Airways

Front 1

The single cartilages of the airway:

Back 1

Thyroid, cricoid, and Epiglottis

Front 2

Paired cartilages:

Back 2

Arytenoids, cuneiform, corniculate,

Front 3

The only complete ring of cartilage in the airway:

Back 3

Cricoid cartilage

Front 4

Narrowest part of pediatric airway

Back 4

Cricoid cartilage (reason why cuffed tubes are not always necessary)

Front 5

Narrowest part of adult airway:

Back 5

Glottis

Front 6

What are the 5 functions of the nose and nasal passages?

Back 6

Respiration
Olfaction
Humidification
Filtration
Phonation

Front 7

The nose has a high potential for _____ because _____

Back 7

Bleeding, large blood supply from arteries and veins, friable tissue

Front 8

The _______ is a structure of the ethmoid bone that, if disrupted, can lead from the nose into the brain

Back 8

Cribriform plate

Front 9

If considering a nasal airway (NP or NT), the nose should be ______ with ______

Back 9

Prepped with phenylephrine and lidocaine

Front 10

How can potential bleeding complications with nasal airways be avoided?

Back 10

Phenylephrine

Front 11

A nasal airway should always be inserted _____ to the patients face

Back 11

Perpendicularly- go straight back

Front 12

Three factors that might limit ability to nasally intubate:

Back 12

Bleeding
Deviated septum
Enlarged adenoids

Front 13

The base of the tongue is attached to:

Back 13

Hyoid bone

Front 14

Blood supply to the tonsils is from:

Back 14

Tonsillar branch of the facial artery

Front 15

The space between the medial and lateral glossoepiglottic folds:

Back 15

Vallecula (depression)

Front 16

When using a MAC blade, the tip of the blade is placed into _______

Back 16

the vallecula

Front 17

When using a MAC blade, the epiglottis is lifted ______ by ______

Back 17

Indirectly by tension on associated structures that pulls the epiglottis up out of the way

Front 18

The adult larynx is located at the level of the ______

Back 18

3-6th cervical vertebrae

Front 19

The anterior boundary of the larynx is the:

Back 19

Epiglottis

Front 20

The posterior boundary of the larynx is the :

Back 20

Arytenoid cartilages and mucous membranes

Front 21

The lateral boundaries of the larynx is the :

Back 21

aryepiglottic folds

Front 22

The cricoid cartilage is shaped like:

Back 22

A signet ring (broad lamina posteriorly and narrow arch anteriorly)

Front 23

The cricothyroid cartilate/membrane:

Back 23

Connects the cricoid and thyroid cartilages, is the site of emergency cricothyrotomy

Front 24

The epiglottis is ____ shaped, and very ____

Back 24

Leaf shaped, very flexible

Front 25

The epiglottis is made of elastic tissue, so never ossifies. For this reason, the epiglottis of a child is _____ and an older adult is_____

Back 25

Children: relatively firm, older adults floppy

Front 26

The epiglottis is connected by ligaments from its stalk to ______

Back 26

the back of the thyroid cartilage

Front 27

Small, pyramid shaped cartilages of the airway

Back 27

Arytenoids

Front 28

The apex of each arytenoid serves as the posterior attachment for the ______

Back 28

aryepiglottic fold

Front 29

The arytenoid cartilages articulate with :

Back 29

Corniculate cartilages

Front 30

The ______ bridge the area between the sides of the epiglottis and the arytenoid cartilages

Back 30

Aryepiglottic folds

Front 31

Which muscles abduct the vocal cords

Back 31

Posterior cycoarytenoid

Front 32

Which muscles adduct the vocal cords?

Back 32

Lateral crycoarytenoid

Front 33

The _______ muscles keep the vocal cords from collapsing

Back 33

posterior crycoarytenoid

Front 34

What nerves are responsible for innervation of the tongue?

Back 34

Lingual nerve (branch of cranial nerve V- Trigeminal)provides sensation to anterior 2/3 of tongue; IX (glossopharyngeal) innervates posterior 1/3

Front 35

What are the borders of innervation of the Superior Laryngeal nerve?

