10. Larynx Anatomy & Pathology Flashcards
spinal level of inferior end of larynx
c6- lower border of cricoid cartilage
is the hyoid bone part of the larynx?
no, but larynx is suspended from it
what type of joints are between laryngeal cartilages?
synovial
what forms the margins of laryngeal inlet?
aryepiglottic folds and upper edge of epiglottis
what’s an aryepiglottic fold?
free upper border of quadrangular membrane
supra glottis
laryngeal inlet up to and includes fans vocal cords
glottis
true vocal cords to 1cm below
infra glottis
below true vocal cords to inferior boundary of cricoid
where does a laryngoscope sit?
valecula
why need a laryngoscope for ET tube?
to view vocal cords so ET tube goes into infraglottic region
on swallowing, why is epiglottis flattened horizontally?
so bolus diverts over top into piriform fossa, and away from laryngeal inlet
position of VCs on swallowing
adducted
larynges inlet also narrowed by muscles in aryepiglottic folds
which muscle increases vocal cord tension?
cricothyroid
external branch of superior laryngeal nerve is closely related to which artery? what surgery risk damage to it?
superior thyroid artery
thyroid surgery
sensory function of superior laryngeal nerve
internal branch- supra glottis and glottis
tracheo-oesophageal groove location
behind lobes of thyroid gland
does unilateral recurrent laryngeal nerve injury affect breathing?
so significant impairment
how to intubate if bilateral recurrent laryngeal nerve injury
(cant do ET tube) need cricothyroidotomy temporarily then tracheostomy
typical head position of child with epiglottitis
sniffing positon, helps maintain some latency of airway bye lifting soft tissues off throat
why don’t you examine someone with epiglottitis?
cause distress and occlude airway completely
common bacterial cause of epiglottitis
haemophilus infuenzae
when to consider further care in child with croup
-cyanosis
-stridor at rest
give nebuliser oxygen and adrenaline, corticosteroids
stridor
harsh inspiratory noise due to upper airway issue
overall goal of airway adjuncts
lift tongue off back of orophraynx
2 airway adjuncts
-oropharyngeal airway (contraindicated for slightly conscious patients due to gag reflex)
-nasopharyngeal airway
disadvantage of simple airway manoeuvres/airway adjuncts
no protection from secretions/vomit for lower respiratory tract
example of supraglottic airway
iGel
definitive airway
endotracheal tube, secures and protects lower respiratory tract from secretions/vomit
benefits of iGel
-moulds to shape of airway when it warms
-some protection against secretions/vomit
-minimal skills needed
