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Principles II > Airway anatomy > Flashcards

Airway anatomy Flashcards

(54 cards)

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1
Q

What type of intubation is associated with 80% of laryngeal injuries?

A

Routine, non-difficult tracheal intubation

Routine doesn’t mean risk-free!*

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2
Q

What is the most common injury reported in airway management claims?

A

Vocal cord paralysis

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3
Q

What do death, brain damage, airway injury, and aspiration in difficult airway claims have in common?

A

All are related to loss of airway

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4
Q

What structure separates the upper and lower airway?

A

Cricoid cartilage

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5
Q

What structures are included in the UPPER airway?

A

Nose, mouth, pharynx, hypopharynx (laryngopharynx), larynx, vocal cords

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6
Q

What anatomical structures are included in the lower airway?

A

Trachea, bronchi, bronchioles, terminal bronchioles, respiratory bronchioles, alveoli

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7
Q

What is the cervical vertebral level of the larynx?

A

C4-C6

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8
Q

How many cartilages are in the larynx?

A

9 cartilages

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9
Q

Which cartilages are unpaired?

A

There are 3 single cartilages:
Thyroid
Cricoid–complete ring
Epiglottis

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10
Q

Which cartilages are paired?

A

There are 3 paired cartilages:
Corniculate–horn shaped
Cuneiform–wedge shaped
Arytenoid–looks like the sorting hat from Harry Potter

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11
Q

What are the 3 major functions of the larynx?

A

1) Protection of the lower airway
2) Facilitate respiration
3) Facilitate phonation

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12
Q

What is the area between the tongue and epiglottis?

A

Vallecula

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13
Q

Which blade goes into the vallecula?

A

Macintosh

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14
Q

What makes the hyoid bone anatomically unique?

A

It does not articulate with any other bone

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15
Q

What does the hyoid bone indirectly attach to?

A

Styloid process
Thyroid cartilage

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16
Q

What does the hyoid bone directly attach to?

A

Intrinsic tongue muscles and pharyngeal constrictors

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17
Q

What does the hyoid bone do?

A

During swallowing: moves superiorly and anteriorly, which elevates the larynx and helps the epiglottis close over the laryngeal inlet, preventing aspiration.

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18
Q

Know this

A

TEST QUESTION

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19
Q

Know this

A

TEST QUESTION

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20
Q

What membrane lies between the thyroid cartilage and hyoid bone?

A

Thyrohyoid membrane

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21
Q

What membrane lies between the thyroid and cricoid cartilages?

A

Cricothyroid ligament

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22
Q

Which cartilage forms a complete ring?

Study These Flashcards
A

Cricoid cartilage

23
Q

What are the two laryngeal joints?

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A

Cricothyroid joint
Cricoarytenoid joint

24
Q

What is the narrowest part of the adult airway?

25
What is the narrowest part of the pediatric airway?
Cricoid
26
Describe the false vocal cords
Vestibular folds which are narrow bands of fibrous tissue on each side
27
Describe the true vocal cords
Pale, white ligament bands
28
How long is the trachea?
10-15 cm
29
What vertebral discs is the trachea at?
C6 to T5 (carina)
30
In a cross section view, is the trachea of the glottic opening larger?
The trachea is LARGER than the glottic opening
31
What is the shape of the tracheal rings?
Horseshoe-shaped and flattened posteriorly
32
Which bronchus has a greater angle?
Left is greater, 45 degrees, compared to right which is 25 degrees
33
What muscle spans the posterior trachea that helps alter the diameter of the trachea?
Trachealis--smooth muscle that alters diameter of trachea, changing the trachea's resistance to flow such as constricting when coughing to expel air more forcibly
34
Why is it more common to accidentally do a R endobrachial intubation?
Because the angle is way less sharp on the right, than the left! Asking this again to reinforce :)
35
What are the two branches of the vagus nerve that innervate the larynx muscles?
Recurrent laryngeal nerve, and the superior laryngeal nerve
36
What nerve innervates all intrinsic muscles of the larynx except cricothyroid?
Recurrent laryngeal nerve (RLN)
37
What nerves are responsible for sensory inneravation in the larynx?
3 branches of trigeminal (V1, V2, V3) Glossopharyngeal (IX) Facial (VII) Internal branch of SLN**
38
What innervates the cricothyroid muscle?
External branch of superior laryngeal nerve
39
What nerve provides SENSORY input ABOVE the vocal cords?
Internal branch of superior laryngeal nerve
40
What nerve provides SENSORY input BELOW the vocal cords?
Recurrent laryngeal nerve
41
Know this!
Know the nerves :)
42
When is the pharyngeal reflex stimulated? When is it suppressed?
Touching the posterior pharynx; suppressed in stage 3 plane 1 Gag relex: pharyngeal muscles elevate and constrict
43
When is the laryngeal reflex stimulated? When is it suppressed?
Touching of irritating the mucosa which results in coughing; suppressed in stage 3 plane 2
44
When is the carinal reflex stimulated? When is it suppressed?
Gagging and couching when the carina is touched; suppressed in stage 3 plane 3
45
What is laryngospasm, and when is it most likely?
Exaggerated glottic closure; most likely in stage 2 (hyperreflexive)
46
What muscle(s) ABDucts (opens) the glottis? Innervation?
Posterior cricoarytenoid; RLN
47
What muscle(s) ADDucts the glottis cords? Innervation?
Lateral cricoarytenoid and arytenoids; RLN
48
What muscle(s)causes tension and elongation of cords (adducts)? Innervation?
Cricothyroid; SLN (external branch)
49
What muscle relaxes/shortens the vocal cords? Innervation?
Thyroarytenoids; RLN
50
What can happen with recurrent laryngeal nerve injury?
Hoarseness, stridor, respiratory distress, aphonia Stridor and respiratory distress is OBVI an emergency!
51
How would acute, bilateral RLN injury present?
Stridor and resp. distress*
52
Which nerve is at risk during thyroid surgery?
RLN
53
What arteries supply the larynx?
Superior and inferior thyroid arteries
54
What veins drain the larynx?
Superior and inferior laryngeal arteries

Principles II (4 decks)

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