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Advanced Principles B (Summer '24) > Head & Neck Surgery: ENT (Exam II) > Flashcards

Head & Neck Surgery: ENT (Exam II) Flashcards

1
Q

What provides motor innervation to the intrinsic muscles of the larynx?

A

Right & Left Recurrent Laryngeal nerves

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2
Q

Which muscles are not innervated by the right and left recurrent laryngeal nerves?

A
  • Cricothyroid
  • Inferior pharyngeal constrictors
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3
Q

Sensory input for the right and left recurrent laryngeal nerves is provided from where?

A
  • Below vocal cords & upper trachea
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4
Q

What occurs with bilateral recurrent laryngeal nerve injury?

A

Vocal Cord paralysis

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5
Q

What does the external branch of the superior laryngeal nerve innervate?

A

Cricothyroid (motor)
Inferior pharyngeal (motor)

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6
Q

What does the internal branch of the superior laryngeal nerve innervate?

A

Sensory to the laryngeal tissue above the vocal cords.

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7
Q

What VAA should be avoided in ear surgery?

A

N₂O

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8
Q

_____ ear surgeries (cocheal implant, endolympathic sac, or labrynth) often are prone to PONV.

A

Inner

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9
Q

What ear surgery requires controlled hypotension?

A

Mastoidectomy

To control bleeding.

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10
Q

No ____ in middle ear surgery.

A

N₂O

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11
Q

What is the Samter Triad?

A
  • Nasal polyps
  • Asthma
  • Sensitivity to aspirin and NSAIDs (leading to severe bronchospasm)
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12
Q

Risk of postoperative bleeding in nasal and throat surgery necessitates the holding of what meds?

A

NSAIDs and aspirin

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13
Q

What dosage of cocaine is used for vasoconstriction in nasal surgeries?

A

4%

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14
Q

What is the maximum dosage of cocaine?

A

1.5 mg/kg

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15
Q

Oxymetazoline should be avoided in patients taking what drug class?

A

MAOI’s

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16
Q

Patients with nasal polyps, asthma, and sensitivity to asthmas are at increased risk for ________ during their procedure.

A

Bronchospasm

17
Q

What are the anesthesia considerations for the presence of a goiter in thyroidectomy?

A
  • Larynx deviation?
  • Possible airway collapse at induction
  • Horner syndrome
  • SVC obstruction
18
Q

What electrolyte imbalance is common secondary to hyperparathyroidism?

A

Hypercalcemia

19
Q

What drugs may be required preoperatively for severe hypercalcemia?

A
  • Fluids
  • Lasix
  • Bisphosphonates
20
Q

What specialized ETT is used in parathyroidectomy and thyroidectomy?
Why?

A

NIMs ETT
- Used to identify the recurrent laryngeal and vagus nerves

21
Q

Risk of false passage creation is more likely with a _____ trach.

A

Shiley

22
Q

What drugs are avoided with free flap neck dissections?

A

Vasoconstrictors (PE, NE, etc.)

23
Q

What are Le Fort fractures?

A

Midfacial fractures

24
Q

What is a Le Fort I fracture?

A

Horizontal fracture involving inferior nasal opening.

Separates teeth and lower mandible from rest of skull.

25
Q

What is a Le Fort II fracture?

A
26
Q

What is a Le Fort III fracture?

A
  • Fracture of nasal/orbital/zygomatic bones
  • Separation of nasopharynx & base of skull

Very unstable

27
Q

What are Le Fort osteotomies used for?

A

Correction of malocclusion of teeth by moving of the maxilla and/or mandible

28
Q

What are the anesthesia considerations for a Le Fort osteotomy?

A
  • Nasal intubation
  • Deliberate hypotension
  • Less fluids
  • Awake extubation
  • Jaws wired afterwards (No PONV)
29
Q

Acute epiglottitis is associated with ______ ______.

A

H. Influenzae

30
Q

What is Ludwig’s angina?

A

Floor of mouth infection

  • Starts at mandibular molars and spreads to rest of mouth.
31
Q

What occurs with the tongue in Ludwig’s angina?

A

Tongue is displaced posteriorly

Airway obstruction occurs in supine position.

32
Q

What triad is required for an OR fire?

A
  • Fuel (alcohol, gowns, drapes)
  • Ignition (cautery)+
  • Oxidizer (O₂ or N₂O)

Advanced Principles B (Summer '24) (8 decks)

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