Review Exam 1 Chapter 22 Flashcards
How much resistance to breathing does the nose provide?
2/3
What separates the upper and lower airway?
Cricoid cartilage
The pharynx extends from the _____ to the ______
base of the skull, level of the cricoid cartilage
What cervical level does the nasopharynx lie? It is bound superiorly to _____ and inferiorly by the ______
C1
Base of the skull
Soft palate
What level does the oropharynx lie? It is bound superiorly by the _____ and inferiorly by the ______
C2 - C3
Soft Palate
Epiglottis
Where does the hypopharynx lie? It is bound superiorly by the _____ and inferiorly by the _____
C5 - C6
Superior border of the epiglottis
Inferior border of the cricoid cartilage
What is the purpose of the cricopharyngeus muscle?
Acts as a barrier to regurgitation in the conscious patient.
What is the motor innervation of the hypopharynx
External SLN - Cricothyroid muscle
RLN - Everything else
What is the sensory innervation of the hypopharynx?
Internal branch of SLN - above vocal cords
RLN - Below vocal cords to trachea
What happens with unilateral injury to the RLN?
Hoarseness
What happens with bilateral injury to the RLN?
Stridor which may lead to severe respiratory distress.
The larynx begins at the epiglottis and extends to the _____
Cricoid cartilage
What three things is the larynx composed of?
3 paired cartilages
3 single cartilages
Intrinsic and extrinsic muscles
What are the 3 single cartilages?
thyroid
cricoid
epiglottis
What are the 3 paired cartilages?
Arytenoid
Corniculate
Cuneiform
What are the 4 functions of the larynx?
- Protect the lower airway from aspiration
- Patency between the hypopharynx and trachea
- Gag & cough reflexes
- Phonation
Blood supply to the larynx originates from the _____.
External carotid
What supplies blood to the supraglottic region of the larynx?
Superior laryngeal artery (arises from superior thyroid artery which is a branch of the external carotid)
What supplies blood to the infraglottic region of the larynx?
Inferior laryngeal artery (a terminal branch of the inferior thyroid artery)
What laryngeal muscles elongate the vocal cords?
CricoThyroid (Chords Tense)
What laryngeal muscles abduct the vocal cords?
Posterior CricoArytenoids (Please Come Apart)
What laryngeal structures Adduct the airway?
Lateral CricoArytenoids
How long is the trachea in adults?
10-20 cm
The trachea is composed of _____ to ______ C-shaped rings
16 to 20
What is the only complete tracheal ring in the trachea?
Cricoid Cartilage
What is the angle of bifurcation of the right mainstem bronchus?
25 - 30 degrees
What is the distance from the right bifurcation to the right upper lobe?
2.5 cm
What is the angle of the left mainstem bronchus?
45 degrees
How long is the left mainstem bronchus?
5 cm
Where do the tracheobronchial trees receive sympathetic and parasympathetic innervation?
Sympathetic: 1st - 5th thoracic ganglia
Parasympathetic: Vagus
What are the hallmark signs of an upper airway obstruction?
Hoarse/muffled voice
Difficulty swallowing secretions
Stridor
Dyspnea
Stridor is associated with a ____% decrease in airway circumference or ____ mm or less
50%
4.5mm
What 3 cranial nerves need to be considered during an airway block?
Trigeminal, Cranial, and Vagus
What does the trigeminal nerve innervate in the arway?
- opthamalic & maxillary division: nasal septum and lateral wall
- maxillary division: forms lingual nerve which provides sensation to anterior 2/3 of tongue
What does the glossopharyngeal nerve innervate in the airway?
Posterior 1/3 of the tongue, soft palate, and oropharynx.
Application of local anesthetic into the nasal passages blocks which nerves?
anterior ethmoidal, nasopalatine, and sphenopalatine nerve.
Methemoglobinemia is associated with what type of topical spray?
Benzocaine (hurricane) spray
How much cricoid pressure should be applied to prevent aspiration?
20 N (2kg) of force prior to loss of consiousness and then 40 N (4 kg) of force after loss of consiousness
LMA size 1 weight
less than 5 kg
LMA 1.5 weight
5-10 kg
LMA 2 weight
10 - 20 kg
LMA 2.5 weight
20-30 kg
LMA 3 weight
30-50 kg
LMA 4 weight
50-70
LMA 5 weight
70-100 kg