Exam 4 - Lecture 1 Flashcards
Upper airway is all _____ cavities.
pharynx
The larynx is a _________ structure that ______ in the middle of the neck.
Cartilagenous; floats
The top of the larynx is connected to the _____. How is it connected? (what type of tissue)
hyoid bone; attaches through ligaments and skeletal muscles
What muscles help secure or camlp larynx to floating hyoid bone?
Pharyngeal muscles
What membrane connects top of thyroid cartilage to hyoid bone?
Thyrohyoid membrane which comes across front of larynx
The trachea is connected to what part of larynx?
base of larynx
What is the length of and width of trachea?
10-13cm long, “couple” cm wide but said its width of their thumb (seems more than a couple to me….)
some folks would say index finger but schmidty says thumb
What manuever changes the length and diameter of the trachea?
Extending the head back will lengthen and make the trachea more narrow, and pushing the head forward will do the opposite.
think of stretching out a plastic tube
The vast majority of trachea is seated where? How many cm?
Inside thorax, 6-9cm
How many cm of trachea is extrathoracic?
4-7cm (based on fact that he said 6-9 is intrathoracic and trachea is 13cm)
the _______ is what connect the trachea cartilage rings to eachother.
annular ligaments
How many cartilaginous rings on average are connected by annular ligaments?
20
Are cartilaginous rings continous?
No
Why does the posterior side of trachea have an opening?
To help us swallow and to help us cough
How does an open back trachea cartilage help with swallowing?
Allows esophagus to expand
How does the trachea increase wind speeds in coughing?
The connective tissue on back of trachea can infold and divide the trachea into “two” areas
whats the role of cilia cells?
Carries junk outta the way
Whats the role of goblet cells?
produce mucus
Cilia in lung cells are positioned around __________
goblet cells
The LEFT lung has __ bronchopulmonary segments that turn into __ segments, which totals __.
4; 2; 8
Right lung has __ total segments.
10
How many total segments between both lungs?
18
during fetal development, the left lung originally starts with 10 segments just like right lung, but two pairs of these segments do what?
Fuse together, reducing total segments to 8.
What are the differences in mainstem sizes between the two lungs?
Right lung has a wider mainstem and left lung has a longer and more narrow mainstem.
How long is the right mainstem?
How long is the left?
“couple cm’s, short and branches almost immediately”
4-6cm
What is the bifurcation angle of each mainstem FROM VERTICAL, and what’s the total angle?
Right: 25 degrees
Left: 45 degrees
Total: 70 degree wedge
The last piece of cartilage on bottom of trachea that starts the bifurcation point is called
carina
What are the 2 spots to do an invasive airway?
Median cricothyroid ligament
Also can go extrathoracic in trachea itself but very limited space
The tissue youre cutting through for an invasive airway is
connective tissue
The median cricothyroid membrane connects what?
Front of cricoid cartilage to front INSIDE of thyroid cartilage
Is the thyroid cartilage continous?
no… open in the back
Is the cricoid cartilage continous?
yes
Most narrow point of airway in 10 years or younger
what about adults?
cricoid cartilage; vocal cords
Fancy name for vocal cords or area between cords?
Transglottic space
What should you be able to palpate after ETT intubation?
The inflated cuff just below the larynx, around the top of the sternum at the sternal notch/angle (he called it both)
What structure do you press on to block off the esophagus?
cricoid cartilage since its continous
Muscle #1 of laryngeal muscles
Cricothyroid muscle
Cricothyroid muscle connects ____ of cricoid cartilage to ____ of thyroid cartilage
front; rear
What happens when the cricothyroid muscle contracts?
Pulls voice box (larynx) down
What is within the cricothyroid muscle structure and what is this thing connected to?
Vocal cords, attached to laryngeal prominence and arytenoid cartilages
What is the only muscle that is fully exterior of larynx?
cricothyroid muscle, rest are internal.
Does the cricothyroid muscle contraction tighten or relax vocal cords?
tighten if the arytenoid cartilage doesnt move.
Does the cricothyroid muscle open or close the vocal cords? What does it do to the pitch of the voice?
NEITHER hehe
It puts tension on them, but thats it.
higher pitched voice
The opening between the vocal cords is called
rima glottidis
Laryngeal muscle #2 is
vocalis muscle
The vocalis muscle runs ____ ___the cords
parallel to
Contracting the vocalis muscle will
tighten up the cords right next to it, same action as cricothyroid.
Will contracting the vocalis muscle open or close the cords?
NEITHER hehe
just like the cricothyroid
Laryngeal muscle #3
thyroarytenoid muscle
The thyroarytenoid muscle attaches what structures?
from back Arytenoid cartilage to medial lateral portion of thyroid cartilage on each side.
The arytenoid cartilage is ____________________ in middle of cartilage, so when it contracts, it rotates the left arytenoid cartilage _____, right arytenoid cartilage ______ and it ____ the vocal cords.
on a swivel with rotational axis cylinder; clockwise; counter clockwise; closes
When you _____ a child, you are taking them
When you give them back, you are ________ them.
abduct; adduct
Adduct means ___ and abduct means ______.
close; open
Abducting little johnny means youre opening a state-wide case, and adducting little johnny closes the case (if you get caught)
What is muscle #4? Where is it and what does it do? Close, open, adduct or abduct?
Transverse arytenoid muscle
Pulls cartilage together, and the rotational axis cylinder on middle of cartilage bends. It CLOSES the vocal cords/ADDUCTS them.
What is the only laryngeal muscle to open the vocal cords?
Posterior cricoarytenoid
What is muscle #5?
Posterior cricoarytenoid
Posterior cricoarytenoid muscle
connects the ____ of arytenoid cartilage to ________ of cricoid cartilage
very back; medial posterior portion
What is the posterior cricoarytenoid muscle opposite of? (the action of another muscle)
thyroarytenoid muscle
What happens if we have a bed set of posterior cricoarytenoid muscles?
Trouble breathing since its the only one that opens the vocal cords
What causes laryngospasm?
Pharyngeal constrictor sets
What is muscle #6 and where is it attached? Open or close?
Lateral cricoarytenoid muscle, from very back of arytenoid cartilages and connects to median lateral cricoid cartilage, aids in closing vocal cords.
Tongue sensory is mostly through what nerve?
CN V (Trigeminal)
What are the 3 divisions of CN V?
Top (V1): forehead
Middle (V2): maxillary (upper mouth and nose)
Bottom (V3): Sensory mandibular division
What do the vocal cords look like while breathing normally? (how much abduction per the chart)
Gentle abduction
What does a stage whisper look like for the cords?
Opening on posterior side, should NOT be vibrating
What do the cords look like during phonation?
Veeeery close together but NOT closed, tightening allows different pitches in voice, and thats why you cant really take a breath while talking (also the fact you’re fucking exhaling, right?)
What nerve innervates and closes voicebox?
inferior laryngeal nerves
What happens if one of our inferior laryngeal nerves are damaged? Who did he use as an example and what does that person claim caused it?
Raspy and offsounding voice; RFK; vaccines
Why can we still speak with minimal nerve function?
Way more muscles that close the cords than open
