44 Questions
What is the most important landmark for the anesthetist in the larynx?
Cricothyroid membrane
Which nerve provides all sensory innervation below the level of the vocal cords?
Recurrent laryngeal nerve
What is the primary motor innervation to the larynx provided by?
Recurrent laryngeal nerve
Where does the arterial blood supply to the larynx come from?
External carotid artery
Which muscle in the larynx is supplied by the external branch of the superior laryngeal nerve?
Cricothyroid muscle
What are the extrinsic muscles of the larynx responsible for?
Shifting the larynx upward and downward
What is the definitive surgical procedure for laryngeal surgery dependent on?
The degree of invasion of the tumor
In which stage of laryngeal cancers is microlaryngeal surgery typically performed?
Stage 0
What does hemilaryngectomy involve?
Removal of one vertical half of the larynx
Which structures are removed during a supracricoid laryngectomy?
Supra-glottic structures, true and false vocal cords, and thyroid cartilage
What proportion of patients undergoing supracricoid laryngectomy may continue to be dependent on a tracheotomy?
Approximately 50%
What is the primary goal of laryngeal surgery?
Maintenance of superior postoperative laryngeal function
Which structures are resected during a supraglottic laryngectomy?
False vocal cords and laryngeal cartilage
In which patients is total laryngectomy performed?
Patients with T3 or T4 cancerous involvement of the larynx
What is involved in total laryngectomy?
Complete removal of the larynx, thyroid cartilage, cricoid cartilage, hyoid bone, and potentially several upper tracheal rings
What is created during a laryngectomy to ensure a patent airway?
Permanent tracheostomy
What are potential complications associated with a laryngectomy?
Fistula development between the trachea and esophagus
What is the primary initial concern for the anesthetist during a laryngectomy?
Securing a patent airway
What is the typical intraoperative period for a laryngectomy dependent on?
The type of laryngectomy being performed
What is frequently unnecessary during a laryngectomy due to low blood loss?
Packed red blood cell transfusion
What can operative times exceed if a radical neck dissection is performed in conjunction with a laryngectomy?
10 hours
What structures are involved in creating a permanent tracheostomy during a laryngectomy?
Tracheal stump and lower portion of the neck
What position is the patient typically placed in for laryngectomy, unless there is preexisting airway obstruction?
Semi-Fowler position
What is the primary goal of thorough preoxygenation before intubation during laryngectomy?
To establish ventilation
Why may video laryngoscopy be a viable option for the initial attempt at intubation during laryngectomy?
To avoid bleeding post radiation therapy
What should be available in several sizes in the event of difficulty with intubation during laryngectomy?
Endotracheal tubes (ETT)
What may the surgeon wish to perform before endotracheal tube (ETT) placement during laryngectomy?
Direct laryngoscopy
What are at risk of bleeding during airway instrumentation in patients who have received radiation therapy?
Cancerous tissue
Why might consideration be given to using a reinforced endotracheal tube (ETT) during laryngectomy?
To prevent damage to the airway during surgery
What is the reason for tucking the patient's arms at his side during laryngectomy surgery?
To provide security and access for drug and fluid therapy
Why might central line placement be indicated for some laryngectomy patients?
To monitor blood pressure changes continuously
Why should the patient be placed on a pillow or shoulder roll during laryngectomy surgery?
To achieve good operative exposure of the head and neck
What is the primary reason for providing patient warming via a lower body or underbody Bair Hugger during laryngectomy surgery?
To maintain stable core body temperature
Why is arterial line placement recommended for laryngectomy patients?
To detect hemodynamic changes associated with this patient population
What is the potential complication related to vagal nerve stimulation during laryngectomy surgery?
Bradycardia
Why is the placement of an esophageal stethoscope important during laryngectomy surgery?
To monitor core temperature accurately
What is the average duration of laryngectomy surgery?
4-6 hours
Why should careful attention be given to safely covering and protecting the eyes during laryngectomy surgery?
To minimize the risk of corneal abrasions or injury
Why is it important to have extension tubing for intravenous lines and breathing circuit during laryngectomy surgery?
To provide access for drug and fluid therapy easily
What is the primary purpose of using a shoulder roll or pillow to create head and neck extension during laryngectomy surgery?
To achieve good operative exposure of the head and neck
Which postoperative complication is a direct result of laryngectomy?
Chyle leak
What is the most common postoperative complication associated with laryngectomy?
Pharyngocutaneous fistula
What is a significant risk associated with partial laryngectomy?
Increased risk of aspiration
Which postoperative complication is NOT commonly associated with laryngectomy?
Pneumonia
Test your knowledge of the anatomy of the larynx, including ligaments, muscles, and important landmarks for medical procedures. This quiz covers topics such as cricothyroid membrane, extrinsic and intrinsic laryngeal muscles, and their functions.
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