Flashcards in Week 7 Airway Deck (26):
What is the Gold Standard of difficult airway management?
Flexible fiber optic bronchoscopy
What cranial nerve supplies sensation to the nasal mucosa and turbinates? If you were going to do an awake nasal intubation...
If you were going to do an oral awake intubation, what cranial nerve supplies the gag reflex?
If you were going to do an awake nasal or oral intubation, it is nice to block the __ nerve, why? Because it anesthetizes the vocal cords on down.
Recurrent laryngeal (comes from vagus)
"So if you don't want them to cough on you as your scope traverses the glottic opening and on down, anesthetize the __"
recurrent laryngeal nerve
the superior laryngeal nerve comes from the __ __ ganglion
superior cervical ganglion
the superior laryngeal branches into two nerves. What are they and what do they innervate?
Internal laryngeal nerve- sensory
external laryngeal nerve- motor
What nerve gives us the recurrent laryngeal?
What does the recurrent laryngeal innervate?
vocal cords down
Do you think you should attempt a nasal intubation on someone on coumadin and an INR or 2.8?
no way jose
Where does the Palatine nerve come from? What does it innervate?
Nasal turbinates and most of septum
Where does the Anterior Ethmoid come from? What does it innervate?
innervates NARES and ANTERIOR 1/3 of SEPTUM
What three cranial nerves innervate the oropharynx?
three branches of glossopharyngeal nerve
lingual (posterior 1/3 of tongue, vallecula, epiglottis)
pharyngeal (walls of pharynx)
what nerve supplies the cricothyroid muscle?
external branch of superior laryngeal
what nerve provides sensory to vocal fold and trachea, and motor to all intrinsic muscles except cricothyroid muscle?
what nerve supplies sensory to base of tongue, posterior epiglottis, aryepiglottic folds, and arytenoids?
internal branch of superior laryngeal
a negative side effect of too much benzocaine
Would a long acting respiratory depressant like morphine be a good idea for your awake fiberoptic intubation?
after you topically anesthetize the oral mucosa with cetacaine spray, how much lidocaine would you deposit just under the skin at the base of the palatoglossal folds? Which nerve are you blocking? What is the major benefit of this block?
2-4 ml's of 4% lidocaine with epi per side
block gag reflex
blocking the glossopharyngeal by injecting LA into the pallatoglossal folds will desensitize four areas, what are they
2. soft palate
3. posterior tongue
4. pharyngeal surface of epiglottis
basically rear of oral cavity down to epiglottis
internal branch of superior laryngeal (a branch of vagus) provides sensory to the
1- base of tongue
2- posterior surface of epiglottis
3- aryepiglottic fold
basically back side of epiglottis to cords
where and how would you block the internal branch of superior laryngeal nerve?
2 ml's of 2% lidocaine infiltrated with SHORT 5/8" 25 ga needle
lateral to greater cornu of hyoid bone
please be careful, on myself this feels very close to the carotid just under the mandible, aspirate carefully
Keep your hands, arms, digits out of the path of needles.
"I was married, that was a bummer."
recurrent laryngeal nerve provides sensory innervation to __
blocking the recurrent laryngeal nerve prevents __
vocal folds and trachea
blocking prevents coughing while ETT passes through vocal cords