Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Intro to Anesthesia > Airway Anatomy > Flashcards

Airway Anatomy Flashcards

1
Q

Upper Airway

A
  • Nasal Passages
  • Oral Cavity
  • Pharynx
  • Larynx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Nasal Passage Components

A
  • septum
  • turbinates
  • adenoids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Nasal Passage function

A
  • 1/2 upper airway resistance

- humidify/filters air

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Nasal Passage Innervation:

A

-Trigeminal Nerve (CN V)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Oral Cavity Components:

A
  • teeth
  • tongue
  • soft palate
  • hard palate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Oral Cavity Innervation:

A

1) Trigeminal (CN V): hard and soft palate, 2/3 anterior tongue
2) Glossopharyngeal (CN IX): posterior 1/3 tongue, soft palate, oropharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pharynx

A
  • muscular tube

- connects base of skull to cricoid cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pharynx components:

A
  • nasopharynx (soft palate to uvula)
  • oropharynx (tonsilis/uvula to epiglottis)
  • laryngopharynx (epiglottis to cricoid cartilage)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Larynx

A

cartilage, muscle, and ligaments from C4-C6; epiglottis to trachea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Larynx functions:

A
  • airway protection
  • respiration
  • phonation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How many cartilages in Larynx?

A

9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How many paired/unpaired cartilages?

A

3 paired

3 unpaired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Paired Cartilages

A
  • Arytenoid
  • Corniculate
  • Cuneform
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Unpaired Cartilages

A
  • Thyroid
  • Cricoid
  • Epiglottis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Cricoid

A
  • connected by CTM
  • only complete cartilagenous ring
  • pushing on it can occlude esophagus
  • signet-shaped
  • narrowest portion of the pediatric airway
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Epiglottis

A

covers opening to the larynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Thyroid Cartilage

A

-anterior attachment for vocal cords

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Arytenoid

A

-posterior attachment for vocal cords

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Corniculate

A

posterior portion of hte aryepiglottic fold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

cuneiform

A
  • in the aryepiglottic fold

- lateral to corniculates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

vocal cords

A

-appear pearly white

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

glottic opening

A
  • triangular fissure

- narrowest portion of the adult airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Intrinsic Laryngeal Muscles: Glottic Opening

A
  • Lateral Cricoarytenoid
  • Arytenoid Muscles
  • Posterior Cricoarytenoid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Lateral Cricoarytenoid

A

-adducts the vocal cords

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Arytenoid Muscles

A
  • oblique arytenoids
  • transverse arytenoids
  • adduct the vocal cords
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Posterior Cricoarytenoid

A

-the only vocal cord abductors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Intrinsic Laryngeal Muscles: Vocal Cord Length

A
  • Cricothyroid
  • Thyroarytenoid
  • Vocalis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Cricothyroid

A

-tenses, elongates vocal cords

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Thyroarytenoid

A

-relaxes/shortens vocal cords

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Vocalis

A

relaxes/shortens vocal cords

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

cricothyroid muscle innervated by:

A

external branch of the superior laryngeal nerve (branch of the vagus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

all other laryngeal muscles innvervated by :

A

recurrent laryngeal nerve (branch of vagus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Vagus Nerve

A

superior laryngeal nerve
internal laryngeal nerve
external laryngeal nerve
recurrent laryngeal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Extrinsic Laryngeal Muscles

A
  • move larynx as a whole
  • suprahyoid group
  • infrahyoid group
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Suprahyoid group

A

moves larynx cephalad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Infrahyoid group

A

move larynx caudad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Lower airway

A
  • trachea
  • carina
  • bronchi
  • terminal bronchioles
  • respiratory bronchioles
  • alveoli
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Trachea

A

-fibromuscular tube
-10-20cm length; 22mm diameter
16-20 U-shaped cartilages
posterior lacks cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Carina

A

bifurcates trachea between T-4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

R mainstem bronchi

A

2.5cm at 25 degrees

41
Q

L mainstem bronchi

A

5cm at 45 degrees

42
Q

Airway Assessment Components:

