Week 2 Flashcards
What are the sensory nerves for the ear:
- auriculotemporal nerve
- greater auricular nerve
- auricular branch of vagus nerve
- tympanic nerve
What is it called when the ossicles and mastoid bone are infected?
cholesteatoma
What types of endotracheal tunes would be best for ear surgery:
- South Facing tube (RAE)
- Reinforced Tube
What type of nerve monitoring would be used during close facial nerve procedures?
-Nerve integration monitor
T/F: Partial or complete NMR (muscle relaxant) blockade abolishes nerve activity.
True
What is ASA I hypotensive technique:
- MAP 50 - 60
- intraoposystoic > preop diastolic
- HR 60
What are some nasal sinuses surgeries:
- Endocopically FESS
- Nasal antrostomy
- Caldwell-Luc
What is the optimal time frame to fix nasal fractures?
-within 10 days after swelling has gone down
What is Samter’s Triad?
- asthma
- NSAID (aspirin) sensitivity
- Nasal polyps
What will occur with Samter’s Triad?
broncho spasms
How does cocaine potentiate sympathetic activity?
- Blocks the reuptake of epi at sympathetic nerve terminal
What is a Coroner’s Clot?
-A blood clot that form during ENT surgery and is not cleared after extubation of patient, which then aspirates caused occlusion of the airway.
What anatomical parts of the body would be worked on during intraoral procedure?
- Tonsillectomy
- adenoidectomy
- palatal surgery
What is Waldeyer’s Ring?
- Tonsils and adenoids lymphoid tissue around the pharynx
What may occur minutes to hours after relief or airway obstruction in children?
-pulmonary edema
What is the dose of decadrone?
- 0.05 to 0.15 mg/kg
- max dose 20 mg
- (some surgeons may use 0.5 mg/kg)
What is the incidence for post extubation laryngospasm and stridor?
- 12 - 25 %
Primary bleeds occurs how long after a tonsillectomy?
- 6 hours
When is the second most common time bleeds occurs after a tonsillectomy?
7 to 8 days post-op due to scab falling off
What is the optimal FiO2 when using a potential heat source that possibly could cause a fire.
< 30 %
What color lens does a YAG laser use?
- Green
What color lens does a argon laser use?
- AMBER
What color lens does a CO2 laser use?
- Clear
What are the appropriate steps for an airway fire?
- Disconnect circuit
- Extubate, ventilate with a new circuit
- Reintubate
- Maintain anesthesia with IV agents
What is the PSI of O2 when using jet ventilation?
30 to 50 P.S.I.
What are some points about supraglottic jet vent?
- Above the vocal cords
- Cannot monitor EtCO2
What risk are more prevalent in supraglottic jet ventilaton
- pneumomediastinum
- pneumothoraz -pneumothora
- -SQ emphysema
What risk are more prevalent in subglottic jet ventilation?
-barotrauma
How many respiration ah minute does HFPPV do a minute.
-60 to 100
How many respiraton ah minutes does HFJV
100 - 200 less than dead space
What are the four d’s?
- dysphagia
- dysphonia
- dyspnea
- drooling
What is the gold standand for OSA:
- CPAP
- BiPAP
What is hypoapnea?
- > 30% drop in airflow to baseline for more than 10 seconds
- > 4% drop in oxygen sats
What is apnea?
- airflow ceases for 10 seconds or more
A polysomnography diagnosis sleep apnea.
YES
Categorize the apnea hypopnea Index (AHI).
- 0-5 event is none
- 6-20 event is mild
- 21 - 40 events is moderate
> 40 events is severe
What is are the characteristics for OSA patients:
- male
- > 50 years of age
- neck circumference >17 inches
- snorer
- > 35 BMI
What does frequent apnea + hypopnea leads to:
-framented sleep
The reticular activating system is stimulated leading to sympathetic hyperactivity due to apnea + hypopnea.
YES
What does apnea + hyponea cause with systemic inflammation?
- increase c reactive protein
- interleukin-6
- endothelial dysfunction
- metabolic dysregulation all leading to CV, neuropsych and endocrine disorders
How is endocrine affected by OSA?
- glucose intolerance
- diabetes
- obesity
- GERD
How is CV affected by OSA?
-HTN
-arrhythmias
-CAD
-nocturnal angina
MI
CHF
Pulm HTN
How is neuropsychologic affected by OSA?
- daytime somnolence
- cognitive impairment
- accident proneness
- anxiety/depression
What is a uvulopalatopharyngoplasty?
-enlarging retropalatial airway
What two nerves must be recognized during thyroidectomy?
- RLN
- SLN
