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AIRWAYS EXAM 1 > THYROID, PARATHYROID, PAROTID > Flashcards

THYROID, PARATHYROID, PAROTID Flashcards

1
Q

how much does a normal healthy thyroid gland generally weigh?

A

~ 30gm

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2
Q

name the three anatomical landmarks of the thyroid gland

A
  1. right lobe
  2. isthmus
  3. left lobe
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3
Q

how many glands compose the parotid glands?

A

4

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4
Q

what nerves are continguous with the thyroid gland?

A

RLNs

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5
Q

what airway structure is contiguous with the thyroid?

A

trachea

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6
Q

how does malignancy of the thyroid affect the RLNs?

A

increases risk of injury of loss of nerves

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7
Q

how can thyroid disease affect the trachea?

A

can deviate and/or compress the trachea

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8
Q

how does stimulation of the vagus nerve affect heart rate and blood pressure?

A

heart rate and blood pressure decrease

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9
Q

where does the vagus nerve originate from?

A

medulla oblongata

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10
Q

which branch of the vagus nerve gives rise to the RLN that hooks around the subclavian artery, contributes to cardiac, pulmonary and esophageal plexuses, and forms the posterior vagal trunk?

A

the right branch of the vagus nerve

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11
Q

which branch of the vagus nerve gives rise to the RLN that hooks around the aorta, gives off thoracic cardiac branches, pulmonary and esophageal plexuses, and forms the anterior vagal trunk?

A

the left branch of the vagus nerve

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12
Q

the vagus nerve is protected in the neck by what anatomical feature?

A

the thyroid cartilage

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13
Q

what is the name of the nerve that serves the posterior cricoarytenoid muscle and other intrinsic laryngeal muscles?

A

the recurrent laryngeal nerve

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14
Q

which intrinsic laryngeal muscle is the only primary vocal cord ABductor?

A

posterior cricoarytenoid muscle

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15
Q

what comorbidities of thyroid disease can affect mechanical integrity of the upper airway?

A

cartilaginous destruction

extrinsic compression

can occur in neck and/or mediastinum

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16
Q

what are the two major considerations of thyroid disease and surgery?

A

destructive effects of thyroid gland on mechanical integrity of the upper airway

injury to one or both recurrent laryngeal nerves

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17
Q

what is the overall effect of RLN injury?

A

vocal cord ADDuction

18
Q

what is the acute consequence of unilateral RLN injury?

A

affected vc will move to the median position, oppposed by the normal vc

19
Q

what is the long-term consequence of unilateral RLN injury?

A

affected vc may force the normal vc away from the midline

20
Q

what would be the acute consequence of bilateral RLN injury?

A

upper airway obstruction

21
Q

what is the overall effect of RLN interruption?

A

paramedian vc position

22
Q

a bilateral interruption of the RLN would acutely result in what?

A

upper airway open

23
Q

a bilateral interruption of the RLN would result in what, long-term?

A

aspiration, dyspnea

24
Q

what are the three differential diagnoses for stridor following thyroid or parathyroid surgery?

A

edema – supraglottic/glottic

RLN injury

hypocalcemia

25
Q

which glands have two lobes: superficial and deep?

A

parotid glands

26
Q

what is another name for the parotid duct?

A

stenson’s duct

27
Q

which cranial nerve traverses the parotid glands?

A

the facial nerve

28
Q

name the 5 branches of the facial nerve

A
  1. temporal nerve
  2. zygomatic nerve
  3. buccal (upper/lower) nerves
  4. mandibular nerve
  5. cervical nerve

(To Zanzibar By Motor Car)

29
Q

what disease makes up 75% of all parotid gland diseases?

A

benign tumors (adenomas)

30
Q

what disease makes up 25% of all parotid gland diseases?

A

malignancies

31
Q

parotid inflammation is also known as

32
Q

what is the unit of measure for NMB monitoring?

A

milliamperes

33
Q

what are the three requirements for electrode placement for NMB monitoring?

A

maximum current density

minimal current dispersion

close to the nerve

34
Q

when should sensory threshold be measured?

A

before induction

35
Q

when should motor threshold be measured?

A

after induction, before muscle relaxant, measured as the first motor response

36
Q

definition: activate all muscle fibers served by the stimulated nerve without directly stimulating the muscle fibers

A

supramaximal stimulus

37
Q

how should the empiric setting be adjusted?

A

25mA above motor threshold

(15mA + 25mA = 40mA)

38
Q

how should rocuronium be administered for maintenance of NMB?

A

5mg increments

39
Q

how much time should be given before testing the maintenance dose of rocuronium?

40
Q

what are the three requirements for endpoint for reversal of NMB?

A

TOF 4/4, sustained tetanus, TOF ration > 0.9

AIRWAYS EXAM 1 (6 decks)

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