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1、AirwayManagementImportanceThemajorresponsibilityoftheanesthesiologististoprovideadequaterespirationforthepatient.Themostvitalelementinprovidingfunctionalrespirationistheairway.Noanestheticissafeunlessdiligenteffortsaredevotedtomaintaininganintactfunctionala
2、irway.Thesameprinciplesofairwaymanagementoutlinedinthischapterareapplicabletoallclinicalsituationsinwhichrespiratoryinadequacymaydevelop.TheFirstSection MaintenanceofAirwaySmooth1.StuctureAndFunctionOfTheAirwaysUpperAirways:Mouth,nose,pharynx,larynxLowerAi
3、rway:Trachea,Bronchus,LungNoseThenoseistheprimarypathwayfornormalbreathingunlessobstructionbypolypsorupperrespiratoryinfectionispresent.Duringquietbreathing,theresistancetoairflowthroughthenasalpassagesaccountsforalmosttwothirdsofthetotalairwayresistance.Th
4、eresistancethroughthenoseisalmosttwicethatassociatedwithmouthbreathing.PharynxThepharyngealairwayextendsfromtheposterioraspectofthenosedowntothecricoidcartilage,wherethepassagecontinuesastheesophagus.OropharynxNasopharynxLaryngopharynxEpiglottisGlottissoftp
5、alatelarynxThelarynx,whichliesatthelevelofthethirdthroughsixthcervicalvertebraeThelaryngealcavityextendsfromtheepiglottistothelowerlevelofthecricoidcartilage.Theglottisrepresentsthenarrowestpointintheadultairway(morethan8yearsofage),whereasthecricoidcartila
6、gerepresentsthenarrowestpointintheinfantairway(birthto1yearofage).TracheaThetracheaisafibromusculartubethatis10to15cmlongwithadiameterofapproximately20mminadults.Itextendsfromthecricoidcartilagetothecarina.Thetracheabifurcatesintotherightandleftmainstembron
7、chiatthecarina.Therightmainstembronchusisapproximately2.5cmlongwithatake-offangleofapproximately25°.Theleftmainstembronchusisapproximately5cmlongwithatake-offangleofapproximately45°.2.ReasonandTreatmentofAirwayObstructionReasonofAirwayObstruction:Secretions
8、,blood,foreignbodyblockairway.GlossocomaLaryngospasmBronchospasmNeuromusculardiseaseGlossocomaGlossocomaisthemostcommonreasonofupperairwayobstruction.SymptomsandSignsInlessseverecases:Snore,thethroatwa
