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?
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What is a Class 3 Mallampati?
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What is a Class 4 Mallampati?
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The Cormack and Lehane is what type of view?
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What is Cormack and Lehane Grade 1?
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What is Cormack and Lehane Grade 2?
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What is Cormack and Lehane Grade 3?
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What is Cormack and Lehane Grade 4?
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What thyromental distance 'predicts' a difficult airway?
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Why does micrognathia pose an issue for intubation?
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What is sternomental distance?
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Mouth opening of what width might 'predict' a difficult airway?
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What palate shape might be problematic?
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How do you test prognathation?
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Match the following upper lip bite test classes to their descriptions:
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What measures the tip of the chin to the hyoid bone?
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The only measurement that is not affected by?
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A difficult airway should be expected if it is < _____ cm.
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BMIs > _____ and neck circumferences > _____ cm have a 5% higher risk of difficult airways.
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A neck circumference >_____ cm has a 35% increased risk of difficult intubation.
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What is the #1 indicator of a difficult airway?
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The Mallampati is often not a good predictor in what patient population?
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What gives us the best information about a pediatric patient's airway?
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Children may have increased difficult airway problems because you are more likely to encounter what?
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What 5 factors can you look at in a child to try and plan your intubation?
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How does the epiglottis in children compare to that of adults?
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Children under the age of 2 have a very large _______ in comparison to the oral cavity.
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What is the narrowest portion of the adult airway?
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What about a child's airway?
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It is not okay to use a cuffed ETT in children.
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Why do some pediatric ETT not have cuffs?
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What part of the airway will be most irritated during intubation?
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What acronym is used to determine laryngeal view to predict ease or difficulty of tracheal intubation?
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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.