OSPE anasthesia pictures slides.........

Exam of anasthesia

1. Anaesthesia – devices &
machines

2. 1.Name the device..

3. Cuffed endotracheal tube

5. Parts of endotracheal tube

7. Uncuffed endotracheal tube

8. Indications of ETT
•Protection from blood during upper respiratory
tract or oral surgery.
•Protection from aspiration of gastric contents in
emergency surgery or patients with full
stomachs, during CPR, or in comatose patients
•During anaesthesia using IPPV and muscle
relaxants.

9. •Operations on the head and neck, e.g. ENT,
dental.
•When a nasotracheal tube may be required.
•To facilitate suction of the respiratory tract.
•An 'unusual' position, e.g. prone or sitting.

10. Complications
•Sore throat,
•Nasal injury
•Oesophageal intubation
•Endobronchial intubation
•Impaction
•Cuff herniation
•Kinking
•Disconnection

11. •Tachycardia or arrhythmia
•Increased blood pressure
•Elevated
 intracranial and introcular pressur
e
•Bronchospasm
•Laryngospasm
•Perforation of the trachea
 or esophagus
•Vocal cord damage or weakness

12. 1.Name the device ..
2.Mention one indication ..

14. 1.Armed or reinforced (or flexometallic) tube
endotracheal tube ..( note the spiral wire
along the tube )
•Intubation in head & neck surgery or
treacheal surgery (resists compression and
kinking , can be curved or angled away from
the field without being obstructed..)
•In the prone position.

17. resists compression and kinking ,
can be curved or angled away from
the field without being obstructed

18. Disadvantage
•Often needs forceps or stylet
•Cannot be shortened
•More frequency of unintentional extubaition
(elastic recoil)

19. 1.Name this devise
2.mention one indication

20. 1. RAE (Ring-Adair-Elwyn)
tube
2. Intubation in Head & neck surgery in
children

26. Advantages
•Fits the mouth or nose without kinking.
•Does not interfere with surgical access: the
bend is located just as the tube emerges so
the connections to the breathing system are
at the level of the chin or forehead.
•Easy to secure: may reduce the risk of
unintentional extubation.

27. Disadvantages
•Higher risk of bronchial intubation than with
ordinary ETT (preformed bend)
•Difficult to pass a suction catheter (preformed
bend)
•Higher resistence

28. 1. Name the devise
2. What is it used for ?

29. •A stylet:
–Made of a malleable metal wire
•To facilitate difficult intubation:
–To strengthen the endotracheal tube during
insertion
–To adjust the tube curvature
–To improve the tube curvature
–To conform the curvature of the tube to the
anatomy of the patient

35. 1.Name this devise
2. mention 2 indications

36. 1.Gum elastic bougie (Eschmann tracheal tube
introducer)
• Has a small "hockey-stick" angle at the
“atraumatic” end
2.Inserted before the endotracheal tube if you
cannot see the vocal cords (blind intubation)
or if the larynx is too anterior (then you pass
the ETT over it)

38. 1. Name this devise
2. Identify its parts

40. 1. Direct laryngoscope
2. Green ; handle ,, yellow ;

42. Complications
•Lacerations of the lips or
 gums or other structures
within the upper airway,
•Chipped, fractured or dislodged teeth
•Tachycardia or arrhythmia
•Increased blood pressure
•Elevated
 intracranial and introcular pressure
•Dislocation of the temporomandibular joint
 or 
•Dislocation of the arytenoid cartilages

43. McCoy Laryngoscope
A laryngoscope blade
with adjustable hinged tip
operated by a lever
mechanism on the back
of the handle
Improves visualisation of
the cords in the setting of
a difficult intubation and
in patients wearing
cervical hard collars.

44. COMPLICATIONS
•trauma of epiglottis if gets caught in hinge of
movable tip

45. 1. Identify the devise
2. Mention one indication

46. 1. Fibro optic scope
2. Used in Intubation when you can`t
see the vocal cords clearly

47. 1. Name this devise
2.Mention 2 indications

48. •Oropharyngeal (Guedel) airway
•Maintains an open airway to facilitate
spontaneous or mask ventilation.
•Allows suction through the mouth

51. Used for
•Short term airway management
•Post anaesthetic
•CPR
•When ETT is either not available or not advisable e.g.
Pre-hospital emergency care
•Used only in unconscious patients: it stimulates the
gag reflex in conscious or semi-conscious persons
vomiting and aspiration and airway obstruction

52. Complications
•Gag-reflex  vomiting and aspiration and
airway obstruction
•When it is too large, it can close the airway
•Trauma

53. Size : from mouth to angle of
mandible

54. Nasopharyngeal airway

55. The device should reach from the patient's nostril
to the earlobe

58. Used for
•Short term airway management
•When ETT is either not available or not advisable e.g.
Pre-hospital emergency care and the patient is
conscious (can’t use an OPA)
•Contraindicated in patients with severe head or
facial injuries, or who have evidence of a fracture
base of the skull, due to the possibility of direct
intrusion upon brain tissue.

