Pre-anaesthetic assessment and perioperative principles: curriculum recognition: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Pre-anaesthetic assessment and perioperative principles: curriculum recognition

Sample item

Before elective surgery an anaesthetist asks a patient to tilt the head back and look at the ceiling while the shoulders stay still. Which movement is being assessed, because it helps bring the oral and pharyngeal axes into line for direct laryngoscopy?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Extension at the atlanto-occipital joint

Extension of the head on the neck at the atlanto-occipital joint, combined with flexion of the lower cervical spine, forms the sniffing position. Limited extension, as in ankylosing spondylitis or rheumatoid disease, makes the laryngeal view poorer. Jaw protrusion is assessed separately.

Option by option

  • A. Protrusion of the mandible at the jaw joint

    Mandibular protrusion (upper lip bite test) assesses jaw room, not neck extension.

  • B. Rotation at the atlantoaxial joint

    Atlantoaxial rotation turns the head side to side and does not align the airway axes.

  • C. Lateral flexion of the cervical spine

    Lateral flexion is not needed for laryngoscopy and is not the test described.

  • D. Extension at the atlanto-occipital joint (correct)

    Correct. Atlanto-occipital extension aligns the oral and pharyngeal axes in the sniffing position.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, Extension at the atlanto-occipital joint. Extension of the head on the neck at the atlanto-occipital joint, combined with flexion of the lower cervical spine, forms the sniffing position.

Why is "Protrusion of the mandible at the jaw joint" not the answer?

Mandibular protrusion (upper lip bite test) assesses jaw room, not neck extension.

Why is "Rotation at the atlantoaxial joint" not the answer?

Atlantoaxial rotation turns the head side to side and does not align the airway axes.

Why is "Lateral flexion of the cervical spine" not the answer?

Lateral flexion is not needed for laryngoscopy and is not the test described.

What concept does this question test?

It tests Pre-anaesthetic assessment and perioperative principles: curriculum recognition in Anaesthesia. Limited extension, as in ankylosing spondylitis or rheumatoid disease, makes the laryngeal view poorer. Jaw protrusion is assessed separately.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Pre-anaesthetic assessment and perioperative principles: curriculum recognition?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.