Basic Airway Mgt wv1.ppt

Why is airway management important physiologically and financially? Identify the structure and function of the anatomic components of the upper airway. Review the anatomy and innervation of the larynx. LARYNX Larynx at level of C-5 in adults, at C-3 in newborn Unpaired cartilage Thyroid Cricoid Epiglottis Paired Cartilage Arytenoid Corniculate Cuneiform Muscles of the Larynx INTRINSIC Posterior cricoarytenoid Lateral cricoarytenoid Arytenoids Cricothyroid Thyroarytenoid EXTRINSIC Sternohyoid Sternothyroid Thyrohyoid Omohyoid INNERVATION of the LARYNX Vagus - Superior and Recurrent laryngeal nerves SLN - Internal and External SLN Internal – sensory above cords External – motor cricothyroid muscle, adducts cords RLN - sensory below cords, motor posterior cricoarytenoid muscle, abducts cords Glossopharyngeal – sensory valleculla and posterior tongue (gag reflex) Vascular Supply to the Larynx Superior thyroid artery -  superior laryngeal artery Inferior thyroid artery -  inferior laryngeal artery Superior thyroid vein -  superior laryngeal vein Inferior thyroid vein -  inferior laryngeal vein What are the elements included in the History and Physical Exam of a patient’s airway? Airway History Prior surgery or hospitalization requiring intubation or tracheostomy? Prior history of difficult intubation? Difficult Intubation Medic Alert Record? History of obstructive sleep apnea? History of oral, pharyngeal, esophageal disease? Trauma, burns, chemicals, radiation ? Airway Physical Exam Initial observation at a distance: General appearance, stature, anomalies, defects, external fixators, trauma Ease of respiration Supplemental oxygen Focused airway exam Face, jaw, mouth Oropharynx, posterior pharynx Neck, larynx Chest How is Mallampati Airway Classification Exam performed? What are the structures visualized in each of the Mallampati Airway Classes? How does Mallampati Class correlate with Cormack Lehone laryngoscopic grade What are the indicators of a