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76 Cards in this Set
- Front
- Back
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Three (broad) regions of the upper airway: |
Nasal passage Oral cavity Pharynx |
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Function of the nasal passages: |
Filter, humidify, warm |
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Components of the oral cavity: |
Teeth Tongue Hard palate Soft palate |
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Which part of the upper airway is responsive to transmucosal local anesthetics? |
The nasal passage |
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Which part of the upper airway is resistant to transmucosal local anesthetic? |
The oral cavity (specifically the gag reflex) |
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What anatomical boundaries define the pharynx? |
The nose and the cricoid cartilage |
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What anatomical boundary separates the nasopharynx and the oropharynx? |
The soft palate |
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What vertebral levels correlate to the oropharynx? |
C2-C3 |
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What are the three divisions of the pharynx? |
Naso- Oro- Laryngo- |
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What structures can be found in the oropharynx? |
Tonsils Uvula Vallecula Epiglottis |
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How does a Mac blade interact with the anatomy of the pharynx? |
Fits into the vallecula and pulls the tongue forward (along with the epiglottis) |
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How does a Miller blade interact with the anatomy of the pharynx? |
Slides behind the epiglottis and pulls the entire structure forward |
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What vertebral level correlates to the cricoid cartilage? |
C6 |
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Which bumpy structures at the base of the glottic opening can still often be seen in direct laryngoscopy even if the vocal cords are occluded? |
Arytenoids |
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Functions of the vocal cords: |
Airway protection Respiration Phonation |
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The term 'caudad' means: |
Toward the feet |
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The term 'cephalad' means: |
Toward the head |
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To what anterior structure do the vocal cords attach? |
The angles of the thyroid |
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To what posterior structure do the vocal cords attach? |
The arytenoid cartilages |
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What is the narrowest portion of the adult airway? |
The glottic opening |
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What is the narrowest portion of the pediatric airway? |
The cricoid cartilage |
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What is the name of the triangular fissure between the vocal cords? |
The glottic opening |
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What size ETT is typical for a female patient? |
6.5 - 7 |
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What size ETT is typical for a male patient? |
7.5 - 8 |
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Name the 3 paired cartilages in the larynx: |
Arytenoid Corniculate Cuneiform |
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Name the 3 unpaired cartilages in the larynx: |
Thyroid Cricoid Epiglottis |
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What is unique about the cricoid cartilage? |
It is a complete cartilaginous ring |
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Where is the cricoid cartilage located relative to the thyroid cartilage? |
Inferior to the thyroid |
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What structure connects the cricoid and thyroid cartilages? |
The cricothyroid membrane |
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What is the function of the intrinsic laryngeal muscles? |
Movement of the laryngeal parts; alters length/tension, size/shape of vocal cords |
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What nerve innervates all but one of the intrinsic muscles of the larynx? |
The recurrent laryngeal nerve |
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What two branches of the vagus nerve innervate the larynx? |
Superior laryngeal nerve Recurrent laryngeal nerve |
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Which nerve innervates the cricothyroid muscle? |
The external branch of the superior laryngeal nerve |
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Which intrinsic laryngeal muscle is innervated by the superior laryngeal nerve? |
The cricothyroid muscle |
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What nerve innervates the back 1/3rd of the tongue? |
Glossopharyngeal |
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What is the common name for CN IX? |
Glossopharyngeal |
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What nerve innervates the nasal passages? |
Trigeminal |
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What is the common name for CN V? |
Trigeminal |
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Which muscles open and close the glottis? |
Lateral cricoarytenoids Arytenoids Posterior cricoarytenoids |
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Which is the only muscle pair to abduct the vocal cords? |
The posterior cricoarytenoids |
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Which nerve(s) controls the vocal cords' ability to open and close? |
Recurrent laryngeal nerve only |
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Which muscles put tension on the vocal cords? |
Cricothyroid Vocalis Thyroarytenoid |
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Which nerve(s) control(s) the tension put on the vocal cords? |
Recurrent laryngeal nerve AND superior laryngeal nerve (cricothyroid) |
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What are the four extrinsic laryngeal muscles? |
Sternohyoid Thyrohyoid Omohyoid Sternothyroid |
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What are the functions of the extrinsic laryngeal muscles? |
Move the larynx as a whole |
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How do the sternohyoid, thyrohyoid, and omohyoid muscles move the larynx? |
By moving the hyoid bone caudad |
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How does the sternothyroid muscle move the larynx? |
By moving the thyroid cartilage caudad |
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What nerve(s) innervate the lower airway? |
The recurrent laryngeal nerve and the superior laryngeal nerve |
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What is the length/diameter of the adult trachea? |
10-20cm long 22mm diameter |
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How many U-shaped cartilage rings does the trachea have? |
16-20 |
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Which side of the trachea lacks cartilage? |
The posterior |
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At what vertebral level is the bifurcation of the trachea? |
T4-T5 |
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What is the angle and length of the R mainstem bronchus? |
2.5cm at 25º |
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What is the angle and length of the L mainstem bronchus? |
5cm at 45º |
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How do you perform a Mallampati assessment? |
With the patient sitting upright and head neutral; mouth opened as wide as possible and tongue protruding as far as possible. Make assessment when patient is not vocalizing. |
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Mallampati Class I view includes: |
The faucil pillars, soft palate, and all of the uvula. |
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Mallampati Class II view includes: |
Partial view of the uvula (tip is masked by tongue) |
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Mallampati Class III view includes: |
The soft palate and base of the uvula (body/tip of uvula masked by tongue) |
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Mallampati Class IV view includes: |
Only the hard palate |
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Define the thyromental distance: |
The distance from the lower border of the mandible to the thyroid notch, with neck fully extended |
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What is a normal thyromental distance? |
6-6.5cm, or 4 fingerbreadths |
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What thyromental distance indicates a possible difficult intubation? |
Less than 3 fingerbreadths |
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What are the two types of oral airways? |
Berman and Guedel |
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What are the three sizes of Berman and Guedel oral airways? |
Small Berman = Guedel #3 = 80mm Medium Berman = Guedel #4 = 90mm Large Berman = Guedel #5 = 100mm |
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What are the possible complications of using an oral airway? |
Laryngospasm Bleeding Soft tissue damage |
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How are nasal airways measured? |
French sizing for diameter |
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How are nasal airways used with elective nasal intubation? |
Used in series (small to large) to dilate the nasal passageway prior to intubation |
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Are nasal or oral airways better tolerated during light anesthesia? |
Nasal |
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Primary complication of nasal airways: |
Epistaxis |
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Precautions to consider with nasal airways: |
Nasal/basal skull fractures Adenoid hypertrophy Anticoagulation status |
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Two primary types of laryngoscopic blades: |
Macintosh (length 1-4) Miller (length 0-4) |
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What is the most desirable position for the tip of the ETT? |
4cm above the carina and 2cm below the vocal cords |
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For males, what is the usual external measurement for the secured ETT? |
23cm at the teeth |
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For females, what is the usual external measurement for the secured ETT? |
21cm at the teeth |
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Which nerves provide sensory innervation for the airway? |
Glossopharyngeal nerve (CN IX) Internal branch of the superior laryngeal nerve Recurrent laryngeal nerve |
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Which nerves provide motor innervation for the airway? |
External branch of superior laryngeal nerve Recurrent laryngeal nerve |
