How does pediatric airway anatomy differ from adults?

• A. The tongue is relatively larger in children, the airway is smaller and more prone to obstruction, and the epiglottis is more floppy
• B. The tongue is smaller in children
• C. The airway is longer in children
• D. The epiglottis is stiffer in children

Answer: (A)

Pediatric airways are smaller in diameter and sit in a proportionally larger tongue, with a more floppy epiglottis, all of which raise the risk of obstruction and make airway management trickier. Because the mouth and airway are smaller, even a small amount of swelling, secretions, or a partially collapsed tongue can quickly obstruct breathing. The tongue, being relatively large for the size of the oral cavity, can fall back and block the airway more readily, especially when the child is supine. The epiglottis being more floppy means it can be more easily drawn toward the airway by airflow or suctioning, complicating visualization during intubation. In contrast, the idea that the tongue is smaller, that the airway is longer, or that the epiglottis is stiffer does not fit pediatric anatomy—the tongue is not smaller, the airway isn’t characteristically longer, and the epiglottis isn’t stiffer in children.