Airway A&P

Question 1

Most common airway management claims?

Answer 1

vocal chord paralysis

Question 2

what landmark separates the upper and lower airway?

Answer 2

cricoid cartilage

Question 3

Upper airway (above cricoid) parts?

Answer 3

nose, mouth, pharynx, hypopharynx (laryngopharynx), larynx and vocal cords

Question 4

Lower airway (below cricoid) parts

Answer 4

Trachea, bronchi, bronchioles, terminal bronchioles, respiratory bronchioles, alveoli

Question 5

part of pharynx at C1 level, skull to soft palate

Answer 5

Nasopharynx

Question 6

part of pharynx at C2-C3 level, soft palate to epiglottis

Answer 6

Oropharynx

Question 7

part of pharynx at C5-C6 level, epiglottis to cricoid

Answer 7

Hypopharynx

Question 8

key airway landmark?

Answer 8

vallecula

Question 9

4 functions of Upper Respiratory Tract

Answer 9

Provides for gas exchange
Filters inspired air
Contains olfactory receptors
Contributes to phonation

Question 10

part of upper airway at Level: C4, C5, C6

higher in females than in males

Answer 10

larynx

Question 11

how many cartilages make up larynx?

Answer 11

9

Question 12

3 single cartilages of larynx

Answer 12

thyroid cartilage
cricoid cartilage
epiglottis

Question 13

what structure protects airway from aspiration?

Answer 13

epiglottis

Question 14

3 paired cartilages of larynx

Answer 14

corniculate
cuneiform
arytenoid

Question 15

3 Major Function of the Larynx

Answer 15

Protection of the lower airway
Facilitate respiration
Facilitate phonation

Question 16

borders of upper airway?

Answer 16

Anterior and lateral border: thyroid cartilage

Posterior border: posterior cricoid cartilage

Question 17

action: vocal cord tension, open,close

Answer 17

Intrinsic muscles upper airway

Question 18

action: position, phonation,swallowing

Answer 18

Extrinsic muscles

Question 19

Anchors and suspends larynx
U shaped
Does not articulate with any other bone

Answer 19

hyoid bone

Question 20

elastic cartilage, attached to hyoid bone and thyroid cartilage

Answer 20

epiglottis

Question 21

‘shield’, articulates with cricoid, provides attachment for vocal fold

Answer 21

thyroid cartilage

Question 22

articulates with thyroid cartilage, attached to 1st tracheal ring

Answer 22

cricoid cartilage

Question 23

pyramidal, vocal and muscular processes, pivot on cricoid lamina to abduct and adduct vocal folds, vocal cord attached to vocal process

Answer 23

arytenoids

Question 24

2 laryngeal joints?

Answer 24

cricothyroid joint

cricoarytenoid joint

Question 25

lengthens and tenses cords- controls pitch

Answer 25

Cricothyroid joint

Question 26

something to consider with older patients?

Answer 26

cartilage continues to grow, chronic diseases (think rheumatoid) destroys joints - including airway

Question 27

opening/inlet to trachea | Triangle in shape

Answer 27

glottis

Question 28

vestibular folds which are narrow bands of fibrous tissue on each side.

Answer 28

False vocal cords

Question 29

: pale, white ligament bands | Attachment: thyroid anterior, arytenoids posterior

Answer 29

True vocal cords

Question 30

C6, lower border of cricoid to T5 carina | 10-15 cm in length.

Answer 30

trachea

Question 31

describe posterior trachea

Answer 31

flattened

Question 32

what are the angles of the right and left bronchus?

Answer 32

Left bronchus is a greater angle (45°) than right bronchus (25°) [easier to intubate right because least resistance with lesser angle]

Question 33

– smooth muscle, alters diameter of trachea, changing trachea’s resistance to flow e.g. constricts when cough to expel air more forceably

Answer 33

trachealis

Question 34

Upper Airway Innervation: 4 sensory

Answer 34

3 branches of trigeminal nerve (V1,V2,V3) Glossopharyngeal nerve Facial nerve Internal branch of superior laryngeal nerve

Question 35

Upper Airway Innervation: motor

Answer 35

Vagus has 2 branches SLN, RLN

Question 36

Recurrent laryngeal nerve (RLN) innervates ALL muscles of larynx except

Answer 36

cricothyroid muscle

Question 37

what innervates cricothyroid muscle?

Answer 37

external branch of the superior laryngeal nerve (SLN)

Question 38

Innervation of Trachea and Bronchial Tree

Answer 38

vagus

Question 39

protect the lower airway from entry of secretions and foreign bodies

Answer 39

Pharynx, epiglottis & vocal cords

Question 40

what is the Pharyngeal Reflex?

Answer 40

posterior wall of pharynx is touched causing the gag reflex. Suppression in stage 3 plane 1.

Question 41

what is the Laryngeal reflex

Answer 41

touching or irritating mucosa results in a cough reflex. Suppression in stage 3 plane 2

Question 42

what is Glottic closure reflex

Answer 42

: laryngeal closure, exaggeration of this is laryngospasm. Most common during stage 2 when reflexes are hyperirritable.

Question 43

what is Carinal reflex

Answer 43

gagging and coughing when carina is touched. Suppressed in stage 3, plane 3

Question 44

Posterior Cricoarytenoid action and nerve?

Answer 44

``` Opens glottis (abducts) RLN ```

Question 45

Lateral cricoarytenoids action and nerve?

Answer 45

``` Closes glottis (adducts) RLN ```

Question 46

Arytenoids (interarytenoids) action and nerve

Answer 46

Closes glottis mainly posterior (adducts) | RLN

Question 47

Cricothyroid action and nerve?

Answer 47

Tension and elongation of cords (adducts) | SLN

Question 48

Thyroarytenoids action and nerve

Answer 48

Relaxes/shortens vocal cords | RLN

Question 49

adjusts length (tension) of the vocal ligaments?

Answer 49

cricothyroid vocalis thyroarytenoid

Question 50

AB or AD ducts vocal folds (glottic opening)

Answer 50

thyroaretynoid lateral cricoarytenoid posterior cricoarytenoid

Question 51

sphincter function?

Answer 51

aryepiglottic | interarytenoid

Question 52

muscles increase tension on vocal ligaments by rotating the thyroid cartilage inferiorly –raises pitch

Answer 52

Cricothyroid (CT

Question 53

relaxes vocal ligaments by pulling arytenoid cartilage anteriorly- lowers pitch

Answer 53

Thyroarytenoid (TA)

Question 54

SLN injury

Answer 54

unilateral - minimal | bilateral - hoarseness, tired voice

Question 55

RLN injury?

Answer 55

unilateral - hoarse bilateral acute: stridor, resp distress chronic: aphonia

Question 56

vagus injury?

Answer 56

unilateral - hoarseness | bilateral - aphonia