You are in the middle of helping Mr. Henderson eat his lunch when he suddenly coughs violently after a sip of water. You stop feeding him immediately and check his airway. That moment was a critical test of his epiglottis—and your quick response ensured he stayed safe.
What is the Epiglottis?
The epiglottis (ep-ih-GLOT-is) is a small, leaf-shaped flap of cartilage located at the base of the tongue, right behind the tongue and in front of the larynx (voice box). Think of it as the body’s “trapdoor.” When a person breathes, it stands open to let air into the trachea (windpipe). The moment someone swallows, it snaps shut over the trachea to direct food and liquid down the esophagus (food pipe) instead of the lungs.
Why the Epiglottis Matters in Your Daily Care
Protecting the resident’s airway is your number one priority during mealtime. If the epiglottis is damaged, swollen, or just slow to close due to age or stroke, food or liquid can enter the lungs. This is called aspiration, which leads to aspiration pneumonia—a serious and common cause of hospitalization in long-term care. Understanding this anatomy reminds you why feeding protocols exist: you aren’t just following rules; you are guarding the lungs.
What You’ll See During Your Shift
You will notice the importance of this structure most often during meal times, especially with residents who have dysphagia (swallowing difficulties). You might hear a “gurgly” voice, see coughing while drinking, or notice residents holding food in their cheeks. This means the “trapdoor” isn’t sealing correctly.
“Hey Nurse Davis, I was feeding Mrs. Lee her pureed lunch and noticed she started coughing after two spoonfuls. She sounds a little wet when she breathes, like the epiglottis isn’t blocking her airway. I stopped the meal immediately and sat her up high. Can you please check her before we try anything else?”
Common Pitfall & Pro Tip
⚠️ Pitfall: Feeding a resident who is slumped over in a chair or lying down. When the body isn’t upright, gravity fights the epiglottis, making it much easier for food to slip into the airway.
Pro Tip: Always ensure residents are sitting in High Fowler’s position (upright at 90 degrees) for meals and for 30 minutes after eating. This posture helps the epiglottis close effectively and keeps the airway clear.
Memory Aid for the Epiglottis
Think of the “Epi-Lid.” The Epiglottis acts like a lid that snaps shut over the windpipe every time we swallow.
If the lid is broken or open, food goes down the wrong pipe.
State Test Connection
On the CNA exam, this appears under “Basic Nursing Skills” regarding anatomy or during the “Feeding” skill check. You may be asked to identify the function of the epiglottis or explain why you must place a resident in an upright position before eating.
Related Care Concepts
The epiglottis is central to preventing aspiration and choking. It is directly related to dysphagia management, aspiration precautions (like using thickened liquids), and oral care (keeping the mouth clean reduces the risk of infection if aspiration occurs). It also connects to CPR, specifically checking the airway for obstructions.
Quick Reference
✓ Key signs: Coughing during meals, wet/gurgly voice, recurrent pneumonia ✓ When to report: Any coughing or choking episode while eating or drinking ✓ Care reminders: • Ensure resident is sitting fully upright (90 degrees) before feeding • Feed slowly, allowing time to swallow between bites/sips • Check the mouth for pocketing food after meals • Stop feeding immediately if coughing occurs and report to the nurse
Keeping your residents safe at mealtime means understanding that small flap of cartilage. When you respect the “lid,” you protect the lungs.