Airway Assessments Flashcards
1
Q
Atlanto-Occipital Joint Mobility
A
- evaluate by having the patient sit with head held erect
- have the patient look up at the ceiling, down at the floor, and then from left to right
- normal extension is 35 degrees
- greater than two-thirds decrease of atlanto-occipital joint extension from a normal of 35 degrees is associated with a grade III to grade IV laryngoscope view
2
Q
Atlanto-Occipital Joint Mobility Rationale
A
- assessment of ability to place patient in sniffing position which aligns the oral, pharyngeal, and laryngeal axis (OPL)
- elevation of head by placing a pillow under the occiput and shoulders on table aligns pharyngeal and laryngeal axes
- head extension at atlanto-occipital joint helps to create the shortest distance and most nearly straight line from the incisor teeth to the glottic opening
3
Q
Temporomandibular Mobility
A
- how wide can patient open their mouth
- distance between incisors with mouth fully open should be 30-40 mm (2-3 fingerbreaths)
4
Q
Upper Lip bite test
A
- have the patient bite their upper lip with their bottom teeth
- assesses the ability to protrude the mandible (jaw will need to move forward with laryngoscopy)
5
Q
Class 1 upper lip bite
A
patient able to fully bite their upper lip
6
Q
Class 2 upper lip bite
A
patient able to bite only part of their upper lip
7
Q
Class 3 upper lip bite
A
patient unable to bite upper lip
8
Q
Mallampati Classification
A
- based on assumption that when the base of the tongue is disproportionately large, the tongue overshadows the larynx, resulting in difficult exposure of the larynx during laryngoscopy
- sensitivity = 60-80%
- specificity = 50-80%
9
Q
MP Class 1
A
hard palate soft palate tonsillar pillars fauces full uvula
10
Q
MP Class 2
A
hard palate soft palate partial uvula fauces *tonsillar pillars not visible*
11
Q
MP Class 3
A
hard palate
soft palate
base of uvula
12
Q
MP Class 4
A
hard palate only
13
Q
thyromental distance (Patil’s Test)
A
- distance form the notch of the thyroid cartilage to the tip of the mentum
- head should be fully extended and mouth closed for evaluation
- distance less than 6cm (~3 fingerbreadths) may indicate difficulty achieving cord visualization for endotracheal intubation
- potential difficulty aligning pharyngeal and laryngeal axis
14
Q
sternomental distance
A
- distance between sternal notch and mentum
- exam done with neck fully extended and mouth closed
- sternomental distance less than 13.5cm suggestive of intubation difficulty
15
Q
dentition
A
- determine presence of loose teeth, chipped teeth, or removable dental prosthesis
- document preexisting problems
- prominent maxillary incisors or overbite may interfere with achieving optimal laryngoscopic view by displacing the laryngoscope in a more cephalad position
