Airway Assessment Flashcards

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Questions and Answers

What space does the Mallampati classify?

oropharyngeal

Protrude the tongue with phonation.

False

What is a Class 1 Mallampati?

Soft palate, uvula, and tonsil pillars are visible.

What is a Class 2 Mallampati?

Soft palate and partial uvula are visible. Signup and view all the answers

What is a Class 3 Mallampati?

Soft palate and base of the uvula are visible. Signup and view all the answers

What is a Class 4 Mallampati?

Soft palate is not visible. Signup and view all the answers

The Cormack and Lehane is what type of view?

laryngoscopic Signup and view all the answers

What is Cormack and Lehane Grade 1?

Most of the glottis is visible. Signup and view all the answers

What is Cormack and Lehane Grade 2?

Only the posterior portion of glottis is visible. Signup and view all the answers

What is Cormack and Lehane Grade 3?

The epiglottis is visible, but no part of the glottis can be seen. Signup and view all the answers

What is Cormack and Lehane Grade 4?

No airway structures are visible. Signup and view all the answers

What thyromental distance 'predicts' a difficult airway?

Less than 3 fingers (6.5 cm) Signup and view all the answers

Why does micrognathia pose an issue for intubation?

Limits the ability to move tongue and tissue out of the pharyngeal space. Signup and view all the answers

What is sternomental distance?

Distance from the tip of the chin (mentum) to the sternal notch. Signup and view all the answers

Mouth opening of what width might 'predict' a difficult airway?

Less than 4-5 cm (2 finger breadths) Signup and view all the answers

What palate shape might be problematic?

Highly arched and narrow. Signup and view all the answers

How do you test prognathation?

Upper lip bite test. Signup and view all the answers

Match the following upper lip bite test classes to their descriptions:

Class 1 = Lower incisors can bite above the vermillion border of the upper lip Class 2 = Lower incisors cannot reach the vermillion border Class 3 = Lower incisors cannot bite the upper lip Signup and view all the answers

What measures the tip of the chin to the hyoid bone?

Hyomental distance (HMD) Signup and view all the answers

The only measurement that is not affected by?

Age or sex Signup and view all the answers

A difficult airway should be expected if it is < _____ cm.

< 3.5 cm Signup and view all the answers

BMIs > _ and neck circumferences > _ cm have a 5% higher risk of difficult airways.

<blockquote> 30; > 40 cm </blockquote> Signup and view all the answers

A neck circumference >_____ cm has a 35% increased risk of difficult intubation.

<blockquote> 60 cm </blockquote> Signup and view all the answers

What is the #1 indicator of a difficult airway?

Neck circumference Signup and view all the answers

The Mallampati is often not a good predictor in what patient population?

Pediatric Signup and view all the answers

What gives us the best information about a pediatric patient's airway?

Comprehensive history Signup and view all the answers

Children may have increased difficult airway problems because you are more likely to encounter what?

Congenital disorders Signup and view all the answers

What 5 factors can you look at in a child to try and plan your intubation?

<ol> <li>Size of head, 2. Facial features, 3. Size of tongue, 4. Incisors, 5. ROM</li> </ol> Signup and view all the answers

How does the epiglottis in children compare to that of adults?

Larger, stiffer and more narrow. Signup and view all the answers

Children under the age of 2 have a very large _______ in comparison to the oral cavity.

Tongue Signup and view all the answers

What is the narrowest portion of the adult airway?

Glottis Signup and view all the answers

What about a child's airway?

Also the glottis according to new studies. Signup and view all the answers

It is not okay to use a cuffed ETT in children.

False Signup and view all the answers

Why do some pediatric ETT not have cuffs?

Cuff sits at the top of the cricoid cartilage. Signup and view all the answers

What part of the airway will be most irritated during intubation?

Cricoid Signup and view all the answers

What acronym is used to determine laryngeal view to predict ease or difficulty of tracheal intubation?

Not specified Signup and view all the answers

Study Notes

Mallampati Classification

Represents oropharyngeal space visibility.
Class 1: Soft palate, uvula, and tonsil pillars visible.
Class 2: Soft palate and partial uvula visible.
Class 3: Soft palate with base of uvula visible.
Class 4: Soft palate is not visible.

Cormack and Lehane Classification

Pertains to laryngoscopic view during intubation.
Grade 1: Most of the glottis is visible.
Grade 2: Only posterior portion of glottis visible.
Grade 3: Epiglottis visible, no glottis visibility.
Grade 4: No airway structures visible.

Airway Prediction Indicators

Thyromental distance less than 3 fingers (6.5 cm) suggests a difficult airway.
Micrognathia limits tongue movement within the pharynx.
Sternomental distance: Measure from chin tip to sternal notch.
Mouth opening of less than 4-5 cm (2 finger breadths) may indicate difficulty.
A highly arched and narrow palate can complicate intubation.
Prognathation assessed with upper lip bite test involves three classes of difficulty.

Hyomental Distance

Hyomental distance (HMD) measures chin to hyoid bone; affected by age and sex.
Difficult airway expected if HMD is less than 3.5 cm.

Body Mass Index (BMI) and Neck Circumference

BMIs over 30 and neck circumferences exceeding 40 cm are linked to a 5% increased risk of difficult airways.
A neck circumference over 60 cm correlates with a 35% increased risk of difficult intubation.

Pediatric Considerations

Mallampati classification is less predictive in pediatric patients.
Comprehensive history provides the best information regarding pediatric airway.
Increased difficulties in children often relate to congenital disorders.
Factors to assess in pediatric intubation: head size, facial features, tongue size, incisor presence, and range of motion (ROM).
Children's epiglottis is larger, stiffer, and more narrow than that of adults, complicating laryngoscopy.
Children under age 2 have proportionally larger tongues, limiting maneuverability during intubation.
Glottis is the narrowest portion of both adult and pediatric airways, updated from previous beliefs regarding children's airways.

Endotracheal Tubes (ETTs)

Cuffed ETTs are acceptable for children, contrary to some beliefs.
Some pediatric ETTs may lack cuffs to prevent swelling at the cricoid cartilage, reducing subglottic edema risk.

Intubation Irritation

The cricoid region experiences the most irritation during intubation.

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Description

Test your knowledge on the Mallampati classification system with these flashcards. This quiz covers the definitions and visual assessments related to airway assessment, specifically focusing on different classes of the Mallampati score. Perfect for medical students and healthcare professionals looking to improve their understanding of oropharyngeal space.