Chapter 51. What Is Unique About the Obstetrical Airway?
Which of the following statements about correct identification of the cricothyroid membrane (CTM) is NOT true?
A. It is easier to establish in male versus female patients.
B. It is more easily achieved by palpation than ultrasound in obese patients.
C. It is important to establish pre-induction in patients with risk factors for difficult intubation.
D. It is vital for successful performance of a surgical airway.
E. Obesity makes identification more challenging.
(B) Identification of the CTM is easier in female versus male patients irrespective of body habitus. Obesity makes identification more challenging irrespective of gender but use of ultrasound is more successful than palpation in these patients. Identification of the CTM ahead of time in patients with risk factors for difficult intubation is good preparation for successful placement of a surgical airway should it be necessary.
Which of the following respiratory changes associated with pregnancy are true?
A. an increase in oxygen consumption
B. a decrease in functional residual capacity (FRC)
C. an increase in minute ventilation
D. rapid oxygen desaturation
(E) All of the listed respiratory changes associated with pregnancy are true.
All of the following are known airway changes associated with pregnancy EXCEPT
A. Generalized edema of the oropharynx and nasopharynx.
B. Voice changes are common due to swelling of the false vocal cords and arytenoids.
C. Preeclampsia, fluid overload, and bearing down can all exacerbate airway edema.
D. Mallampati classification of the oropharyngeal space has been reported to advance by one or two classes during labor.
E. All the airway changes return to pre-labor state within 12 hours postpartum.
(E) Airway edema, swelling, voice change, higher Mallampati grade during labor are known airway changes associated with pregnancy, worsened by preeclampsia, fluid overload, and bearing down. However, these changes do not return to pre-labor state within 12 hours postpartum.