NBCRNA EXAM WITH ALL QUESTIONS AND
CORRECT ANSWERS 2026-2027!!
Muscle that tenses vocal cords
Cricothyroid
Muscle that relaxes vocal cords
Thyroarytenoid
Muscle that abducts vocal cords
Posterior cricoarytenoid
Muscle that adducts vocal cords
Lateral cricoarytenoid
Sensory innervation of upper airway
Trigeminal nerve:
V1 (ophthalmic) - nares + anterior 1/3 septum
V2 (maxillary) - turbinates + septum
V3 (mandibular) - anterior 2/4 tongue
Glossopharyngeal nerve:
Posterior 1/3 tongue/soft palate/oropharynx
Vallecula, anterior epiglottis
Vagus nerve:
SLN (internal branch): posterior epiglottis to vocal cords
RLN: below vocal cords to trachea
Superior laryngeal nerve external branch
Motor to cricothyroid muscle
Superior laryngeal nerve internal branch
Sensory posterior epiglottis to vocal cords
Recurrent laryngeal nerve
,Sensation below vocal cords to trachea
Motor: all intrinsic Laryngeal muscles except cricothyroid
Recurrent laryngeal nerve injury
Bilateral acute: respiratory distress due to unopposed action of cricothyroid
muscles
Bilateral chronic and unilateral = no respiratory distress
Superior laryngeal nerve injury
No respiratory distress but possible voice changes /hoarseness
Glossopharyngeal nerve block location
Anterior tonsilar pillar
Superior laryngeal nerve block location
Greater corneu of hyoid bone
Transtracheal nerve block location
Cricothyroid membrane
3 paired cartilages of larynx
Corniculate
Arytenoid
Cuneiform
3 unpaired cartilages of the larynx
Epiglottis
Thyroid
Cricoid
Adult larynx spinal levels
C3-C6
Where do vocal cords attach?
Anteriorly: thyroid cartilage
Posteriorly: arytenoids
Laryngospasm risk factors
Recent URI
Infants/young children
,Asthma
Smoking
ASA 4, prematurity, GERD, OSA
Airway procedures (T&A)
Muscles of inspiration
Diaphragm, external intercostals
Accessory muscle of inspiration
Sternocleidomastoid
Scalene
Muscles of active expiration
Transverse abdominis
Internal obliques
Rectus abdominis
External obliques
(I let the air out of my "tire"s)
V/Q ratio > 1
Dead space
V/Q ratio < 1
Shunt
Normal minute ventilation
4 L/min
Normal cardiac output
5 L/min
Normal V/Q ratio
0.8
Alveolar gas equation
PAO2 = FiO2(Pb - PH2O) - PaCO2/RQ
Pb = 760 at sea level
PH2O = 47
RQ = 0.8
, Normal PAO2 at sea level & room air
~ 105 mmHg
Normal A-a gradient
5-15 mmHg
Formula for A-a gradient
(Age/4) + 4
5 causes of hypoxemia
Normal A-a:
1. Reduced FiO2
2. Hypoventilation
Increased A-a:
3. Diffusion limitation
4. V/Q mismatch
5. Shunt
What cause of hypoxemia can't be fixed with supplemental O2?
Shunt
Normal IRV
3000 mL
Normal ERV
1100 mL
Normal residual volume
1200 mL
Closing volume
The volume above residual volume where the small airways begin to close
The point where dynamic compression of the airways begins
Factors that increase closing volume
"CLOSE-P"
COPD
CORRECT ANSWERS 2026-2027!!
Muscle that tenses vocal cords
Cricothyroid
Muscle that relaxes vocal cords
Thyroarytenoid
Muscle that abducts vocal cords
Posterior cricoarytenoid
Muscle that adducts vocal cords
Lateral cricoarytenoid
Sensory innervation of upper airway
Trigeminal nerve:
V1 (ophthalmic) - nares + anterior 1/3 septum
V2 (maxillary) - turbinates + septum
V3 (mandibular) - anterior 2/4 tongue
Glossopharyngeal nerve:
Posterior 1/3 tongue/soft palate/oropharynx
Vallecula, anterior epiglottis
Vagus nerve:
SLN (internal branch): posterior epiglottis to vocal cords
RLN: below vocal cords to trachea
Superior laryngeal nerve external branch
Motor to cricothyroid muscle
Superior laryngeal nerve internal branch
Sensory posterior epiglottis to vocal cords
Recurrent laryngeal nerve
,Sensation below vocal cords to trachea
Motor: all intrinsic Laryngeal muscles except cricothyroid
Recurrent laryngeal nerve injury
Bilateral acute: respiratory distress due to unopposed action of cricothyroid
muscles
Bilateral chronic and unilateral = no respiratory distress
Superior laryngeal nerve injury
No respiratory distress but possible voice changes /hoarseness
Glossopharyngeal nerve block location
Anterior tonsilar pillar
Superior laryngeal nerve block location
Greater corneu of hyoid bone
Transtracheal nerve block location
Cricothyroid membrane
3 paired cartilages of larynx
Corniculate
Arytenoid
Cuneiform
3 unpaired cartilages of the larynx
Epiglottis
Thyroid
Cricoid
Adult larynx spinal levels
C3-C6
Where do vocal cords attach?
Anteriorly: thyroid cartilage
Posteriorly: arytenoids
Laryngospasm risk factors
Recent URI
Infants/young children
,Asthma
Smoking
ASA 4, prematurity, GERD, OSA
Airway procedures (T&A)
Muscles of inspiration
Diaphragm, external intercostals
Accessory muscle of inspiration
Sternocleidomastoid
Scalene
Muscles of active expiration
Transverse abdominis
Internal obliques
Rectus abdominis
External obliques
(I let the air out of my "tire"s)
V/Q ratio > 1
Dead space
V/Q ratio < 1
Shunt
Normal minute ventilation
4 L/min
Normal cardiac output
5 L/min
Normal V/Q ratio
0.8
Alveolar gas equation
PAO2 = FiO2(Pb - PH2O) - PaCO2/RQ
Pb = 760 at sea level
PH2O = 47
RQ = 0.8
, Normal PAO2 at sea level & room air
~ 105 mmHg
Normal A-a gradient
5-15 mmHg
Formula for A-a gradient
(Age/4) + 4
5 causes of hypoxemia
Normal A-a:
1. Reduced FiO2
2. Hypoventilation
Increased A-a:
3. Diffusion limitation
4. V/Q mismatch
5. Shunt
What cause of hypoxemia can't be fixed with supplemental O2?
Shunt
Normal IRV
3000 mL
Normal ERV
1100 mL
Normal residual volume
1200 mL
Closing volume
The volume above residual volume where the small airways begin to close
The point where dynamic compression of the airways begins
Factors that increase closing volume
"CLOSE-P"
COPD
