Abstract: A positive pressure airway device for providing resistance in an air pathway for a patient exhaling. The device includes a central tube region, a inspiratory air passageway for passing air into the central tube region when a patient breathing through the device inhales, and an expiratory air passageway for passing air out of the central tube region when a patient breathing through the device exhales, A valve in the expiratory air passageway allows air to flow out only when a patient using the device exhales with an expiratory air pressure greater than a selected pressure. The valve includes a stopper and a stopper-biasing spring. The passageways and/or stopper and/or spring are adapted to provide unbalanced forces against the stopper, thus causing the stopper to flutter and providing an oscillating pressure drop as the patient exhales.

Abstract: A pulmonary secretion clearing airway structure and related airway management system is disclosed that has a double lumen portion which each lumen of the double lumen portion operably secured to an airway management system so that inspiratory fluid (air/oxygen mixtures, with or without added water vapor) is delivered to the distal end of the ventilation catheter through one of the two lumens and expired inspiratory fluid, pulmonary secretions, and pulmonary fluids are removed from the patient through the other lumen. The expiratory fluid pathway preferably includes a secretion collection system for removing the pulmonary secretions and the like from the pathway, thereby improving operation and safety of the system. The airway structure can be a ventilation catheter or a supraglottic airway system such as laryngeal mask and the like.

Abstract: Methods, apparatus, and kits for enhancing breathing in patients suffering from chronic pulmonary obstructive disease are described. The methods and apparatus rely on increasing flow resistance to expiration in a manner which mimics “pursed lip” breathing which has been found to benefit patients suffering from this disease. In a first example, a device is implanted in a trachea or bronchial passage to increase flow resistance, preferably selectively increase resistance to expiration relative to inspiration. In a second embodiment, a mouthpiece is provided, again to increase resistance to expiration, preferably with a lesser increase in flow resistance to inspiration. In a third embodiment, the patient's trachea or bronchial passage is modified by the application of energy in order to partially close the lumen therethrough.

Abstract: A respiratory probe including two channels in parallel, equipped with unidirectional valves connected head-to-tail.

Abstract: A valve, usable in connection with a tracheostomy tube, permits phonation by selectively blocking passage of air therethrough. The valve includes a main body portion with first and second internal passages. A first aperture extends radially through a peripheral wall, connecting the first internal passage to an environment external to the main body. A second aperture extends radially through the peripheral wall, connecting the second internal passage to the environment. A trach body portion defines a third internal passage and is connected to the main body portion. A flapper valve is sandwiched between the main body portion and the trach body portion. First and second adjustment rings permit adjustment of opening defined by the first and second apertures, thereby permitting control over the air passing through the first and second apertures.

Abstract: Spontaneous respiration is detected by sensors. An additional amount of oxygen is administered to the lungs via a jet gas current at the end of an inhalation procedure. Breathing volume, absorption of oxygen during inhalation, and clearance of carbon dioxide during exhalation are improved. If required, the exhalation procedure of the patient can be arrested or slowed by a countercurrent to avoid a collapse of the respiration paths. An apparatus including an oxygen pump can be connected to an oxygen source and includes a tracheal prosthesis that can be connected via a catheter. The respiration detections sensors are connected to a control unit for activating the oxygen pump. The tracheal prosthesis includes a tubular support body with a connection for the catheter, and the sensors are associated with the support body. The tracheal prosthesis and jet catheter are dimensioned so the patient can freely breathe and speak without restriction.

Abstract: A respiratory valve device includes a catheter balloon configured for being disposed in a respiratory gas pathway and valving the respiratory gas pathway.

Abstract: One aspect of the invention is a method to vent gas from a body cavity during an endoscopic procedure. A body cavity is in fluid communication with an exhaust gas inlet of a vacuum break device. The vacuum break device has a chamber in fluid communication with both the inlet and an outlet. The chamber may comprise one or more openings in fluid communication with the atmosphere. A conduit in fluid communication with the exhaust gas outlet may be connected directly or indirectly to a suction source. The suction source may be activated.

Abstract: According to various embodiments, a tracheal tube may include a pressure monitoring lumen configured to sample the gases in the tracheal space. The pressure monitoring lumen may be in fluid communication with a pressure transducer that provides pressure measurements. An opening of the lumen may be covered with a porous membrane that allow gas to diffuse freely in and out of the lumen, but that prevents secretions from clogging the lumen.

