Airway Management: Anatomy
The overall goal in airway management is to maintain a patent airway to provide oxygenation and ventilation.
Anatomy
Intubation is traditionally achieved with direct laryngoscopy. The optimal patient position for intubation is called the “sniffing position” or flexion-extension position. This allows for a direct line of site to the larynx. The three main axes involved are the mouth, oropharynx, and trachea.
Figure 1: In the neutral position
![Airway - Neutral](assets/images/Airway_neutral.png)
Figure 2: Extension of lower c-spine
![Airway - Extension of C-spine](assets/images/Airway_Ext_C-spine.png)
Figure 3: Extension at atlanto-occipital joint
![Airway - Extension at atlanto-occipital joint](assets/images/Airway_Ext_atlanto-occipital.png)
A laryngoscope or video laryngoscope should be inserted into the vallecular, the fold where the epiglottis meets the base of the tongue. The following structures can be seen on insertion of a laryngoscope or video laryngoscope.
![Airway - Laryngoscopic view](assets/images/Airway_Laryngoscopic_view.png)
The modified Cormack-Lehane grading system classifies the view seen from laryngoscopy.
![Airway - Laryngoscopic view](assets/images/Airway_Cormack-Lehane.png)
Next page: Options for Airway Management