Mod 13 Bronchoscopy

Question 1

What is the primary purpose of a Bronchoscopy?

Answer 1

To view the airways and check for any abnormalities

Question 2

Insert image for slide 5

Question 3

What Airway anatomy is evaluated/indicated for assessment for Flexible Bronchoscopy?

Answer 3

• Fistulas
• Hemangiomas or tumours
• Stenoses or strictures
• Tracheal bronchus
• Vascular rings
• Congenital anomalies

Question 4

What are indications for Bronchoscopies?

• Insert image from slide 6

Answer 4

• Airway anatomy evaulation
• Biopsy
• Cytopathology
• Microbiology
• Foreign body aspiration
• Functional airway evaluation
• Inhalation injury
• Therapeutic use

Question 5

For diagnostic purposes, what are the most common indications for Bronchoscopy?

Answer 5

• Persistent or recurrent respiratory symptoms (i.e stridor, abnormal voice)
• Persistent abnormalities on CxR

Question 6

Absolute contraindications for bronchoscopy?

Answer 6

• Absence of informed consent
• Cardiovascular instability
• Inability to oxygenate the patient adequately
• Uncontrolled coagulopathy or bleeding
• When risks outweigh benefits

Question 7

Relative contraindications for bronchoscopy s?

Answer 7

• Severe bleeding diatheses or coagulopathy
• Hypercapnia w/acidosis
• hypoxemia
• Severe pulmonary hypertension
• Severe upper airway obstruction
• Severe superior vena cava obstruction
• Uncooperative patient
• Uncontrolled asthma
• Uremia

Question 8

Bleeding control bronchoscopy

Answer 8

epinephrine 1:1000 or cold neb

Question 9

Topical anesthetic for bronchoscopy

Answer 9

Lidocaine

Question 10

What is used for Bronchospasm control in bronchoscopy?

Answer 10

Ventolin

Question 11

Secretion reduction in bronchoscopy

Answer 11

Anticholinergics (atropine)

Question 12

SpO2 goal bronchoscopy

Answer 12

> 95%

Question 13

Saline dose bronchoscopy

Answer 13

3-5 aliquots of 1ml/kg

Question 14

Bronchial brushings

Answer 14

Obtaining a sample of a suspected lesions in the lungs

• Use brush and brush 5-10 times.

Question 15

Adult saline dose bronchoscopy

Answer 15

30-60ml 3-5x

Question 16

BAL (bronchoalveolar lavage)

Answer 16

Bronchoscope wedged into position f selected segment, washed with saline and suctioned out

• Use suction and saline

Question 17

Bronchial biopsy

Answer 17

Used to obtain samples from lesions

• Use alligator clips

Question 18

Complications in bronchial biopsy

Answer 18

Bleeding or pneumothorax

Question 19

Bronchoscopy needle aspiration

Answer 19

Wang needle
allows to get tissue samples otuside surface of bronchioles

Question 20

Rigid bronchoscopy

Answer 20

used to remove obstructions or large amounts of secretions from the respiratory tract

Question 21

Bronchoscopy intubation

Answer 21

Used for difficult or C-spine precautions

Question 22

Monitoring in bronchoscopy

Answer 22

BP, HR, SpO2

• Frequent inspection and auscultation

Question 23

Common location BAL

Answer 23

lingula

Question 24

Common complications bronchoscopy

Answer 24

Cough fever transient hypoxia

Question 25

La Places law

Answer 25

1. As pressure increases, the surface tension increases 2. As radius decreases, pressure and surface tension increase