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Thoracic Anesthesia and the Respiratory System
Two mind maps on seperate pages:
Page 1: Respiratory System
Page 2: Thoracic Anesthesia
Page 1: Respiratory System
Page 2: Thoracic Anesthesia
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Mallampati
Cor Mc Lehane
improve view
cricoid pressure
decrease LES tone
may obscure view
C/i: vomiting, unstable C-spine
thyroid pressure
BURP maneuver=improve view/grade

upper incisor lenght
maxilla-mandible rel'p
normal jaw closure
jaw protrusion/ prognation
inter incisor distance/ mouth opening
uvula visibility/ mallampati
shape of palate
submandibular space compliance
thyromental distance
neck
length
thickness
range of motion

CVCI
SGA: LMA
Invasive/ surgical airway

tissue ph
acidosis
favors O2 release
alkalosis
P50: 27
Left shift
2,3 DPG
hypothermia
alkalosis
CO poisoning
fetal Hgb: 18-20
right shift
2,3 DPG
hyperthermia
Acidosis
sickle cell
maternal Hgb

indications
air embolism
CO poisoning
Cyanide toxicity
CRAO
toxicity
seizure
tx: decrease iO2
o2 toxicity
tracheobronchial irritation
ARDS
100% O2 x 10-12hrs
sx:
seizures, n/v, twitching
myopia
narrowing visual fields

Altitude
hyperventilation
inc MV(RR+TV)
HPV
pulmonary hypertension
HAPE
HACE
LUNG COMPLIANCE
dynamic complicance
reflect resistance to gas flow
peak airway pressure
decrease: ETT obst., Bronchospasm
Static Compliance
pressure required to hold lungs at end inspiration
plateau pressure
decreased: stiff lungs, pneumonia
change in volume/ change in pressure
OBESITY
normal lung compliance
PFT
decreased
ERV
FRC
rapid desat w/ apnea
increased O2 consumption
TLC
FEV1, FVC
restrictive ventilation
normal FEV1/FVC
supine: TV< closing capacity
OSA
STOP BANG criteria
>3: high risk
OSA vs. OHS
AGING
emphysema-like
RV, FRC
PaO2
alveolar surface area
lung compliance
closing capacity
closing volume
response to CO2 build up
resp. to low O2
chest wall compliance
airway reflexes
LAPAROSCOPY
Pneumoperitoneum
PaCO2-EtCo2 gradient
hypercapnea
respiratory acidosis
pulmonary HPN
compliance
Lung volumes and FRC
Trendelenburg position
migration of ETT
diaphragm compression
peak airway pressure

Parasympathetics
@bronchi and Bronchioles
vagus
Ach M3
bronchoconstrictions
tx: glycopyrrolate, atropine
ipratropium
Sympathetics
B2 adrenergic
bronchodilation
salbutamol
epinephrine
Histamine
H1 receptor
bronchoconstriction
H2 receptor
bronchodilation

inspiratory problem
extrathoracic pathology
expiratory problem
intrathoracic pathology

URTI
airway reactivity
6wks ff. URTI
risk
laryngospasm
bronchospasm
coughing
desturation
predictors of adverse events
airway surgery
hx of asthma
wheezing, rhonchi
passive smoke exposure
purulent/ productive secretions
Respiratory Failure
Acute RF
hypoxemia
hypoventilation
Preoxygenation/ denitrogenation
ETO2 >90%
CPAP/ PS
safe apnea time
FRC
Obese
pregnant
pediatric pt.
shunt physiology
o2 consumption
fever
Airway edema
ACE inhibitor induced
angioedema