ANATOMY OF NEONATAL AIRWAY

Question 1

Complicating anatomic factors in infants (6)

Answer 1

1. Narrow nares
2. Large tongue
3. High glottis
4. Slanting vocal cords
5. Narrow cricoid ring
6. Large occiput

Question 2

Level of glottis

1. Adult
2. Full-term infant
3. Premature infant

Answer 2

1. Adult - C5-C6
2. Full-term infant - C4
3. Premature infant - C3

Question 3

Infant’s LARYNX

Answer 3

Anterior/Cephalad

Question 4

Epiglottis

Answer 4

Omega/tubular shaped

Question 5

Aryepiglottic folds

Answer 5

Thick and bulky

Question 6

Vocal cords

Answer 6

Anterior-slanting

Question 7

Tip of glottis

Answer 7

C1

Close apposition with soft palate allowing newborns to simultaneously suckle and breathe (preferential nasal breathers)

Question 8

Neonatal subglottic area

Answer 8

Funnel shaped

Question 9

Narrowest aspect of upper airway

1. Adult
2. Neonate

Answer 9

1. Adult - Vocal cords

2. Neonate - Cricoid ring (first complete cartilaginous ring)

Question 10

Tube sizes: UNCUFFED

Answer 10

1. <1500 g - 2.5 mm
2. 1,500 to full term - 3 mm
3. Neonate to 6 monts - 3.5 mm
4. 0.5 to 1.5 year - 4 mm
5. > 2 years old - age/4+4

Question 11

Tube size: CUFFED

Answer 11

1. <2 years old - age/4 + 3

2. >2 years old - age/4 + 3.5

Question 12

Tube length

Answer 12

1. <1000 g - 6 cm
2. 1000 to 3000 g - 7 to 9 cm
3. Term neonates - 10 cm
4. Infants and children - 10 + age