Abstract: A single lumen endobronchial tube for selective mechanical ventilation of the lungs can include a medical tube having a single lumen with an opening at each of opposed distal and proximal ends of the tube, the opening at the proximal end of the tube being adapted for connection to an external mechanical ventilation device, and the opening at the distal end of the tube being adapted for delivery of a medical gas; a wall extending throughout the tube's entire length having an internal wall surface, an external wall surface and a thickness therebetween, a portion of the wall having an aperture and a shaft adapted to house a mechanism for sealing the aperture; a distal bronchial cuff positioned along the external wall surface and adapted to expand radially outward; and at least a first proximal tracheal cuff positioned along the external wall surface and adapted to expand radially outward.

Abstract: There is provided a looped tether to prevent the over-withdrawal of a suction catheter from a connecting fitting in a closed suction catheter respiratory device. The looped tether is made from a single thread or strand that is looped or doubled in length with the two loose ends connected together to produce the loop. The looped tether provides better distribution of the forces at the ends of the device and is relatively simple to assemble. Also provided is a system for preventing the over-withdrawal of a suction catheter from a connecting fitting in a closed suction catheter respiratory device.

Abstract: The invention relates to a breathing assistance device for a patient, the device including: a source of respiratory pressurised gas; a gas transmission duct comprising a distal end coupled to said source and a proximal end coupled to the patient; a gas regulating valve interposed in the gas transmission duct at a proximal location, comprising a leakage orifice and an obstruction means capable of varying the opening of the leakage orifice upon signal of controlling means and allowing a bidirectional gas flow through the leakage orifice in both expiration and inspiration phases.

Abstract: According to a preferred embodiment of the present invention there is provided a bite block assembly adapted for capnography and oxygen delivery to a subject, the bite block assembly including a first capnography passageway adapted for passage therethrough of exhaled breath from the subject to a capnograph and a second oxygen delivery passageway, separate from the first passageway, adapted for passage therethrough of oxygen from an oxygen source to the mouth of the subject.

Abstract: A respiratory valve assembly (1), such as in a manual resuscitator, has a carbon dioxide color change indicator element (52) in a disc shape housing (50) arranged to clip onto a grove (59) on the valve assembly. Expiratory and inspiratory gas is supplied to the housing via two flexible tubes (60) and (61) extending side-by-side from the valve assembly (1) to the indicator housing (50) so that the indicator can be undipped from the valve and repositioned if desired.

Abstract: An airway management apparatus for engagement with a catheter for oxygenation of a patient includes a main body having a major axis, a first port extending in a proximal direction along the major axis, a second port, and a third port extending in a distal direction along the major axis. The third port comprises a connector for engagement with a proximal end of the catheter. The connector may have a plurality of radially compressible members extending in a distal direction, and circumferentially aligned to receive the catheter proximal end. An axially movable member is positioned to selectively compress the compressible members around the catheter proximal end to form a locking engagement, and to release the compressible members. A wire guide is insertable into the trachea through the first and third ports, and the catheter.

Abstract: An inflatable balloon cuff may be adapted to seal a patient's trachea when associated with an endotracheal tube. These cuffs may include features that facilitate detection or visualization of the cuff, for example with ultrasound devices, to ensure proper placement of the cuff and the tube. Such surface features may include particular types of materials or shaped or protruding features that may be detected in the environment of the trachea.

Abstract: The present invention provides in some embodiments, an endotracheal tube with subglottic secretion suction and a detachable suction line. The endotracheal tube is an elongate tube having an outer wall defining an elongate central lumen and an elongate suction lumen. An inflatable cuff is attached near a distal end of the elongate tube. The shoulder of the inflatable cuff is inverted in order to increase the diameter of the cuff from its distal end to its proximal end. The endotracheal tube also includes a connector to couple the suction lumen to a source of suction to remove subglottic secretions from the area above the cuff.

Abstract: The present invention concerns a plaster for attaching a trachestoma valve or the like in connection with a tracheostoma on a person's neck. The plaster comprises a socket and an annular flange, communicating with a central opening of the flange which is connected with a single-coated adhesive tape which extends radially beyond the edge of the flange. The connection includes a first annular joint at or inwardly of the outer periphery of the flange, and a second annular joint located between the outer periphery of the flange and the inner periphery of the flange spaced radially from the first annular joint. A protecting liner covers the adhesive on the tape.

