Basic Airway Concepts Flashcards
pharynx
back of throat
leads to trachea and esophagus
trachea
windpipe
leads to lungs
anterior to esophagus
esophagus
canal that carriers food/water from the pharynx to the stomach
posterior to trachea
glottis
opening between the vocal cords
opening into the trachea
epiglottis
portion of soft tissue in the throat that covers the glottis whenever we swallow
what position is the epiglottis usually in?
open for breathing
when is the epiglottis closed?
when we swallow
to block food/water from entering trachea/lungs
in anesthesia, the epiglotttis…
protects the airway by preventing food/water from entering the trachea and keeping the lungs sterile
why do we need to protect the airway?
lungs/vocal cords dislike food/water and will become irritated anytime they come in contact with secretions/saliva/endotracheal tubes
airway reflexes
protective reflexes of the airway that keep foreign objects out of the lungs
3 types of airway reflexes
- swallowing
- bronchospasm
- laryngospasm
swallowing
epiglottis covers glottis
prevents food/water from entering lungs
bronchospasm
bronchiole constriction
narrowing of bronchioles w/coughing helps dispel foreign objects that have entered the lungs
bronchospasm example
when water accidentally enters the lungs after swallowing and the airway constricts/patient coughs
laryngospasm
closed vocal cords
irritated vocal cords completely close off in effect to keep things out of the airway
airway reflexes in awake patients
intact
airway is protected
airway reflexes in anesthetized patients
depressed
airway is not protected
non-protected airways means
gastric contents can bypass the epiglottis and enter the lungs causing aspiration
how to prevent aspiration
- ensure patients have an empty stomach (if possible)
- intubation - endotracheal tube seals the trachea to protect the airway
larynx
aka voice box
includes: epiglottis, glottis, vocal cords, upper trachea
thyroid cartilage
covers and protects the larynx
aka adams apple
vallecula
pocket where tongue meets the epiglottis
arytenoid cartilages
lie posterior to the glottis
can help identify tracheal location in difficult intubation
cricoid cartilage
first tracheal ring directly below the thyroid cartilage
only tracheal ring in a complete circle
only tracheal ring in contact w/esophagus
cricothyroid membrane
directly between thyroid and cricoid cartilages
cricoid pressure
- prevent aspiration of gastric contents prior to intubation in full stomachs
- impove view of vocal cords during intubation
carina
point where the trachea splits into left and right mainstem bronchus
anterior tracheal wall
has rings
posterior tracheal wall
has fibers
right mainstem bronchus
less of an angle off trachea
leads to 3 lung lobes on right side
left mainstem bronchus
more of an angle
leads to 2 lung lobes on the left side
bronchioles
smallest airways
smooth muscle
bronchiolar constriction = bronchospasm
alveoli
tiny air sacs at the most distal part of the airways
receive blood flow from pulmonary capillaries
alveolar capillary membrane
site of gas exchange
pulmonary artery capillaries “pick up” O2 and “drop off” CO2
lower esophageal sphincter
“one way valve”
open during swallowing
closed when not swallowing
prevents food from the stomach from coming back up into the esophagus
upper esophageal sphincter
“one way valve”
open during swallowing
closed when not swallowing
prevents stomach from inflating when we breathe
GERD
(Gastroesophageal Reflux Disease)
patients have decreased lower esophageal sphincter tone
gastic contents go back up into the esophagus
can cause aspiration in non-intubated patients
arpiration
foreign objects entering the trachea/lungs
potential fatal
