(Anatomy) Flashcards
What is the more simple/less effective way of describing filtration of things through the nose?
The stuff we breathe in has mass to it = therefore it will get stuck in the back of the nose to all the mucous, preventing it from being able to make the necessary sharp turn to get into the lungs.
What is the more efficient method of filtration through the nose?
There is a spinning process going on by the concha/turbinates which gives a higher likelihood that the particles will get stuck in the mucous.
Smoke is an inhibitor of ___ and can cause a loss of ___.
Alpha-1 Anti-trypsin
elastic tissue
The linings of all of our airways are ___.
What does this help with?
How is this affected with smoke ingestion?
What is something we could do that would affect these?**
Ciliated
Helps us move junk out of the airways and down into the GI tract.
Smoke can paralyze these cilia = the junk stays in the lungs
ETT = Decreases the ability of them to work normally
True/False:
After smoking for a long time, the cilia in the airways are irreversibly paralyzed.
False: After a few weeks they can come back and work = this is why smokers that have quit, cough up so much crap.
Correct placement of a MAC blade during intubation would have the tip of the blade situated between the ___ & ___.
What is another name for this space?
Linguil Tonsil & epiglottis
Vallecula
What is unique about the cricoid cartilage in the larynx?
What does this allow for?
Only continuous piece of cartilage that forms a circle.
Allows for an occlusion of the opening to the esophagus = if gastric contents are aspirating out of the esophagus
Downside of using cricoid pressure:
Pressure can build up in the stomach and lower esophagus. Eventually the sphincter between stomach and esophagus can get blown out.
The hyoid bone is connected to the thyroid cartilage via what 3 ligaments:
(Order is most anterior to posterior)
- Median Thyrohyoid Ligament
- Thyrohyoid Membrane
- Thyrohyoid Ligament
Which ligament found in the larynx has an opening? What is the opening for?
The thyrohyoid membrane has a foramen for the internal branch of the superior laryngeal nerve and artery.
The superior laryngeal nerve is a branch of the…?
Internal vs. External locations and functions?
Vagus Nerve
Internal = goes through foramen = sensory function
External = is more superficial, motor function for a set of muscles that are just outside the larynx
What set of muscles does the external branch of the superior laryngeal nerve innervate?
Cricothyroid muscles
All of the other muscles (besides cricothyroid muscles) on the inside of the voicebox are innervated by the ___.
What does this nerve wrap around? (Left and Right side of the body)
Inferior laryngeal nerve
Left: Aortic arch
Right: Brachiocephalic trunk
(more superior than left side)
What connects back of thyroid cartilage to the back of the hyoid bone via the thyrohyoid ligament?
Superior Horn of the laryngeal cartilage
At the base of the thyroid cartilage the ___ of the thyroid cartilage connects to the cricoid cartilage via the ____.
Inferior horn
Cricothyroid joint
As we swallow what do the thyroid cartilage and the laryngeal prominence do?
What does this allow the epiglottis to do?
Thyroid cartilage moves up and the laryngeal prominence moves down.
This allows the epiglottis to swing into place and close off the airway.
Where is the access point if we need to place an invasive airway?
Cricothyroid Ligament
What is the name for the pivot point, divot in the side of cricoid cartilage?
Articular Facet for Thyroid cartilage
Size difference between the front and back of the cricoid cartilage?
The front is much narrower compared to the back
(Front = Arch, Back = Lamina)
Name of the place where our cricoid cartilage attaches to our vocal cords?
Articular Facet for arytenoid cartilage
Normal Length of the trachea:
How much is extrathoracic?
10-12 cm
(2-4 cm is extrathoracic)
What is the benefits of the trachial rings being C-Shaped?
- The opening behind trachea provides a structure that isn’t liable to obstructing food stuff from going down esophagus
- Also allows for more flexibility so we can manipulate the shape of the trachea when necessary
What do our tracheal rings do when we cough?
Is this a good thing?
The trachea becomes more narrow = the connective tissue on the back of the rings fold in which makes 2 smaller conduits for air to move through.
It is a good thing, because now we can get rid of the junk faster and get a more productive cough.
Sneeze = 100 mph, Cough 50 mph
How many tracheal rings do we have normally?
How are they fused together?
20
Fused together by some fibrous annular ligaments
What degree angle is formed by the 2 mainstem bronchi?
What about each one specifically?
Overall: 70 degrees
R: 25 degrees
L: 45 degrees
How can the angle of the mainstem bronchi change?
Very large breaths during negative pressure breathing = diaphragm pulls everything down = angle is < 70 degrees
What is the name of the structure on the superior-most point of the arytenoid cartilage?
Corniculate cartilage
What happens to our vocal cords when swallowing?
The vocal cords get more stretched out/taut.
Name the 6 laryngeal Muscles:
- Cricothyroid muscle
- Vocalis muscle
- Thyroarytenoid muscle
- Transverse arytenoid muscle
- Posterior cricoarytenoid muscle
- Lateral cricoarytenoid muscle
Which 2 muscles both tighten the vocal folds, but have no effect on the Rima Glottidis when contracted?
Crocothyroid and vocalis muscle
Vocalis muscle location and attachment points:
Runs just lateral to the vocal ligament.
Attaches at the vocal process of arytenoid cartilage and the front of the thyroid cartilage
Which 3 muscles adduct the vocal cords and close the Rima Glottidis when contracted?
Thyroarytenoid muscle
Transverse arytenoid muscle
Lateral cricoarytenoid muscle
Where does the Transverse arytenoid muscle connect?
connects the middle parts of arytenoid cartilage medially
Which intrinsic muscle will abduct the cords and open the Rima Glottidis?
Posterior Cricoarytenoid Muscle
If we could theoretically pick and choose which muscles we paralyze during intubation, which one would we not want to paralyze?
Why?
Posterior Cricoarytenoid Muscle
It is the only one of these 6 muscles that, when contracted, will open the vocal cords
Most narrow point of the upper airway in an adult and in a kid:
Peds: Cricoid cartilage
Adult: Vocal cords (transglottic space)
Connection of the superior and inferior laryngeal nerve:
Galen’s Anastomosis
When these 3 “sets” of muscles are relaxed, it makes for a much easier intubation.
Superior pharyngeal constrictor muscles
Middle pharyngeal constrictor muscles
Inferior pharyngeal constrictor muscles
The inferior set of the pharyngeal constrictor muscles sit “right on top of” the:
Larynx
What are the muscles above and below the hyoid bone called?
Suprahyoid and Infrahyoid muscles
The Diagastric Muscle has _ parts called “_”
They are seperated by a ____
What are the THREE areas in which this muscle is connected/attached to?
2 parts called “Bellys”
Seperated by a central/intermediate tendon
Mandible, mastoid process and wrapped around the hyoid bone via a connective tissue “sling”
Where is the styloid process located?
What is something per lecture we should know about the styloid process?
Just superior to the Mastoid process
It is very fragile
Which muscle attaches the hyoid bone to the floor of the mouth?
What about attaching the hyoid bone to the jaw?
Mylohyoid
Geniohyoid
What are the names of the 4 infrahyoid muscles?
Omohyoid
Sternohyoid
Sternothyroid
Thyrohyoid
This muscle attaches the hyoid bone to the shoulder.
It also has 2 “bellys” and is fastened into ___ similar to how the diagastric belly is fastened to the hyoid bone.
Omohyoid
Rib 1
