Hensley's Practical Approach to Cardiothoracic Anesthesia
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IV. Thoracic Anesthesia
Hard palate
Uvula Soft palate
Palatoglossal arch
Palatopharyngeal arch
Palatine tonsil
GPNB
GPNB
Tongue
Superior laryngeal nerve
Hyoid bone
SLNB
SLNB
Thyrohyoid membrane
Thyroid cartilage
Cricothyroid muscles
Cricothyroid membrane
Cricoid cartilage
TTB
Trachea
Recurrent laryngeal nerve
Copyright © 2024 Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited. FIGURE 26.1 Topicalization of the oropharynx and upper airway. The glossopharyngeal nerve innervates the oro pharynx, including the tongue and upper epiglottis; it mediates the afferent limb of the gag reflex. It can be blocked transorally by injecting just medial to the palatine tonsils bilaterally (GPNB). The superior laryngeal nerve can be blocked (SLNB) at the thyrohyoid membrane bilaterally; the internal branch provides sensation above vocal cords, and the exter nal branch provides motor function to the cricothyroid muscle. The recurrent laryngeal nerve can be blocked by transcri cothyroid (transtracheal) injection (TTB [transtracheal block]); it provides sensation to the trachea and motor function to all intrinsic laryngeal muscles, except the cricothyroid muscle. The superior and the recurrent laryngeal nerves are branches of the vagus nerve. (Courtesy of Julia Scarpa.)
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