Abstract: A breathing device for placing on a tracheostoma of a patient comprising a cylindrical housing, an annular housing support, a flexible flat part with sealing and adhesive functions, a filter or a speech valve, and a cover plate. The housing comprises, in the wall thereof, recesses for introducing and extracting inhaled air, and on the proximal opening thereof, an outer edge comprises at least three edge segments which are on the outer wall and at least three edge recesses. Holding rods support the filter on the proximal opening, the housing support comprises an annular flange having at least three inner wall support projections and an annular outer wall base. The support projections have a receiving area, the housing support supports the housing with the filter or speech valve into which the edge segment can be introduced in a precise manner into the support projections.

Abstract: The volume of a hyperinflated lung compartment is reduced by sealing a distal end of the catheter in an airway feeding the lung compartment. Air passes out of the lung compartment through a passage in the catheter while the patient exhales. A one-way flow element associated with the catheter prevents air from re-entering the lung compartment as the patient inhales. Over time, the pressure of regions surrounding the lung compartment cause it to collapse as the volume of air diminishes. Residual volume reduction effectively results in functional lung volume expansion. Optionally, the lung compartment may be sealed in order to permanently prevent air from re-entering the lung compartment.

Abstract: Medical devices and related methods are disclosed for delivering an implant into the body of a patient. The devices include a damping assembly having an internal chamber with a varying inner diameter, and a piston slideably disposed therein. The piston is operably connected with a catheter portion such that movement of the piston is associated with concurrent movement of the catheter for implant delivery. The varying inner diameter of the damping assembly results in a decrease in damping force during implant delivery, thus providing a substantially constant velocity of implant delivery.

Abstract: Disclosed are methods and devices for regulating fluid flow to and from a region of a patient's lung, such as to achieve a desired fluid flow dynamic to a lung region during respiration and/or to induce collapse in one or more lung regions. Pursuant to an exemplary procedure, an identified region of the lung is targeted for treatment. The targeted lung region is then bronchially isolated to regulate airflow into and/or out of the targeted lung region through one or more bronchial passageways that feed air to the targeted lung region.

Abstract: Apparatus for randomly varying the breathing resistance applied to human and animal subjects to improve their performance.

Abstract: A flexible transparent multiple use face mask that encloses a user's face allowing the user's airway to be ventilated that includes a transparent flexible airway mask that encloses and ventilates a user's airway, an airway adaptor that directs a quantity of ventilation to the transparent flexible airway mask, a manual resuscitation bag valve that receives the airway adaptor and controls the quantity of ventilation directed to the transparent flexible airway mask and a manual resuscitation bag that produces the quantity of ventilation transmitted through the airway adaptor to the transparent flexible airway mask. The multiple-use airway mask can also be turned inside out and be used in combination with an endotracheal tube or a tracheotomy tube and also includes an attachment strap to prevent losing the transparent flexible airway mask as an added safety measure to keep the mask and bag connected.

Abstract: Various embodiments of a tracheal tube capable of suctioning accumulated mucus secretions from the airway of intubated patients are provided. Disclosed embodiments include a variety of endrotracheal tubes with integral suction lumens terminating in ports optimally located at the distal end of the endrotracheal tubes between a Murphy's Eye and a cuff. During intubation, the foregoing features, among others, of the tracheal tube may have the effect of preventing bacterial colonization of the respiratory airway and the subsequent development of ventilator associated pneumonia (VAP) in the lungs.

Abstract: A method of intubating a subject is disclosed. The method comprises inserting an endotracheal tube into the tracheal airway of the subject; inflating a cuff associated with the endotracheal tube within the airway below the vocal cords; measuring a level of at least one measure being indicative of leakage of secretion past the cuff to the lungs; comparing the level of the measure with an optimal level of the measure; and adjusting inflation of the cuff based on the comparison so as to generally minimize leakage of secretion from above the cuff to the lungs, while minimizing pressure associated damages to the airway. The measure(s) can be carbon dioxide concentration, a proxy measure from which such concentration can be inferred, or the level of one or more additives delivered to a subject during intubation.

