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Apex > Laryngeal Anatomy > Flashcards

Laryngeal Anatomy Flashcards

1
Q

What are the three unpaired cartilages of the larynx?

A

Epiglottis

Thyroid

Cricoid

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2
Q

The thyroid cartilage is suspended from the ______ via the _______

A

Hyoid

Thyrohyoid Ligament

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3
Q

The larynx lies anterior to which vertebrae?

A

C3-C6

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4
Q

What is the landmark for a cricothyrotomy?

A

The cricothyroid ligament

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5
Q

There is only one complete cartilaginous ring in the airway:

A

The cricoid cartilage

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6
Q

What are the three paired cartilages of the larynx?

A

Arytenoids

Corniculates

Cuneiform

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7
Q

Identify the orange and blue structures in the photo

A

Blue: Cuneiform

Orange: Corniculate

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8
Q

Identify the following structures:

A
  1. Anterior Commissure
  2. Epiglottis
  3. Ventricular Fold
  4. True Vocal Cord
  5. Aryepiglottic Fold
  6. Tracheal Rings
  7. Posterior Commissure
  8. Corniculate Cartilage
  9. Pyriform Sinus
  10. Cuneiform Cartilage
  11. Glottis
  12. Vallecula
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9
Q

What are some pre-op risk factors for laryngospasm?

A

Active URI in past 2 weeks

Second-hand smoke

GERD

Age < 1 yr

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10
Q

What are some intra-op risk factors for laryngospasm?

A

Light anesthesia (especially when lots of airway manipulation is necessary)

Saliva or blood in the upper airway

HYPERventilation/HYPOcapnea

Surgical Procedures anywhere in the airway

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11
Q

What are some interventions to reduce the risk of laryngospasm?

A

Avoid airway manipulation during light anesthesia

CPAP 5-10 during induction and after extubation

Suction pharynx before intubation

Extubate when the patient is deep or completely awake - not somewhere in between

Laryngeal lidocaine

IV Lidocaine before extubation

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12
Q

How should you treat a laryngospasm?

A
  1. 100% FiO2
  2. Remove noxious stimuli
  3. Deepen anesthesia via IV (if complete) or gas (if some air is moving)
  4. CPAP 15-20 with chin lift/jaw thrust
  5. Succinylcholine
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13
Q

If you give a child < 5 years succinylcholine for a laryngospasm, you also need to give ______

A

Atropine 0.02 mg/kg to prevent bradycardia

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14
Q

What is Larson’s Maneuver?

A

Applying pressure just behind the earlobe toward the base of the skull

Displaces the mandible and triggers pt to sigh, breaking the spasm

Apply for 5 sec, release for 10 and repeat

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15
Q

What non-depolarizing NMB can be given IM?

A

Rocuronium

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16
Q

During anesthesia, the upper airway can obstruct in three places:

A

Soft Palate

Tongue

Epiglottis

17
Q

Relaxation of the _____ muscle causes the tongue to form an upper airway obstruction

A

genioglossus

18
Q

Relaxation of the _____ muscle can cause obstruction at the level of the soft palate

A

tensor palatine

19
Q

Identify the structure

A

Adenoid Tonsil

20
Q

Identify the structure

A

Lingual Tonsil

21
Q

When inserting a nasal airway, the bevel should face:

A

out, with the pointed end against the septum

Prevents the point from making contact with the turbinates

22
Q

Anytime you place a device in the nose, you should place it between which two structures?

A

Inferior turbinate

Floor of the nasal cavity

23
Q

Why do people revert to mouth breathing when they’re in distress?

A

Resistance through the nares is 2x higher than through the mouth

24
Q

Due to pressure, the airway tends to ______ during inspiration

A

collapse

Negative pressure in the thorax pulls air in, which naturally makes the soft tissues likely to collapse

25
Q

In normal states, which three muscles keep the airway from collapsing during inspiration?

These muscles are collectively called:

A

Tensor Palatine (opens the nasopharynx)

Genioglossus (opens the oropharynx)

Hyoid Muscles (opens the hypopharynx)

The Pharyngeal Dilators

26
Q

In terms of airway structures, the trachea begins at _____ and ends at _____

A

The bottom of the cricoid

the carina

27
Q

The right bronchus departs from midline at an angle of ______

The left bronchus has an angle of _____

A

25

45

RIGHT MAIN STEM INTUBATION MORE COMMON

28
Q

What are Type 1 Pneumocytes?

A

Flat squamous cells

80% of Surface Area for gas exchange

Form tight junctions

29
Q

What are Type II Pneumocytes?

A

Produce surfactant

Resistant to oxygen toxicity

Capable of cell division

Can produce Type I cells

30
Q

What are Type III Pneumocytes?

A

Macrophages

Fight Infections, produce inflammation etc

31
Q

In terms of vertebrae, the trachea begins at _____ and ends at _____

A

C6

T4-T5

32
Q

Sensory innervation of the trachea is provided by:

A

RLN

33
Q

What is the standard distance from the incisors to the carina?

A

~ 26 cm:

~13cm from the incisors to the larynx

~13cm from the larynx to the carina

34
Q

Until the age of 5, what is the angle of the L and R bronchi at the carina?

A

55 degrees for BOTH

35
Q

What decreases as an airway bifurcates?

A

Airflow Velocity

Amount of cartilage

Goblet Cells

Ciliated Cells

36
Q

What increases as an airway bifurcates?

A

Number of airways

Cross-Sectional Area

Muscular Layer

37
Q

What 2 landmarks correspond with the carina?

A

Angle of Louis

T4-T5

38
Q

What is the afferent limb of the laryngospasm pathway?

What is the Efferent?

A

Afferent: Internal SLN
Efferent: Ext SLN and RLN

Apex (46 decks)

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