APEX Unit 1 - Respiratory EXAM TESTBANK WITH QUESTIONS AND DETAILED CORRECT ANSWERS GRADED A+ ASSURED SUCCESS

APEX Unit 1 - Respiratory Flashcards
Study online at https://quizlet.com/_gov7ab

1. -Which muscles -Cricothyroid: "Cords Tense" (enlongate)
tense and relax the
vocal cords? -Thyroarytenoid: "They Relax" (shorten)

2. Which muscles -Posterior Cricoarytenoid: "Please Come Apart"
abduct and adduct
the vocal cords? -Lateral Cricoarytenoid: "Let's Close Airway"

3. what are extrin- support/swallowing
sic laryngeal mus-
cles? -All end in -hyoid except digastric
-Elevate larynx: Digastric (ant belly), mylohyoid, stylohyoid, digastric (post bel-
ly), thyrohyoid
-Depress larynx: Omohyoid, sternohyoid, sternothyroid

4. Describe the sen- Trigeminal
sory innervation of -V1 (Ophthalmic) = Nares and anterior 1/3 of septum
the upper airway -V2 (Maxillary) = Turbinates and septum
-V3 (Mandibular) = Anterior 2/3 of tongue

Glossopharyngeal
-Posterior 1/3 of tongue
-Soft palate
-Oropharynx
-Vallecula
-Anterior side of epiglottis

Superior laryngeal
-Internal branch = posterior side of epiglottis to the level of the vocal cords

-External branch = 0 sensory function, motor innervation to the cricothyroid
muscle




, APEX Unit 1 - Respiratory Flashcards
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Recurrent laryngeal:
-motor: All intrinsic muscles except the cricothyroid
- sensory: below VC
Left RLN: under aortic arch, higher risk injury
right RLN: under subclavian

5. examples of what both: external pressure by ETT/LMA, surgery to thyriod/parathyroid, neck
can cause injury to stretching, tumor
RLN
left RLN: PDA ligation, MS, aortic arch aneurysm, thoracic tumor

6. How does re- Bilateral
current laryngeal -Acute = Respiratory distress (unopposed action of cricothyroid muscles)
nerve injury affect
the integrity of the -Chronic = No respiratory distress
airway?

7. How does superior -Bilateral = Hoarseness/No respiratory distress
laryngeal nerve in-
jury affect the in- -Unilateral = No respiratory distress
tegrity of the air-
way?

8. ways to anes- o Cotton soaked in nares; 4% lido + vasoconstrictor; cocaine (caution: PChE def,
thetize the upper inc SNS, MAOI drugs)
airway o Topical LA in each nare
o Swish and swallow: 4% viscous lidocaine
o LA spray: 20% benzocaine -> methgbemia-> tx methylene blue
o Nebulization

9. Name 3 airway -Glossopharyngeal nerve block: Palatoglossal arch at the anterior tonsillar pil-
blocks and identify lar




, APEX Unit 1 - Respiratory Flashcards
Study online at https://quizlet.com/_gov7ab

the key landmarks -Superior laryngeal nerve block: Greater cornu of hyoid
for each one
-Transtracheal nerve block: Cricothyroid membrane

10. they adult larynx is - Adult larynx: C3-C6; airway protect, respiration, phonation
located

11. Narrowest area in - Narrowest area in adults: glottic opening
adults - Narrowest fixed area in kids: cricoid ring
Narrowest fixed - Narrowest dynamic area in kids: VC
area in kids
Narrowest dynam-
ic area in kids

12. What are the 3 -Unpaired: Epiglottis, thyroid, cricoid
paired and 3 un-
paired cartilages -Paired: Corniculate, arytenoid, cuneiform
of the larynx?

13. what is the patho- - Sustained, involuntary contraction of laryngeal muscles
physiology behind - Internal SLN: afferent limb
a laryngospasm? - External SLN: efferent limb: cricothyroid (tense)
- RLN: Lat cricoarytenoid: adduct; thyroarytenoid: adduct
- s/s: stridor, rocking horse, absent/altered EtCO2
- risks:
o pre: UTI <2 wks; second hand smoke, reactive airway, GERD, <1yo
o in OR: light anesthesia, secretions, dec CO2, upper airway surgery

14. What is the treat- -100% FiO2
ment for laryn- -Remove noxious stimulation
gospasm? -Deepen anesthesia
-CPAP 15-20 cmH2O
-Open the airway (head extension, chin lift)