"Big Airway Lecture"
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Questions and Answers

What is the primary function of the nose in the respiratory system?

  • To assist in the sense of smell
  • To filter out particulate matter from the air
  • To warm and humidify air (correct)
  • To aid in speech production

    • Which structure is NOT found in the oropharynx?

  • Uvula
  • Palatine tonsil
  • Thyroid cartilage (correct)
  • Epiglottis

    • Where is the larynx located in the body?

  • Between the first and fifth cervical vertebrae
  • Between the first and third cervical vertebrae
  • Between the third and sixth cervical vertebrae (correct)
  • Between the second and fourth cervical vertebrae

    • Which structure is responsible for resistance to airflow in the respiratory system?

    <p>Nasopharynx</p> Signup and view all the answers

    What is not an advantage of supraglottic airways (SGA) compared to face mask ventilation?

    <p>Less risk of facial nerve trauma</p> Signup and view all the answers

    What is a relative contraindication for using a supraglottic airway in the elective setting?

    <p>Full stomach</p> Signup and view all the answers

    Which SGA device has a second lumen that acts as an esophageal vent?

    <p>LMA ProSeal</p> Signup and view all the answers

    What is the main purpose of raising a patient's head for the sniffing position?

    <p>To optimize the laryngeal axis</p> Signup and view all the answers

    What is a disadvantage of using an SGA compared to an endotracheal tube (ETT)?

    <p>Limits maximum positive pressure ventilation (PPV)</p> Signup and view all the answers

    What is a common complication of extubation?

    <p>Laryngospasm</p> Signup and view all the answers

    What is the main purpose of the LMA Fastrach device?

    <p>To allow for blind intubation through LMA</p> Signup and view all the answers

    What type of patients may have difficulty being positioned in the sniffing position?

    <p>Obese patients</p> Signup and view all the answers

    What should be performed before extubation to ensure adequate muscle reversal?

    <p>Train of four ratio &gt;0.9 (four strong twitches)</p> Signup and view all the answers

    Which of the following is not a complication associated with the LMA?

    <p>Tonsillar displacement</p> Signup and view all the answers

    What is the primary role of the Combitube in airway management?

    <p>Esophageal obturator function</p> Signup and view all the answers

    What technique is used for positioning the double-lumen tube and bronchial blocker during fiberoptic laryngoscopy?

    <p>Positioning the targets in the center of view</p> Signup and view all the answers

    What is a potential complication of translaryngeal nerve block?

    <p>Complete airway obstruction</p> Signup and view all the answers

    What is the purpose of using a bougie during intubation?

    <p>Maintaining shape of the endotracheal tube (ETT)</p> Signup and view all the answers

    What is indicated by a localized glow when using a lighted stylet for intubation?

    <p>Tracheal position</p> Signup and view all the answers

    What is a key feature of the Glidescope in airway management?

    <p>Ability to see 'around a corner'</p> Signup and view all the answers

    What type of block anesthetizes below the vocal cords and stimulates cough reflex?

    <p>Translaryngeal block</p> Signup and view all the answers

    What type of block anesthetizes inferior aspect of epiglottis to vocal cords?

    <p>Superior Laryngeal Nerve Block</p> Signup and view all the answers

    Which laryngoscope is recommended for minimal neck movement and/or small mouth opening?

    <p>Bullard rigid indirect laryngoscope</p> Signup and view all the answers

    What is the start position for the Bullard technique?

    <p>With the Bullard handle close to the chest and the tip within the mouth</p> Signup and view all the answers

    In which situation is percutaneous airway insertion necessary?

    <p>When noninvasive techniques fail to relieve the 'cannot intubate, cannot ventilate' situation</p> Signup and view all the answers

    What is advantageous about surgical cricothyrotomy compared to tracheotomy?

    <p>It is advantageous to tracheotomy due to the superficial nature of the membrane being relatively avascular</p> Signup and view all the answers

    What is a serious problem that can occur during retrograde intubation/ Seldinger cricothyrotomy?

    <p>Kinking of the guidewire</p> Signup and view all the answers

    What happens if low pressure systems are used for percutaneous translaryngeal jet ventilation?

    <p>They do not provide enough flow to expand the chest adequately</p> Signup and view all the answers

    What syndrome is characterized by micrognathia, glossoptosis, and a cleft soft palate?

