Airway anatomy 3 Flashcards

1
Q

Tensor palantine muscle relaxation will MOST likely cause airway obstruction at which level?
a. hard palate
b. soft palate
c. epiglottis
d. tongue

A

b. soft palate

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2
Q

During anesthesia, the upper airway can obstruct in three places:

A

soft palate
tongue
epiglottis

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3
Q

The upper airway extends from the ____ & _______ to the _________

A

mouth & nares to the cricoid cartilage

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4
Q

Airway resistance is _________ in the nasal passage compared to the mouth

A

2x higher

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5
Q

The primary functions of the upper airway include

A

warming & humidifying inspired air, filtering particulate matter, and preventing aspiration

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6
Q

The nasal turbinates project from

A

the lateral wall of each nasal passage (have 3 on each side)

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7
Q

The nasal turbinates are highly

A

vascular & they’re at risk for trauma during airway instrumentation

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8
Q

To reduce the risk of trauma during airway instrumentation, you should direct the NPA

A

between the inferior turbinate and the floor of the nasal cavity

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9
Q

Anesthetic agents reduce ______- muscle tone

A

pharyngeal dilator muscle tone which can cause airway obstruction

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10
Q

If you have obstruction at the level of the tongue, this is

A

genioglossus muscle relaxation (most common)

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11
Q

If you have obstruction at the level of the soft palate, this is

A

tensor palantine muscle relaxation

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12
Q

Anatomic factors that impact airway patency include

A

obesity, large tongue, tonsil/adenoid hypertrophy, and craniofacial deformity

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13
Q

What are the three sets of dilator muscles in the upper airway that counteract the tendency for airway collapse when the patient takes a breath?

A

tensor palantine
genioglossus
hyoid muscles

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14
Q

Conditions that reduce the diameter of the pharynx include

A

reduce pharyngeal dilator muscle tone
negative pressure during inspiration

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15
Q

Conditions that reduce the size of the box (head and neck tissue) include

A

increased soft tissue inside the box: obesity, large tongue, tonsil/adenoid hypertrophy
decreased size of the box: small craniofacial structures, craniofacial deformity

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16
Q

What does the tensor palatine do?

A

opens the nasopharynx

17
Q

What does the genioglossus muscle do?

A

opens the oropharynx

18
Q

What does the hyoid muscle do?

A

opens the hypopharynx

19
Q

When compared to the trachea, which factor is GREATER in the terminal bronchioles?
a. total cross-sectional area
b. airflow velocity
c. amount of cartilage
d. quantity of goblet cells

A

a. total cross-sectional area

20
Q

The lower airway begins at _________ and ends at __________

A

the trachea and ends at the alveoli

21
Q

The trachea begins at

A

the inferior border of the cricoid cartilage and ends at the carina

22
Q

Where is the carina located?

A

T4-T5

23
Q

Neck flexion ______ the distance from the mouth to the carina

A

reduces

24
Q

Neck extension _____ the distance from the mouth to the carina

A

increases (the tube follows the nose)

25
Q

The lower airway begins as __________, and then it continues to bifurcate along __________

A

a single tube (the trachea) and then bifurcates along 23 generations

26
Q

Type 1 pneumocytes provide

A

the surface for gas exchange

27
Q

Type 2 pneumocytes

A

produce surfactant and they can also produce type 1 pneumocytes

28
Q

In children up to 3 years of age, both bronchi take off

A

55 degrees from the long axis of the trachea

29
Q

Describe why there is greater likelihood for right mainstem intubation?

A

the right bronchus projects at 25 degrees where as the left takes off at 45 degrees

30
Q

Type III pneumocytes

A

are macrophages & fight lung infection & produce inflammatory response

31
Q

_______ are present in the alveoli in smokers and patients with acute lung injury

A

Neutrophils

32
Q

The distance from the incisors to the carina is

A

~26 cm

33
Q

As the airway bifurcates, these factors increase

A

number of airways
total cross-sectional area

34
Q

As the airway bifurcates, these factors decrease

A

airflow velocity
amount of cartilage
goblet cells (produce mucus)
ciliated cells (clear mucus)

35
Q

These factors are variable as the airway bifurcates:

A

muscular layer

36
Q

What vertebral level corresponds with the adult trachea?

A

C6

37
Q

What 2 landmarks correspond with the carina?

A

T4-T5
angle of louis

38
Q

What structures permit air movement between alveoli?

A

pores of Kohn