Back 35

The base of the tongue to the larynx

Front 36

The internal branch of the Superior laryngeal nerve is ______, the external branch is _____

Back 36

Internal sensory, external motor

Front 37

The Vagus nerve branches into the _____ and _____ to innervate the airway

Back 37

Superior Laryngeal Nerve and Recurrent Laryngeal Nerve

Front 38

Muscular innervation (motor) of the airway is controlled by which cranial nerve (except for the palatoglossus muscle_?

Back 38

Hypoglossal (CN XII); vagus (external branch of the superior laryngeal nerve) supplies the palatoglossus muscle

Front 39

What nerve is responsible for taste>

Back 39

VII (Facial)

Front 40

The ______ nerve supplies sensory innervation to the larynx and trachea below the vocal cords

Back 40

Recurrent laryngeal nerve

Front 41

What cranial nerve is responsible for smell?

Back 41

CN I (Olfactory)

Front 42

CN V (Trigeminal) provides innervation to:

Back 42

opthalmic and maxillary divions if CN V provide inntervation to the nasal mucosa(by means of anterior ethmoidal, nasopalatine, and sphenopalatine nerves); Palatine Nerve innervates the hard and soft palate, and the mandibular division firns the Lingual nerve, which provides sensation to the anterior 2/3 of tongue

Front 43

Stimulation of what nerve can cause laryngospasm?

Back 43

Superior laryngeal nerve- causes involuntary closure of cords

Front 44

What things can cause laryngospasm?

Back 44

Blood, secretions, swelling that trigger the Superior Laryngeal Nerve

Front 45

The external branch of the Superior Laryngeal nerve innervates the ______, and causes changes in ______ in response to laryngospasm

Back 45

Cricothyroid muscle, results in changes in phonation (squeaky)

Front 46

What steps do you take to break laryngospasm?

Back 46

Positive pressure with 100% O2 (close APL and hold bag squeezed) and good mask seal, pressure on the mastoid process, and if all else fails, can give 1/4 dose of succinylcholine= 0.25 mg/kg)

Front 47

When providing a regional airway block for an awake intubation, the landmark for the Superior Laryngeal Nerve is ________

Back 47

The hyoid bone

Front 48

The three paired cartilages of the airway

Back 48

Arytenoid, cuneiform, corniculate

Front 49

What forms the border between the oropharynx and the hypopharyns?

Back 49

The epiglottis

Front 50

What nerve controls the muscles that adduct and abduct the vocal cords?

Back 50

The recurrent laryngeal nerve

Front 51

The carina overlies the_____

Back 51

5th thoracic vertebrae

Front 52

In a Mallampati Class I airway, what structures are visible?

Back 52

Soft palate, fauces, uvula, and tonsillar pillars

Front 53

In a Mallampati Class II airway, what structures are visible?

Back 53

Soft palate, fauces, some uvula

Front 54

An interincisor distance less than _____ is correllated with a difficult airway

Back 54

3cm

Front 55

A thyromental distance less than ______ is correllated with a difficult airway

Back 55

6-7 cm (3 fingerbreadths)

Front 56

What 4 factors are an imperative part of an airway assessment for intubation? What other things are important to take note of?

Back 56

1. Mallampati Class
2. Thyromental distance and compliance
3. Mouth opening
4. Atlooccipital joint mobility
Others: neck thickness, sternomental distance (neck length), shape of palate, ability to bring lower teeth in front of upper teeth, overbite, length of incisors, hx sleep apnea, body habitus

Front 57

What to the Cormack and Lehane scores (laryngeal view) mean?

Back 57

I: All or almost all of the glottis is visible
II. Only the posterior portion of the glottis is visible
III. Only the epiglottis can be seen (no glottis)
IV: No airway structures are visualized

Front 58

Predictors of difficult facemask ventilation:

Back 58

1. Age greater than 55 (large nose + increased airway resistance)
2. BMI > 26
3. Beard
4. No teeth
5. History of snoring