Basic Airway Concepts

Question 1

pharynx

Answer 1

back of throat
leads to trachea and esophagus

Question 1

trachea

Answer 1

windpipe
leads to lungs
anterior to esophagus

Question 1

esophagus

Answer 1

canal that carriers food/water from the pharynx to the stomach
posterior to trachea

Question 1

glottis

Answer 1

opening between the vocal cords
opening into the trachea

Question 1

epiglottis

Answer 1

portion of soft tissue in the throat that covers the glottis whenever we swallow

Question 1

what position is the epiglottis usually in?

Answer 1

open for breathing

Question 1

when is the epiglottis closed?

Answer 1

when we swallow
to block food/water from entering trachea/lungs

Question 1

in anesthesia, the epiglotttis…

Answer 1

protects the airway by preventing food/water from entering the trachea and keeping the lungs sterile

Question 1

why do we need to protect the airway?

Answer 1

lungs/vocal cords dislike food/water and will become irritated anytime they come in contact with secretions/saliva/endotracheal tubes

Question 2

airway reflexes

Answer 2

protective reflexes of the airway that keep foreign objects out of the lungs

Question 2

3 types of airway reflexes

Answer 2

1. swallowing
2. bronchospasm
3. laryngospasm

Question 2

swallowing

Answer 2

epiglottis covers glottis
prevents food/water from entering lungs

Question 3

bronchospasm

Answer 3

bronchiole constriction
narrowing of bronchioles w/coughing helps dispel foreign objects that have entered the lungs

Question 4

bronchospasm example

Answer 4

when water accidentally enters the lungs after swallowing and the airway constricts/patient coughs

Question 5

laryngospasm

Answer 5

closed vocal cords
irritated vocal cords completely close off in effect to keep things out of the airway

Question 6

airway reflexes in awake patients

Answer 6

intact
airway is protected

Question 7

airway reflexes in anesthetized patients

Answer 7

depressed
airway is not protected

Question 8

non-protected airways means

Answer 8

gastric contents can bypass the epiglottis and enter the lungs causing aspiration

Question 9

how to prevent aspiration

Answer 9

1. ensure patients have an empty stomach (if possible)
2. intubation - endotracheal tube seals the trachea to protect the airway

Question 10

larynx

Answer 10

aka voice box
includes: epiglottis, glottis, vocal cords, upper trachea

Question 11

thyroid cartilage

Answer 11

covers and protects the larynx
aka adams apple

Question 12

vallecula

Answer 12

pocket where tongue meets the epiglottis

Question 13

arytenoid cartilages

Answer 13

lie posterior to the glottis
can help identify tracheal location in difficult intubation

Question 14

cricoid cartilage

Answer 14

first tracheal ring directly below the thyroid cartilage
only tracheal ring in a complete circle
only tracheal ring in contact w/esophagus

Question 15

cricothyroid membrane

Answer 15

directly between thyroid and cricoid cartilages

Question 16

cricoid pressure

Answer 16

1. prevent aspiration of gastric contents prior to intubation in full stomachs
2. impove view of vocal cords during intubation

Question 17

carina

Answer 17

point where the trachea splits into left and right mainstem bronchus

Question 18

anterior tracheal wall

Answer 18

has rings

Question 19

posterior tracheal wall

Answer 19

has fibers

Question 20

right mainstem bronchus

Answer 20

less of an angle off trachea
leads to 3 lung lobes on right side

Question 21

left mainstem bronchus

Answer 21

more of an angle
leads to 2 lung lobes on the left side

Question 22

bronchioles

Answer 22

smallest airways
smooth muscle
bronchiolar constriction = bronchospasm

Question 23

alveoli

Answer 23

tiny air sacs at the most distal part of the airways
receive blood flow from pulmonary capillaries

Question 24

alveolar capillary membrane

Answer 24

site of gas exchange
pulmonary artery capillaries “pick up” O2 and “drop off” CO2

Question 25

lower esophageal sphincter

Answer 25

“one way valve”
open during swallowing
closed when not swallowing
prevents food from the stomach from coming back up into the esophagus

Question 26

upper esophageal sphincter

Answer 26

“one way valve”
open during swallowing
closed when not swallowing
prevents stomach from inflating when we breathe

Question 27

GERD
(Gastroesophageal Reflux Disease)

Answer 27

patients have decreased lower esophageal sphincter tone
gastic contents go back up into the esophagus
can cause aspiration in non-intubated patients

Question 28

arpiration

Answer 28

foreign objects entering the trachea/lungs
potential fatal