?
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During extubation of a pediatric patient, which factor is crucial to ensure?
During extubation of a pediatric patient, which factor is crucial to ensure?
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What are the signs of severe laryngospasm in a patient?
What are the signs of severe laryngospasm in a patient?
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Which management technique is preferred for ventilation in pediatric patients due to being more gentle?
Which management technique is preferred for ventilation in pediatric patients due to being more gentle?
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In which scenario should deep extubation be avoided?
In which scenario should deep extubation be avoided?
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What should be done prior to repositioning a pediatric patient with an ETT in place?
What should be done prior to repositioning a pediatric patient with an ETT in place?
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When managing respiratory distress in pediatrics, what is a recommended physiological PEEP setting?
When managing respiratory distress in pediatrics, what is a recommended physiological PEEP setting?
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What is the impact of environmental factors such as room temperature on neonates?
What is the impact of environmental factors such as room temperature on neonates?
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Which airway evaluation technique is often necessary to manage pediatric airway complications?
Which airway evaluation technique is often necessary to manage pediatric airway complications?
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Study Notes
Pediatric Airway Anatomy
- The head is proportionally larger compared to the rest of the body in infants, with a larger occiput.
- Infants are in a flexed position due to the lack of muscle tone and the weight of the head.
- Infants are obligate nose breathers for the first year of life.
- Infant nostrils are smaller compared to the trachea.
- The tongue is proportionally larger in infants.
- The oropharynx is smaller in infants.
- The larynx is higher in relation to the cervical spine in infants compared to adults.
- The airway is more conical in shape in infants.
- The cords have a concave appearance and slant down and forward in infants.
- The cricoid cartilage is the narrowest part of the airway in infants.
- The epiglottis is larger and stiffer in infants compared to adults.
- The hyoid bone pushes the tongue and epiglottis to the pharyngeal cavity, causing a more horizontal position of the epiglottis.
- Vocal cords in infants slant downward from posterior to anterior.
- Infant's major airways are shorter and narrower.
- Mainstem bronchi divide more equally in infants.
- The right mainstem bronchus is more likely to be the site of endotracheal tube (ETT) placement due to the decreased angle.
Pediatric Airway Clinical Implications
- The ETT size should be smaller in infants with a micro-cuff (size 3-3.5) if there is no cuff, to avoid the mainstem.
- The cuff should be inflated 20cmH2O to avoid inflating the stomach during intubation.
Pediatric Airway Considerations
- Pre-cordial should be used to assess ETT placement.
- Airway resistance is significantly increased in infants due to edemas.
- Edema in the airway in infants, and the associated reduction in cross sectional area can decrease the airway by 75% compared to an adult.
- Infants have 5-7x greater resistance to airflow compared to adults.
- Infants breathe through the nose until 3-6 months old, or longer for preemies.
- Respiratory control in infants is less responsive to changes.
- Infants have higher metabolic rates and oxygen needs.
- There's a higher risk of nasal obstruction, aspiration, intubating a bronchus, and increased edema in the airways for infants concerning intubation.
- Infants have smaller airways with a less acute angle, more soft tissue, and active lymph tissue.
- Larynx is more anterior and larger with slanted vocal cords.
- Epiglottis is proportionately large, short, stiff with U-shape.
- Fewer alveoli and collateral airways.
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Description
Test your knowledge on the unique features of pediatric airway anatomy. This quiz covers essential characteristics of infant airways, including structural differences and implications for breathing and intubation. Perfect for medical students or healthcare professionals working with infants.