Abstract: Spontaneous respiration is detected by sensors. An additional amount of oxygen is administered to the lungs via a jet gas current at the end of an inhalation procedure. Breathing volume, absorption of oxygen during inhalation, and clearance of carbon dioxide during exhalation are improved. If required, the exhalation procedure of the patient can be arrested or slowed by a countercurrent to avoid a collapse of the respiration paths. An apparatus including an oxygen pump can be connected to an oxygen source and includes a tracheal prosthesis that can be connected via a catheter. The respiration detections sensors are connected to a control unit for activating the oxygen pump. The tracheal prosthesis includes a tubular support body with a connection for the catheter, and the sensors are associated with the support body. The tracheal prosthesis and jet catheter are dimensioned so the patient can freely breathe and speak without restriction.

Abstract: One aspect of the invention is a method to vent gas from a body cavity during an endoscopic procedure. A body cavity is in fluid communication with an exhaust gas inlet of a vacuum break device. The vacuum break device has a chamber in fluid communication with both the inlet and an outlet. The chamber may comprise one or more openings in fluid communication with the atmosphere. A conduit in fluid communication with the exhaust gas outlet may be connected directly or indirectly to a suction source. The suction source may be activated.

Abstract: An instrument may continuously monitoring acoustic reflections from within and/or beyond an intubation tube positioned within the mouth of a patient while the patient is breathing. The instrument may include an acoustic reflectometer configured to detect the acoustic reflections. An acoustic flow channel may contain the acoustic reflectometer within it. The acoustic flow channel may be configured to acoustically couple the acoustic reflectometer to an end of the intubation tube, but to substantially block the free flow of expiratory gas from the end of the intubation tube through the acoustic flow channel. A gas flow channel may be separate from the acoustic flow channel and may be configured to allow the free flow of expiratory gas from the end of the intubation tube through the gas flow channel.

Abstract: Modes, methods, systems and devices are described for providing assisted ventilation to a patient, including wearable ventilation systems with integral gas supplies, special gas supply features, ventilation catheters and access devices, and breath sensing techniques.

Abstract: A pulsed breathing device has a base unit containing a motor and control circuit and a detachable head unit containing a valve, driven by the motor, which can interrupt the flow of air being breathed.

Abstract: Systems, methods and devices for performing pulmonary procedures, and in particular treating lung disease. A flow control element includes a valve that prevents airflow in the inhalation direction but permits airflow in the exhalation direction. The flow control element is guided to and positioned at the site by a bronchoscope that is introduced into the patient's trachea and used to view the lungs during delivery of the flow control element. The valve may include one, two or more valve elements, and it may be collapsible for easier delivery. A source of vacuum or suction may be used to increase the amount of fluid withdrawn from the lung tissue. A device for measuring hollow structures, such as bronchioles, and a device for removing a previously-placed flow control element are disclosed as well.

Abstract: An endotracheal intubation device 10 is disclosed. The endotracheal intubation device 10 includes a stylet 100, an elongate rod 300 mounted within the stylet 100 and adapted to deform/curve the stylet 100 as well as an endotracheal tube 400 mounted thereto by contacting an inner wall of the endotracheal tube 400 via a slot 130 through which the rod 300 bows outwardly, and a handle 200 mounted to the stylet 100 and adapted to actuate the elongate rod 300 to deform/curve the stylet 100. The endotracheal intubation device 10 can be used on a patient by a medical professional to access the patient's trachea by inserting the endotracheal tube 400 into the patient. Upon insertion, the handle 200 is actuated to deform the stylet 100.

Abstract: A nasal interface device delivers a high flow rate of a gas having a pressure that is adjustable to a patient. The device includes a nasal insert that is adapted to deliver pressurized gas to a nasal cavity of the patient, and receive and direct expired air. The nasal insert has a pressurized breathing gas delivery port and an expired gas port. An expiratory limb pressure regulator is in fluid communication with the expired gas port.

Abstract: A breathing circuit is described for the supplying of low pressure oxygen to a patient that is at risk of hypoxia. The breathing circuit includes a patent airway maintaining device, a first tube that includes a substantially rigid elbow and connectors and a flexible tubular extension. An inflatable bag is coupled to the first tube and has a pressure relief valve that exhausts into the atmosphere. A second tube has a first end that terminates in proximity to the patent airway maintaining device and a second opposed end that terminates external to the first tube. A third tube connects an external source of oxygen to the second tube. A method for an oxygen breathing circuit is also described that further includes the use of a carbon dioxide monitor and the inflatable bag for assisted breathing. The breathing circuit uses only non-metallic polymer or composite type materials.

