Question:hard
Which of the following instrument insertion will be difficult:
Which of the following instrument insertion will be difficult:
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The X-ray shows a tracheal problem. Which procedure must enter the tracheal lumen itself? That is the one made difficult.
Updated On: Jun 22, 2026
- Nasogastric Tube
- LMA
- Tracheostomy
- Indirect Laryngoscopy
Show Solution
The Correct Option is C
Solution and Explanation
Decide by asking one question: which device must actually live inside the trachea? The accompanying chest X-ray points to a tracheal abnormality - the trachea is deviated, narrowed, or compressed by a mass. So the procedure that will struggle is the single one whose success depends on a normal, accessible tracheal lumen.
Sort the four options by the anatomical compartment each one targets:
- Nasogastric tube $\rightarrow$ travels nose to pharynx to OESOPHAGUS to stomach; it deliberately bypasses the airway, so the trachea is completely irrelevant to its passage.
- LMA (laryngeal mask airway) $\rightarrow$ a supraglottic airway that seats in the hypopharynx ABOVE the vocal cords and laryngeal inlet; it is designed NOT to enter the trachea.
- Indirect laryngoscopy $\rightarrow$ merely a way to LOOK at the larynx using a mirror or fibrescope; nothing physical is pushed down into the trachea, so a distorted trachea does not obstruct it.
- Tracheostomy $\rightarrow$ a surgical opening made DIRECTLY into the trachea with a tube placed in the tracheal lumen itself.
Apply the radiographic abnormality. A trachea that is shifted off the midline, narrowed by stenosis, or squeezed by a mass makes locating and cannulating the tracheal lumen technically hard and potentially hazardous (risk of false passage and bleeding). Of the four manoeuvres, this difficulty falls only on the tracheostomy.
So the three non-tracheal manoeuvres stay comparatively easy: the NGT uses the oesophageal route, the LMA seats supraglottically, and indirect laryngoscopy only visualises - none of them depends on the deranged trachea. The procedure requiring direct cannulation of the abnormal trachea - tracheostomy - is therefore the difficult one.
Answer: C.
Sort the four options by the anatomical compartment each one targets:
- Nasogastric tube $\rightarrow$ travels nose to pharynx to OESOPHAGUS to stomach; it deliberately bypasses the airway, so the trachea is completely irrelevant to its passage.
- LMA (laryngeal mask airway) $\rightarrow$ a supraglottic airway that seats in the hypopharynx ABOVE the vocal cords and laryngeal inlet; it is designed NOT to enter the trachea.
- Indirect laryngoscopy $\rightarrow$ merely a way to LOOK at the larynx using a mirror or fibrescope; nothing physical is pushed down into the trachea, so a distorted trachea does not obstruct it.
- Tracheostomy $\rightarrow$ a surgical opening made DIRECTLY into the trachea with a tube placed in the tracheal lumen itself.
Apply the radiographic abnormality. A trachea that is shifted off the midline, narrowed by stenosis, or squeezed by a mass makes locating and cannulating the tracheal lumen technically hard and potentially hazardous (risk of false passage and bleeding). Of the four manoeuvres, this difficulty falls only on the tracheostomy.
So the three non-tracheal manoeuvres stay comparatively easy: the NGT uses the oesophageal route, the LMA seats supraglottically, and indirect laryngoscopy only visualises - none of them depends on the deranged trachea. The procedure requiring direct cannulation of the abnormal trachea - tracheostomy - is therefore the difficult one.
Answer: C.
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