Nasal Cavity, Oropharynx, And Larynx Flashcards
The floor of the nose is
The palatine bone.
The roof of the nose is formed from
The cribriform plate in the ethmoid bone.
What separates the nasal cavity from the cranial cavity?
The cribriform plate in the ethmoid bone
The nasal cavity has sinuses called
Paranasal sinuses
Paranasal sinuses are formed from
Extensions of the ethmoid bone, frontal, maxillary, and sphenoid bones. Extensions are also called Turbinates or nasal conchae.
The posterior aspect of the nasal cavities is the _______, which separates them from the nasopharynx.
Choana.
The nasal cavities drain into the
Superior, inferior, and middle meatus.
The nasolacrimal duct drains into the
Inferior meatus.
A congenital anomaly of the choana is known as
Choanal atresia.
Choanal atresia occurs when infants are born with one or both _________ obstructed. This requires emergency surgery to restore __________.
Choanae airflow.
The paired ______ sinuses are the large sinuses below the ocular orbits.
Maxillary
The paired _______ sinuses lie behind the lower forehead.
Frontal.
The _______ sinuses consist of many small air cells in the lateral wall of the nasal cavity between the lateral nasal wall and the turbinates.
Ethmoid
The _______ sinuses lie at the posterior superior extent of the nasal cavity.
Sphenoid
Pituitary glands may be accessed through a _______ approach.
Transsphenoidal
The oral cavity is divided into two sections. Name them.
Vestibule: The inner surface of the lips, the buccal mucosa (cheeks) and the lateral aspects of the mandible and maxilla.
Oral cavity proper: medial surfaces of the maxillary and mandivular teeth.
The soft palate meets in the middle to form the
Uvula.
The tongue is attached to the floor of the mouth by the
Frenulum.
The floor of the mouth contains the ducts for the paired ______ and _______ salivary glands.
Sublingual and submandibular.
The pharynx is the tubular structure extending from the _____ to the _______. The three regions are called:
Nose to the esophagus. Nasopharynx, oropharynx, and hypopharynx.
The larynx is composed of _______ segments. How many are paired, unpaired?
9, 3 paired and 3 unpaired.
The cricoid, thyroid, and epiglottis segments of the larynx are ________.
Unpaired.
The arytenoids, corniculate and cuneiform segments of the larynx are _______.
Paired.
What is the only closed ring in the upper airway?
Cricoid.
The true vocal cords are located in what area of the larynx?
The glottis.
The microscope used to examine the upper airway is ___-mm lens.
400
What is the vasoconstrictive agent commonly used in the nose or larynx?
Cocaine.
The Alar, Fomon, Aufricht, and cottle are what type of common instrument used in nasal surgery>
Retractors.
The Joseph, ballenger swivel, and button knife is used for
Deep dissection in the nasal cavity.
The cottle, lempert, freer and penfield are what type of common instrument used in nasal surgery?
Dissectors or elevators.
The takahashi ethmoid, Noyes alligator, Blakesley-wilde, Walsham, and knight are what type of common instrument used in nasal surgery?
Forceps.
The kerrison, hartman, wilde, and jansen-middleton are what common type of instrument used in nasal surgery?
Rongeurs.
The ____- degree scope is used for maxillary, sphenoid, and ethmoid sinus procedures. The ____- degree scope is used for procedures of the frontal sinuses.
30
70.
___to _____% cocaine can be applied topically.
4 -10%
What is often used as a local anesthetic and hemostatic agent during nasal and sinus surgery?
1 to 2% lidocaine (Xylocaine) with epi.
Other than cocaine, what is another drug used to decrease bleeding in the nose?
Phenylephrine (Neo-synephrine)
Epistaxis
Nosebleed
Where does a nose bleed generally occur from>
Arterial plexus in the anterior nasal septum
Afrin is used as what during a nasal procedure?
Vasoconstrictor.
A Fess is what?
Function endoscopic sinus surgery
Polypectomy, maxillary antrostomy, ethmoidectomy, turbinectomy, and sphenoidectomy are techniques of what?
Endoscopic sinus surgery
The 0 degree endoscope is used for
Sinus explorationand evaluation in all procedures.
A caldwell-luc procedure is a technique used to
drain an abscess in the maxillary sinus and to removal granulation tissue that has accumulated as a result of chronic sinus infections.
The caldwell luc procedures uses what type of incision.
Gingival-buccal sulcus (junction of gum and upper lip.)
The caldwell luc operation is also called
Antrostomy
A turbinectomy is removal of
The bony turbinate to increase airflow through the nose.
