Anesthesia for Lap & ENT Sx Flashcards
What physiologic changes would suggest subcutaneous emphysema?
Crepitus, hypercarbia, elevated ETCO2, decreased lung compliance, cardiac arrhythmias, & HTN
Insufflation of the peritoneum displaces the diaphragm in a _____ direction, ______ FRC, ______ Vital capacity, & induces collapse of the _______ regions of the lungs
cephalad; decreases; decreases; dependent
The da Vinci system consists of what 3 components?
the vision system
the surgeon console
the patient-side cart
______ is a rare but devastating complication following robotic surgery
postoperative visual loss
Benefits of TIPS
reduction in bleeding from varices & control of refractory cirrhotic ascites
Paired cartilages:
Arytenoid, Corniculate, Cuneiform
Unpaired cartilages:
Thyroid, cricoid, epiglottic
Innervates laryngeal mucosa below vocal cords
Recurrent laryngeal
Innervates laryngeal mucosa above vocal cords (inferior epiglottis)
superior laryngeal (internal branch (vagus))
Innervates superior aspect of epiglottis and base of tongue
Glossopharyngeal
Innervates all intrinsic muscles except cricothyroid (motor)
Recurrent laryngeal
Innervates cricothyroid muscles (motor)
Superior laryngeal (external branch)
Tension & elongates vocal cords
cricothyroid (SLN)
Relaxes vocal cords
Thyroarytenoid (RLN)
Abducts vocal cords
Posterior cricoarytenoid (RLN)
Adducts vocal cords
Lateral cricoarytenoid (RLN)
Bc SNS hyperactivity is a/w increased amounts of _______, it is essential that all pts having elective thyroidectomy be rendered ______ prior to surgery
thyroid hormone; euthyroid
A thyroidectomy is performed as definitive treatment for ____ or ____
Thyrotoxicosis; malignancy
The red wire pair of the NIM tube should contact the anterior & posterior of the _____, and the blue wire pair should contact the anterior and posterior portion of the ______
right true vocal cord; left true vocal cord
What are the most common complications from thyroid surgery?
hypocalcemia, RLN damage, & hematoma at surgical site
Unlike unilateral nerve injury, bilateral nerve injury necessitates immediate intervention requiring what?
emergent reintubation or tracheostomy
What increases IOP?
asphyxia, administration of carbon dioxide, & hypoventilation
What decreases IOP?
inhalation anesthetics
hyperventilation
hypothermia
hypertonic solutions (dextran, urea, mannitol, & sorbitol) elevate plasma osmotic pressure –> decrease IOP
Acetazolamide is contraindicated in which pts?
marked hepatic or renal dysfunction, or those w/ low sodium levels or abnormal K values
