10. Larynx Anatomy & Pathology

Question 1

spinal level of inferior end of larynx

Answer 1

c6- lower border of cricoid cartilage

Question 2

is the hyoid bone part of the larynx?

Answer 2

no, but larynx is suspended from it

Question 3

what type of joints are between laryngeal cartilages?

Answer 3

synovial

Question 4

what forms the margins of laryngeal inlet?

Answer 4

aryepiglottic folds and upper edge of epiglottis

Question 5

what’s an aryepiglottic fold?

Answer 5

free upper border of quadrangular membrane

Question 6

supra glottis

Answer 6

laryngeal inlet up to and includes fans vocal cords

Question 7

glottis

Answer 7

true vocal cords to 1cm below

Question 8

infra glottis

Answer 8

below true vocal cords to inferior boundary of cricoid

Question 9

where does a laryngoscope sit?

Answer 9

valecula

Question 10

why need a laryngoscope for ET tube?

Answer 10

to view vocal cords so ET tube goes into infraglottic region

Question 11

on swallowing, why is epiglottis flattened horizontally?

Answer 11

so bolus diverts over top into piriform fossa, and away from laryngeal inlet

Question 12

position of VCs on swallowing

Answer 12

adducted
larynges inlet also narrowed by muscles in aryepiglottic folds

Question 13

which muscle increases vocal cord tension?

Answer 13

cricothyroid

Question 14

external branch of superior laryngeal nerve is closely related to which artery? what surgery risk damage to it?

Answer 14

superior thyroid artery
thyroid surgery

Question 15

sensory function of superior laryngeal nerve

Answer 15

internal branch- supra glottis and glottis

Question 16

tracheo-oesophageal groove location

Answer 16

behind lobes of thyroid gland

Question 17

does unilateral recurrent laryngeal nerve injury affect breathing?

Answer 17

so significant impairment

Question 18

how to intubate if bilateral recurrent laryngeal nerve injury

Answer 18

(cant do ET tube) need cricothyroidotomy temporarily then tracheostomy

Question 19

typical head position of child with epiglottitis

Answer 19

sniffing positon, helps maintain some latency of airway bye lifting soft tissues off throat

Question 20

why don’t you examine someone with epiglottitis?

Answer 20

cause distress and occlude airway completely

Question 21

common bacterial cause of epiglottitis

Answer 21

haemophilus infuenzae

Question 22

when to consider further care in child with croup

Answer 22

-cyanosis
-stridor at rest

give nebuliser oxygen and adrenaline, corticosteroids

Question 23

stridor

Answer 23

harsh inspiratory noise due to upper airway issue

Question 24

overall goal of airway adjuncts

Answer 24

lift tongue off back of orophraynx

Question 25

2 airway adjuncts

Answer 25

-oropharyngeal airway (contraindicated for slightly conscious patients due to gag reflex)
-nasopharyngeal airway

Question 26

disadvantage of simple airway manoeuvres/airway adjuncts

Answer 26

no protection from secretions/vomit for lower respiratory tract

Question 27

example of supraglottic airway

Answer 27

iGel

Question 28

definitive airway

Answer 28

endotracheal tube, secures and protects lower respiratory tract from secretions/vomit

Question 29

benefits of iGel

Answer 29

-moulds to shape of airway when it warms
-some protection against secretions/vomit
-minimal skills needed