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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
Cuneiform and Corniculate
neither play a prominent role in laryngoscopic appearance or function
25
Thyroid cartilage
* large and most prominent cartilage | * anterior attachment of the vocal cords
26
Epiglottis
covers opening of larynx during swallowing
27
Indications for endotracheal intubation
* 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
Mallampati classification: Class I
can visualize faucil pillars, soft palate and uvula
29
Mallampati: Class II
visualize pharyngeal pillars and soft palate, with visulaization of the uvula obstructed by the tongue
30
Mallampati: Class III
soft palate is visible, base of uvula (cannot see pillars)
31
Mallampati: Class IV
only the hard palate is visible; the soft palate, pillars and uvula are not visualized
32
Mallampati
the appearance of the posterior pharnyx may predict difficulty in laryngoscopy and visualization of the larnyx
33
Thyromental distance measurement:
measured from the border of the mandible process to the thyroid notch with neck fully extended
34
Ideal thyromental distance
normal is 4 fingerbreadths (6-6.5cm)
35
Thyromental distance- shorter than 3 finger breadths, receding mandible
suggests difficulty in visualizing the larnyx/intubation
36
Name the 3 axes that need to be aligned for successful intubation
Oral axis Pharyngeal axis Laryngeal axis
37
Narrowest point of the pediatric airway
cricoid cartilage
38
Cricothyroid membrane is inferior to
thyroid cartilage
39
All intrinsic muscles of the larnyx are supplied by the:
recurrent laryngeal nerve (branch of the vagus nerve- CN X)
40
Intrinsic muscles of larnyx are concerned with what movements:
* making alterations in the length and tension of the vocal cords * and the size and shape
41
Cricoidthyroid muscle is innervated by
external branch of the superior laryngeal nerve
42
Intrinsic muscles of the larnyx that OPEN and CLOSE the glottis:
* lateral cricoarytenoid (adducts) * arytenoids (adducts) * posterior cricoarytenoid (abducts)
43
What is the ONLY vocal cord ABDUCTOR?
posterior cricoarytenoids (recurrent vagus nerve)
44
Intrinsic muscles of the larynx that put TENSION on the vocal ligaments
* cricothyroid * vocalis * thyroarytenoid
45
Cricothyroid muscle
puts tension and elongates the vocal cords
46
Vocalis muscle
puts tension and shortens the vocal cords
47
Thyroarytenoid muscle
puts tension, shortens and relaxes the vocal cords
48
Extrinsic laryngeal muscles
move the larnyx as a whole
49
What are the extrinsic laryngeal muscles
* sternohyoid * thyrohyoid * omohyoid * these 3 move the hyoid bone caudad * sternothyroid (moves thyroid cartilage caudad)
50
Carina sits at the
5th thoracic vertebrae
51
Lower airway consists of:
* trachea *resp bronchioles * carina * alveoli * bronchi * brochioles * terminal bronchioles
52
Trachea (list 4)
* fibromuscular tube 10-20cm long (adult 22mm diameter) * 16-20 U shaped cartilages * posterior side lacks cartilage * bifurcates T4 to carina
53
Airway History/Evaluation
* 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
Caudad
down from the head
55
Cephilad
toward the head
56
CN I
olfactory- smell
57
CN II
optic nerve- governs ocular and sensory functions
58
CN III
occulomotor-motorically innervates eye muscles and allows the eye to move within the orbit
59
CN IV
trochlear- motorically governs the abduction, depression and internal rotation of the eye.
60
CN V
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
CN VI
abducent- innervates the lateral rectus muscle of the eye, which retracts the eye within the orbit
62
CN VII
facial- supplies the muscles of the face with motoric fibers and taste sensation to the anterior two thirds of the tongue.
63
CN VIII
vestibulocochlear- supply sensory innervation to the inner ear
64
CN IX
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
CN X
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
CN XI
accessory- motorically innervates the sternocleidomastoid and trapezius muscles
67
CN XII
hypoglossal- motorically innervates the muscles of the tongue

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