1) Airway Oral Flashcards
What is the pharynx and how is it innervated?
- Nashopharynx (border is soft palate)
- oropharynx (uvula to epiglottis)
- laryngopharynx (epiglottis to cricoid cartilage)
- innervated by glossopharyngeal nerve and vagus nerve
Describe the vocal cords and epiglottic fold
- vocal cords are pearly white on direct laryngoscopy, arteriorly connected to thyroid cartilage, and posteriorly connected to arytenoid cartilages, formed from the thyroarytenoid ligament
- epiglottic opening is the triangular fissure between the vocal cords, possibly the narrowest opening of the adult airway
What is the lower airway consisted of
-trachea, carina, bronchi, bronchioles, terminal bronchioles, respiratory bronchioles, alveoli
Basic questions to ask for PMH for airway?
-anesthesia before, difficult airway, DM, RA, anylosing spondylitis, radiations or burns to neck, tumors or masses, OSA, hoarseness or sore throat, opening mouth or moving neck, dysphasia or stidor, prior trach
Airway setup
-O2 source, suction, PPV (machine or ambu), well fitted mask, tongue depressor, OPA, NPA, LMA, ETT x2, blade (mac + miller), handle, check light, stylet, 20cc syringe, tape
What are advantages/disadvantages of LMA
A: easy to use/insert, lower anesthetic depth, less HD compromise, less SNS stimulation, less incidence sore throat, less coughing on emergence
D: not secure airway, increase incidence of gastric insufflation and aspiration, cannot use with ventilator (use PC), does not protect against laryngospasm
MAC case
- complete airway setup
- everyone gets O2
- SV patient
- nasal airway if snoring
Mask Case
- difficult airway not present
- surgeon does not need airway access
- no bleeding or secretions
- short duration
- no position changes
- SV breathing/no NMBA
- OPA/NPA if obstruction
LMA case
- difficult airway not present
- surgeon does not need access to head/neck
- no bleeding/secretions
- short duration
- no table position changes
- SV patient/ no NMBA used
- OPA/NPA can relieve occlusion
- hands free