    <p>Pierre Robin syndrome</p> Signup and view all the answers

    Which condition is associated with absent thyroid tissue or defective synthesis of thyroxine?

    <p>Cretinism</p> Signup and view all the answers

    What is a characteristic of Down syndrome related to the airway?

    <p>Macroglossia</p> Signup and view all the answers

    What disease is characterized by muscle deposits and macroglossia?

    <p>Pompe disease</p> Signup and view all the answers

    What condition is characterized by an increased incidence of pheochromocytoma and tumors in the larynx and right ventricle outflow tract?

    <p>Von Recklinghausen disease</p> Signup and view all the answers

    Which syndrome is characterized by stiff joints and upper airway obstruction due to infiltration of lymphoid tissue?

    <p>Hurler/Hunter syndrome</p> Signup and view all the answers

    Which cartilage is the only complete ring of the trachea?

    <p>Cricoid</p> Signup and view all the answers

    What is the primary function of the vocal cords in the adult airway?

    <p>Generating sound</p> Signup and view all the answers

    Which nerve provides sensory innervation to both sides of the epiglottis and airway mucosa above the vocal cords?

    <p>Superior laryngeal nerve</p> Signup and view all the answers

    Which muscle is responsible for abducting the vocal cords?

    <p>Posterior Cricoarytenoid</p> Signup and view all the answers

    What is a likely symptom of unilateral injury to the recurrent laryngeal nerve?

    <p>Hoarseness</p> Signup and view all the answers

    What is the main indication for using an oral endotracheal tube (ETT) in airway management?

    <p>Provide a patent airway</p> Signup and view all the answers

    What should be done before passing the laryngoscope blade into the hypopharynx during direct visual laryngoscopy (DVL)?

    <p>Hyper-oxygenate the patient with 100% oxygen for 2 minutes</p> Signup and view all the answers

    What is a contraindication for using nasal airways in airway management?

    <p>Coagulation abnormalities</p> Signup and view all the answers

    What does a Cormack & Lehane Grade II laryngoscopy view show?

    <p>Only the posterior portion of the glottis is visible</p> Signup and view all the answers

    What of the following blades could be used on an adult?

    <p>Miller #2</p> Signup and view all the answers

    How is the size of an endotracheal tube (ETT) determined?

    <p>By lengthwise cm markings</p> Signup and view all the answers

    When should cricoid pressure be released?

    <p>When the ETT is correctly placed</p> Signup and view all the answers

    What is a contraindication for nasal endotracheal intubation (NETT)?

    <p>Nasal foreign bodies</p> Signup and view all the answers

    What equipment is required for nasal endotracheal intubation (NETT)?

    <p>Magill forceps and nasal vasoconstrictor</p> Signup and view all the answers

    What is a potential complication of laryngoscopy?

    <p>Retropharyngeal dissection</p> Signup and view all the answers

    What is the purpose of using a bougie during intubation?

    <p>To guide the endotracheal tube through the vocal cords</p> Signup and view all the answers

    What is NOT a risk of aspiration during intubation?

