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

Explanation

## 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.