Implantation Procedure IS Model #2954 Flashcards
T/F monopolar diathermy can be used at any time during the procedure
FALSE - only PRIOR to IS placement
What type of NIM electrodes are used and what should the probe be?
12-18mm (18mm recommended, prass paired, with suturing hole), bipolar handheld probe
What type of sutures should be used for IS suturing
Ethicon ethibond RB1 2.0 non absorbable
What muscles are these intended to stimulate and where should the electrodes be placed?
Stylo/Hyo - lateral side of tongue, in mucosa at shallow angle, 3-5cm away from tip of tongue
What muscles are these testing for and where should the electrodes be placed?
Genioglossus - close to midline of tongue, close to mandible bone with angle of max 45 degrees to capture both GGo and GGh while avoiding the frenulum and the whartons ducts
Name the lines from top to bottom
Mandible inferior boarder
6cm incision line
Hyoid bone
Thyroid notch
(Dotted line is midline from chin to thyroid notch)
What is the distance between the incision line and the hyoid bone? What is the length of the incision?
1cm, 6cm
Name the 6 layers you go through during the procedure
Skin, platysma, digastric, mylohyoid, geniohyoid, Genioglossus
What do you do with the digastric muscles if they are visible?
Retract laterally
How do you identify the platysma?
Thin, large vertical fibers underneath skin and fat
How do you identify the digastric?
Paired anterior bellies, vertical fibers underneath platysma
How do you identify the mylohyoid?
Thin, horizontal/oblique fibers that unite along midline
How do you identify the geniohyoid? Attachment?
Thick and robust, verticals fibers, attached at hyoid bone
How do you identify the Genioglossus?
Vertical fibers, fatty raphe in between GG bellies, attached to mandible, PALE IN APPEARANCE
Where is the HGN usually hiding?
In the fatty tissue on the lateral boarders of the Genioglossus muscle
T/F - retracting the genioglossus medially helps expose its lateral boarder and identify the HGN easier
TRUE
What can serve as a landmark for the HGN?
Rainine vein
GGh fibers _____ the tongue while GGo fibers _____ it
Protrude, depress
Inclusionary branch nerves are muscles…
GGo, GGh, T/V
What can be used to help assist with hemostasis?
Neuropattie dipped in epinephrine
On the NIM, polymorphic, low amplitude, fractioned, high frequency EMG signals are associated with what muscles
EXCLUSIONARY - SG/HG
On the NIM, high amplitude, short latency and short signal duration are associated with what muscles
GG, T/V (on Stylo/hypo channel)
Inclusionary or exclusionary?
Inclusionary
What MUST you do after locating your inclusionary branches on one side before moving on to another?
Create and mark paddle area with neurosurgical patty
