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Basics EXAm 1 > Apex WB #1-Airway Anatomy > Flashcards

Apex WB #1-Airway Anatomy Flashcards

1
Q

Laryngeal muscles are classified as

A

Intrinsic or Extrinsic

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2
Q

intrinsic laryngeal muscles control the

A

Tension & position of the vocal cords

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3
Q

The Recurrent laryngeal nerve innervates

A

ALL the intrinsic laryngeal muscles, which are innervated by the external branch of the superior laryngeal nerve

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4
Q

The posterior cricoarytenoid is responsible for

A

Opening the vocal cords

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5
Q

The extrinsic laryngeal muscles support the

A

Larynx inside the neck & assist with swallowing

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6
Q

All the extrinsic muscle (except the digastric) end in

A

-HYOID

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7
Q

The cricothyroid____the VC

A

Elongates/Tenses

(SLN external branch)

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8
Q

The Thyroarytenoid ______ the vocal folds & _____ the glottis

A

Shortens/relaxes

ADDUCTS vocal folds

Closes glottis

(RLN)

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9
Q

The Vocalis causes

A

Shortening & relaxation

(RLN)

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10
Q

The lateral Cricoarytenoid causes _____ of vocal folds & ____glottis

A

ADDUCTION

Closes glottis

(RLN)

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11
Q

The Posterior Cricoarytenoid _____ vocal folds & _____ glottis

A

ABDUCTS

Opens glottis

(RLN)

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12
Q

Muscular Innervation=

SCAR

A

Superior Laryngeal- Cricothyroid Muscle

All others- Recurrent Laryngeal

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13
Q

The _____ nerve provides sensory innervation to the face & neck

A

Trigeminal

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14
Q

Ophthalmic covers

A

Nares & anterior 1/3 of nasal septum

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15
Q

Maxillary covers

A

Turbinates & nasal septum

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16
Q

Mandibular covers

A

Anterior 2/3 of tongue (somatic)

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17
Q

The Glossopharyngeal nerve (CN9) provides sensation from the

A

Oropharynx down to the anterior side of the epiglottis

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18
Q

The vagus nerve (CN 10) gives rise to the

A

Superior laryngeal nerve, which divides into the internal & external branches

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19
Q

The SLN internal branch provides

A

Sensory function

Posterior side of epiglottis (level of vocal cords)

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20
Q

The SLN external branch provides

A

Motor function

Cricothyroid muscle (tenses VC)

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21
Q

The Vagus nerve also gives rise to the

A

RLN, which provides sensation to the level of VC to the trachea

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22
Q

The RLN innervates the

A

Posterior cricoarytenoid muscle

When paralyzes, the cord tensing action of the cricothyroid muscle acts unopposed

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23
Q

Bilateral RLN injury (acute) will cause

A

respiratory distress

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24
Q

Bilateral RLN (chronic) will cause

A

No respiratory distress

25
Q

What happens with the SLN is injured?

A

No respiratory distress, but can cause hoarseness

26
Q

What structures need to be anesthetized for an awake intubation?

A

Base of tongue

Oro/Hypo pharynx

Larynx

27
Q

What is the treatment for Methemoglobinemia?

A

Methylene Blue

28
Q

When should Cocaine be avoided?

A

PChE deficiency

MAOI use

Increase in SNS tone

Hx CAD

29
Q

What 3 nerves need to be blocked for an awake intubation?

A

Glossopharyngeal (bilat)

Superior laryngeal (Bilat)

RLN (transtracheal)

30
Q

The adult larynx lies anterior to

A

C3-C6

31
Q

Where is the narrowest region in the adult airway

A

Glottic opening

32
Q

The pediatric larynx is shaped like a funnel when they are

A

Less than or equal to 5 years old

33
Q

What is the narrowest fixed region in the airway of a pediatric patient?

A

Cricoid Ring

34
Q

What is the narrowest dynamic region in the airway of a pediatric patient?

A

Vocal Cords

35
Q

What are the common signs of laryngospasm?

A

Inspiratory Stridor

Suprasternal/Clavicular retraction during Inspiration

Rocking hoarse of chest wall

Increased Diaphragmatic excursion

Lower Rib flailing

Absent/altered EtCO2 waveform

36
Q

What are common causes of laryngospasm?

A

Less than 1 year old

Active/recent respiratory infection

2nd hand smoke

Reactive airway disease

GERD

Hypervent/Hypocapnia

37
Q

What maneuver can relieve laryngospasm?

A

Larson’s

Hold pressure & given 15-20cmH2O of CPAP

38
Q

In the adult, how much Succinylcholine can be given to break a laryngospasm?

A

IV 0.1-1mg/kg

IM 4mg/kg

39
Q

What is the Valsalva maneuver?

A

Exhalation against a closed glottis

Ex: coughing, bucking or bearing down

40
Q

What is the risk of Valsalva maneuver?

A

Increased pressure in the thorax, ABD & brain

41
Q

What is the Muller’s maneuver?

A

Inhalation against a closed glottis

Ex: bite ETT & takes a deep breath

42
Q

What is the risk of Muller’s maneuver?

A

Sub-atmospheric pressure in the thorax, leading to negative pressure & pulmonary edema

43
Q

The bevel when placing a naso instrument should point towards the

A

Turbinates

44
Q

Anesthetic agents reduce

A

Pharyngeal delator muscle tone, leading to obstruction

45
Q

What is the most common type of airway obstruction?

A

At the level of the tongue

Genioglossus muscle relaxation

46
Q

What is another location where airway obstruction can occur?

A

Level of soft palate

Tensor palatine muscle relaxation

47
Q

The genioglossus muscle helps

A

Open oropharynx

48
Q

The tensor palatine muscle opens the

A

Nasoparynx

49
Q

The carina is at

A

T4-5

Angle if Louis

50
Q

What allows air movement between alveoli?

A

Pores of Kohn

51
Q

Type 1 pneumocytes participate in

A

Gas Exchange

52
Q

Type 2 pneumocytes participate in

A

Production of surfactant

Resistant to O2 toxicity

Produce type 1

53
Q

Type 3 pneumocytes are

A

Macrophages

54
Q

Neutrophils are present in the

A

Alveoli in smokers & patients with acute lung injury

55
Q

The SLN innervates the

A

Cricothyroid muscle

Underside of the epiglottis

56
Q

What 4 structures are involved in airway innervation?

A

Trigeminal

Glossopharyngeal

SLN

RLN

57
Q

What are the Neural pathways of the Airway

A

Trigeminal CN5 (sensory)

Glossopharyngeal CN9 (afferent nerve gag reflex-soft palate stimulation)

Vagus CN 10 (efferent limb-pharyngeal constriction

58
Q

Tongue movement is due to

A

CN 12

59
Q
A

Basics EXAm 1 (4 decks)

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