can see only the hard palate
mallampati score of?4can see only the hard palate and soft palate
mallampati score of?3can see the hard palate, soft palate, and uvula
mallampati score of?2can see the hard palate, soft palate, uvula, and tonsils
mallampati score of?1 (BEST)Patil's test measures whatthyromental distancestraight distance b/t the thyroid cartilage and mandibular border with neck extended fully and mouth closed.
-distance < _____ cm associated with difficult intubationthyromental distance
-distance < *6cm* associated with difficult intubation (3 finger widths)distance measured from the upper border of the manubrium to the mentum with the patients neck fully extended and mouth closed
-distance < _____ cm associated with difficult intubationsternomental distance
-distance < *12.5cm* associated with difficult intubationlip bite test and 3-3-2 test mobility of?mandible and assess ability to view airwaysdescribe 3-3-2 rule3: fingers in mouth opening to assess ability to obtain a glottic view
3: fingers between tip of mentum to hyoid bone to test if tongue can be deflected to accommodate a laryngoscope
2: thyromental distance to predict location of larynx to base of tongue: if larynx is high, creates a difficult intubation anglerelaxation of _____ allows tongue to fall into oropharynxgenioglossus musclerelaxation of the ________ muscls results in obstruction of the soft palatetensor palantineconnects oral and nasal cavities with larynx and esophaguspharynxONLY complete cartilage ringcricoid cartilageknown as the "crossroads b/t food and air"larynxhow many larynx cartilage rings? paired/unpaired?9 total; 3 paired, 6 unpairedpyramid shaped posterior structure that abducts and adducts the vocal cordsarytenoid cartilage# of rings in trachea16-20 semi-circular ringssends sensory info to the face and has 3 divisionstrigeminal nerve (CN V)
-3 divisions are opthalamic, maxillary, and mandibularprovides sensory innervation to the posterior 1/3 of tongue, oropharynx, vallecula, and anterior epglottisglossopharyngeal nerve (CN IX)
*afferent limb of gag reflexinterior branch provides sensory info to posterior epiglottis and vocal cords, and external branch provides motor innervation below vocal cordsvagus nerve (CN X)acute injury to ____ or ____ can cause hoarsenessacute injury to *superior laryngeal nerve* or *external branch of vagus nerve* can cause hoarsenessprovides sensory info below vocal cords and trachea, and motor innervation to all intrinsic laryngeal musclesrecurrent laryngeal nerve (RLN)unilateral ______ nerve injury will affect abductors (arytenoids); will result in?unilateral *recurrent laryngeal* nerve injury will affect abductors (arytenoids); will result in? *hoarseness*Bilateral ______ nerve injury will affect abductors (arytenoids); will result in?bilateral *recurrent laryngeal* nerve injury will affect abductors (arytenoids); will result in?
