Elisa Chapter 3 Laryngectomy
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Questions and Answers

What is the most important landmark for the anesthetist in the larynx?

  • Cricothyroid membrane (correct)
  • Hyoepiglottic ligament
  • Cricothyroid muscle
  • Superior laryngeal nerve

    • Which nerve provides all sensory innervation below the level of the vocal cords?

  • Vagus nerve
  • Superior laryngeal nerve
  • Internal branch of the superior laryngeal nerve
  • Recurrent laryngeal nerve (correct)

    • What is the primary motor innervation to the larynx provided by?

  • Inferior laryngeal artery
  • Superior laryngeal nerve
  • Vagus nerve
  • Recurrent laryngeal nerve (correct)

    • Where does the arterial blood supply to the larynx come from?

    <p>External carotid artery</p> Signup and view all the answers

    Which muscle in the larynx is supplied by the external branch of the superior laryngeal nerve?

    <p>Cricothyroid muscle</p> Signup and view all the answers

    What are the extrinsic muscles of the larynx responsible for?

    <p>Shifting the larynx upward and downward</p> Signup and view all the answers

    What is the definitive surgical procedure for laryngeal surgery dependent on?

    <p>The degree of invasion of the tumor</p> Signup and view all the answers

    In which stage of laryngeal cancers is microlaryngeal surgery typically performed?

    <p>Stage 0</p> Signup and view all the answers

    What does hemilaryngectomy involve?

    <p>Removal of one vertical half of the larynx</p> Signup and view all the answers

    Which structures are removed during a supracricoid laryngectomy?

    <p>Supra-glottic structures, true and false vocal cords, and thyroid cartilage</p> Signup and view all the answers

    What proportion of patients undergoing supracricoid laryngectomy may continue to be dependent on a tracheotomy?

    <p>Approximately 50%</p> Signup and view all the answers

    What is the primary goal of laryngeal surgery?

    <p>Maintenance of superior postoperative laryngeal function</p> Signup and view all the answers

    Which structures are resected during a supraglottic laryngectomy?

    <p>False vocal cords and laryngeal cartilage</p> Signup and view all the answers

    In which patients is total laryngectomy performed?

    <p>Patients with T3 or T4 cancerous involvement of the larynx</p> Signup and view all the answers

    What is involved in total laryngectomy?

    <p>Complete removal of the larynx, thyroid cartilage, cricoid cartilage, hyoid bone, and potentially several upper tracheal rings</p> Signup and view all the answers

    What is created during a laryngectomy to ensure a patent airway?

    <p>Permanent tracheostomy</p> Signup and view all the answers

    What are potential complications associated with a laryngectomy?

    <p>Fistula development between the trachea and esophagus</p> Signup and view all the answers

    What is the primary initial concern for the anesthetist during a laryngectomy?

    <p>Securing a patent airway</p> Signup and view all the answers

    What is the typical intraoperative period for a laryngectomy dependent on?

    <p>The type of laryngectomy being performed</p> Signup and view all the answers

    What is frequently unnecessary during a laryngectomy due to low blood loss?

    <p>Packed red blood cell transfusion</p> Signup and view all the answers

    What can operative times exceed if a radical neck dissection is performed in conjunction with a laryngectomy?

    <p>10 hours</p> Signup and view all the answers

    What structures are involved in creating a permanent tracheostomy during a laryngectomy?

    <p>Tracheal stump and lower portion of the neck</p> Signup and view all the answers

    What position is the patient typically placed in for laryngectomy, unless there is preexisting airway obstruction?

    <p>Semi-Fowler position</p> Signup and view all the answers

    What is the primary goal of thorough preoxygenation before intubation during laryngectomy?

    <p>To establish ventilation</p> Signup and view all the answers

    Why may video laryngoscopy be a viable option for the initial attempt at intubation during laryngectomy?

    <p>To avoid bleeding post radiation therapy</p> Signup and view all the answers

    What should be available in several sizes in the event of difficulty with intubation during laryngectomy?

    <p>Endotracheal tubes (ETT)</p> Signup and view all the answers

    What may the surgeon wish to perform before endotracheal tube (ETT) placement during laryngectomy?

    <p>Direct laryngoscopy</p> Signup and view all the answers

    What are at risk of bleeding during airway instrumentation in patients who have received radiation therapy?

    <p>Cancerous tissue</p> Signup and view all the answers

    Why might consideration be given to using a reinforced endotracheal tube (ETT) during laryngectomy?

    <p>To prevent damage to the airway during surgery</p> Signup and view all the answers

    What is the reason for tucking the patient's arms at his side during laryngectomy surgery?

    <p>To provide security and access for drug and fluid therapy</p> Signup and view all the answers

    Why might central line placement be indicated for some laryngectomy patients?

    <p>To monitor blood pressure changes continuously</p> Signup and view all the answers

    Why should the patient be placed on a pillow or shoulder roll during laryngectomy surgery?

    <p>To achieve good operative exposure of the head and neck</p> Signup and view all the answers

    What is the primary reason for providing patient warming via a lower body or underbody Bair Hugger during laryngectomy surgery?

    <p>To maintain stable core body temperature</p> Signup and view all the answers

    Why is arterial line placement recommended for laryngectomy patients?

    <p>To detect hemodynamic changes associated with this patient population</p> Signup and view all the answers

    What is the potential complication related to vagal nerve stimulation during laryngectomy surgery?

    <p>Bradycardia</p> Signup and view all the answers

    Why is the placement of an esophageal stethoscope important during laryngectomy surgery?

    <p>To monitor core temperature accurately</p> Signup and view all the answers

    What is the average duration of laryngectomy surgery?

    <p>4-6 hours</p> Signup and view all the answers

    Why should careful attention be given to safely covering and protecting the eyes during laryngectomy surgery?

    <p>To minimize the risk of corneal abrasions or injury</p> Signup and view all the answers

    Why is it important to have extension tubing for intravenous lines and breathing circuit during laryngectomy surgery?

    <p>To provide access for drug and fluid therapy easily</p> Signup and view all the answers

    What is the primary purpose of using a shoulder roll or pillow to create head and neck extension during laryngectomy surgery?

    <p>To achieve good operative exposure of the head and neck</p> Signup and view all the answers

    Which postoperative complication is a direct result of laryngectomy?

    <p>Chyle leak</p> Signup and view all the answers

    What is the most common postoperative complication associated with laryngectomy?

    <p>Pharyngocutaneous fistula</p> Signup and view all the answers

    What is a significant risk associated with partial laryngectomy?

    <p>Increased risk of aspiration</p> Signup and view all the answers

    Which postoperative complication is NOT commonly associated with laryngectomy?

    <p>Pneumonia</p> Signup and view all the answers

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