Lecture 1 - Introduction to Airway and Airway Anatomy

Question 1

Where does the airway start?

Answer 1

nose and mouth

Question 2

Where does the airway end?

Answer 2

Terminal bronchioles

Question 3

The airway allows for […] to and from alveoli

Answer 3

gas exchange

Question 4

What does the upper airway consist of? (5 structures)

Answer 4

nasal cavity, oral cavity, nasopharynx, oropharynx, laryngopharynx

Question 5

What does the lower airway consist of? (3 structures)

Answer 5

trachea, bronchi, alveoli

Question 6

What seperates the upper and lower airway?

Answer 6

Vocal cords (glottic opening)

Question 7

The pharynx starts at the […] and extends to the […]

Answer 7

base of skull , cricoid cartilage

Question 8

How long (in cm) is the pharynx?

Answer 8

12-15 cm

Question 9

What are the 3 areas of the pharynx?

Answer 9

nasopharynx, oropharynx, hypopharynx

Question 10

What are 2 functions of the pharynx?

Answer 10

Respiratory and digestive (swallowing/defend against pathogens/gas exchange)

Question 11

What level of vertebrae does the pharynx extend to?

Answer 11

C6

Question 12

What nerves provide sensation to the pharynx?

Answer 12

trigeminal, glossopharyngeal, vagus

Question 13

What are some functions of the nasal cavity?

Answer 13

Olfaction, respiration, humidification, warming, filtration, secretions, rich blood supply from ophthalmic/maxillary/facial arteries

Question 14

What can nosebleeds lead to?

Answer 14

aspiration

Question 15

What are turbinates? What are they also called?

Answer 15

Protruding structures in nasal passage made of bone/vessels/tissues (nasal conchae)

Question 16

Turbinates are highly […] which can cause lots of bleeding

Answer 16

vascularized

Question 17

Turbinates spray […] substances to […] blood flow

Answer 17

vasoconstrictive , decrease

Question 18

What should be avoided in patients with facial trauma? Why?

Answer 18

positive pressure ventilation; air will enter cranial fossa leading to meningitis or sepsis

Question 19

Which nare is usually easier to insert a nasal tube through?

Answer 19

Right nare

Question 20

When you are doing a nasal intubation, how should you position the nasal tube when inserting it?

Answer 20

Parallel to roof of mouth (NOT UPWARDS - can hit inferior turbinate)

Question 21

What cranial nerve provides sensation to the mucous membranes of the nasal cavity?

Answer 21

Trigeminal Nerve (CN V)

Question 22

What can nasal drainage lead to?

Answer 22

laryngospasm

Question 23

What can fix nosebleeds?

Answer 23

Cauterization

Question 24

What are 3 solutions to a laryngospasm?

Answer 24

positive pressure ventilation, bolus of propofol, paralytic

Question 25

What 3 arteries supply blood to the nose?

Answer 25

ophthalmic, maxillary, facial arteries

Question 26

What is Kiesselbach's plexus (little's area)? What is it a common source of?

Answer 26

Network of arteries located in anterior portion of nose; epistaxis

Question 27

[...] is posterior to the nasal cavity and above the oropharynx

Answer 27

Nasopharynx

Question 28

Nasopharynx serves as a conduit for [...]

Answer 28

air

Question 29

What structure in the nasopharynx can lead to ear infections if there is an upper airway infection present?

Answer 29

Eustachian tubes

Question 30

What structures in the nasopharynx can be enlarged and cause obstruction/bleeding/difficult airway?

Answer 30

Tonsils/adenoids

Question 31

What 4 important structures does the oral cavity contain?

Answer 31

Hard palate, soft palate, tongue, dentition

Question 32

What can the patient's oral cavity provide us clues to?

Answer 32

How easy/difficult airway manipulation will be

Question 33

What nerves provide sensory innervation to the tongue?

Answer 33

Trigeminal (CN V) to anterior 2/3rd & Glossopharyngeal (CN IX) to posterior 1/3rd

Question 34

A branch of the [...] provides blood flow to the oral cavity

Answer 34

external carotid artery

Question 35

What teeth are most likely to be injured during intubation?

Answer 35

7, 8, 9, 10

Question 36

How does teeth numbering work?

Answer 36

1 to 16 (Right upper corner to left upper corner) ; 17 to 32 (left lower corner to right lower corner)

Question 37

What type of function does the oropharynx have?

Answer 37

digestive

Question 38

Oropharynx extends inferiorly from the [...] to the [...]