*could close glottis and result in laryngospasm-type event*
*could result in NO air movement at all*use which probe for shallow structureslinear probe (high frequency)
-5-10MHzuse what probe for deep structureslow frequency: phased array or curvilinearphased array probe
frequency:
depth:
use for:phased array probe
frequency: 1-5MHz
depth: 35cm
use for: lungs, pleura, abdomen, heartCurvilinear probe
frequency:
depth:
use for:Curvilinear probe
frequency: 2-5MHz
depth: 30cm
use for: gallbladder, kidney, liver, bladder, uterus, ovaries, aortalinear probe
frequency:
depth:
use for:linear probe
frequency: 5-10MHz (high frequency)
depth: 9cm
use for: arteries, veins, skin, MSK, testicles, eyes, breasts, DVT diagnosisorient U/S transducer to your ____ in transverse view, and _____ in sagittal vieworient U/S transducer to your *LEFT* in transverse view, and *towards patients head* in sagittal viewincreasing depth ____ resolutiondecreasesgain compensates for ____; adjusting gain adjusts _____gain compensates for *attenuation*; adjusting gain adjusts *contrast*B mode imaging"Brightness-mode" imaging displays anatomy in two dimensions on the display screen. The stronger the returning echo, the brighter the corresponding dot is on the display"BART" for doppler U/S means?Blue means
AWAY
Red means
Towardsdiagnostic U/S image results from ____ of sound waves created at the borders of tissues with different densitiesreflections (echoes)defined in Hzfrequencyreflections are created by _____ differences at borders of tissuesacoustic impedencethe greater the acoustic impendeace the _____ the reflectiongreater (brighter)acoustic impedance is a product of the ___ and ____ of sound through tissuesacoustic impedance is a product of the *density* and *propagation velocity* of sound through tissuesbody tissue acoustic impedance most to leastbone > muscle > kidney > blood > liver > fat > lungs > air
bone has MOST acoustic impedance, and air has LEAST
note: greater the acoustic impedance, the greater the reflectiongreatest reflection, and least reflectiongreatest: bone
least: air
because reflection is greater with greater acoustic impedanceex of specular reflectionU/S of wrist: sound reflected off of the smooth bone, and doesnt penetrate very deepoccurs when sound contacts tissues of different densities and various angles and reflection returns at various angles to transducerdiffuse reflection
ex: brachial plexusreflection that occurs at an anglerefractionoccurs when U/S sound wave contacts an abject smaller than the sound wavescatteringanechoic structure examplesveins, arteries, blood : fluid filled structures! (cysts anechoic or hypoechoic)decreasing intensity of a sound wave as it passes through tissuesattenuationhigher frequency waves are attenuated _____ than lower frequency wavesMOREattenuation of tissues most to leastbone > muscle > kidney > liver > fat > blood > waterex of hyperechoic structuresnerves, tendons, pleura, boneex of heterogenous structures seen on U/Smuscle: d/t different acoustic impedancesU/S systems operate under several basic assumptions:1: sound travels exactly 1540m/sec through tissue
2: sound waves travel in a straight line
3: sound waves travel directly to the reflector and back
4: echo intensity corresponds directly to reflection strengththis type of artifact occurs when a needle appears to "bend"bayonetting
-due to passage through tissues of varying densitieswhen sound passes through tissue with low acoustic impedance and contacts tissue with a higher one, it appears more echogenic: this is called?acoustic enhancementwhen sound reflects off 2 strong specular reflectors separated by a thin layer of air or fluid, an illusion of multiple structures is displayed. What is this called?reverberationsound is a longitudinal _____ wavemechanical
-mechanical waves require a medium for transmissionsound waves propagate ____ from the transducerparallelhigh frequency= ____ wavelengthshortpropagation velocity of sound fastest to slowestbone > soft tissue> fat > muscle > liver > kidney > brain> air
air propagates sound SLOWEST
bone propagates FASTEST
(less dense= slower sound travel)propagtion velocity of soft tissue1540m/secsound waves compress and relax, and cause vibrations that can cause a degree of _____backward motion
-the less stiff a medium is, the more backward motion occurs (slows wave proagation)most important component of any U/Spiezoelectric crystalshow sound detects motion= _____ effectdopplerdoppler is dependent on _______the angle of insonationfor doppler function to work, either sender or receiver must be moving (T/F)true. detects motionwhen angle of insonation = 0, _____ effect is obtainedfull effectwhen angle of insonation = 90, _____ effect is obtainedno effectbeam area with greatest resolutionfocal zone (where beam narrows ~2-3cm)doppler labels _____ not arterial/venous bloodflowex hypOechoic structures:cysts, lung parenchyma, fathow can you differentiate nerves and tendons on U/S?scan proximal or distal toward the muscle belly; tendons will become flat and disappearbrightest echo would be created by?
a: bone and muscle
b: kidney and muscle
c: blood and muscle
d: fat and muscleA: bone and muscle (largest difference in acoustic impedanceartifact can be created byproperties of sound, tissue composition, provider technique, and provider interpretation