Select the FALSE statement regarding nasotracheal intubation with Magill forceps:

Select the FALSE statement regarding nasotracheal intubation with Magill forceps:

• A. If a Magill forceps is used for a nasotracheal intubation, the right nares is preferable for insertion of the nasotracheal tube
• B. Extension of the neck can convert an endotracheal intubation to an endobronchial intubation
• C. Bucking signifies the return of the coughing reflex
• D. Postintubation pharyngitis is more likely to occur in females

Answer: (B)

The situation hinges on how neck position changes the depth and direction of an endotracheal tube during nasotracheal intubation with Magill forceps. When the neck is flexed, the tube tends to move deeper toward the carina, increasing the risk of endobronchial (mainstem) intubation. Extending the neck, on the other hand, tends to pull the tube slightly upward, away from the carina, and can even shorten the tube’s intratracheal length. So extending the neck does not convert a normal endotracheal intubation into an endobronchial one; that would be the effect of flexion, not extension. Hence the statement about extension causing endobronchial intubation is false. The other statements fit with established practice and physiology. Using the right nostril for nasotracheal intubation with Magill forceps generally offers a more direct, straighter path to the glottis and tends to encounter less resistance and trauma. Bucking reflects the return of the coughing reflex, signaling awakening or inadequate suppression of airway reflexes. Postintubation pharyngitis being more common in females is a noted clinical observation, likely related to anatomical and sensitivity differences.

The situation hinges on how neck position changes the depth and direction of an endotracheal tube during nasotracheal intubation with Magill forceps. When the neck is flexed, the tube tends to move deeper toward the carina, increasing the risk of endobronchial (mainstem) intubation. Extending the neck, on the other hand, tends to pull the tube slightly upward, away from the carina, and can even shorten the tube’s intratracheal length. So extending the neck does not convert a normal endotracheal intubation into an endobronchial one; that would be the effect of flexion, not extension. Hence the statement about extension causing endobronchial intubation is false.

The other statements fit with established practice and physiology. Using the right nostril for nasotracheal intubation with Magill forceps generally offers a more direct, straighter path to the glottis and tends to encounter less resistance and trauma. Bucking reflects the return of the coughing reflex, signaling awakening or inadequate suppression of airway reflexes. Postintubation pharyngitis being more common in females is a noted clinical observation, likely related to anatomical and sensitivity differences.