59. Complications
•Injuring the nasal mucosa causing bleeding.
This can lead to aspiration of blood or clots.
•If nasal airway doesn’t have flange at the
nasal end can lose airway in nose and the
airway.

60. 1. Name this devise

61. 1. Classic Laryngeal mask airway
LMA Classic™

68. Indications
•To maintain a patent airway to facilitate
spontaneous breathing or ventilation e.g. during
GA
•Temporizing measure in patients with difficult
airways (those who cannot be ventilated or
intubated)
•To facilitate passage of an ETT in a patient with a
difficult airway.

69. Advantages
•More secure than a face mask
•Allows single-handed ventilation
•Rapid, blind insertion (no laryngoscopy)

71. Contraindications
•Increased aspiration risk
–Full stomach
–Intestinal obstruction
–Severe gastrointestinal reflux disease
–Diabetes with gastroparesis
–Pregnancy, particularly second and third trimester
•Patients with pharyngeal pathology (eg, abscess)
•Pharyngeal obstruction

72. •Where surgical access (e.g. to the pharynx) is
impeded by the cuff of the LMA.
•Significantly reduced pulmonary compliance
•Major trauma to maxilla, mandible, or larynx
•Unstable cervical spine
•Unusual operative positioning; particularly
prone position
•Tracheoesophageal fistula

73. Compared with face mask
•Advantages:
–Hands-free operation
–Better seal in bearded patients
–Less cumbersome in ENT surgery
–Often easier to maintain airway
–Protects against airway secretions
–Less facial nerve and eye trauma
–Less operating room pollution

74. •Disadvantages:
–More invasive
–More risk of airway trauma
–Requires new skill
–Deeper anesthesia required
–Requires some TMJ mobility
–N
2O diffusion into cuff
–Multiple contraindications

75. Compared with tracheal
intubation
•Advantages
–Less invasive
–Very useful in difficult intubations
–Less tooth and laryngeal trauma
–Less laryngospasm and bronchospasm
–Does not require muscle relaxation
–Does not require neck mobility
–No risk of esophageal or endobronchial
intubation

76. •Disadvantages:
–Increased risk of gastrointestinal
aspiration
–Less safe in prone or jackknife
positions
–Limits maximum PPV
–Greater risk of gas leak and pollution
–Can cause gastric distention

77. 1.Name this devise
2. what is the use of the 2 tubes

80. Proseal

81. 1. Name this device
2.Mention one use

82. •Suction machine (suction unit or aspirator)
•suction nozzle (Yankauer suction tip)

83. Suction nozzle

85. •Suction of secretions & blood from mouth

86. 1. What is this devise
2. Mention one indication
3. Mention one complication of that
procedure

88. •1.Spinal needle
2. spinal anasthesia
3. hypotention , spinal headache ,hematoma
cord compression & paralysis

89. 1. Monitor
2. identify the graphs (arrows)

90. 1.monitre
2. green : ECG , blue : pulse, yellow :
capnograph

91. 1.Name the devise
2. what is it used for

92. •1. Anaesthetic vaporizer
2. Add the required concentration of a volatile
anaesthetic agent to the gas mixture.
•Induction of inhalational anaesthesia
•Maintenance of anaesthesia

93. 1.Name the devise

94. 1.Flowmeter

95. 1. Name this devise
2.What is it used for

96. 1. Anaesthetic Ventilator
2.Ventilation of pt during general
anaesthesia

97. 1.Identify
2.purpose of use

98. •1.Soda lime
2.Absorb & react with CO
2 from the gas
exhaled by the patient into the breathing
system (circle system), producing water
•CO
2 + Ca(OH)
2  CaCO
3 + H
2O + heat

100. 1.Name this devise
2. what is it used for ?

101. •Reservoir bag
•Indicates that the pt is breathing ,,
•Used to ventilate the patient
•Reservoir for the gas mixture

102. 1.Identify this
2. mention 2 uses

103. 1.NG tube (feeding tube ) small size
2. suction ,, feeding

104. 1.Identify the device ?
2. mention its use

105. •1.Magill forceps
•
2.To:
•Assist nasotracheal intubation
•Remove foreign bodies from the mouth and
throat
•Insert a throat pack

106. 1.Identify the device?
2. mention its uses

107. 1.face mask
2.Delivers anaesthetic gases, oxygen, etc. to the patient’s airways (nose and mouth)
1.Induction of anesthesia
2.Maintenance
3.giving oxygen in the recovery phase
4.CPR
5.Respiratory failure

109. Oxygen mask

110. •Oxygen mask
•Delivers supplementary oxygen to a
spontaneously breathing patient
•Hypoxia
•In recovery
•Respiratory failure

111. 1.Identify the device

112. Nasal canula

114. •Nasal cannula
•Delivers supplementary oxygen to a
spontaneously breathing patient
•Hypoxia
•Sedation
•Spinal anaesthesia

115. بينأ هيلإ و تلكوت هيلع للهاب لاا يقيفوت ام و