Abstract: An improved method and device for securely inserting a tubular element (30) into a through-aperture (40) in a flexible wall (60) accessible from one side only. The tubular element has a retainer (31, 32) projecting transversely at each end thereof, said retainer being resiliently foldable towards the axis of said tubular element. The element is inserted into a loading tube (11), wherein the retainers are automatically folded into the correct orientation by an automatic bending means (18). The bending means is part of a self-contained device for inserting said tubular element (30) into said through-aperture (40).

Abstract: A pneumatic single-lumen medical gas conserver combines the advantages of typical single-lumen and dual-lumen conservers. In particular, a pneumatic single-lumen conserver can provide a rapid response to patient inhalations without the need for a more expensive dual-lumen cannula hose. In addition, after delivering oxygen the conserver has a specific pneumatically-implemented delay period before being able to detect the next inhalation to inhibit “double pulse” deliveries. In addition to a conserving or pulse flow mode, the conserver can provide a user-selectable gas flow at a continuous or constant flow mode.

Abstract: A multi-layer inflatable balloon cuff may be adapted to seal a patient's trachea when associated with an endotracheal tube. The outer layer and the inner layer of the balloon cuff may have different material properties that may enhance a cuff's mechanical pressure seal by reducing wrinkles or folds that may form against a patient's tracheal walls.

Abstract: A snorkel is provided on an upper end section of a conduit with an opening for breathing and a valve adapted to open and to close the opening. The valve is pivotally mounted on an upper end section of the conduit via arms integral with the valve. Below the valve, there are provided two or more floats. The respective floats are housed inside an annular housing defined outside the upper end section of the conduit in a manner that these floats may move up- and downward. When any one of these two or more floats is given buoyancy and moves upward, the arms are reliably actuated upward and thereby the valve reliably closes the opening.

Abstract: A respiratory valve device includes a catheter balloon configured for being disposed in a respiratory gas pathway and valving the respiratory gas pathway.

Abstract: A respiratory valve, comprising a valve housing with a chamber, inlet (21) and respiration (22) openings. The chamber is limited by an arcuated or aslant interior wall section (18) extending from a lower part and into an upper part of the chamber, and is terminated in the upper part of the chamber, under the respiration opening. An outlet opening (23) is provided in the interior wall section. An elongated valve flap (32) in the form of a resilient plate element fixed to the lower part of the chamber terminates in the upper part of chamber. The flap is wide enough to cover the outlet opening, and is adapted to be positioned, in a rest position, in a distance from the interior wall section, and, in a work position, in contact with a part of the interior wall section. In the work position, the flap substantially covers and closes the outlet opening, and establishes a passageway between the inlet and respiration openings.

Abstract: A therapeutic device for improving the respiration of a patient, with a curved or bent pipe section and a mouthpiece inserted in a first end of the mouthpiece and adapted to provide an easy-to-handle medicinal device by means of which diseases of the airway can be treated, or the pulmonary volume, as well as the pulmonary inhalation performance, of a patient can be improved. This is achieved in that a holding peg connected to the pipe section can be pushed into a second end of the pipe section, and a passage channel disposed in the holding peg which penetrates into the inside of the pipe section, completely or in part, and the holding peg has a flexible hose is attached to it which runs inside the pipe section, the free end of which can move freely in the area of the mouthpiece between inner walls of the pipe section.

Abstract: A respiratory access assembly includes a distal plate having a port, which is adapted to be positioned in operable communication with an artificial airway of a patient. The assembly includes a distal plate having a port and a proximal plate which has a first port and a second port. The distal plate is positioned against the proximal plate in a stacked configuration, and each plate is configured to move relative to the other. The assembly has an actuator which is positioned adjacent to at least one plate. The actuator cooperates with both plates to substantially prevent movement of the plates when the port of the distal plate is positioned in an alignment with at least one port of the proximal plate and an object, such as a suction catheter, is positioned through the aligned ports of the plates. The actuator cooperates with at least one plate to permit movement of at least one plate when (a) no object is positioned through aligned ports, and (b) when no ports are aligned.

