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ENT: Paralysis of the Larynx and Tracheostomy
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ENT: Paralysis of the Larynx and Tracheostomy

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Questions and Answers

What is the position of the vocal cord in recurrent laryngeal nerve paralysis?

  • Lateral position
  • Abducted position
  • Median position (correct)
  • Cadaveric position

    • What is the treatment for bilateral paralysis of the vocal cords?

  • Waiting for spontaneous recovery
  • Arytenoidectomy
  • Phonosurgical procedures
  • Tracheostomy (correct)

    • What is tracheostomy defined as?

  • Repair of the larynx
  • Creation of an opening in the trachea (correct)
  • Removal of the trachea
  • Removal of the larynx

    • Which of the following is an indication for tracheostomy?

    <p>Bilateral vocal cord paralysis</p> Signup and view all the answers

    What is the time frame for spontaneous recovery from paralysis?

    <p>Up to 2 years</p> Signup and view all the answers

    Which of the following is NOT an indication for tracheostomy?

    <p>Unilateral vocal cord paralysis</p> Signup and view all the answers

    What is a potential cause of cardiac arrest during a tracheostomy procedure?

    <p>Adrenaline surge</p> Signup and view all the answers

    What is a potential complication of the tracheostomy tube being completely displaced outside the tracheal opening?

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

    What is a potential long-term complication of tracheostomy involving the 1st tracheal ring?

    <p>Perichondritis and stenosis</p> Signup and view all the answers

    What is a potential complication of an ill-fitting tracheostomy tube?

    <p>All of the above</p> Signup and view all the answers

    What is a potential immediate complication of tracheostomy?

    <p>Apnea secondary to loss of hypoxic drive</p> Signup and view all the answers

    What is the most common side affected by paralysis of the larynx?

    <p>Left side</p> Signup and view all the answers

    What is a common cause of paralysis of the motor nerves of the larynx?

    <p>Disease of the central nervous system</p> Signup and view all the answers

    What is a characteristic feature of bilateral recurrent laryngeal nerve paralysis?

    <p>Severe dyspnoea</p> Signup and view all the answers

    What can lead to polyneuritis, resulting in paralysis of the larynx?

    <p>All of the above</p> Signup and view all the answers

    What is a characteristic feature of unilateral recurrent laryngeal nerve paralysis?

    <p>Hoarseness of voice</p> Signup and view all the answers

    What is the result of paralysis of the superior laryngeal nerve?

    <p>Slack and wavy cord</p> Signup and view all the answers

    What is the recommended method for introducing humid air into the lungs during tracheostomy?

    <p>Humidifying the inspired air</p> Signup and view all the answers

    What is the purpose of regularly deflating the cuff in cuffed tubes?

    <p>To prevent pressure necrosis</p> Signup and view all the answers

    Why should tube changing be avoided for 2-3 days?

    <p>To allow the track to establish itself</p> Signup and view all the answers

    What is a physiological change that occurs after tracheostomy?

    <p>A 10-50% reduction in anatomical dead space</p> Signup and view all the answers

    What is a complication of tracheostomy?

    <p>Immediate respiratory failure</p> Signup and view all the answers

    What is a criterion for decannulation?

    <p>The patient's ability to manage with the tube occluded for at least 24 h</p> Signup and view all the answers

    What is one of the conditions where tracheostomy aids respiration?

    <p>All of the above</p> Signup and view all the answers

    What is the length of the transverse skin incision for elective tracheostomy?

    <p>2-5cm</p> Signup and view all the answers

    What type of tracheostomy tube is used in children?

    <p>Vertical slit incision tube</p> Signup and view all the answers

    Why is it important to position adult patients sitting well propped up in the post-operative period?

    <p>To prevent dislodgement</p> Signup and view all the answers

    How often should suction be applied in tracheostomy after-care?

    <p>At regular intervals dictated by the amount of secretions</p> Signup and view all the answers

    What is done to the bulky isthmus during tracheostomy?

    <p>It is retracted cranially</p> Signup and view all the answers

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