Figure 42-10 Insertion of the laryngeal mask airway (LMA). A, The tip of the cuff is pressed upward against the hard palate by the index finger while the middle finger opens the mouth. B, The LMA is pressed backward in a smooth movement. Notice that the nondominant hand is used to extend the head. C, The LMA is advanced until definite resistance is felt. D, Before the index finger is removed, the nondominant hand presses down on the LMA to prevent dislodgment during removal of the index finger. The cuff is subsequently inflated, and outward movement of the tube is often observed during this inflation. (Courtesy of LMA North America, Inc., San Diego, CA.)