Congenital malformation of the middle turbinate is called
Concha bullosa
A turbinectomy requries what type of incision?
Intranasal
A septoplasty is the surgical manipulation of the
Septum to return it to the correct anatomical position or to gain access to the sphenoid sinus for removal of a pituitary tumor.
The incision for a septoplasty is where
Intranasal or submucosa.
Ecchymosis
Black eye
An Ethmoidectomy is
A drainage procedure for diseased tissue of the middle turbinate or other part of the ethmoid bone
What type of incision is used for an ethmoidectomy?
Intranasal, sinuscope or external incision from the eyebrow along side the nose
A tonsillectomy is performed to
Eradicated infection and improve airway
The tonsil is separated from the fossa leaving the
Pillar
Tonsillectomy is removal of what tonsils?
Palatine
When a tonsillectomy and adenoidectomy are performed together, which is done first?
Adenoidectomy
What is important to remember about the emergence on a patient who has had throat surgery?
The patient can experience gagging and bucking, which can become emergent. The set up should remain sterile.
An adenoidectomy is the surgical removal of what
Adenoids or pharyngeal tonsils.
What type of laser can be used for the removal of adneoids?
CO2
The soft palate can be retracted with what?
A red robinson catheter.
A uvulopalatopharyngoplasty is reconstruction of what
Uvula and oropharynx UPP.
Why is a UPP performed?
To reduce and tighten oropharyngeal tissue. Sleep apena.
What type of set-up should be available during a UPP for a difficult airway?
Tracheotomy.
A benign proliferative overgrowth of epithelium is called
Papilloma
A benign lesion of the laryngeal epithelium is
Leuloplakia.
Phonation
Speak
Neoplasms, foreign bodies, papilloma, laryngeal polyps, leukoplakia, and laryngeal web are examples of what
Laryngeal lesions
A laryngoscopy is examination of what
Larynx.
An indirect laryngoscopy is use of what? A Direct?
Scope
Microscope.
What is used to collect specimens during a bronchoscopy>
Lukens trap.
Rigid bronchoscopes are commonly used for what?
Removal of foreign object.
Esophagoscopy
Direct visualization of the. Esophagus inserted through the mouth into esophagus, removal of foreign body or polyp, or dilation of strictures.
Tracheotomy or tracheostomy is performed to provide
A patent airway or provision or creation of a patent airway.
A tracheal hook is placed in the ________ to elevate the trachea.
Cricoid cartilage
A tracheal incision is usually made between the
Third and fourth tracheal rings.
What must be kept with the patient after a tracheostomy?
The obturator.
What is the largest salivary gland?
The parotid
Where is the parotid gland found?
Over the mandible, anterior to the ear
The submandibular duct is also called
Wharton duct
The sublingual ducts are also called
Ducts of rivinus
The thryoid gland is located where
In midneck overlies the trachea below the larynx.
The trachea is also called the
Windpipe.
The two lobes of the thryoid gland is divided by what?
The isthmus.
The thyroid gland secretes what three hormones?
Thyroxin t4, triiodothyronine t3 and calcitonin.
Thyroid hormones are necessary for what?
Cell metabolism and growth.
Calcitonin is necessary for
Calcium regulation
The parathyroid hormones influence what
Calcium and phosphate levels in the blood
What is Sellick’s maneuver?
Pressure on the cricoid cartilage of the larynx, first tracheal ring, to close off the esophagus to prevent aspiration in an unconscious person.
Parotid ducts are also called
Stensen’s duct
What is the major blood supply to the thyroid gland?
Superior lobe: external carotid branches
inferior lobe: subclavian branches.
Hyperthyroidism is also called
Graves
Hypothyroidism in adults is called? In childeren?
Myxedema
Cretinism
Goiters are a defiency in what
Iodine
Hyperparathryoidism is associated with
Hypercalcemia
Parotidectomy is the removal of
The parotid gland
What is required during a parotidectomy to ensure the facial nerve is not damaged?
Facial nerve stimulator.
What is the incision of a parotidectomy?
Y shape on either side of ear
Removal of approximately five-sixths of the thyroid glamd to treat hyperthyroidism is
Subtotal thyroidectomy.
Excision of an entire lobe for benign malignancy or toxic diffuse goiter is
Thyroid lobectomy
Removal of the thyroid gland for malignancy or to relieve compression on the trachea or esophagus is
Thyroidectomy
The incision for a thyroidectomy is
Transverse incision collar, in crease of neck 1 inch above suprasternal notch. Silk suture may be pressed to mark line of incision.
