The BURP maneuver improves the laryngoscopic view of the glottic opening by applying pressure in which direction set?

• A. Backward, Upward, Leftward
• B. Backward, Upward, Rightward
• C. Backward, Upward, Centerward
• D. Backward, Downward, Rightward

Answer: (B)

External laryngeal manipulation helps bring the glottic opening into a line of sight during direct laryngoscopy. The BURP maneuver applies pressure on the thyroid cartilage in three directions: backward, upward, and to the right. This combination moves the larynx posteriorly and cephalad and slightly toward the patient’s right, reorienting the laryngeal inlet so the vocal cords are better aligned with the laryngoscope blade. The result is an improved view of the glottis, often converting a poor view to a clearer one. Apply gently and reassess continuously; if there’s no improvement or it causes discomfort, release and consider other adjustments.