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Flashcards > Anesthesia Concepts- Upper Airway > Flashcards

Anesthesia Concepts- Upper Airway Flashcards

0
Q

Nasal Passages Includes:

A

Septum
Turbinates
Adenoids

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1
Q

Upper Airway Includes

A

Nasal Passages and Oral Cavity

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2
Q

Function of Nasal Passage

A

Humidification
Filter
Wark

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3
Q

Oral Cavity includes

A

teeth
tongue
hard palate
soft palate

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4
Q

Cricoid cartilage innervated by:

A

Trigemial Nerve

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5
Q

Posterior 1/3 of tongue innervated by:

A

Glossopharyngeal nerve

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6
Q

Pharnyx includes:

A

Nose to Cricoid cartilage

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7
Q

Nasopharnyx

A

seperates at the soft palate

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8
Q

Oropharanyx includes

A

tonsils, uvula, epiglottis

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9
Q

U shaped space in front of the epiglottis

A

Veleculla

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10
Q

Larynx in the adult is at the (regarding spine)

A

C3 to C6

Epiglottis to the cricoid cartilage

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11
Q

Functions of the Larnyx

A

Airway protection- epiglottis protects from aspiration
Respiration
Phonation

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12
Q

Cricoid cartilage is located at the:

A

C6 vertebrae

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13
Q

Larynx contains:

A

muscles, ligaments and vocal cords

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14
Q

Vocal cord attachment:

A

attach to the angles of the thyroid anteriorly and to the arytenoids posteriorly

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15
Q

Muscles and Ligaments of the Larnyx

A

Thyroid
Cricoid
Arytenoids
Epiglottis

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16
Q

Unique aspect of the cricoid carilage

A

complete cartilanigous Signet-shaped ring

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17
Q

Glottic opening

A
  • triangular fissure btw vocal cords

* narrowest portion of the adult airway (6-9cm)

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18
Q

Larnyx contains how many cartilages?

How many paired? How many unpaired?

A
  • 9 cartilages total
  • 3 paired
  • 3 unpaired
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19
Q

3 paired cartilages of larnyx:

A

Arytenoid
Corniculate
Cuneiform

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20
Q

3 unpaired cartilages of the larnyx

A

Thyroid
Cricoid
Epiglottis

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21
Q

Adduct vocal cords

A

pull cords together

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22
Q

Abduct vocal cord

A

open the vocal cords

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23
Q

Arytenoid attachment

A

posterior attachment to vocal cords

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24
Q

Cuneiform and Corniculate

A

neither play a prominent role in laryngoscopic appearance or function

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25
Q

Thyroid cartilage

A
  • large and most prominent cartilage

* anterior attachment of the vocal cords

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26
Q

Epiglottis

A

covers opening of larynx during swallowing

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27
Q

Indications for endotracheal intubation

A
  • general anesthesia *procedures within the chest, abdomen, head
  • positive airway pressure *protect healthy lung from diseased lung
  • protect airway from aspiration *severe pulm and multi sys injury assoc
  • neuromuscular paralysis resp failure
  • intercranial hypertension
28
Q

Mallampati classification: Class I

A

can visualize faucil pillars, soft palate and uvula

29
Q

Mallampati: Class II

A

visualize pharyngeal pillars and soft palate, with visulaization of the uvula obstructed by the tongue

30
Q

Mallampati: Class III

A

soft palate is visible, base of uvula (cannot see pillars)

31
Q

Mallampati: Class IV

A

only the hard palate is visible; the soft palate, pillars and uvula are not visualized

32
Q

Mallampati

A

the appearance of the posterior pharnyx may predict difficulty in laryngoscopy and visualization of the larnyx

33
Q

Thyromental distance measurement:

A

measured from the border of the mandible process to the thyroid notch with neck fully extended

34
Q

Ideal thyromental distance

A

normal is 4 fingerbreadths (6-6.5cm)

