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NURSAN 2700 Airway

Terms in this set (29)

What part of the upper airway contains the Contains adenoids and Eustachian tubes?
Nasopharynx
What vertebral level is the epiglottis in kids and adults?
At level of C3 in children
At level of C5 in adults
What are the 9 laryngeal cartilages?
Epiglottis
2 cuneiform
2 corniculate
2 arytenoid
Thyroid
Cricoid
What laryngeal cartilages are paired, pyramidal, and posterior, and are the primary posterior vocal cord attachments?
arytenoids
Which is the Largest laryngeal cartilage
Thyroid cartilage
What are the 3 segments of the esophagus?
1. upper esophageal sphincter
2. tubular esophagus
3. lower esophageal sphincter
Sphincters have high resting tone, relax with swallowing.
What is the thickest of the 3 pharyngeal constrictor muscles?
cricopharyngeal muscle
How much pressure should be used during Sellick's maneuver?
Most widely acepted range is 30-40 Newtons
Some evidence that > 40 N can cause damage (compressible cricoid ring)
Describe the posterior cricoarytenoid muscles.
Posterior aspect of cricoid to the arytenoids
External arytenoid rotation = ABduction
Posterior Cricoarytenoid (PCA) = Pulls the Cords Apart
Describe the lateral cricoarytenoid muscles.
Superior aspect of cricoid to the arytenoids
Internal arytenoid rotation = ADDuction
Lateral Cricoarytenoids (LCA) = Leave the Cords Alone
Interarytenoids also aids in adduction
What is the function of the Thyroarytenoid muscle?
relaxes the vocal cords
among the fastest contracting striated muscles
phonation and vocal fine tuning
arises on the lower border of thyroid
What is the vocalis muscle?
segment of the thyroarytenoid
major tensor of vocal fold to achieve high pitch
What does the thyroepiglottic muscle do?
shortens and relaxes vocal ligament
What muscles contract to shift the anatomical orientation of the larynx, causing cord stretch, tension, and laryngospasm?
cricothyroid muscles
What is the function of the thyrohyoid membrane?
Connects the thyroid cartilage with the hyoid bone
The internal branch of the SLN penetrates the membrane at the level of the superior cornu of the hyoid.
Why does the cricothyroid membrane work well for emergency airway maneuvers?
It is easy to find and relatively avascular
What vessel supplies the interior laryngeal structures?
superior laryngeal artery
What vessel supplies the surrounding laryngeal structures?
Inferior laryngeal artery
What veins drain the laryngeal structures?
Superior/Inferior Thyroid veins (drain to subclavian)
What nerves innervate the nasal, maxillary and mandibular areas of the upper airway?
CN V (trigeminal)
CN VII (facial)
What nerve innervates the roof of the pharynx, tonsils and posterior of soft palate?
CN IX (glossopharyngeal)
What nerve innervates airway structures below the epiglottis?
CN X (vagus)
Describe the laryngeal branches of the vagus nerve
Vagus is divided into two branches: superior laryngeal nerve (SLN) and recurrent laryngeal nerve (RLN). The SLN bifurcates into the internal laryngeal branch and the external laryngeal branch.
What does the internal laryngeal branch of the superior laryngeal nerve innervate?
SENSORY to Lower pharynx, Underside of Epiglottis, Larynx above the cords
What does the external laryngeal branch of the superior laryngeal nerve innervate?
MOTOR to cricothyroid muscles
What does the recurrent laryngeal nerve innervate?
Sensory to larynx below cords & upper esophagus
Motor to all intrinsic muscles
What are the results of superior laryngeal nerve injury?
Unilateral: minimal effect
Bilateral: hoarseness, tiring of voice
What are the results of recurrent laryngeal nerve injury?
Unilateral: hoarseness
Bilateral: acute: stridor, respiratory distress; chronic: aphonia
Describe the anatomy of the trachea
Average adult = 15 cm
Cartilaginous/Muscular Tube
C6-T6/Dorsally Flattened
Continuous with the larynx above/bronchi below
Fibroelastic membrane holding 16-20 C shaped cartilages
Length = 10-15 cm (avg 12)
2 cm below cords to carina
Mucosa: Ciliated columnar epithelium interspersed with occasional goblet cells
2 muscle layers: Transverse/scattered longitudinal
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