Answer 38

soft palate ; superior border of epiglottis

Question 39

[...] serves as a passageway for food/liquid into the esophagus

Answer 39

oropharynx

Question 40

Laryngopharynx is also known as the [...]

Answer 40

hypopharynx

Question 41

Laryngopharynx starts at the [...] and goes to [...]

Answer 41

top of the epiglottis ; bottom of cricoid cartilage

Question 42

Laryngopharynx becomes continuous with the [...]

Answer 42

esophagus

Question 43

At what vertebrae level is the laryngopharynx located?

Answer 43

C4-C6

Question 44

At what vertebrae level is the larynx located?

Answer 44

C3-C6

Question 45

What structure connects the pharynx with the trachea?

Answer 45

larynx

Question 46

[...] serves as a passageway for air and gas exchange and prevents substances from entering trachea

Answer 46

larynx

Question 47

What structure is the area of phonation/vocalization?

Answer 47

larynx

Question 48

What structure is responsible for coughing?

Answer 48

larynx

Question 49

How many cartilages is the larynx comprised of? How many single? How many paired?

Answer 49

9 total (3 single / 3 paired)

Question 50

What are the paired cartilage of the larynx?

Answer 50

arytenoid, corniculate, cuneiform

Question 51

What are the unpaired cartilage of the larynx?

Answer 51

thyroid, cricoid, epiglottic

Question 52

What unpaired cartilage of the larynx is the largest?

Answer 52

Thyroid cartilage

Question 53

What cartilage protects the larynx?

Answer 53

Thyroid cartilage

Question 54

What structure forms the adam's apple?

Answer 54

Thyroid cartilage

Question 55

[...] is inferior to the thyroid cartilage and the only complete ring in the airway

Answer 55

cricoid cartilage

Question 56

[...] is leaf shaped and closes off glottis while eating/drinking to prevent aspiration

Answer 56

epiglottic cartilage

Question 57

[...] is a conduit for gas exchange and produces clear secretions

Answer 57

trachea

Question 58

Trachea starts [...] and ends at [...]

Answer 58

below cricoid cartilage ; carina

Question 59

What vertebra does the trachea begin?

Answer 59

6th cervical

Question 60

How long in cm is the trachea?

Answer 60

10-15 cm

Question 61

What is the trachea supported by?

Answer 61

16-20 horeshoe shaped cartilages

Question 62

Where should the tip of the MAC blade sit during intubation?

Answer 62

Vallecula

Question 63

[...] blade goes past the vallecula during intubation

Answer 63

Miller

Question 64

[...] refers to the vocal cords being open and moved away

Answer 64

abduction

Question 65

[...] refers to the vocal cords being closed and moving towards each other

Answer 65

adduction

Question 66

[...] occurs when vocal cords are closed and stridor is heard

Answer 66

laryngospasm

Question 67

What is the purpose of the airway?

Answer 67

Filtration/humidification/warming of air AND gas exchange

Question 68

After chewing, the tongue moves [...] and food bolus enters [...]

Answer 68

upward ; esophagus

Question 69

Food travels down esophagus to stomach via [...]

Answer 69

peristalsis

Question 70

Why is dangerous for substances to enter tracheal opening?

Answer 70

Infection and death can occur

Question 71

What cranial nerve provides motor innervation to the tongue?

Answer 71

Hypoglossal (CN XII)

Question 72

What cranial nerve allows for taste in the tongue?

Answer 72

Facial (VII)

Question 73

What cranial nerve innervates the airway? What are its subdivisions of it?

Answer 73

Vagus (CN X) ; Superior laryngeal and Recurrent laryngeal

Question 74

What does the recurrent laryngeal nerve innervate?

Answer 74

Intrinsic muscles of larynx except cricothyroid muscle AND sensory below cords

Question 75

What does the superior laryngeal nerve innervate?

Answer 75

**Internal branch**: sensory to posterior epiglottis to vocal cords (*above cords*) **External branch**: motor to cricothyroid muscle

Question 76

What does the glossopharyngeal nerve innervate?

Answer 76

Sensory to vallecula and base of tongue

Question 77

What cranial nerve provides the gag reflex?

Answer 77

Glossopharyngeal (C9)

Question 78

What cranial nerves are involved in airway innervation?

Answer 78

CN 5 / 9 / 10

Question 79

What does unilateral laryngeal nerve damage cause?

Answer 79

Hoarseness

Question 80

What does bilateral laryngeal nerve damage cause?

Answer 80

aphonia and airway obstruction