Lecture 1 - Introduction to Airway and Airway Anatomy Flashcards

1
Q

Where does the airway start?

A

nose and mouth

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2
Q

Where does the airway end?

A

Terminal bronchioles

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3
Q

The airway allows for […] to and from alveoli

A

gas exchange

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4
Q

What does the upper airway consist of? (5 structures)

A

nasal cavity, oral cavity, nasopharynx, oropharynx, laryngopharynx

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5
Q

What does the lower airway consist of? (3 structures)

A

trachea, bronchi, alveoli

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6
Q

What seperates the upper and lower airway?

A

Vocal cords (glottic opening)

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7
Q

The pharynx starts at the […] and extends to the […]

A

base of skull , cricoid cartilage

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8
Q

How long (in cm) is the pharynx?

A

12-15 cm

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9
Q

What are the 3 areas of the pharynx?

A

nasopharynx, oropharynx, hypopharynx

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10
Q

What are 2 functions of the pharynx?

A

Respiratory and digestive (swallowing/defend against pathogens/gas exchange)

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11
Q

What level of vertebrae does the pharynx extend to?

A

C6

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12
Q

What nerves provide sensation to the pharynx?

A

trigeminal, glossopharyngeal, vagus

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13
Q

What are some functions of the nasal cavity?

A

Olfaction, respiration, humidification, warming, filtration, secretions, rich blood supply from ophthalmic/maxillary/facial arteries

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14
Q

What can nosebleeds lead to?

A

aspiration

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15
Q

What are turbinates? What are they also called?

A

Protruding structures in nasal passage made of bone/vessels/tissues (nasal conchae)

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16
Q

Turbinates are highly […] which can cause lots of bleeding

A

vascularized

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17
Q

Turbinates spray […] substances to […] blood flow

A

vasoconstrictive , decrease

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18
Q

What should be avoided in patients with facial trauma? Why?

A

positive pressure ventilation; air will enter cranial fossa leading to meningitis or sepsis

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19
Q

Which nare is usually easier to insert a nasal tube through?

A

Right nare

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20
Q

When you are doing a nasal intubation, how should you position the nasal tube when inserting it?

A

Parallel to roof of mouth (NOT UPWARDS - can hit inferior turbinate)

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21
Q

What cranial nerve provides sensation to the mucous membranes of the nasal cavity?

A

Trigeminal Nerve (CN V)

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22
Q

What can nasal drainage lead to?

A

laryngospasm

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23
Q

What can fix nosebleeds?

A

Cauterization

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24
Q

What are 3 solutions to a laryngospasm?

A

positive pressure ventilation, bolus of propofol, paralytic

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25
Q

What 3 arteries supply blood to the nose?

A

ophthalmic, maxillary, facial arteries

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26
Q

What is Kiesselbach’s plexus (little’s area)? What is it a common source of?

A

Network of arteries located in anterior portion of nose; epistaxis

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27
Q

[…] is posterior to the nasal cavity and above the oropharynx

A

Nasopharynx

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28
Q

Nasopharynx serves as a conduit for […]

A

air

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29
Q

What structure in the nasopharynx can lead to ear infections if there is an upper airway infection present?

A

Eustachian tubes

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30
Q

What structures in the nasopharynx can be enlarged and cause obstruction/bleeding/difficult airway?

A

Tonsils/adenoids

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31
Q

What 4 important structures does the oral cavity contain?

A

Hard palate, soft palate, tongue, dentition

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32
Q

What can the patient’s oral cavity provide us clues to?

A

How easy/difficult airway manipulation will be

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33
Q

What nerves provide sensory innervation to the tongue?

A

Trigeminal (CN V) to anterior 2/3rd & Glossopharyngeal (CN IX) to posterior 1/3rd

34
Q

A branch of the […] provides blood flow to the oral cavity

A

external carotid artery

35
Q

What teeth are most likely to be injured during intubation?

A

7, 8, 9, 10

36
Q

How does teeth numbering work?

A

1 to 16 (Right upper corner to left upper corner) ; 17 to 32 (left lower corner to right lower corner)

37
Q

What type of function does the oropharynx have?

