Positioning
Last modified: 15 June 2022, 2:33:46 PM AEST
Sniffing Position1 / 5
- Tragus inline with sternal notch
- Combination of
- Neck flexion 35°
- Atlanto-occipital extension 15°
- Originally described by Chevalier Jackson as the "Boyce-Jackson" position in 1913
- Termed the sniffing position by Magill in 1936
3 Axis alignment theory2 / 5
- Bannister and MacBeth 1944
- 3 axes
- laryngeal axis
- pharyngeal axis
- oral axis
- All 3 need to be brought into alignment for direct laryngoscopy
2 curve theory3 / 5
- Greenland 2010
- Curves
- Primary curve = oropharyngeal curve
- Secondary curve = pharyngo-glotto-tracheal curve
- Point of inflection = base of epiglottis
- Tangent = laryngeal vestibule axis
- Changes in airway configuration with different head and neck positions using magnetic resonance imaging of normal airways: a new concept with possible clinical applications, BJA 2010
3 Column Theory4 / 5
- Keith Greenland 2008
- Groups anatomical structures that affect AW Mx
- Posterior column
- Cervical spine
- Middle column
- Pathology affecting lumen of AW
- Anterior column
- Triangular-shaped pyrmaid
- Submandibular space + glossal muscles + laryngeal skeleton
- Vertices at TMJs and lower incisors
- Apex at hyoid
- Triangular-shaped pyrmaid