Airway anatomy 3 Flashcards
Tensor palantine muscle relaxation will MOST likely cause airway obstruction at which level?
a. hard palate
b. soft palate
c. epiglottis
d. tongue
b. soft palate
During anesthesia, the upper airway can obstruct in three places:
soft palate
tongue
epiglottis
The upper airway extends from the ____ & _______ to the _________
mouth & nares to the cricoid cartilage
Airway resistance is _________ in the nasal passage compared to the mouth
2x higher
The primary functions of the upper airway include
warming & humidifying inspired air, filtering particulate matter, and preventing aspiration
The nasal turbinates project from
the lateral wall of each nasal passage (have 3 on each side)
The nasal turbinates are highly
vascular & they’re at risk for trauma during airway instrumentation
To reduce the risk of trauma during airway instrumentation, you should direct the NPA
between the inferior turbinate and the floor of the nasal cavity
Anesthetic agents reduce ______- muscle tone
pharyngeal dilator muscle tone which can cause airway obstruction
If you have obstruction at the level of the tongue, this is
genioglossus muscle relaxation (most common)
If you have obstruction at the level of the soft palate, this is
tensor palantine muscle relaxation
Anatomic factors that impact airway patency include
obesity, large tongue, tonsil/adenoid hypertrophy, and craniofacial deformity
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?
tensor palantine
genioglossus
hyoid muscles
Conditions that reduce the diameter of the pharynx include
reduce pharyngeal dilator muscle tone
negative pressure during inspiration
Conditions that reduce the size of the box (head and neck tissue) include
increased soft tissue inside the box: obesity, large tongue, tonsil/adenoid hypertrophy
decreased size of the box: small craniofacial structures, craniofacial deformity
What does the tensor palatine do?
opens the nasopharynx
What does the genioglossus muscle do?
opens the oropharynx
What does the hyoid muscle do?
opens the hypopharynx
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. total cross-sectional area
The lower airway begins at _________ and ends at __________
the trachea and ends at the alveoli
The trachea begins at
the inferior border of the cricoid cartilage and ends at the carina
Where is the carina located?
T4-T5
Neck flexion ______ the distance from the mouth to the carina
reduces
Neck extension _____ the distance from the mouth to the carina
increases (the tube follows the nose)
The lower airway begins as __________, and then it continues to bifurcate along __________
a single tube (the trachea) and then bifurcates along 23 generations
Type 1 pneumocytes provide
the surface for gas exchange
Type 2 pneumocytes
produce surfactant and they can also produce type 1 pneumocytes
In children up to 3 years of age, both bronchi take off
55 degrees from the long axis of the trachea
Describe why there is greater likelihood for right mainstem intubation?
the right bronchus projects at 25 degrees where as the left takes off at 45 degrees
Type III pneumocytes
are macrophages & fight lung infection & produce inflammatory response
_______ are present in the alveoli in smokers and patients with acute lung injury
Neutrophils
The distance from the incisors to the carina is
~26 cm
As the airway bifurcates, these factors increase
number of airways
total cross-sectional area
As the airway bifurcates, these factors decrease
airflow velocity
amount of cartilage
goblet cells (produce mucus)
ciliated cells (clear mucus)
These factors are variable as the airway bifurcates:
muscular layer
What vertebral level corresponds with the adult trachea?
C6
What 2 landmarks correspond with the carina?
T4-T5
angle of louis
What structures permit air movement between alveoli?
pores of Kohn
