Airway anatomy

Question 1

The laryngeal muscles are classified as

Answer 1

intrinsic or extrinsic

Question 2

The intrinsic laryngeal muscles control

Answer 2

the tension and position of the vocal cords
involved in phonation

Question 3

What is the function of the cricothyroid?

Answer 3

“Cords tense”

Question 4

What is the function of the thyroarytenoid?

Answer 4

“They relax”

Question 5

What is the function of the posterior cricoarytenoid?

Answer 5

ABducts vocal cords
“Please come apart”

Question 6

What is the function of the lateral cricoarytenoid?

Answer 6

ADDucts vocal cords
“let’s close airway”

Question 7

The ____________ innervates all of the intrinsic laryngeal muscles except for the cricothyroid muscle, which is innervated by the _______________

Answer 7

recurrent laryngeal nerve; external branch of the superior laryngeal nerve

Question 8

The ____________ is solely responsible for opening the vocal cords.

Answer 8

posterior cricoarytenoid

Question 9

The ______ support the larynx inside the neck and assist with swallowing

Answer 9

extrinsic laryngeal muscles

Question 10

All the extrinsic muscles end in

Answer 10

“-hyoid”

Question 11

What is the only extrinsic muscle that doesn’t end in “-hyoid”

Answer 11

digastric

Question 12

Muscles that depress the larynx include

Answer 12

thyrohyoid
omohyoid
sternohyoid
all other extrinsic muscles elevate the larynx

Question 13

The superior laryngeal nerve innervates the:
a. cricothyroid muscle
b. trachea
c. posterior third of the tongue
d. underside of the epiglottis

Answer 13

a. cricothyroid muscle
d. underside of the epiglottis

Question 14

The internal branch of the superior laryngeal nerve is a

Answer 14

sensory nerve

Question 15

The external branch of the superior laryngeal nerve is a

Answer 15

motor nerve

Question 16

The ______ provides sensory innervation to the face and head

Answer 16

trigeminal nerve (CN 5)

Question 17

The CN 5 is divided into three branches

Answer 17

V1 (ophthalmic)
V2 (maxillary)
V3 (mandibular)

Question 18

The V1 or ophthalmic nerve innervates the

Answer 18

nares and anterior 1/3rd of the nasal septum

Question 19

The V2 or maxillary nerve innervates the

Answer 19

turbinates and nasal septum

Question 20

The V3 or mandibular nerve innervates the

Answer 20

anterior 2/3rd of tongue (somatic)

Question 21

The ______ provides sensation from the oropharynx down to the anterior side of the epiglottis

Answer 21

glossopharyngeal nerve (CN9)

Question 22

The ________ gives rise to the superior laryngeal nerve

Answer 22

Vagus nerve (CN10)

Question 23

The superior laryngeal nerve is divided into

Answer 23

the internal branch
external branch

Question 24

The __________ gives rise to the recurrent laryngeal nerve which provides sensation below the level of the vocal cords

Answer 24

vagus nerve

Question 25

The recurrent laryngeal nerve innervates the _______

Answer 25

posterior cricoartyenoid muscle

Question 26

When the recurrent laryngeal nerve is paralyzed

Answer 26

unilateral injury--> no respiratory distress bilateral injury (acute)--> respiratory distress bilateral injury (chronic)--> no respiratory distress

Question 27

Risk factors for recurrent laryngeal nerve injury include

Answer 27

PDA ligation, left atrial enlargement (mitral stenosis), aortic arch aneurysm, and thoracic tumor

Question 28

If the superior laryngeal nerve is injuryed

Answer 28

bilateral injury can cause hoarseness

Question 29

Which recurrent laryngeal nerve is more susceptible to injury?

Answer 29

left RLN

Question 30

If the patient gags during fiberoptic intubation, then this nerve was not adequately anesthetized:

Answer 30

glossopharyngeal nerve

Question 31

The sensory function of the recurrent laryngeal nerve is at

Answer 31

below level of the vocal cords--> trachea

Question 32

The internal branch of the superior laryngeal nerve penetrates the

Answer 32

thyrohyoid membrane between the greater cornu of the hyoid bone and the superior horn of the thyroid cartilage

Question 33

The external branch of the superior laryngeal nerve penetrates the

Answer 33

cricothyroid muscle

Question 34

RLN injury that can affect either side includes

Answer 34

external pressure from ETT/LMA surgery: Thyroid/parathyroid neck stretching neck tumor

Question 35

RLN injury that affects the left side only

Answer 35

PDA ligation left atrial enlargement (mitral stenosis) aortic arch aneurysm thoracic tumor

Question 36

The most common nerve injury following subtotal thyroidectomy is

Answer 36

unilateral RLN injury

Question 37

Treatment for bilateral RLN injury is

Answer 37

emergent intubation or a surgical airway

Question 38

The ___________ has no motor function

Answer 38

The superior laryngeal internal branch

Question 39

The _______ provides sensation below the level of the vocal cords to the trachea

Answer 39

RLN

Question 40

The ___________ has no sensory function

Answer 40

SLN external branch

Question 41

The ____________ has sensation to the posterior side of the epiglottis to vocal cords

Answer 41

SLN internal branch

Question 42

he ________ has motor function to the cricothyroid muscles

Answer 42

SLN external branch

Question 43

The ___________ has motor function to all intrinsic laryngeal muscles except the cricothyroid

Answer 43

RLN

Question 44

Which landmark is identified for a superior laryngeal nerve block? a. greater cornu of hyoid bone b. superior horn of thyroid cartilage c. cricothyroid membrane d. palatoglossal arch

Answer 44

a. greater cornu of hyoid bone