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733 > Airway Assessment And Anatomy > Flashcards

Airway Assessment And Anatomy Flashcards

(61 cards)

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1
Q

List types of preanesthetic airway assessment

A

Mouth opening- incisor distance >3cm

Mallampati- PUSH

Thyromental distance- 332

Neck circumference <17cm

Upper lip bite test

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2
Q

What is the earliest indication of bronchial intubation?

A

High peak inspiratory pressures

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3
Q
A

Know IT

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4
Q

What is the larynx?

A

Part of respiratory tract between pharynx and trachea

Voice box

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5
Q

Cervical vertebrae location of larynx

A

C4-c6

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6
Q

3 single and 3 paired cartilages

A

Epiglottis
Thyroid
Cricoid

Arytenoid
Corniculate
Cuneiform

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7
Q

Types of cartilage in the airway

A

All major cartilages are hyaline cartilage

Exception: epiglottis is elastic cartilage

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8
Q

Describe surface anatomy of arytenoid cartilages

A

Apex
Anterolateral surface
Medial surface

Muscular process
Vocal process

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9
Q

Purpose of corniculate/ cuneiform cartilages

A

Support ary-epiglottic folds (swelling under mucosa are called tubercles)

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10
Q

Attachment points for epiglottis

A

Hyo-epiglottic ligament

Thyro-epiglottic ligament

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11
Q

Extrinsic ligaments

A

Thyrohyoid ligament (elevation of larynx during swallowing)

Cricothyroid ligament

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12
Q

Other name for laryngeal inlet

A

Aditus

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13
Q

How many vocal folds in the laryngeal cavity?

A

Vestibular folds

Vocal folds…

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14
Q

Term for the space between the vocal folds

A

Rima glottidis

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15
Q

2 parts of the fibro elastic membrane of the larynx

A

Quardangular membrane- supports vestibule between vestibular and vocal folds

Conus elasticus- superior, internal continuation of the cricothyroid ligament

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16
Q

Movement of arytenoids

A

Rotating
Gliding

Adduction- together
Abduction- apart

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17
Q

What are the four basic action of the “muscles of phonation”

A

Adduct
Abduct
Tense/relax
Close laryngeal inlet

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18
Q

Muscles that ABduct vocal cords and innervation

A

Posterior Crico-arytenoid muscles

Recurrent Laryngeal Nerve

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19
Q

Muscles that ADduct the vocal cords

A

Lateral crico-arytenoid muscles and transverse arytenoid muscles

Recurrent Laryngeal Nerve

Close rima glottidis

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20
Q

Muscles that tense the vocal cords and motor innervation

A

Cricothyroid muscles

External branch of the superior laryngeal nerve

Pull down and tilting forward of thyroid c

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21
Q

Fine, regional adjustments of tension on vocal cords

A

Vocalis muscles

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22
Q

Muscles that close the laryngeal inlet

A

Transverse arytenoid, ary-epiglottic, and thyro-epiglottic muscles

Recurrent LN

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23
Q

Blood supply to the larynx

A

Superior and inferior laryngeal arteries

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24
Q

All the nerves of the larynx

A

Vagus!! CN X

Superior laryngeal nerve (internal and external)

Recurrent laryngeal nerve

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25
Explain motor innervation of larynx
RLN supplies all muscles EXCEPT cricothyroid-external branch of superior laryngeal nerve
26
Sensory innervation inferior to the vocal cords
Recurrent laryngeal nerve
27
Sensory innervation superior to vocal cords
Internal branch of superior laryngeal nerve INCLUDES vocal cords
28
Lymph drainage pathways above and below vocal folds
Above: superior group of deep cervical nodes Below: paratracheal and inferior group of deep cervical nodes
29
5 steps of airway assessment
H&P Assess intubation difficulty preop Formulate multiple plans Aspiration risk Approximate risk of airway failure
30
H&P of airway?
Previous issues Congenital or anatomical issues Visual inspection Active pathologies Weight changes OSA
31
Pierre robin
Micrognathia- small jaw (Mandibular hypoplasia) (Choanal atresia-narrowing of nasal passages) Large tongue
32
Treacher Collins
Cleft palate Micrognathia Recessed mandible
33
Down syndrome-trisomy 21
Extreme variation Redundant skin (neck) Large tongue- acute angle
34
Klippel-feil
Vertebral fusion Can’t place spirals
35
Cretinism
Caused by iodine deficiency during pregnancy Goiters common
36
Beckwith syndrome
VERY large tongue
37
Cherubism
Cyst filled sacs in facial structures
38
Neurofibromatosis type 1
Fairly common Accompanies scoliosis commonly
39
Croup
Barking cough Inflammation/narrowing of upper airways
40
Ludwig angina
Submandibular space infection (fluid sacs) Push tongue up
41
Acromegaly considerations
Instability in c1/c2 Longer tube
42
Rheumatoid arthritis
Always elevate head, you can decapitate them
43
Ankylosing spondylitis
Very painful inflammation of vertebrae resulting in fusion
44
Aspiration risk chart
45
Five airway measurements
Thyromental distance Mouth opening Mallampati score Head and neck mobility Ability to prognath
46
Thyromental distance
3 fingers (6 cm)
47
Cormack lehane
Grade 1: full view of glottic opening Grade 2a- posterior portion of glottic opening Grade 2b- epiglottis and arytenoids Grade 3- epiglottis Grade 4- nothing/palates
48
Mallampati
1- uvula, pillars, hard and soft 2- pillars, hard and soft 3- hard and soft 4- hard only
49
Which joint are we assessing in neck mobility
Atlantoaxial?
50
ULBT
1- full bite 2- doesn’t cross vermillion border 3- can’t bite upper lip
51
Best airway screening test?
ULBT
52
Mask ventilation difficulty mneumonic
BONES Beard Obese BMI>26 No teeth Elderly >55 Snoring
53
Rapid airway assessment LEMON
LEMON Look- malformations Evaluate 332 Mallampati Obstruction? Neck mobility Saturation
54
Notes on preoxygenation
Tight fitting mask 5 minutes 10-12L flows Gives you 8 min of apnea in healthy adult
55
ASA minimum monitoring standards
56
Four indications for awake intubation
Difficult mask ventilation Significant risk of aspiration Increased risk of rapid desaturation Suspected difficult emergent airway
57
Pharynx cranial nerves
Nasopharynx-trigeminal Oropharynx- glossopharyngeal Larynx- vagus nerve -superior laryngeal nerve External branch Internal branch Recurrent laryngeal nerve
58
Also called the cricovocal ligament
Conus elasticus Superior, internal continuation of cricothyroid ligament
59
Differentiate between conus elasticus and quadrangular membranes in relation to vocal cords
Conus- inferior Quad- superior
60
Risk factors for airway assessment to get percentages
Mallampati >1 or =4 Mouth opening <4cm Do they have teeth or history of difficult intubation
61
Least to most sensitive muscle mnemonic
Very -vocal cords Daring -diaphram Octopuses -orbicularis oculi Also - abdominal rectus Admire- adductor pollicis Mighty- masseter Pearls - pharyngeal Everyday- extraocular

733 (10 decks)

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