airway evaluation Flashcards
atlanto-occipatal joint mobility - how to assess
align the oral, pharyngeal, and laryngeal axis - sniffing position
assess by having pt sit with head held up, normal extension is 35 degrees, if they can’t do that = difficult intubation
what axes align during just elevation of head
pharyngeal and laryngeal axes
TMJ mobility
how wide can they open their mouth
should be 30-40mm (2-3 fingerbreadths)
can you protude mandible
mallampati basis
based on the assumption that when the base of the tonge is disproportionately large, the tongue overshadows the larynx, resulting in difficult exposure of larynx during DL
positive predictive value = 20%
subject to inter-observer variability
class 1 mallampati
hard palate, soft palate, tonsillar pillars, uvula
class 2 malampati
hard palate, soft palate, tonsillar pillars
base of uvula hidden by tongue
class 3 mallampati
hard palate and soft palate
class 4 mallampati
hard pallate only
upper lip bite test
demonstrates how well or poorly a pt can protrude their mandible
indicates space available for us to displace tongue anteriorly during DL
thyromental distance
distance from notch of thyroid to tip of mentum
head be extended and mouth closed
less than 6cm may indicate in difficulty achieving cord visualization
sternomental distance
sternal notch to mentum
neck fully extended and mouth closed
less than 13.5 cm = difficult to intubate
what does a narrow palate indicate
decreases oropharyngeal space for both laryngoscope and ETT
what does a short/thick neck on assessment or poor tracheal mobility indicate
inability to align airway axes
grade 1 view
full view of glottic opening
grade 2 view
posterior portion of glottic opening and arytenoid cartilage