What is the postoperative position for thyroidectomy patients?
Fowlers.
Scalene node biopsy
Incision is made just below clavicle, and biopsy is take to determine the spread of tuberculosis or cancer from the lungs.
Removal of the pretracheal cystic pouch
Thyroglossal duct cystectomy
Removal of all lymph tissue from the midline to the trapezius muscle and clavicle, deep cervical fascia, and platysma mucsle, jugular vein, spinal accessory nerve, sternocleidomastoid muscle, and submandibular gland is
Mmodified radical neck dissection
Removal of the tongue to treat cancer
Glossectomy
What type of flap is used after a total glossectomy?
Pectoralix majr myocutaneous.
Removal of the larynx usually with wide excision and tissue grafting.
Laryngectomy
A laryngectomy is performed for four reasons: name them
- Cancer
- Diversion for total separation fo the respiratory and diverstibe tracts
- Chondroradionecrosis
- Major trauma that precludes open reduction and internal fixation.
What provides better outcomes during oral and maxillofacial surgery?
Early repair
What are the bones of the upper face?
The frontal bone.
What are the bones of the midface?
Ethmoid nasal bone, zygoma, and maxillary bone
The zygomatic arch is the
Cheek bones
The lower face contains what bones?
Mandilbe
What is the only movable bone of the face?
Mandible
Describe a le fort 1 fracture.
This is a horizontal fracture of the maxilla that causes the hard palate and alveolar process to become separated from the rest of the maxilla. The demarcation extends into the lower nasal septum, lateral maxillary sinus, and palatine bones.
Describe a le fort 2 fracture.
pyramidal shape. Extends from the nasal bone to the frontal preocesses of the maxilla, lacrimal bones, and inferior orbital floor and may extend into the orbital foramen. Inferiorly it extends into the anterior maxillary sinus and the pterygoid plates.
Describe a le fort 3 fracture.
The fracture involves separation of all the facial bones from their cranial bases. It includes fracture of the zygoma, maxilla, and nasal bones. The demarcation line extends through the ethmoid bone and bony orbit with severe facial flattening and swelling.
What type of fracture is associated with cerebral spinal fluid leakage into the sinuses/
Le fort II
Facial bones are fixed with what?
Mini-plates and cortical and lag screws.
Open reduction and internal fixation of an orbital floor fracture is performed to prevent entrapment of ___________ and support _______.
Extracoular muscles and support orbital contents.
Zygomatic fractures are also called
Malar fractures
When applying arch bars, the wire is twisted in what direction?
Clockwise
____ or _____ gauge stainless steel suture wires are used to apply arch bars.
24 or 26
What type of needle holder is used with stainless steel suture wires?
Rubio
What type of arch bars are there?
Erich
What type of intubation is used for patients with facial fractures?
Nasal
What are the three main concerns for a patient with severe facial injuries?
Airway, cervical spine injury, and hemorrhage.
What is kept with the patient who has had arch bars applied?
Wire cutters.
For midface fractures, what size plates are typically used?
1.7 or 2mm
For mandibular fractures, what size plates are typically used?
2.4 or 2.7 mm
A tooth extraction is also called
Odontectomy.
What incision is used for a tooth extraction?
Periodontal
Reshaping or repositioning of the jaws to correct a malocclusion or for cosmetic purposes is called:
Orthognathic surgery.
Jaw projecting forward:
Prognathism
Receding chin:
Retrognathism
Open bite created by the back teeth coming together first, thus preventing closure of the front teeth:
Apertognathia
Dental arch is too small to accommodate the teeth, causing them to be pushed out of alignment or crowed together:
Micrognathia
Imbalance between the right and left side of the face due to a discrepancy in the size, shape, or position of the jaw
Asymmetry.
Grinding of the teeth
Bruxism
An arthroscopy of the temporomandibular joint is performed with what size scope?
1.7 or 1.9 mm
Surgical contouring of alveolar processes and repair of the tooth sockets in preparation for dentures
Alveoloplasty
Open bite
Apertognathia
Without teeth
Edentulous
Surgical excision of a portion of the gums to remove deep pockets of inflamed tissue or plaque
Gingivectomy
Misfit of upper and lower teeth
Malocclusion
One who treats disease of the gums and alveoli surrounding the teeth
Periodontist
One who restores intraoral and external facial structures with prostheses.
Prosthodontist
A tracheotomy would procede what procedure?
Laryngectomy
The drill used in ear surgery is called
Ototome
Tonsillar fossa bleeders encountered during tonsillectomy are ligated with
Surgical gut
