Airway things

Question 1

Pharynx is comprised of what sections?

Answer 1

• Oropharynx
• Oropharynx
• Hypopharynx (Laryngeopharynx)

Question 2

Caudal to the pharynx is what structure of the airway and how far does it extend?

Answer 2

larynx
C3 - C6

Question 3

Within your larynx you have what 3 paired cartilages?

Answer 3

• Corniculates
• Arytenoids
• Cuneiform

Question 4

Within you larynx, you have what 3 unpaired cartilages?

Answer 4

• Thyroid
• Cricoid
• Epiglottis

Question 5

What is special about the cricoid cartilage?

Answer 5

The only cartilage that forms a complete ring around the trachea
- signant ring

Question 6

Order of structures decending starting at the Epiglottis

Answer 6

• Epiglottis
• Hyoid bone
• tyrohyoid ligament
• thyroid cartilage
• cricothyroid ligament (where to do your cric)
• cricoid cartilage

Question 7

What is the narrowest part of the airway in an adult and a child?

Answer 7

• Adult: Vocal cords
• Peds: cricoid cartilage (funnel shaped)

Question 8

What cartilage do the anterior part of the vocal cords attach to?

Answer 8

Posterior side of the Thyroid cartilage

Question 9

Trigeminal nerve (CN V) splits into what sections?

Answer 9

• Opthalmic
• Maxillary
• Mandibular

Question 10

What does the opthalmic branch innervate? and is it sensory or motor?

Answer 10

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

Question 11

What does the maxillary branch of CN V branch into and innervate?

Answer 11

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

Question 12

What does the Mandibular branch of CN V branch into and innervate?

Answer 12

Mandibular branches into:
- Inferior Alveolar Nerve (Jaw)
- Mental Nerve (Chin)
- Lingual Nerve (Anterior sensory of 2/3 of tongue sensory)

Question 13

Glossopharngeal N (CN IX) innervates

Answer 13

Soft palate and oropharynx and all the way up to the anterior side of the epiglottis and vallecula
- posteior 1/3 of the tongue

Question 14

Caudal from CN IX, we have vagas innervation, what are the splits?

Answer 14

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.

Question 15

Internal branch of the superior larengeal N. supplies motor to what structures?

Answer 15

Trick question. The internal branch is sensory only

Question 16

The internal branch of the superior larengeal N supplies sensory to what?

Answer 16

• Posterior epiglottis
• Vocal cords
• Most other structures of the larynx

Question 17

External branch of the Superior larengeal N. supplies sensory to what structure?

Answer 17

Trick question, External branch is motor only

Question 18

External Branch of the superior larengeal N supplies Motor to what?

Answer 18

Innervated the cricothyroid mucle
- which elongates/tenses the cords

Question 19

Recurrent Laryngeal Nerve becomes inferior laryngeal nerve when it ____

Answer 19

enters the larynx

Question 20

Inferior laryngeal N. provides motor innervation to:

Answer 20

• Vocalis muscle
• Thyroarytenoid muscle
• Lateral Crycoaryteniod muscle
• posterior crycoarytenoid muscle

Question 21

What motion does the Thyroarytenoid do for the vocal cords?

Answer 21

Adducts vocal folds

Question 22

What motion does the Lateral Cricoarytenoid do for the vocal folds?

Answer 22

Adducts vocal folds

Question 23

What motion does the Posterior Cricoarytenoid do for the vocal folds?

Answer 23

Abduct the vocal folds

Question 24

What motion does the vocalis muscle do for the volcal folds?

Answer 24

Tenses the vocal folds (no movement lateral or medial)

Question 25

Structures you are likely to see during a DL (What CRNAs want us to talk through outloud)

Answer 25

• 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