NextGen Learning To Elevate Your Airway Practice
Overview
What am I feeling? Am I in the right place? Can I be confident that I’m not going to injure something important? These are the practical questions you will ask yourself as you pick up that scalpel, and if you can’t answer them, you might be inclined to delay or, worse, not perform FONA at all. Don’t do that. Instead, get comfortable with the clinically relevant anatomy and use the expert tips here to assure yourself you’re in the right place.
External Landmarks
This is as easy as it gets. Extend the neck. Now feel for the biggest lump in the middle (that’s the thyroid cartilage). Now feel the hard ring below it (that’s the cricoid cartilage). Now feel the soft bouncy part in between them? That’s your target. The cricothyroid membrane.
Relationship to Deeper Anatomy
Here you can see the outlined external landmarks and their relationship to the deeper structures. Notice the thyroid cartilage above and the cricoid cartilage below locate a clearly palpable and identifiable cricothyroid membrane.
Built in Safety
One concern that clinicians have is the fear that they will “overshoot” when making the incision through the CTM and cause damage. Fortunately, human anatomy already has a safety net. The cricoid ring has a large posterior surface that backstops any incidental incision that might go through the trachea, and most importantly, neuro-vascular structures are off midline away from the point of incision.
Dive Deeper
curated med ed
This video by Andy Neill MD, is a great deep dive into the clinically relevant anatomy for performing a cricothyroidotomy. The key take-home points? Most of the anatomy in the area is NOT RELEVANT, so don’t worry about it. Second, if you identify the CTM and stay midline, it’s very hard to cause serious injury, so again, DON’T WORRY.
Curated MedEd
30 second review (dance party)
No discussion of eFONA anatomy would be complete without this lighthearted gem and perhaps the greatest performance of FONA anatomy palpation of all time. Follow the @sangrialovingairwaydoc for another great social network learning builder.
Summary
Here is a review of some of the key points of important FONA anatomy. This will complete the learning space on airway anatomy. Next, we will move on to our upper airway lifelines and then our Fearless FONA learning space, where you will have the opportunity to apply this knowledge of clinical anatomy.
End of Anatomy Section
What’s Next
Find Or Click Me
Nice work—you’re through this section! To keep going, scan the QR code on the physical poster at the next station in our pop-up training space to access the next set of digital content. Prefer to stay online? Just click the poster image here to continue your journey.
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