Airway anatomy 3

Question 1

Tensor palantine muscle relaxation will MOST likely cause airway obstruction at which level?
a. hard palate
b. soft palate
c. epiglottis
d. tongue

Answer 1

b. soft palate

Question 2

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

Answer 2

soft palate
tongue
epiglottis

Question 3

The upper airway extends from the ____ & _______ to the _________

Answer 3

mouth & nares to the cricoid cartilage

Question 4

Airway resistance is _________ in the nasal passage compared to the mouth

Answer 4

2x higher

Question 5

The primary functions of the upper airway include

Answer 5

warming & humidifying inspired air, filtering particulate matter, and preventing aspiration

Question 6

The nasal turbinates project from

Answer 6

the lateral wall of each nasal passage (have 3 on each side)

Question 7

The nasal turbinates are highly

Answer 7

vascular & they’re at risk for trauma during airway instrumentation

Question 8

To reduce the risk of trauma during airway instrumentation, you should direct the NPA

Answer 8

between the inferior turbinate and the floor of the nasal cavity

Question 9

Anesthetic agents reduce ______- muscle tone

Answer 9

pharyngeal dilator muscle tone which can cause airway obstruction

Question 10

If you have obstruction at the level of the tongue, this is

Answer 10

genioglossus muscle relaxation (most common)

Question 11

If you have obstruction at the level of the soft palate, this is

Answer 11

tensor palantine muscle relaxation

Question 12

Anatomic factors that impact airway patency include

Answer 12

obesity, large tongue, tonsil/adenoid hypertrophy, and craniofacial deformity

Question 13

What are the three sets of dilator muscles in the upper airway that counteract the tendency for airway collapse when the patient takes a breath?

Answer 13

tensor palantine
genioglossus
hyoid muscles

Question 14

Conditions that reduce the diameter of the pharynx include

Answer 14

reduce pharyngeal dilator muscle tone
negative pressure during inspiration

Question 15

Conditions that reduce the size of the box (head and neck tissue) include

Answer 15

increased soft tissue inside the box: obesity, large tongue, tonsil/adenoid hypertrophy
decreased size of the box: small craniofacial structures, craniofacial deformity

Question 16

What does the tensor palatine do?

Answer 16

opens the nasopharynx

Question 17

What does the genioglossus muscle do?

Answer 17

opens the oropharynx

Question 18

What does the hyoid muscle do?

Answer 18

opens the hypopharynx

Question 19

When compared to the trachea, which factor is GREATER in the terminal bronchioles?
a. total cross-sectional area
b. airflow velocity
c. amount of cartilage
d. quantity of goblet cells

Answer 19

a. total cross-sectional area

Question 20

The lower airway begins at _________ and ends at __________

Answer 20

the trachea and ends at the alveoli

Question 21

The trachea begins at

Answer 21

the inferior border of the cricoid cartilage and ends at the carina

Question 22

Where is the carina located?

Answer 22

T4-T5

Question 23

Neck flexion ______ the distance from the mouth to the carina

Answer 23

reduces

Question 24

Neck extension _____ the distance from the mouth to the carina

Answer 24

increases (the tube follows the nose)

Question 25

The lower airway begins as __________, and then it continues to bifurcate along __________

Answer 25

a single tube (the trachea) and then bifurcates along 23 generations

Question 26

Type 1 pneumocytes provide

Answer 26

the surface for gas exchange

Question 27

Type 2 pneumocytes

Answer 27

produce surfactant and they can also produce type 1 pneumocytes

Question 28

In children up to 3 years of age, both bronchi take off

Answer 28

55 degrees from the long axis of the trachea

Question 29

Describe why there is greater likelihood for right mainstem intubation?

Answer 29

the right bronchus projects at 25 degrees where as the left takes off at 45 degrees

Question 30

Type III pneumocytes

Answer 30

are macrophages & fight lung infection & produce inflammatory response

Question 31

_______ are present in the alveoli in smokers and patients with acute lung injury

Answer 31

Neutrophils

Question 32

The distance from the incisors to the carina is

Answer 32

~26 cm

Question 33

As the airway bifurcates, these factors increase

Answer 33

number of airways
total cross-sectional area

Question 34

As the airway bifurcates, these factors decrease

Answer 34

airflow velocity
amount of cartilage
goblet cells (produce mucus)
ciliated cells (clear mucus)

Question 35

These factors are variable as the airway bifurcates:

Answer 35

muscular layer

Question 36

What vertebral level corresponds with the adult trachea?

Answer 36

C6

Question 37

What 2 landmarks correspond with the carina?

Answer 37

T4-T5
angle of louis

Question 38

What structures permit air movement between alveoli?

Answer 38

pores of Kohn