Sun10October0740PM 12

A difficult intubation may be associated with:

True / False

A thyromental distance greater than 7 cm Correct

Micrognathia Correct

Macroglossia Correct

An absent atlanto-occipital gap Incorrect answer selected

An increased atlanto-occipital gap Incorrect answer selected

Explanation

Anatomical features identified during patient examination and radiological investigations provide useful information during the preoperative assessment of the airway. The ability to predict which patients may prove difficult to intubate is an important skill.

The anatomical variations that are associated with difficult intubations include

A reduced interdental gap

Protruding upper incisor teeth

Micrognathia (mandibular hypoplasia)

Macroglossia (large tongue)

A thyromental distance less than 6.5 cm

A high arched palate

A reduced or absent atlanto-occipital gap (not an increased gap).

The atlanto-occipital gap is assessed using a lateral cervical spine x ray taken in the neutral position, and measuring the distance between the occiput and the spine of the atlas. When the gap is reduced, extending the head causes bowing of the cervical spine and anterior displacement of the larynx.

In patients with a thyromental distance of less than 6.5 cm, intubation may be difficult, as there is likely to be to insufficient space for displacement of the tongue. A thyromental distance greater than 6.5 cm is not usually associated with difficult intubation.

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Times answered: 274