A
  • general appearance (head/neck size)
  • range of motion neck/jaw (Thyromental Distance, Mandibular Protusion)
  • dentition
  • mouth (Mallampati, Cormack, Lehane)
  • mouth opening
  • voice
  • body habitus (pregnant, fat)
43
Q

PMH that would concern you regarding airway placment

A 
Diabetes
Rheumatoid Arthiris
OSA
history of difficult airway
asthma
44
Q

Mallampati Classification

A
  • correlates the oropharyngeal space with the ease of DL and tracheal intubation
  • hypothesis: when the base of the tongue is disproportionally large is overshadows the larynx, making it difficult to expose the vocal cords
45
Q

How to test of Mallampati

A
  • patient upright
  • mouth wide open
  • NO AHHH
46
Q

Mallampati Class I

A

I: faucial Pillars, entire uvula, soft/hard palates

47
Q

Mallampati Class II

A

II: Uvula tip masked by tongue and soft and hard palates

48
Q

Mallampati Class III

A

III: Soft and hard palates uvula base only

49
Q

Mallampati Class IV

A

IV: Hard Palate only

50
Q

Cormack and Lehane Score

A

the laryngoscopic view of the glottis

51
Q

Cormack and Lehane Score Grade I

A

most of glottis visible

52
Q

Cormack and Lehane Score Grade II

A

only posterior portion of the glottis visible

53
Q

Cormack and Lehane Score Grade III

A

only epiglottis visible

54
Q

Cormack and Lehane Score Grade IV

A

no airway structures visible

55
Q

Thyromental Distance

A
  • distance from lower border of mandible to thyroid notch with neck fully extended
  • normal = 6-6.5cm
  • difficult intubation = <3 fingers/ receding mandible
56
Q

Mandibular Protrusion Test looks at what?

A

good jaw thrust

57
Q

Mandibular Protrusion Test Class A

A

lower incisors can be protruded anterior to upper incisors

58
Q

Mandibular Protrusion Test Class B

A

The lower incisors can be brought to edge to edge with upper incisors

59
Q

Mandibular Protrusion Test Class C

A

The lower incisors cannot be brought edge to edge with upper incisors

60
Q

Preparation for Induction

MsMAIDS

A 
Monitors
Suction
Machine checked
Airway
IV
Drugs
Special Equipment
61
Q

Preoxygenation

A
  • washes out Nitrogen

- proper preoxygenation gives you safe apnea time

62
Q

3-5 minutes of “tight” mask fit during normal tidal breathing with 100% FiO2 at >6L/min

A

gives 10 minutes of safe apnea time

63
Q

4 vital capacity breaths within 30 seconds with 100% FiO2 at >6L/min

A

gives 5 minutes safe apnea time

64
Q

High Risk for Aspiration

A
  • loss of AW reflexes
  • full stomach
  • GERD
  • hiatal hernia
  • NGT presence
  • morbid obesity
  • diabetic gastroparesis
  • pregnancy
65
Q

Goals of aspiration prophylaxis

A
  • decrease gastric volume
  • increase gastric pH
  • antacids, promotility drugs, H-2 receptor antagonists
66
Q

NPO orders

A

clears up to 2H prior

solids up to 6H prior

67
Q

Airway Setup

A
  • face mask
  • PPV source
  • suction
  • tongue depressor
  • OPA
  • NT
  • laryngoscope handle
  • 2 blades
  • ETT (2 sizes)
  • stylet
  • syringe 10cc
  • LMA
  • tape
68
Q

Anesthesia Face Masks

A
  • hyperoxygenate and induct

- hold with C-E technique

69
Q

Predictors of difficult mask ventilation

A

-OSA
-older than 55
-male
-BMI >30
Mallampati III or IV
beard
edentulousness (no teeth)

70
Q

Airway Obstruction signs

A
  • no Vt
  • capnography <20/no waveforms
  • resistance to bagging
  • poor O2 sat
  • no condensation on tube
71
Q

