Airway Management: Anatomy

The overall goal in airway management is to maintain a patent airway to provide oxygenation and ventilation.

Anatomy

Intubation is traditionally achieved with direct laryngoscopy. The optimal patient position for intubation is called the “sniffing position” or flexion-extension position. This allows for a direct line of site to the larynx. The three main axes involved are the mouth, oropharynx, and trachea.

Figure 1: In the neutral position

Airway - Neutral

Figure 2: Extension of lower c-spine

Airway - Extension of C-spine

Figure 3: Extension at atlanto-occipital joint

Airway - Extension at atlanto-occipital joint

A laryngoscope or video laryngoscope should be inserted into the vallecular, the fold where the epiglottis meets the base of the tongue. The following structures can be seen on insertion of a laryngoscope or video laryngoscope.

Airway - Laryngoscopic view

The modified Cormack-Lehane grading system classifies the view seen from laryngoscopy.

Airway - Laryngoscopic view

Next page: Options for Airway Management

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