35
Q

Thyromental distance- shorter than 3 finger breadths, receding mandible

A

suggests difficulty in visualizing the larnyx/intubation

36
Q

Name the 3 axes that need to be aligned for successful intubation

A

Oral axis
Pharyngeal axis
Laryngeal axis

37
Q

Narrowest point of the pediatric airway

A

cricoid cartilage

38
Q

Cricothyroid membrane is inferior to

A

thyroid cartilage

39
Q

All intrinsic muscles of the larnyx are supplied by the:

A

recurrent laryngeal nerve (branch of the vagus nerve- CN X)

40
Q

Intrinsic muscles of larnyx are concerned with what movements:

A
  • making alterations in the length and tension of the vocal cords
  • and the size and shape
41
Q

Cricoidthyroid muscle is innervated by

A

external branch of the superior laryngeal nerve

42
Q

Intrinsic muscles of the larnyx that OPEN and CLOSE the glottis:

A
  • lateral cricoarytenoid (adducts)
  • arytenoids (adducts)
  • posterior cricoarytenoid (abducts)
43
Q

What is the ONLY vocal cord ABDUCTOR?

A

posterior cricoarytenoids (recurrent vagus nerve)

44
Q

Intrinsic muscles of the larynx that put TENSION on the vocal ligaments

A
  • cricothyroid
  • vocalis
  • thyroarytenoid
45
Q

Cricothyroid muscle

A

puts tension and elongates the vocal cords

46
Q

Vocalis muscle

A

puts tension and shortens the vocal cords

47
Q

Thyroarytenoid muscle

A

puts tension, shortens and relaxes the vocal cords

48
Q

Extrinsic laryngeal muscles

A

move the larnyx as a whole

49
Q

What are the extrinsic laryngeal muscles

A
  • sternohyoid
  • thyrohyoid
  • omohyoid
    * these 3 move the hyoid bone caudad
  • sternothyroid (moves thyroid cartilage caudad)
50
Q

Carina sits at the

A

5th thoracic vertebrae

51
Q

Lower airway consists of:

A
  • trachea *resp bronchioles
  • carina * alveoli
  • bronchi
  • brochioles
  • terminal bronchioles
52
Q

Trachea (list 4)

A
  • fibromuscular tube 10-20cm long (adult 22mm diameter)
  • 16-20 U shaped cartilages
  • posterior side lacks cartilage
  • bifurcates T4 to carina
53
Q

Airway History/Evaluation

A
  • radiation or burn to head or neck *dysphagia/stridor
  • c-spine pain or LROM *Mallampati
  • RA or ankylosing spondylitis or TMJ *assess surrounding tissue
  • snoring/OSA
  • tracheostomy
54
Q

Caudad

A

down from the head

55
Q

Cephilad

A

toward the head

56
Q

CN I

A

olfactory- smell

57
Q

CN II

A

optic nerve- governs ocular and sensory functions

58
Q

CN III

A

occulomotor-motorically innervates eye muscles and allows the eye to move within the orbit

59
Q

CN IV

A

trochlear- motorically governs the abduction, depression and internal rotation of the eye.

60
Q

CN V

A

trigeminal- governs the sensory innervation of the face, sinuses and teeth
*this nerve branches into three: V/I ophthalmic, V/II maxillary and V/III mandibular nerves.

61
Q

CN VI

A

abducent- innervates the lateral rectus muscle of the eye, which retracts the eye within the orbit

62
Q

CN VII

A

facial- supplies the muscles of the face with motoric fibers and taste sensation to the anterior two thirds of the tongue.

63
Q

CN VIII

A

vestibulocochlear- supply sensory innervation to the inner ear

64
Q

CN IX

A

glossopharyngeal- provides taste sensation for the posterior third of the tongue, sensation to the tonsils, pharynx and middle ear and motoric fibers to the stylopharyngeus muscle and the parotid gland

65
Q

CN X

A

vagus- motorically innervates the heart, lungs, palate, pharynx, larynx, trachea, bronchi and gastrointestinal tract. It provides sensation to the heart, lungs, trachea, bronchi, larynx, pharynx, gastrointestinal tract and the external ear.

66
Q

CN XI

A

accessory- motorically innervates the sternocleidomastoid and trapezius muscles

67
Q

CN XII

A

hypoglossal- motorically innervates the muscles of the tongue

Flashcards (5 decks)

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