above the cricoid cartilage:

below the cricoid cartilage

jaw and anterior 2/3 of tongue

facial structures and ears

hyoid bone and structures of the upper pharynx

larynx and structures of lower pharynx

3&4

arch 5

clefts; pouches

external auditory meatus

majority of the tympanic cavity and the eustachian tubes

2

3

4

4

nose/nasal cavity

nose

C1; C2/C3

larynx

nasopharynx

nasopharynx

maxillary division of the trigeminal nerve

oropharynx

oropharynx

cricoid cartilage; C5-6

upper esophageal sphincter

base of the skull; cricoid cartilage

internal branch of the superior laryngeal nerve

external br. of the superior laryngeal nerve

sensory to the subglottic area and the trachea

hoarseness but no compromise to respiratory status

stridor d/t unopposed tension and adduction of cords

thyroid

arytenoid

1. protection to lower airway from aspiration

C3/4; C6

thyroid cartilage

abduction of vocal cords ("pulls cords apart") role in respiration

lateral cricoarytenoids

lateral thyroarytenoids

medial cricoarytenoid

lengthening and increasing tension of vocal cords

closing of posterior commissure of the glottis

closing of laryngeal vestibule

stylohyoid

omohyoid

superior thyroid artery which branches into the superior laryngeal artery

inferior laryngeal artery

10-15 cm in miller

cricoid

when you have reached the level of the bronchioles (size 0.6-0.8 mm)

humidification and warming of inspired air

25-30 degrees

45 degrees

2.5 cm

5 cm

1-5 thoracic ganglia

vagus nerve

1. relatively long upper incisors

1. beard, edentulous, NGT

1. restricted mouth opening

1. distortion of neck anatomy

left thumb and index finger around the collar of the mask

hoarse/muffled voice

high peak airway pressures

primary mechanism of airway management

surgery

8

- FRC is limited

1. respiratory bag that moves with each inhale/exhale

have patient take 8 vital capacity breaths over 60 seconds

valleculae; hyoepiglottic ligament; indirect

posterior to epiglottis; direct

cric pressure --> person places pressure on cricoid membrane backwards, upwards, rightwards.

improve visualization of the vocal cords

maintenance of adequate oxygenation and ventilation

type of surgical procedure

1. immobility

a drug induced loss of consciousness during which patients are not arousable even by painful stimulation

hypnotics, NMB, analgesics

spinal, epidural, caudal

1980s

"standby anesthesia"

specific anesthesia service in which an anesthesiologist has been requested to participate in the care of a patient undergoing a diagnostic or therapeutic procedure

true; d/t the possibility of converting to unplanned GA

1. preference and experience of pt, provider, and surgeon

1. hypovolemia increases risk of significant hypotension

respiratory depression from sedative drugs

peds

sevo

1. pre-oxygenated well

reactive airway dz

1. pre-oxygenate well

look (head, neck, teeth)

1. decrease intraoperative blood loss

1. easily titratable

1. increase postoperative nausea vomiting

1. decreased postop N/V

depth not accurately measure without EEG

1. etCO2 (not as reliable in this population)

1. maxillary (sphenopalatine)

opthlalamic and maxillary divisions of the trigemial nerve

7th cranial nerve (facial) via pterygopalatine ganglion

superior cervical ganglion

engorgement --> increased bleeding potential during manipulation of nasal airways/ETT

42

26

36

3

Males: 42

Males: 43

Loose or false teeth

1. move patient to the OR table

(1) knowledge of the anatomy and physiology of the airway, (2) a thorough history and physical examination focused on the airway, (3) proficiency with the range of airway devices, (4) individualized primary and backup airway management plans, (5) effective team communication, and (6) application of cognitive aids and guidelines such as the American Society of Anesthesiologists (ASA) difficult airway algorithm

tongue which is from the relaxation of the genioglossus muscle during anesthesia

lymphoid tissue

superior laryngeal external division

irradiation

uvula, fauces, soft palate, and pillars visible

soft palate, uvula, faces

soft palate and base of uvula

hard palate only

Able to bite above the vermilion boarder of the upper lip

bites below the vermilion board of the lips

lower incisors cannot bite the upper lip

Ludwig angina, tumor, radiation, burns and previous neck surgery

on the bridge of the nose and between the lip and chin

"BOOTS"

Less than 20 cm of H20

1. attempt masking if failed

against the upper esophageal sphincter, lateral edges rest in the piriform sinuses and the proximal end seats posterior to the base of the tongue

it has a second lumen which acts as a vent to keep gases and fluids separate which can prevent regurgitation and aspiration of gastric contents

provide a patent airway

oral, pharyngeal and laryngeal

Sellicks maneuver

difficult laryngoscopy: inability to visualize any portion of the vocal cords

ETCO2

21-23 cm

standard: Mac 3 and Miller 2

1. open mouth

Video Laryngoscopy

1. antisialogue should be administered

between the greater cornu and the hyoid bone

1. prep the skin

dental and oral saoft tissue trauma

tube obstruction

laryngospasm

vocal cords

22 days or 4 weeks

Glossopharyngeal is the afferent --> vagus which is efferent and stimulated the gag reflex

formed by the space between the inferior edge of the epiglottis and the true vocal cords

arises from the C3, C4 and C5--> phrenic

1. Minimal or no chest rise

SHORT

a line from the Tragus of ear to their sternum

hemorrhage, coagulopathies, basilar skull fractures, anatomical abnormalities, septal deviation, CSF leak, pregnancy

Noramal PVC

Pharynx/ hypo-pharynx

designed to facilitate blind intuition without the need to manipulate the head or neck allowing for single handed insertion

prepare similar to the standard LMA

superiorly cricoid cartilage

Modified a few breathes will be given after propofol and lidocaine

Pre anxiolytic

Narcotic

Blunts the SNS response and pain with propofol

works on Gaba (gaba is an inhibitory neurotransmitter)

Depolarizing NMB (works on ACH and Nicotinic receptors)