Exam 3 - Airway Anatomy Flashcards
Describe the main differences between the right and left lung?
Right: 3 lobes, larger
Left: 2 lobes, smaller, taller
Why is the left lung smaller and taller than the right?
- Smaller because the heart takes up space in the left chest
- Taller becasue the heart weighs down the left diaphragm and increases room for the left lung
Label 1 and 2
- Horizontal Fissure of right lung
- Oblique Fissure of right lung
How many bronchopulmonary segments are in the right and left lung?
Right: 10
Left: 8
What is 1 below?
What can be found here?
Costodiaphragmatic recess
Can be a space where air or fluid can collect
Where does the diaphragm anchor?
Lumbar vertebral bodies
What are these?
How many are there?
What is their purpose?
- Scalene muscles
- 6 total, 3 on each side
- Prevents the thorax from being pulled down by the diaphragm
What is the indicated muscle?
What are it’s attachement points?
What is its purpose?
- Sternocleidomastoid muscle
- Attaches to the sternum and mastoid process
- Can contract to prevent the diaphragm from pulling the thorax downwards
Where are the external intercostals?
What is their purpose?
- In between ribs on the outside
- Helps expand the chest outward during forced inspiration
Where are the internal intercostals?
What is their purpose?
- In between ribs on the inside
- Compresses thorax to help with forced expiration
What other muscles help with forced expiration?
Abdominal muscles by pushing up the diaphragm (rectus abdominus and obliques)
Where do the pec minor muscles attach?
How can they aid in respiration?
- Top of the rib cage and shoulder blade
- If you lean against something solid with your arms, the pec minor muscles increase ability to inspire
Label 1, 2, and 3
- Nasopharynx
- Oropharynx
- Laryngopharynx
What type of muscle is the tongue?
How is this affected by NMB?
- Skeletal muscles
- Will be paralyzed and fall into the airway when supine during intubation
What purposes does the porousness of turbinates serve?
- Allows room for lots of blood vessels which humidifies air
- Nerves are also here to sense smell
Label 1, 2, and 3.
Why do the have a curved shaped?
- Superior concha (turbinate)
- Middle concha (turbinate)
- Inferior concha (turbinate)
Curves generate turbulence and helps air run into the walls more - allowing mucous to filter air better
What bone do the superior and middle concha attach to?
Ethmoid bone (in red)
What bone do the inferior concha project from?
Maxilla
Why do we need to be careful when inserting airways into the nose?
The porous turbinates are easily broken, and highly vascular - can lead to blood pooling in the airway
Insert at the floor, the inferior concha are more sturdy
What is 5?
Frontal sinus
What is 4?
What is it’s purpose?
Crista galli
Attachment for falx cerebri
Label 1 and 2
- Crista galli
- Middle concha
What nerve innervates the face?
What are it’s subdivisions?
Cranial Nerve V - Trigeminal
Opthalmic
Maxillary
Mandibular
Why do we get a brain freeze?
The maxillary nerves sense pain, but the parent nerve (trigeminal) gets confused as to where its coming from and registers it as a headache
Label the structure
Mastoid process
Label 1 and 2
Function of 1?
- Cribiform plate of ethmoid bone - nerves that sense smell are here
- Crista galli
What innervates the oropharynx and back of the nasopharynx?
Trigeminal nerve (V)
What innervates the back of the oropharynx and base of the tongue?
Glossopharyngeal nerve (IX)
What innervates the larynx and trachea, as well as the epiglottis?
Vagus nerve (X)
Label 1-3, the nerves are for taste
- Vagus (X)
- Glosspharyngeal (IX)
- Facial nerve - branch of CN VII
Label 4-6, the nerves involed in somatic sensation
- Vagus (X)
- Glossopharyngeal (IX)
- Mandibular nerve - branch of trigeminal (V)
Label 1-4
- Hard Palate
- Soft palate
- Uvula
- Palatine tonsil
What oral structure contributes to snoring and difficult airways?
Soft palate
Label the structures on the right and left
Left - Enlarged palatine tonsils
Right - enlarged pharyngeal tonsils
Why are enlarged pharyngeal tonsils a problem?
They can push the soft palate forward, occluding the airway
What is 1?
Lingual tonsil
Label 1, 2 and 3
What are these?
What happens if these are damaged?
- Sublingual gland
- Submandibular gland
- Parotid gland
Salivary glands
They are highly vascular and will enlarge greatly
What is 6?
What is it made of?
Epiglottis
Cartiledge
What is the small space between 1 and 6?
Vallecula
MAC blade goes here
What are the two ways that the epiglottis is closed?
- The epiglottis moves down
- The larynx moves up
What is 5?
Hyoid bone
Floating
Label the structures
- Epiglottis
- Thyroid cartiledge
- Cricothyroid joint
- Cricoid cartilage
- Hyoid bone
What is the purpose of the cricothyroid joint?
- Attaches the thyroid cartilage to the cricoid cartilage
- Allows for pivoting of the thyroid cartilage downwards
Label the structures and what attaches to each one
- Superior horn of thyroid cartilage - hyoid bone
- Inferior horn of thyroid cartilage - cricoid cartilage
- Left lamina- thyroid gland
- Laryngeal prominence - vocal cords
What causes men to have a deeper voice?
Men have a larger laryngeal prominence, making the vocal cords longer, causing a lower pitch
Label the structures and what they attach to
- Articular facet for arytenoid cartilage
- Articular facet for thyroid cartilage - attaches to inferior horn
- Lamina
Label the image
- Thyroid cartilage
- Cricoid cartilage
- Arytenoid cartilage
The 2 attachments for the vocal cords?
- Arytenoid cartilages
- Laryngeal prominence
Label 1 and 2
- Arytenoid cartilage
- Corniculate cartilage
What are the unpaired cartilages?
Thyroid
Cricoid
What are the paired cartilages?
Arytenoid
Corniculate
What is 1?
What is its function?
Cricothyroid muscle
Pulls thyroid cartilage down, helps with phonation
Label 2, 3, 4 and 5
- Cricoid cartilage
- Cricoid cartilage
- Thyroid cartilage
- Hyoid bone
What is the narrowest part of the airway for an adult?
A child < 10?
Adult: glottic opening
Child < 10: Cricoid cartilage
What is the point of cricoid pressure?
Pressure on the front of the cricoid causes the posterior ring of the cartilage to occlude the esophagus, in order to prevent aspiration in full stomachs
Why is cricoid pressure bad if someone does throw up?
The LES can be permanantly damaged
What is 1?
Pectoralis minor