Abstract: An endotracheal tube holder is provided. The endotracheal tube holder includes an adjustable securing clamp, an adjusting unit, a bite block, and a securing strap. The adjustable securing clamp includes a first clamping unit having a first clamping portion, and a second clamping unit having a second clamping portion. The first clamping portion and the second clamping portion are oppositely and correspondingly aligned for holding an endotracheal tube. The adjusting unit includes an elastic member, coupled between the first clamping unit and the second clamping unit. The bite block is configured at one side of the first clamping portion and includes an endotracheal tube accommodation portion. The endotracheal tube accommodation portion covers over the endotracheal tube for providing a protection to the endotracheal tube. The securing strap includes two ends respectively coupled to two lateral sides of the first clamping unit.

Abstract: A pressure sensitive valve device for use with respiratory equipment of the type that produces a pressurized flow of breathing gas. The valve device combines the exhalation and entrainment functions in one valve with a single air path. The valve device provides an exhaust valve function during normal operation and provides a less restricted access to the ambient atmosphere in the event of respiratory equipment malfunction. The valve device includes a valve element that moves between at least two positions. During normal operation, when the pressure generating system is generating a flow of gas, the valve element is in a “closed” or “exhaust valve” position. When in the exhaust valve position, the gas flow to the atmosphere is restricted without being completely blocked off. When the flow of gas is decreased or interrupted, the valve element moves to the “entrainment valve” or “open” position that allows a greater, i.e., less restricted flow, of gas between the user and the ambient atmosphere.

Abstract: Disclosed is a flow control device for a bronchial passageway. The device can includes a valve member that regulates fluid flow through the flow control device, a frame coupled to the valve member, and a membrane attached to the frame. At least a portion of the flow control device forms a seal with the interior wall of the bronchial passageway when the flow control device is implanted in the bronchial passageway. The membrane forms a fluid pathway from the seal into the valve member to direct fluid flowing through the bronchial passageway into the valve member.

Abstract: The present invention relates to a respiration valve (401) for performing respiration tests on e.g. humans, consisting of at least three ports, a first mouth port (402) and two breathing ports (403, 404). The breathing ports (403, 404) comprise pneumatic pinch valves consisting of a channel (101) with a flexible wall (201) to be used for the flow of material and molded as an integrated part of a surrounding chamber (102). The flexible wall (201) comprises two opposing angularly interconnected wall segments (202) which are angularly connected at interconnection points (203) and which flexible wall (201) is pinched by a pressure from fluid, such as air, introduced into the chamber (102). The cross sectional shape corresponds in one embodiment approximately to a elongated hexagon. The construction of the respiration valve (401) comprising these pneumatic pinch is valves enables a very small, light, hygienic, and safe yet inexpensive construction with a long life expectancy.

Abstract: A kink resistant silicon endotracheal tube includes an inflatable cuff for positioning the endotracheal tube in a patient's trachea. The cuff is folded over onto itself to provide a cavity for accumulating bacteria and secretions that are then removed by suction. The cuff in the lower part of the endotracheal tube is also folded over onto itself for centering the endotracheal tube in the center of an airway. A suction catheter is also positioned in a portion of the tube under tension as opposed to a portion under compression to reduce the likelihood of kinking. A kink resistant endotracheal tube also includes a thickened and/or reinforced area of the curved portion of the endotracheal tube in an area under compression.

Abstract: An airway device (10) comprising an airway tube (14) and a laryngeal mask (12). The mask has an inflatable cuff (36) which has a tip (38) for insertion, in use, into a patient's oesophagus. The mask further includes a guide member (42) projecting from the tip of the cuff. The guide member carries an inflatable balloon (60) for blocking the patient's oesophagus during use. The guide member helps to position the mask correctly and reduces the risk of pulmonary aspiration of gastric contents during use.

Abstract: Systems and methods are provided for decreasing intracranial pressure and enhancing circulation in a breathing person, as well as for increasing the respiratory rate and encouraging spontaneous respiration. According to such methods, a valve system is interfaced to a person's airway. The valve system has a threshold valve and an airway member that interfaces with the person's airway. The threshold valve is configured to prevent respiratory gas flow to the person's lungs during a portion of an inhalation event until the inspiration equals or exceeds an opening pressure of the threshold valve. Also, a small level of external vacuum is constantly supplied at a juncture between the threshold valve and the airway member.