13. Airway Block

Question 1

superior laryngeal nerve is a branch of

Answer 1

vagus nerve

Question 2

internal branch superior laryngeal nerve innervates

Answer 2

sensory only
above the vocal cords

Question 3

external branch of superior laryngeal nerve innervates

Answer 3

motor only
cricothyroid muscle

Question 4

reccurent laryngeal nerve is a branch of the

Answer 4

vagus nerve

Question 5

RLN innervates

Answer 5

motor
intrinsic laryngeal muscles (not cricothyroid)
larynx below the vocal cords
trachea

Question 6

unilateral injury to SLN SE

Answer 6

minor side effects

Question 7

bilateral injury to SLN SE

Answer 7

hoarseness

Question 8

unilateral injury to RLN SE

Answer 8

hoarseness

Question 9

bilateral damage to RLN SE

Answer 9

dyspnea
stridor
aphonia

Question 10

branches of trigeminal nerve

Answer 10

opthalmic (V1)
maxillary (V2)
mandibular (V3)

Question 11

the mandibular nerve branches into

Answer 11

lingual nerve

Question 12

lingual nerve innervation

Answer 12

anterior 2/3 of tongue

Question 13

glossopharyngeal nerve (IX) innervation

Answer 13

posterior 1/3 of tongue
posterior pharynx
tonsils
epiglottis

Question 14

blocking glossopharyngeal nerve SE

Answer 14

suppress gag reflex

Question 15

blocking SLN anesthetizes

Answer 15

larynx above vocal cords:
base of tongue
epiglottis
arytenoids

Question 16

blocking RLN anesthetizes

Answer 16

vocal cords
below vocal cords (trachea)

Question 17

which nerves must be blocked to completely anesthetize airway for awake intubation

Answer 17

glossopharyngeal nerve
SLN
RLN

Question 18

glossopharyngeal nerve block complications

Answer 18

dysphagia
loss of taste
hoarseness

Question 19

2 methods for glosspharyngeal nerve block

Answer 19

lidocaine spray
lidocaine injection

Question 20

lidocaine spray dosing

Answer 20

10% lidocaine

Question 21

lidocaine spray onset

Answer 21

1-3 mins

Question 22

lidocaine spray duration

Answer 22

10-15 mins

Question 23

how many seconds between each lidocaine spray

Answer 23

3 swallows or 15-30 seconds

Question 24

glossopharyngeal injection location

Answer 24

submucosa of posterior tonsillar pillar

Question 25

glossopharyngeal injection needle size

Answer 25

25ga

Question 26

glossopharyngeal injection drug

Answer 26

2% lidocaine

Question 27

glossophargyneal injection volume

Answer 27

2-5 mL

Question 28

glossopharyngeal injection onset

Answer 28

10-20 mins

Question 29

glossopharyngeal injection duration

Answer 29

2-5 hrs

Question 30

SLN block patient positioning

Answer 30

extend neck displace hyoid bone

Question 31

SLN block needle insertion

Answer 31

greater cornu of hyoid bone

Question 32

SLN block needle size

Answer 32

25ga

Question 33

why do you aspirate before injecting SLN?

Answer 33

to aovid injection into superior laryngeal artery

Question 34

SLN block needle advance

Answer 34

walk needle off bone inferiorly

Question 35

SLN block drug dose

Answer 35

2mL of 2% lidocaine

Question 36

SLN nerve block anesthetizes

Answer 36

internal SLN (sensory) external SLN (motor)

Question 37

RLN/transtracheal block indication

Answer 37

glottic closure reflex

Question 38

which pts are direct RLN blocks CI

Answer 38

all pts due to risk of bilateral vocal cord paralysis and airway obstruction

Question 39

transtracheal block needle insertion

Answer 39

through cricothyroid membrane

Question 40

transtracheal block needle gauge

Answer 40

22 ga

Question 41

when do you stop advancing needle for transtracheal block

Answer 41

aspirate on syringe while advancing stop advancing when you see bubbles

Question 42

transtracheal block drug/dose

Answer 42

5 mL of 4% lidocaine

Question 43

how should you inject the LA for transtracheal?

Answer 43

rapid to encourage coughing and spread of the anesthetic

Question 44

transtracheal block onset

Answer 44

5-15 mins

Question 45

transtracheal block duration

Answer 45

2 hrs

Question 46

sedation options for awake intubations

Answer 46

dexmedetomidine remi robinul (dry mouth out) ketamine (preserve respiratory drive)

Question 47

awake DL sedation

Answer 47

versed remifentanil bolus cetacaine gargel