Possible causes of obstruction

A

1) tongue
2) laryngospasm
3) bronchospasm

72
Q

Tongue obstruction etiology

A

relaxation of the genioglossus muscle; snoring JAW TRUST, OPA

73
Q

laryngospasm

A
  • exaggerated glottic closure

- innervated via glossopharngeal or vagal stimulation

74
Q

treatment of laryngospasm

A
  • remove irritants
  • remove blade
  • sedate/paralyze
75
Q

bronchospasm

A
  • spasm of the bronchus
  • sedate
  • anticholinergic
76
Q

OPA

A
  • patient must be deeply seated

- measured from corner of mouth to angle of jaw or earlobe

77
Q

complications of OPA

A
  • laryngospasm
  • bleeding
  • soft tissue damge
  • lingual nerve palsy
  • damage to teeth
78
Q

Nasal Trumpet

A
  • patients can be more awake
  • measured nares to meatus of ear
  • lubricate
79
Q

complications of nasal trumpet

A
  • epistaxis
  • basal skull fracture
  • adenoid hypertrophy
80
Q

Risk of Difficult Intubation

A

-long incisors
-overbite
-small mouth
-Mallampati III or IV
high arched palate
-short thyromental distance
-short thick neck
-limited cervical mobility

81
Q

Laryngoscope Blades

A

Mac (1-4) vs Miller (0-4)

82
Q

Mac insertion

A
  • insert R side mouth

- position in the veleculum

83
Q

Miller insertion

A

-position posterior to epiglottis

84
Q

Indications for ETT

A
  • difficult airway (failed SGA)
  • NMBA
  • type of surgery (positioning or area being operated on)
  • full stomach/high risk aspiration
  • critically ill/post-op vent need
  • lung abnormalities
85
Q

ETT components

A
  • 15mm connector
  • pilot balloon
  • high volume, low pressure cuff
  • bevel
  • Murphy eye
86
Q

Murphy Eye

A

-distal opening in the side wall for ventilation should the distal end become obstructed

87
Q

high volume, low pressure cuff vs low volume high pressure cuff

A

Low P/High V =

High P/ Low V =

88
Q

ETT sizes

A
  • based on internal diameter
  • adult: 6.5mm-8mm
  • 4cm above carina
  • 2cm below vocal cords
  • 3xID = depth
89
Q

stylet

A
  • shapes ETT; malleable

- shape into hockey puck about 60 degrees

90
Q

What is the optimal intubating position?

A

-sniffing position

91
Q

Sniffing Position

A
  • aligns oral axis, pharyngeal axis, laryngeal axis
  • 35 degree cervical flexion; 7-9cm head elevation
  • achieved with pillow and neck extended
  • obese patients = ramps; tragus aligned with sternum
92
Q

LMA

A
  • supraglottic airway device
  • rescue airway
  • conduit for ETT intubation
93
Q

LMA size

A

3-6

use largest size possible for tightest seal

94
Q

LMA components

A
  • airway tube
  • drain tube
  • fixation tab
  • bite block
  • modified cuff (allows up to 30cm H2O)
95
Q

LMA insertion equipment needed

A
  • 20-50cc syringe
  • lubricant
  • stethoscope
  • tape
  • soft bite block
96
Q

LMA insertion

A
  • adequate anesthesia
  • lubricate posterior of cuff
  • inflate to 40-60cm H20
  • measure cuff pressure periodically if N2O is administered
97
Q

Advantages of LMA

A
  • improved HD stability
  • lower frequency of coughing
  • lower incidence sore throat
98
Q

Disadvantages of LMA

A
  • inability to use PPV at higher peak pressures
  • higher frequency gastric insufflation
  • no protection against laryngoscopy
99
Q

Confirmation of correct airway placement

A
  • chest rise
  • lung sounds
  • capnography
  • condensation in tube
  • waveform on vent

Intro to Anesthesia (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions