Where does the blood supply of the larynx come from?
Thyroid artery - branch of the external carotid artery.
100
What is the optimal position for intubation?
Sniffing position - flexion of the neck on the body and extension of the head on the neck
100
Describe Mallampati score
Class I - uvula, faucial pillars, soft palate visible
Class II - faucial pillars, soft palate visible
Class III - soft and hard palate visible
Class IV - hard palate visible
100
Name the three paired cartilages of the upper airway.
Arytenoids, Corniculate, Cuneiform
100
How do you size a nasal trumpet?
The length of the nasal trumpet should be from the nares to the meatus of the ear/earlobe/angle of jaw.
200
Which nerve innervates the larynx below the vocal cords and the trachea?
The recurrent laryngeal nerve.
200
What airway concerns do you have for a patient with Down Syndrome?
Large tongue
C-spine instability
Microcephaly
200
List the physical exam findings for to predict difficult laryngoscopy.
Which nerve supplies mucosa from the epiglottis to the level of the cords?
Superior laryngeal nerve
200
What size endotracheal tube will fit through a size 4 Classic LMA?
#6
300
The cricothyroid muscle is innervated by which nerve?
External branch of the superior laryngeal nerve
300
It is now your 3rd time attempting to intubate Mrs. Bennet. You give it one last try and sadly fail. When you go to BMV Mrs. Bennet you find you are now unable to BMV her. What should you do now?
Insert an LMA.
300
List the predictors of difficult supraglottic airway placement.
Restricted mouth opening
Obstruction
Distorted or disrupted anatomy
Stiff lungs or C-spine
300
What are the three unpaired cartilage of the larynx?
Thyroid, Cricoid, Epiglottis
300
Describe the Cormack and Lehane grading of laryngoscopic view.
Grade 1: entire aperture visible
Grade 2: posterior arytenoids visible, some of glottic aperture
Grade 3: epiglottis visible
Grade 4: no visible structures (only can see the soft palate)
400
What does the posterior cricoarytenoid muscle do?
Abducts the vocal cords.
400
List four congenital conditions associated with difficult airway management.
Pierre Robin
Treacher Collins
Goldenhar
Down syndrome
Klippel-Feil syndrome
Alpert syndrome
Beckwith syndrome
Cherubism
Cretinism
Cri du chat syndrome
Mecketl syndrome
von Recklinghausen disease
Hurler/Hunter syndrome
Pompe disease
400
List the predictors of difficult surgical airway.
Surgery or disrupted airway
Hematoma/infection/abscess
Obesity
Radiation
Tumor
400
At what vertebral level is the carina in an adult?
5th thoracic vertebra
400
What are three contraindications to fiberoptic bronchoscopy?
Hypoxia
Heavy airway secretions not relieved with suction or antisialogogues
Bleeding from the upper or lower airway not relieved with suction
Local anesthetic allergy (for awake attempts)
Inability to cooperate (for awake attempts)
500
What would happen if you had acute bilateral recurrent laryngeal nerve injury?
Stridor, respiratory distress
500
List the predictors of difficult mask ventilation.
Presence of a beard (M - mask seal)
BMI > 26 (O - obesity/obstruction)
Age > 55 years (A - age)
Edentulous (N - no teeth)
History of snoring (S - snoring, stiff lungs)
500
Which predictor of difficult bag mask ventilation is most predictive?
Presence of a beard (Odds ratio 3.18)
BMI (Odds ratio 2.75)
Edentulous (Odds ratio 2.28)
Age > 55 years (Odds ratio 2.26)
History of snoring (Odds ratio 1.84)