METHODS OF SECURING AND MAINTAINING THE AIRWAY

Question 1

What are the two openings to the human airways

Answer 1

Nasopharynx
Oropharynx

Question 2

What separates the oropharynx from the hypopharynx (the connecting part between the oropharynx and the larynx and esophagus)

Answer 2

The epiglottis

Question 3

How many cartilages make up the larynx? Group and list them.

Answer 3

Larynx is made up of 9 cartilages

PAIRED
● Arythenoid
● Corniculate
● Cuneiform

UNPAIRED
● Epiglottis
● Thyroid
● Cricoid

Question 4

List the components of the upper airway

Answer 4

Nose & paranasal sinuses
Oral cavity
Pharynx
Larynx

Question 5

List the components of the lower

Answer 5

Trachea
Lt and Rt Principal bronchi
Secondary bronchi
Segmental bronchi
Terminal bronchiole
Respiratory bronchiole
Alveolar sac

Question 6

What ate the indications for securing and maintaining airway

Answer 6

Partial or complete obstruction to normal air movement such as

● Acute Airway obstruction
● General anaesthesia
● Head trauma/injury
● Loss of consciousness
● Chocking
● Head and neck tumour
● Drowning
Etc

Question 7

How would you assess a patients airway?

Answer 7

● General Examination checking for;
- Shape of head or face
- Obesity
- Short neck
- Huge chest mass

● Specific examination (scoring systems)
- Mouth opening/inter incisor gap
- Upper lip bite test
- Mallampati classification
- Thyromental distance (Normal >6.5cm), (Moderate 6-6.5cm), (Difficult <6cm)
- Sternomental distance (Not <12.5cm)
- Neck circumference
- Wilson score(wgt, receding mandible(retrognathia), protruding upper teeth, jaw movement, mobility of head and neck)(0-1 easy, 2-3 possibly difficult, 4 and above= often difficult)

Question 8

What is the mallampati scoring system?

Answer 8

It is one of the scoring systems used in determining the possible ease of intubation. It is based on structures that can be seen with an open mouth. It has 4 points;

1. Soft palate and uvula
2. Uvula
3. Base of uvula
4. Nothing

Question 9

List some of the airway devices

Answer 9

● Oropharyngeal airway
● Nasopharyngeal airway
● Laryngeal mask airway
● Endotracheal tube

Question 10

What are the tires of laryngeal mask airway (LMA)

Answer 10

• Classic LMA
• LMA ProSeal
• i-gel
• Intubating LMA

Question 11

What are the indications for use of LMA

Answer 11

• Difficult intubation
• Failed intubation

Question 12

What are the contraindications for use of LMA

Answer 12

• Full stomach
• Resuscitation

NB:- It does not prevent aspiration

Question 13

List the materials needed for endotracheal intubation

Answer 13

● Laryngoscope blade and handle
● Large sized syringe for inflation of cuff
● Suction apparatus
● Stethoscope

Question 14

What is the good standard for confirming an endotracheal tube placement?

Answer 14

Wave of CAPNOGRAPHY

Question 15

What is the positioning for ET tube insertion

Answer 15

SNIFFING POSITION
- Extension of the atlanto-occipital joint (extension of head)
- Flexion of cervical spine (neck flexion)