KEY POINTS

1. The patient with partial upper airway obstruction exhibits diminished tidal exchange associated with chest wall retraction. This is accompanied by a snoring sound if obstruction is nasopharyngeal or inspiratory stridor if the obstruction is in the area of the larynx.
2. Extension of the neck and anterior displacement of the mandible moves the hyoid bone anteriorly and lifts the epiglottis to provide clear access to the laryngeal inlet.
3. If lower incisors can be brought forward to bite the upper lip beyond the vermilion, mandibular displacement can be expected to aid intubation.
4. During laryngoscopy with the curved MacIntosh blade, the maximal cervical motion occurs at the atlanto-occipital and atlantoaxial joints.
5. The use of anticholinergics during conscious intubation provides a reduction of secretions. This aids in laryngoscopic visualization and enhances the action of topical anesthetics by diminishing their dilution and removal from the mucosa.
6. Visualization of the glottis in the conscious patient does not guarantee the same quality view after anesthesia and paralysis, because these procedures cause the larynx to shift cephalad and anteriorly.
7. The absence of a leak after cuff deflation suggests the likelihood of glottic or subglottic edema and potential airway obstruction after extubation.