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The Cormack–Lehane system classifies views obtained by direct laryngoscopy based on the structures seen. It was initially described by R.S. Cormack and J. Lehane in 1984 as a way of simulating potential scenarios that trainee anaesthetists might face. [1] A modified version that subdivided Grade 2 was initially described in 1998. [2]
It is an indirect way of assessing how difficult an intubation will be; this is more definitively scored using the Cormack–Lehane classification system, which describes what is actually seen using direct laryngoscopy during the intubation process itself.
[77] [78] Furthermore, one study of experienced anesthesiologists, on the widely used Cormack–Lehane classification system, found they did not score the same patients consistently over time, and that only 25% could correctly define all four grades of the widely used Cormack–Lehane classification system. [79]
"The most useful modification is a subclassification of grade 3 into 3a when the epiglottis can be lifted from the posterior pharyngeal wall and 3b when it cannot be lifted." Indeed this is true, and in fact, it is more important whether the epiglottis can be lifted or not, rather than the vocal cords or arithenoids are fully seen (2a/2b)
Anatomical parts seen during laryngoscopy. Direct laryngoscopy is carried out (usually) with the patient lying on their back; the laryngoscope is inserted into the mouth on the right side and flipped to the left to trap and move the tongue out of the line of sight, and, depending on the type of blade used, inserted either anterior or posterior to the epiglottis and then lifted with an upwards ...
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There are many grading systems for degeneration of intervertebral discs and facet joints in the cervical and lumbar vertebrae, of which the following radiographic systems can be recommended in terms of interobserver reliability: [1] Kellgren grading of cervical disc degeneration; Kellgren grading of cervical facet joint degeneration