Procedural Anatomy

Question 1

Cricothyrotomy - What is it and when do we do it?

Answer 1

Incision made to establish a patent airway underneath the level of a laryngeal obstruction, or for long-term mechanical ventilation.

May be necessary in scenarios of severe laryngeal edema, such as anaphylaxis, ACE inhibitor adverse reaction, or croup. Only performed after orotracheal and nasotracheal intubation is unsuccessful or contraindicated (as in hemorrhage, airway obstruction, vomiting)

Question 2

Cricothyrotomy – How do we do it?

Answer 2

Requires incision through:

• The skin
• Superficial cervical fascia (including subcutaneous fat and platysma muscle)
• Investing and pretracheal layers of the deep cervical fascia
• Cricothyroid membrane

Question 3

Superficial anterior neck anatomy

Answer 3

Question 4

Following insertion of a central venous catheter, the next thing you ALWAYS need to do is. . .

Answer 4

. . . get a CXR to make sure you didn’t fuck up the catheterization

Complications: Pneumothorax, pneumomediastinum, bleeding/cardiac tamponade, arterial puncture, arrhythmia

Question 5

Branchial cleft cyst

Answer 5