Advanced | Airway Flashcards by Hashim Abdullah

Needle puncture of cricothyroid membrane should be made in:

A. Superior 1/3 of the CTM (cricothyroid membrane)

B. Inferioir 1/3 of the CTM

C. Lateral aspect of CTM

D. Medial aspect of CTM

B. Inferioir 1/3 of the CTM

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Bailey maneuver is a technique of exchanging an ETT for an SGA during extubation attempt. Which of the following anesthetic plane should bailey maneuver be attempted?

A. Stage II

B. Stage III

C. Light anesthesia

D. Stage IV

B. Stage III

An alternative extubation
technique, known as the Bailey maneuver, involves exchanging an ETT for an SGA while the patient is under deep anesthesia.

Extubation during a light plane of anesthesia (stage II) can increase the risk for laryngospasm and
other airway complications and should be avoided.

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Which of the following will highly predict a ‘Difficult
Laryngoscopy’

A. Long upper incisors

B. Inability to protrude mandible

C. Mallampati classification III or IV

D. Limited cervical mobility

E. All of the above

ALL OF THE ABOVE

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Which of the following will highly predict a difficult bag mask-ventilation and difficult laryngoscopy?

A. Long upper incisors

B. Inability to protrude mandible

C. Mallampati classification III or IV

D. Limited cervical mobility

C. Mallampati classification III or IV

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Which is the nerve supply to the all the intrinsic muscles of the larynx?

A. Inferior laryngeal n.

B. Glossopharyngeal n.

C. Superior laryngeal n.

D. recurrent laryngeal n.

The recurrent laryngeal nerves supply all the intrinsic muscles of the larynx (with the exception of the cricothyroid muscle).

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Which of the following is NOT innervated by the recurrent laryngeal nerve?

A. Thyrohyoid m.

B. Cricothyroid m.

C. Posterior cricoarytenoid m.

B. Cricothyroid m.

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This muscle is the tensor of the vocal cord:

A. Thyrohyoid m.

B. Cricothyroid m.

C. Aryepiglotticus m.

D. Thyroepiglotticus m.

B. Cricothyroid m.

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Coughing that occurs during awake intubation can be prevented by local anesthetic blockade at which nerve:

A. Glossopharyngeal n.

B. Hypoglossal n.

C. Recurrent Laryngeal n. & superior laryngeal n.

D. Vagus n.

C. Recurrent Laryngeal n. & superior laryngeal n.

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Suppression of the ‘gag’ reflex during awake intubation can be done with blockade of which nerve?

A. Glossopharyngeal n.

B. Hypoglossal n.

C. Recurrent Laryngeal n.

D. superior laryngeal n.

E. Vagus n.

A. Glossopharyngeal n.

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All of the following are intrinsic muscles of the larynx EXCEPT:

A. Thyrohyoid m.

B. Cricothyroid m.

C. Posterior cricoarytenoid m.

D. Mylohyoid m.

INTRINSIC MUSCLES OF THE LARYNX

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Hoarseness after laryngoscopy is indicative of an injury to which nerve?

A. Unilateral recurrent laryngeal n.

B. Bilateral superior laryngeal n.

C. Unilateral superior laryngeal n.

D. Vagus n.

A. Unilateral recurrent laryngeal n.

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Unopposed vocal cord ADDUCTION means an injury to which nerve?

A. Bilateral recurrent laryngeal n.

B. Bilateral superior laryngeal n.

C. Inferior laryngeal n.

A. Bilateral recurrent laryngeal n.

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The adult larynx is vertically situated in:

A. C4 - C6

B. C5 - C7

C. C3 - C5

A. C4 - C6

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In adult, the 1st tracheal ring is anterior to what cervical vertebrae?

A. C4

B. C5

C. C6

D. C2

C. C6

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TRUE or FALSE

The upper epiglottis is innervated by CN 9 (Glossopharyngeal n.)

TRUE

Upper epiglottis - CN 9

Lower epiglottis - CN 10

Gag reflex - CN 9

Carina is opposite to which level of vertebrae?

A. T7

B. T5

C. T4

B. T5

Larynx in ADDUCTION corresponds to a:

A. closed larynx

B. open larynx

A. closed larynx

ADDUCTION = larynx is closed

ABDUCTION = larynx is open

The muscle responsible for the adduction of larynx:

A. lateral cricoarytenoid

B. posterior cricoarytenoid

C. superior cricoarytenoid

B. posterior cricoarytenoid

ADDUCTION = Closed larynx = Posterior cricoarytenoid m.

ABDUCTION = Open larynx = Lateral cricoarytenoid m.

The most common location where nasogastric tube is misplaced:

A. pyriform fossa

B. arytenoid

C. false cord

A. pyriform fossa

What nerve innervates the cricothyroid muscle?

A. External branch of SLN

B. Internal branch of RLN

C. Internal branch of SLN

A. External branch of SLN

Mouth opening is measured from which of the following among edentulous patient?

A. Interalveolar distance

B. Interincisor distance

C. Perialveolar distance

A. Interalveolar distance

Normal set of teeth = measure from Interincisor distance

Which of the following is the LEAST sensitive indicator of a DIFFICULT LARYNGOSCOPY?

A. Mouth opening

B. Mallampati

C. TM distance

D. Upper lip bite

A. Mouth opening

Mouth opening - 20%

Upper lip bite - 67% (most sensitive indicator)

Which of the following is the LEAST specific indicator of a DIFFICULT LARYNGOSCOPY?

A. TM distance

B. Sternomental distance

C. Mouth opening

D. Mallampati

Mallampati - 80%

Mouth opening - 97% (most specific)

Transtracheal block during awake intubation targets which nerve? A. Recurrent laryngeal n. B. Superior laryngeal n. C. Hypoglossal n.

A. Recurrent laryngeal n.

Tactile sensation from the anterior third of the tongue is carried by fibers of the: A. Trigeminal nerve B. Facial nerve C. Glossopharyngeal nerve D. Hypoglossal nerve

A. Trigeminal nerve The tongue has innervation for both gustatory (aka “taste”) and tactile (general sensory) input. Gustatory (taste) sensation for the anterior two-thirds of the tongue is provided by the facial nerve (CN VII), and for the posterior third of the tongue by the glossopharyngeal nerve (CN IX). Tactile sensation for the anterior two-thirds of the tongue is provided by the trigeminal nerve (CN V), and for the posterior one-third of the tongue by the glossopharyngeal nerve (CN IX).

Which among the following is the MOST SPECIFIC method of airway evaluation? A. Mallampati classification B. Thyromental distance C. Sternomental distance D. Mouth opening

B. Thyromental distance

Which among the following is the most SENSITIVE method of airway evaluation? A. Mallampati classification B. Thyromental distance C. Sternomental distance D. Mouth opening

C. Sternomental distance

Any incisions or needle punctures to the cricothyroid membrane must be made in its ______ to avoid vessel puncture. A. Superior third B. Middle third C. Inferior third

C. Inferior third

The following are independent risk factors for difficult mask ventilation EXCEPT: A. Presence of teeth B. Presence of a beard C. Body mass index >26 ng/m2 D. Age >55 yrs

A. Presence of teeth

Which is NOT among the criteria for difficult mask ventilation? A. Inability for one anesthesiologist to maintain oxygen saturation >92% B. Use of fresh gas flow button more than twice C. Change of operator required D. Minimal gas leak around face mask

D. Minimal gas leak around face mask

Expiratory chin drop facilitates _______ A. Positive pressure inspiration B. Gas egress C. Endotracheal intubation D. LMA placement

B. Gas egress