physiology of airway protection

Question 1

components that protect the lower airway from aspiration of foreign bodies and secretions

Answer 1

pharynx, epiglottis, vocal cords

Question 2

what does epiglottis do

Answer 2

covers laryngeal inlet during swallowing

Question 3

what is a laryngospasm

Answer 3

prolonged, intense glottic closure and an exaggeration of the glottic closure reflex

results from direct glottic or supraglottic stimulation

Question 4

what is the most important reflex for airway protection

Answer 4

glottic closure reflex

Question 5

treatment for laryngospasm

Answer 5

remove stimulus
CPAP for mild, incomplete glottic closure
deepen anesthesia
muscle relaxation
intubate if necessary

Question 6

signs of partial upper airway obstruction

Answer 6

• diminished tidal exchange
• retraction of upper chest
• snoring sound heard with pharyngeal obstruction
• inspiratory stridor heard with laryngeal obstruction

Question 7

sings of complete upper airway obstruction

Answer 7

lack of air movement/breath sounds

diaphragmatic tugging or paradoxical movements of abdomen and rib cage

Question 8

treatment of upper airway obstruction

Answer 8

head tilt, chin lift, jaw thrust
*moves hyoid bone anteriorly and lifts epiglottis to clear obstruction

place oropharyngeal or nasopharyngeal airway to create an artificial passage behind tongue to allow gas exchange

Question 9

predictors of difficult mask ventilation

Answer 9

M - mask seal (beard)
O - obesity (BMI > 26)
A - age >55y
N - no teeth (edentulous)
S - snores

Question 10

predictors for difficult intubation

Answer 10

L - look externally
E - evaluate mandibular space
M - mallampati classification
O - obstructions
N - neck mobility