Surface anatomy of the upper airway and digestive tract

Question 1

Locate the thyroid cartilage.

Answer 1

By sight and palpation identify the laryngeal prominence (thyroid cartilage) on the patient’s neck. Explore by gentle palpation the other parts of the thyroid cartilage: the notch in the superior border, and the two laminae.

Question 2

Locate the cricoid cartilage.

Answer 2

Follow the anterior border of the thyroid cartilage (laryngeal prominence) downward until you feel a depression due to the cricothyroid membrane and then the convex anterior part of the cricoid cartilage below it.

Question 3

Locate the hyoid bone.

Answer 3

The hyoid bone lies above the thyroid cartilage (laryngeal prominence) and is connected to it by the thyrohyoid membrane. Gently palpate the body anteriorly, and the horns laterally.

Question 4

Locate the cervical part of the trachea.

Answer 4

Below the cricoid cartilage (in the interval bounded by the sternomastoids and the jugular notch of the manubrium) the first two rings of the trachea can be felt.

Question 5

Locate the thyroid isthmus.

Answer 5

Directly below (inferior to) the cricoid cartilage, centrally. Before the first 2 rings of the trachea.

Question 6

Demonstrate the position of the mastoid air cells.

Answer 6

In the mastoid process, behind the external ear (part of the middle ear). Stop at the mastoid antrum.

Question 7

Demonstrate the anatomical basis of tracheostomy and cricothyroidotomy.

Answer 7

A tracheostomy is the formation of an opening into the trachea, usually between the 2nd and 3rd tracheal cartilage rings. Tracheostomy tube is inserted to assist ventilation. A cricothyroidectomy is a small incision in the lower larynx to allow air passage in an emergency. Temporary until the patient can undergo a tracheostomy in theatre or other ventilation.

Question 8

Label the following diagram:

Answer 8

Question 9

How should you use an otoscope?

Answer 9

Straighten the ear canal by gently pulling the pinna upwards and backwards (for adults- downwards for children).

Hold the otoscope like a pen and rest your little finger on the patient’s cheek to prevent any trauma to the ear.

Observe the condition of the tympanic membrane and ear canal by rotating the otoscope.