1. Can I ventilate the patient?

2. Can I place a LMA?

3. Can I intubate this patient?

4. Can I secure an emergency airway? 

Above the Level of the Cricoid

(Mouth/Nose to End of larynx/beginning of trachea)

Nose, mouth, pharynx, hypopharynx to larynx

Anything below the Cricoid

Trachea, bronchi, bronchioles, alveoli

Posterior 1/3 of mouth

Protects against aspiration but can block airway movement (age, obesity) 

Innervated by glossopharyngeal nerve IX

At the base of it is the epiglottis

Main source of airway obstruction 

Anterior 2/3 innervated by Trigeminal nerve

Posterior 1/3 innervated by Glossopharyngeal

Sits at the base of the tongue 

Attached to the hyoid bone by the hyoepiglottic ligament

Prevents aspiration with swallowing- can cause obstruction 

Anterior Epiglottis is innervated by the Glossopharyngeal

The Posterior epiglottis is innervated by the Internal Superior Laryngeal Nerve 

Soft Palate- relaxation of tensor palate

Tongue- relaxation of geniglossus muscle

Epiglottis- relaxation of hyoid muscle 

10,000 L pass through a day

1L of mositure is added

Highly vascular membrane

Need to vasocontrict before passing Nasal ETT 

U shaped muscle structure that etends from base of the skull to level of the cricoid cartilage 

Naso-Oro-Hypo/Laryngo

Anterior to C1

From base of the skull to soft palate

Includes the adenoids and eustachian tubes 

Aneterior to C2-C3

From the soft palate to the epiglottis 

Innervated by the glossopharyngeal nerve 

From the superior border of the epiglottis and the inferior boarder of the cricoid cartilage at C5-C6

Includes the uppper esophageal spinchter and cricopharyngeus muscle 

Extends from the hyoid bone to the cricoid cartilage

Begins at C3 and ends at C6 in an adult

Infants C3- C5

Innervated by the Vagus 

Thyroid

Cricoid

Epiglottis

Artenoids

Corniculate

Cuneiform

Forms a C shaped barrier around the anterier and lateral walls

Helps to create structure 

Site for blocks and surgical procedures 

Narrowest part of the adult airway is the glottis opening

Located at C5

Subglottis region is narrowest in peds 

Only complete ring in the upper airway 

Attaches to the thyroid by the cricothyroid membrane 

1 to 1.5 fingerbreadths below thyroid notch 

This is where you do your surgical airway 

Inferior Ligaments- Vocal Folds- inner produce sounds 

Superior Ligaments- vestibular folds (false cords)- outer protection

Lateral CricoArytenoid

Thyroid Arytenoid

Posterior CricoAryenoid

Cricothyroid 

"Lets cords approximate"

adducts 

Innervated by the recurrent laryngeal nerve

Shortens the vocal cords

Innervated by the recurrent laryngeal nerve 

"Pulls cords apart"

Abducts

Innervated by the recurrent laryngeal nerve 

Muscle used in breathing and phonation 

Elongates the cords

Tenses

Innervated by the external superior laryngeal nerve 

Used in phonation- tenses the cords 

Space on top of the epiglottis

Where you insert your MAC blade

Has a superior and inferior part

Innervated by the glossopharyngeal 

C6-T5

Begins with the cricoid- ends with the carina 

Carotid branches- thyroid artery

Thyroid artery branch- cricothyroid artery 

Trigeminal

Glossopharyngeal

Superior Laryngeal Nerve

Recurrent Laryngeal Nerve 

Anterior 2/3 of tongue

Mandibular division

Nasal mucosa 

Posterior 1/3 on Tongue

Soft Palate

Tonsils

Oropharynx

Vallecula

Anterior epiglottis

Posterior epiglottis 

Vocal cords

Vocal Cords

Trachea 

Larynx

Efferent limb of gag reflex 

Major motor nerve 

and sensory below the cords 

Unilateral- minimal effects

Bilateral- horseness, tiring of voice, but airway control is fine 

Unilateral- hoarseness, paralysis of the ipsilateral vocal cord

Bilateral- Acute vs Chronic

Acute- stridor, respiratory distress from unopposed tension of the cricothyroid

Chronic- aphonia, obsurction duringi nspiration