NBCRNA Exam Questions With 100% Correct Answers 2024

NBCRNA Exam Questions With 100% Correct Answers 2024 What muscle abducts the vocal cords? - answerposterior cricoarytenoid What is the only muscle that tenses (elongates) the vocal cords? - answercricothyroid "cords tense" What muscle opens the glottis? - answerthyroepiglottic What two muscles close the glottis? - answeraryepiglottic oblique arytenoid What muscles adduct the vocal cords and arytenoids? - there are two - answerlateral cricoarytenoid transverse arytenoid What muscle shortens the vocal cords? (relaxes?) - there are two - answerthyroarytenoid "they relax" vocalis The cricothyroid muscle is innervated by? - answerexternal branch of SLN - the only branch that tenses (elongates) the VCs The internal branch of the SLN is purely? - sensory or motor? - answersensory Recurrent laryngeal innervates... - answerbelow vocal cords --> the trachea Branches off vagus in thorax Motor: all intrinsic except cricothyroid Glossopharyngeal innervates... - answerthe vallecula topside of epiglottis soft palate oropharynx post 1/3 of tongue tonsils *afferent limb of gag reflex* CN IX - sensory Superior laryngeal innervates... - answerposterior epiglottis --> vocal cords Internal branch is sensory - underside of epiglottis External branch is motor - cricothyroid muscle Trigeminal (V) V3 innervates... - answeranterior 2/3 tongue Trigeminal nerve (V) contains what 3 branches? - answerV1 ophthalmic (anterior ethmoidal) - nares/ant 1/3 septum V2 maxillary (sphenopalatine) - turbinates/septum V3 Mandibular (lingual) Superior laryngeal nerve block: - answer3ml at the inferior aspect of the greater cornu of hyoid bone bilaterally - helps tolerate FO intubation once past the oropharynx Glossopharyngeal block: - answer1-2 ml at the tonsillar pillar bilaterally Transtracheal block: - answer3-5 ml through the cricothyroid membrane What is most likely to injure the left RLN while sparing the right RLN? - answerMitral stenosis (LA enlargement compresses the nerve and may present as hoarseness) PDA ligation Aortic arch aneurysm Thoracic tumor Causes of left OR right RLN injury: - answerparathyroid or thyroid surgery external pressure from LMA/ETT neck tumor neck extension Where does the right RLN loop? left RLN loop? - answerunder the right subclavian artery - left under the aorta (more susceptible to injury) For the patient in sitting position, order the cartilages from superior to inferior: cricoid epiglottis arytenoid corniculate - answerepiglottis corniculate arytenoid cricoid How many unpaired cartilages present in the larynx? Paired? - answer3 unpaired 3 paired 9 cartilages total Where is the adult larynx located? Infant larynx? - answerC3-C6 Infant is C2-C4 What is the narrowest part of the airway? adult/infant - answerVocal cords for adult Cricoid for infant, if paralyzed = vocal cords Risk factors for intraoperative laryngospasm? - answerGERD Exposure to 2nd hand smoke recent URI Age < 1 year HYPOcapnia light anesthesia saliva or blood in the upper airway What is the definition of laryngospasm? - answerSustained and involuntary contraction of the vocal cord Adductors that result in the inabilit