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The airway is influenced by anatomical changes in the tissues of the mouth and neck. In a young
child the occiput is relatively large and the neck short, potentially resulting in neck flexion and
airway narrowing when the child is laid flat in the supine position. The face and mandible are small,
and teeth or orthodontic appliances may be loose. The tongue is relatively large and not only tends
to obstruct the airway in an unconscious child, but may also impede the view at laryngoscopy.
Finally, the floor of the mouth is easily compressible, requiring care in the positioning of fingers
when holding the jaw for airway positioning.
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In his book Verbal Behavior, the psychologist B.F. Skinner
recalls a dinner party at which the philosopher Alfred North Whitehead
challenged him to provide a behavioural analysis of the thought ‘No black
scorpion is falling upon this table’. Needless to say, the challenge went
unmet.
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