Pre-anaesthetic Evaluation & Airway · NEET PG Preparation Anaesthesia
A patient with severe rheumatoid arthritis involving the cervical spine presents for total knee replacement. During pre-anaesthetic evaluation, which…
Practice question from Pre-anaesthetic Evaluation & Airway (NEET PG Preparation Anaesthesia), with the correct answer and a step-by-step solution.
hard · MCQ · Q-4728E4
A patient with severe rheumatoid arthritis involving the cervical spine presents for total knee replacement. During pre-anaesthetic evaluation, which specific airway-related pathology must be carefully screened for to prevent neurological injury during direct laryngoscopy?
- A.Temporomandibular joint ankylosis
- B.Atlantoaxial instabilityCorrect answer
- C.Cricoarytenoid joint fixation
- D.Macroglossia
Solution
Rheumatoid arthritis frequently involves the cervical spine, leading to atlantoaxial subluxation/instability. Extension of the neck during direct laryngoscopy and intubation can cause anterior displacement of the atlas on the axis, compressing the spinal cord and causing quadriplegia or respiratory arrest. Screening includes lateral cervical spine radiographs in flexion and extension.
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