What muscle abducts the vocal cords? correct answers posterior cricoarytenoid
What is the only muscle that tenses (elongates) the vocal cords? correct answers cricothyroid "cords tense"
What muscle opens the glottis? correct answers thyroepiglottic
What two muscles close the glott...
NBCRNA STUDY COURSE QUESTIONS
WITH COMPLETE SOLUTIONS
What muscle abducts the vocal cords? correct answers posterior cricoarytenoid
What is the only muscle that tenses (elongates) the vocal cords? correct answers cricothyroid "cords tense"
What muscle opens the glottis? correct answers thyroepiglottic
What two muscles close the glottis? correct answers aryepiglottic
oblique arytenoid
What muscles adduct the vocal cords and arytenoids?
- there are two correct answers lateral cricoarytenoid transverse arytenoid
What muscle shortens the vocal cords? (relaxes?)
- there are two correct answers thyroarytenoid "they relax" vocalis
The cricothyroid muscle is innervated by? correct answers external branch of SLN
- the only branch that tenses (elongates) the VCs
The internal branch of the SLN is purely?
- sensory or motor? correct answers sensory
Recurrent laryngeal innervates... correct answers below vocal cords --
> the trachea
Branches off vagus in thorax
Motor: all intrinsic except cricothyroid Glossopharyngeal innervates... correct answers the vallecula
topside of epiglottis
soft palate oropharynx
post 1/3 of tongue
tonsils
*afferent limb of gag reflex* CN IX - sensory
Superior laryngeal innervates... correct answers posterior epiglottis -->
vocal cords
Internal branch is sensory - underside of epiglottis
External branch is motor - cricothyroid muscle
Trigeminal (V) V3 innervates... correct answers anterior 2/3 tongue
Trigeminal nerve (V) contains what 3 branches? correct answers V1 ophthalmic (anterior ethmoidal) - nares/ant 1/3 septum
V2 maxillary (sphenopalatine) - turbinates/septum
V3 Mandibular (lingual)
Superior laryngeal nerve block: correct answers 3ml at the inferior aspect of the greater cornu of hyoid bone bilaterally - helps tolerate FO intubation once past the oropharynx
Glossopharyngeal block: correct answers 1-2 ml at the tonsillar pillar bilaterally
Transtracheal block: correct answers 3-5 ml through the cricothyroid membrane
What is most likely to injure the left RLN while sparing the right RLN? correct answers Mitral stenosis (LA enlargement compresses the nerve and may present as hoarseness)
PDA ligation Aortic arch aneurysm
Thoracic tumor
Causes of left OR right RLN injury: correct answers parathyroid or thyroid surgery
external pressure from LMA/ETT
neck tumor
neck extension
Where does the right RLN loop?
left RLN loop? correct answers under the right subclavian artery
- left under the aorta (more susceptible to injury)
For the patient in sitting position, order the cartilages from superior to inferior:
cricoid
epiglottis
arytenoid
corniculate correct answers epiglottis
corniculate
arytenoid
cricoid
How many unpaired cartilages present in the larynx?
Paired? correct answers 3 unpaired
3 paired
9 cartilages total
Where is the adult larynx located?
Infant larynx? correct answers C3-C6
Infant is C2-C4
What is the narrowest part of the airway? adult/infant correct answers Vocal cords for adult
Cricoid for infant, if paralyzed = vocal cords Risk factors for intraoperative laryngospasm? correct answers GERD
Exposure to 2nd hand smoke
recent URI
Age < 1 year
HYPOcapnia
light anesthesia
saliva or blood in the upper airway
What is the definition of laryngospasm? correct answers Sustained and
involuntary contraction of the vocal cord Adductors that result in the inability to ventilate.
Tensor palatine opens? correct answers nasopharynx
Genioglossus opens? correct answers the oropharynx
Hyoid muscles open? correct answers the hypopharynx
Landmarks for the Larson's maneuver? correct answers posterior: mastoid process
superior: skull base
Anterior: ramus of mandible
Muller's maneuver? correct answers inhaling against a closed glottis
Which type of pneumocystis produce surfactant? correct answers type 2
Three types of pneumocytes? correct answers type 1 - 3
type 1 - cover 80% of alveolar surface
type 3 - macrophages that fight lung infection
Most common etiology of hypoxemia in the PACU? correct answers V/Q mismatch: specifically atelectasis
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