    <p>Hemodialysis</p> Signup and view all the answers

    Study Notes

    Respiratory System and Airway Management

    • The primary function of the nose in the respiratory system is to filter, warm, and humidify the air before it enters the lungs.
    • The oropharynx does not contain the epiglottis; it primarily includes the soft palate, uvula, and posterior tongue.
    • The larynx is located in the neck, lying between the pharynx and trachea, and plays a crucial role in voice production and protection of the airway.
    • Turbinates are structures responsible for resistance to airflow in the respiratory system, increasing air turbulence and conditioning.
    • A disadvantage of supraglottic airways (SGA) compared to face mask ventilation is limited control of ventilation and inability to secure the airway as effectively as an endotracheal tube.
    • A relative contraindication for using a supraglottic airway in elective settings includes the presence of gastrointestinal obstruction.
    • The LMA (Laryngeal Mask Airway) has a second lumen that functions as an esophageal vent to prevent gastric inflation.
    • Elevating a patient's head for the sniffing position optimizes the alignment of the oral, pharyngeal, and laryngeal axes for easier intubation.
    • A common complication of extubation is airway obstruction due to edema or residual secretions.
    • The main purpose of the LMA Fastrach device is to facilitate rapid intubation in difficult airway scenarios.
    • Patients with obesity or limited cervical spine mobility may struggle to assume the sniffing position effectively.
    • Prior to extubation, it is essential to ensure adequate reversal of neuromuscular blockade to allow for spontaneous breathing.
    • The LMA is typically not associated with aspiration; this is one of its advantages in airway management.
    • The Combitube is primarily used for airway management in cases of unknown or difficult intubation situations.
    • The double-lumen tube and bronchial blocker are positioned using the fiberoptic laryngoscopy technique for precise placement.
    • A potential complication of translaryngeal nerve block includes inadvertent injury to surrounding structures, leading to additional complications.
    • During intubation, a bougie is utilized to navigate difficult airways and guide the placement of an endotracheal tube.
    • A localized glow observed with a lighted stylet during intubation indicates proper placement near the tracheal opening.
    • The Glidescope provides a better visual angle for intubation, enhancing visualization in challenging cases.
    • A superior laryngeal nerve block affects sensation below the vocal cords while stimulating the cough reflex.
    • A recurrent laryngeal nerve block anesthetizes the region from the inferior aspect of the epiglottis to the vocal cords.
    • The McGrath laryngoscope is recommended for patients requiring minimal neck movement or those with small mouth openings.
    • The start position for the Bullard technique involves the patient being placed supine with their neck in a neutral position.
    • Percutaneous airway insertion becomes necessary in cases of severe obstruction or failure to intubate quickly.
    • Surgical cricothyrotomy is advantageous due to its quicker access compared to a tracheotomy in emergency scenarios.
    • Serious complications during retrograde intubation/Seldinger cricothyrotomy can include injury to the surrounding vessels or tissues.
    • Using low-pressure systems during percutaneous translaryngeal jet ventilation may lead to inadequate ventilation and hypoxia.
    • Pierre Robin syndrome is characterized by micrognathia, glossoptosis, and a cleft soft palate, affecting airway management.
    • Congenital hypothyroidism is associated with absent thyroid tissue or impaired synthesis of thyroxine.
    • Down syndrome features can include potential airway obstruction due to anatomical variations such as macroglossia.
    • Beckwith-Wiedemann syndrome is marked by muscle deposits and macroglossia, leading to potential airway challenges.
    • Multiple Endocrine Neoplasia (MEN) syndrome is associated with a higher incidence of pheochromocytomas and laryngeal tumors.
    • Systemic sclerosis can lead to stiff joints and upper airway obstruction due to lymphoid tissue infiltration.
    • The cricoid cartilage is the only complete ring of the trachea, providing structural support.
    • The primary function of the vocal cords is to modulate airflow and produce sound during phonation.
    • The internal branch of the superior laryngeal nerve provides sensory innervation above the vocal cords and to the epiglottis.
    • The posterior cricoarytenoid muscle is responsible for abducting the vocal cords, crucial for breathing.
    • Unilateral injury to the recurrent laryngeal nerve may result in hoarseness or breathiness due to vocal cord immobility.
    • The main indication for using an oral endotracheal tube (ETT) is for secure airway access and ventilation during surgical procedures.
    • Before passing the laryngoscope blade into the hypopharynx during direct visual laryngoscopy (DVL), proper positioning and neck extension should be ensured.
    • A contraindication for using nasal airways includes facial trauma or suspected basilar skull fracture.
    • Cormack & Lehane Grade II laryngoscopy view shows partial visualization of the vocal cords, indicating moderate difficulty.
    • Miller and Macintosh blades can be used on adults for laryngoscopy, depending on the preferred technique.
    • The size of an endotracheal tube (ETT) is generally calculated based on the patient's age or suitable airway diameter.
    • Cricoid pressure should be released during the intubation process once tube placement is confirmable and ventilation is assured.
    • Contraindications for nasal endotracheal intubation (NETT) include nasal fractures or severe coagulopathy.
    • Equipment required for NETT includes nasal tubes, a laryngoscope, and lubricating jelly for easier passage.
    • Potential complications of laryngoscopy may include dental injury, airway trauma, or difficulty in visualization.
    • Bougies assist in intubation by acting as a guide for the ETT, especially in difficult airways.
    • No risk of aspiration occurs with tight and proper positioning of the ETT during intubation, given secured placement.

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    Big Airway Lecture- Students .pptx

    Description

    Test your knowledge on the sniffing position and its impact on airway alignment during intubation. Explore the controversies and benefits associated with the sniffing position, as well as its effects on pharyngeal patency in patients with sleep apnea.

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