In Mallampati classification, which structures are visible when the patient is seated upright, mouth wide open, and tongue protruded maximally?

Question

Accepted Answer

A. Soft palate, anterior and posterior tonsillar pillars, and uvula. ## Mallampati Classification Overview

**Key Point:** Mallampati classification is a simple, non-invasive bedside test used to predict difficult intubation by assessing the degree of oropharyngeal visibility.

### Mallampati Grades

| Grade | Structures Visible | Difficulty Prediction |
|-------|-------------------|----------------------|
| I | Soft palate, fauces, uvula, anterior and posterior tonsillar pillars | Easy intubation |
| II | Soft palate, fauces, uvula (partially obscured) | Easy to moderate |
| III | Soft palate, base of uvula | Moderate to difficult |
| IV | Hard palate only | Difficult intubation |

### Examination Technique

1. Patient seated upright
2. Mouth opened maximally
3. Tongue protruded maximally (without phonation)
4. Examiner observes from eye level

**High-Yield:** Grade I (full visibility of tonsillar pillars and uvula) indicates an easy airway. Grades III and IV suggest difficult intubation and warrant additional airway assessment tools (Cormack-Lehane, thyromental distance, neck mobility).

**Clinical Pearl:** Mallampati grade can be affected by patient positioning, obesity, and edema. A single assessment tool is insufficient — always combine with other predictors of difficult airway (limited neck extension, reduced mouth opening, micrognathia, macroglossia).

**Mnemonic:** **SPUPP** = Soft palate, Posterior tonsillar pillars, Uvula, Pillars (anterior), Palate (hard) — remember what is visible in Grade I.

Answer

B. Hard palate and soft palate only

Answer

C. Soft palate and uvula only

Answer

D. Entire oropharynx including base of tongue

In Mallampati classification, which structures are visible when the patient is seated upright, mouth wide open, and tongue protruded maximally?

Explanation

Mallampati Classification Overview

Mallampati Grades

Examination Technique

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Grade	Structures Visible	Difficulty Prediction
I	Soft palate, fauces, uvula, anterior and posterior tonsillar pillars	Easy intubation
II	Soft palate, fauces, uvula (partially obscured)	Easy to moderate
III	Soft palate, base of uvula	Moderate to difficult
IV	Hard palate only	Difficult intubation