Airway things Flashcards
Pharynx is comprised of what sections?
- Oropharynx
- Oropharynx
- Hypopharynx (Laryngeopharynx)
Caudal to the pharynx is what structure of the airway and how far does it extend?
larynx
C3 - C6
Within your larynx you have what 3 paired cartilages?
- Corniculates
- Arytenoids
- Cuneiform
Within you larynx, you have what 3 unpaired cartilages?
- Thyroid
- Cricoid
- Epiglottis
What is special about the cricoid cartilage?
The only cartilage that forms a complete ring around the trachea
- signant ring
Order of structures decending starting at the Epiglottis
- Epiglottis
- Hyoid bone
- tyrohyoid ligament
- thyroid cartilage
- cricothyroid ligament (where to do your cric)
- cricoid cartilage
What is the narrowest part of the airway in an adult and a child?
- Adult: Vocal cords
- Peds: cricoid cartilage (funnel shaped)
What cartilage do the anterior part of the vocal cords attach to?
Posterior side of the Thyroid cartilage
Trigeminal nerve (CN V) splits into what sections?
- Opthalmic
- Maxillary
- Mandibular
What does the opthalmic branch innervate? and is it sensory or motor?
The opthalmic branch branches into:
- Supraorbital Nerve (branched to the top skull)
- Supratrochlear Nerve (branched to the nose)
- the opthalmic branch provides sensory to the anterior 1/3 of the nasal septum and the nose
What does the maxillary branch of CN V branch into and innervate?
Maxillary branches into
- Infraorbital N.
- Greater and Lesser Palentine Ns. (from sphenopalentine ganglion)
- Greater Palentine N innervates the hard palate
- Lesser Palentine N innervates the soft palate and the nasal terbinates
What does the Mandibular branch of CN V branch into and innervate?
Mandibular branches into:
- Inferior Alveolar Nerve (Jaw)
- Mental Nerve (Chin)
- Lingual Nerve (Anterior sensory of 2/3 of tongue sensory)
Glossopharngeal N (CN IX) innervates
Soft palate and oropharynx and all the way up to the anterior side of the epiglottis and vallecula
- posteior 1/3 of the tongue
Caudal from CN IX, we have vagas innervation, what are the splits?
CN X splits into:
- Superior larengeal N.
- Internal branch
- external branch
- Recurrent Larengeal N.
- L side recurrs at aortic arch
- R side recurrs at subclavian a.
- Inferior Larengeal N.
Internal branch of the superior larengeal N. supplies motor to what structures?
Trick question. The internal branch is sensory only
The internal branch of the superior larengeal N supplies sensory to what?
- Posterior epiglottis
- Vocal cords
- Most other structures of the larynx
External branch of the Superior larengeal N. supplies sensory to what structure?
Trick question, External branch is motor only
External Branch of the superior larengeal N supplies Motor to what?
Innervated the cricothyroid mucle
- which elongates/tenses the cords
Recurrent Laryngeal Nerve becomes inferior laryngeal nerve when it ____
enters the larynx
Inferior laryngeal N. provides motor innervation to:
- Vocalis muscle
- Thyroarytenoid muscle
- Lateral Crycoaryteniod muscle
- posterior crycoarytenoid muscle
What motion does the Thyroarytenoid do for the vocal cords?
Adducts vocal folds
What motion does the Lateral Cricoarytenoid do for the vocal folds?
Adducts vocal folds
What motion does the Posterior Cricoarytenoid do for the vocal folds?
Abduct the vocal folds
What motion does the vocalis muscle do for the volcal folds?
Tenses the vocal folds (no movement lateral or medial)
Structures you are likely to see during a DL (What CRNAs want us to talk through outloud)
- I’m scissoring the pts mouth open and inserting the blade into the right side of the mouth and sweeping the tongue
- I see hard palate, soft palate, tonsils
- I see the epiglottis and I am directing my blade to the epiglottis (or vallecula if using a Mac)
- I am directing my hand to the upper corner of the room and I see the Corniculate and Arytenoid cartilages
- I see the vocal folds, and I will direct my tube through
- The gold standard for a successful intubation is visualizing the tube passing though the cords.
- I will now listen, look for chest rise, and observe EtCO2 on the monitor
