A patient in the operating theatre cannot be intubated or ventilated and oxygen saturation is falling rapidly. An emergency surgical airway is created by incising a membrane that lies in the midline between the thyroid cartilage and the cricoid cartilage. This membrane is also pierced by:
- A The recurrent laryngeal nerve and inferior laryngeal artery
- B The internal laryngeal nerve and superior laryngeal artery ✓
- C The external laryngeal nerve only
- D No neurovascular structure; it is avascular
Correct answer: B. The internal laryngeal nerve and superior laryngeal artery
Explanation
The cricothyroid membrane (median cricothyroid ligament) spans between the thyroid cartilage and the cricoid arch and is the standard site for emergency cricothyrotomy because it is superficial, midline, and relatively avascular. It is pierced by the internal laryngeal nerve and the superior laryngeal artery entering the larynx, so a high entry risks injuring them. The recurrent laryngeal nerve ascends in the tracheo-oesophageal groove far posterolateral to this membrane.
Reference: Gray's Anatomy for Students, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.