What is the “glottis”? What is its role in the intubation procedure? What role does the vallecula potentially play during an intubation procedure? (hint: look up Mac and Miller intubation blades)
The correct answer and explanation is:
The glottis is the opening between the vocal cords in the larynx (voice box) that leads into the trachea (windpipe). It is a crucial structure in respiratory function, as it controls airflow into the lungs. During an intubation procedure, the glottis is the primary target for the placement of the endotracheal tube (ET tube).
Intubation is a medical procedure used to secure an airway by inserting a tube into the trachea, typically in patients who require mechanical ventilation or are at risk of airway obstruction. To perform this, a healthcare provider uses a laryngoscope to visualize the airway, and the goal is to locate the glottis to insert the ET tube correctly.
The Macintosh (Mac) and Miller blades are types of laryngoscope blades used in intubation. The Mac blade is curved and is designed to lift the epiglottis (a flap of tissue that covers the windpipe) and reveal the glottis. On the other hand, the Miller blade is straight and is designed to lift the epiglottis directly. The choice between the two depends on the patient’s anatomy and the clinician’s experience.
The vallecula is a space located just behind the epiglottis, at the base of the tongue. During intubation, the vallecula plays a key role, particularly when using a Macintosh blade. The blade is often inserted into the vallecula to indirectly lift the epiglottis and expose the glottis. By providing a space to leverage the epiglottis, the vallecula allows for better visualization of the glottic opening and facilitates smoother ET tube placement. If the vallecula is not adequately visualized, it can make intubation more difficult, as it may be harder to lift the epiglottis and expose the glottis.
In summary, the glottis is the target of intubation, and the vallecula aids in lifting the epiglottis for better glottic visualization. Both are crucial for a successful intubation.