Airway Basics: Functional Airway Management

Abstract

The anesthesiologist maintains patency of the airway through the use of various airway techniques, from simple maneuvers such as jaw thrust and chin lift, to the insertion of oropharyngeal or nasopharyngeal airways, to the placement of advanced airway devices such as supraglottic airways and endotracheal tubes. Understanding the structure, function and anatomic relationships of the airway provides the foundation to evaluate the patient and determine a safe plan for airway management.The nose and mouth are the beginning point of the airway, which can be divided into the upper airway consisting of nasal cavity, nasopharynx, oral cavity, oropharynx, hypopharynx and larynx, and the lower airway consisting of the trachea, bronchi and subdivisions of the bronchi. The airway is the conduit from which air flows to and from the alveoli, where oxygenation and ventilation occurs. It plays important functions in trapping airborne contaminants, producing mucus and secretions, permitting olfactory and general sensation, warming and humidifying the air, providing immunologic defense from infection through lymphoid tissues, allowing a mechanism for vocalization, creating a functional separation between the swallowing and breathing, and protecting from aspiration of oral and stomach contents. This review contains 2 tables and 34 references. Key words: airway, intubation, pharynx, larynx, kiesselbach’s plexus, vocal cord injury, swallow, cough, laryngospasm, bronchospasm, obstruction, aspiration, pediatric airway