A

digestive

38
Q

Oropharynx extends inferiorly from the […] to the […]

A

soft palate ; superior border of epiglottis

39
Q

[…] serves as a passageway for food/liquid into the esophagus

A

oropharynx

40
Q

Laryngopharynx is also known as the […]

A

hypopharynx

41
Q

Laryngopharynx starts at the […] and goes to […]

A

top of the epiglottis ; bottom of cricoid cartilage

42
Q

Laryngopharynx becomes continuous with the […]

A

esophagus

43
Q

At what vertebrae level is the laryngopharynx located?

A

C4-C6

44
Q

At what vertebrae level is the larynx located?

A

C3-C6

45
Q

What structure connects the pharynx with the trachea?

A

larynx

46
Q

[…] serves as a passageway for air and gas exchange and prevents substances from entering trachea

A

larynx

47
Q

What structure is the area of phonation/vocalization?

A

larynx

48
Q

What structure is responsible for coughing?

A

larynx

49
Q

How many cartilages is the larynx comprised of? How many single? How many paired?

A

9 total (3 single / 3 paired)

50
Q

What are the paired cartilage of the larynx?

A

arytenoid, corniculate, cuneiform

51
Q

What are the unpaired cartilage of the larynx?

A

thyroid, cricoid, epiglottic

52
Q

What unpaired cartilage of the larynx is the largest?

A

Thyroid cartilage

53
Q

What cartilage protects the larynx?

A

Thyroid cartilage

54
Q

What structure forms the adam’s apple?

A

Thyroid cartilage

55
Q

[…] is inferior to the thyroid cartilage and the only complete ring in the airway

A

cricoid cartilage

56
Q

[…] is leaf shaped and closes off glottis while eating/drinking to prevent aspiration

A

epiglottic cartilage

57
Q

[…] is a conduit for gas exchange and produces clear secretions

A

trachea

58
Q

Trachea starts […] and ends at […]

A

below cricoid cartilage ; carina

59
Q

What vertebra does the trachea begin?

A

6th cervical

60
Q

How long in cm is the trachea?

A

10-15 cm

61
Q

What is the trachea supported by?

A

16-20 horeshoe shaped cartilages

62
Q

Where should the tip of the MAC blade sit during intubation?

A

Vallecula

63
Q

[…] blade goes past the vallecula during intubation

A

Miller

64
Q

[…] refers to the vocal cords being open and moved away

A

abduction

65
Q

[…] refers to the vocal cords being closed and moving towards each other

A

adduction

66
Q

[…] occurs when vocal cords are closed and stridor is heard

A

laryngospasm

67
Q

What is the purpose of the airway?

A

Filtration/humidification/warming of air AND gas exchange

68
Q

After chewing, the tongue moves […] and food bolus enters […]

A

upward ; esophagus

69
Q

Food travels down esophagus to stomach via […]

A

peristalsis

70
Q

Why is dangerous for substances to enter tracheal opening?

A

Infection and death can occur

71
Q

What cranial nerve provides motor innervation to the tongue?

A

Hypoglossal (CN XII)

72
Q

What cranial nerve allows for taste in the tongue?

A

Facial (VII)

73
Q

What cranial nerve innervates the airway? What are its subdivisions of it?

A

Vagus (CN X) ; Superior laryngeal and Recurrent laryngeal

74
Q

What does the recurrent laryngeal nerve innervate?

A

Intrinsic muscles of larynx except cricothyroid muscle AND sensory below cords

75
Q

What does the superior laryngeal nerve innervate?

A

Internal branch: sensory to posterior epiglottis to vocal cords (above cords)

External branch: motor to cricothyroid muscle

76
Q

What does the glossopharyngeal nerve innervate?

A

Sensory to vallecula and base of tongue

77
Q

What cranial nerve provides the gag reflex?

A

Glossopharyngeal (C9)

78
Q

What cranial nerves are involved in airway innervation?

A

CN 5 / 9 / 10

79
Q

What does unilateral laryngeal nerve damage cause?

A

Hoarseness

80
Q

What does bilateral laryngeal nerve damage cause?

A

aphonia and airway obstruction