Module 20: ENT

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Questions and Answers

What structure separates the two external nares of the nose?

Nasal septum

Alar cartilages

External nares

Columella (correct)

Which of the following sinuses does not communicate through the meatus?

Sphenoid sinus

Maxillary sinus

Palatine sinus (correct)

Frontal sinus

Which section of the throat primarily serves as a passageway for both food and air?

Pharynx (correct)

Nasal cavity

Larynx

Oral cavity

Which of the following statements about the epiglottis is correct?

It closes off the larynx during swallowing. Signup and view all the answers

What is the primary function of the hair cells on the basilar membrane of the cochlea?

Convert mechanical energy into electrochemical impulses Signup and view all the answers

Which of the following correctly describes the components of the nasal septum?

Nasal cartilage, perpendicular plate of the ethmoid, and vomer bone Signup and view all the answers

Which set of structures is included in the vestibular labyrinth?

Utricle, saccule, and three semicircular canals Signup and view all the answers

What is the airway opening to the nasal cavity called?

External nares Signup and view all the answers

What is the primary function of the sterile nerve stimulator during head and neck surgeries?

To protect the recurrent laryngeal nerves Signup and view all the answers

Which equipment is necessary for providing illumination in complex ENT procedures?

Surgical microscope Signup and view all the answers

What must be assessed continuously to ensure normothermia during surgery?

Patient's temperature Signup and view all the answers

When using power drills in surgical procedures, why is sterile water necessary during operation?

To cool the drill and prevent overheating Signup and view all the answers

Which of the following types of lasers is used to vaporize scar tissue without damaging surrounding tissue?

Nd:YAG laser Signup and view all the answers

What should be done when the surgical microscope is not in use?

Store it in an upright position in a low-traffic area Signup and view all the answers

What type of surgical procedures are primarily performed through the ear canal?

Otologic procedures Signup and view all the answers

What is the key advantage of using forced-air warming blankets during surgery?

To prevent hypothermia Signup and view all the answers

Which surgical instruments are essential for tissue grasping during tonsil surgery?

Tonsil forceps Signup and view all the answers

What is the process that ensures proper inventory count of surgical instruments?

Minor Count → Closing Count → Final Count Signup and view all the answers

What is the main objective of performing a nasoseptoplasty?

To straighten the cartilaginous or osseous segments of the septum Signup and view all the answers

Why is local infiltration with epinephrine commonly used during nasoseptoplasty?

To aid in hemostasis by constricting blood vessels Signup and view all the answers

What is utilized to stabilize the reduction after closed reduction of a nasal fracture?

Denver splint Signup and view all the answers

What is a key reason a surgeon may use a suspension laryngoscope for laryngoscopy?

To free the surgeon's hands during the procedure Signup and view all the answers

What type of dressing is typically applied postoperatively after nasal surgery?

Mustache dressing Signup and view all the answers

Which solution is generally safe for use in the middle ear during surgery, given the absence of allergies?

Providone-iodine Signup and view all the answers

What is the primary reason for avoiding the use of Chlorhexidine in otorhinolaryngology procedures?

It is ototoxic. Signup and view all the answers

What position are patients usually placed in for head and neck surgeries to enhance visualization?

Supine position with a shoulder roll Signup and view all the answers

Which of the following instruments is used specifically for Otologic surgery?

Aural speculum Signup and view all the answers

In the context of surgical procedures, how should the perioperative nurse ensure patient safety regarding positioning?

By collaborating with the surgical team to confirm safe positioning Signup and view all the answers

What type of positioning device is recommended for ensuring maximum visualization during head and neck surgery?

Shoulder roll Signup and view all the answers

Which instrument is NOT typically associated with rhinosurgery?

Otoscope Signup and view all the answers

Which of the following instruments would be used in oral cavity or laryngologic surgeries?

Biopsy forceps Signup and view all the answers

Before the surgical procedure, what should be done regarding hair clipping?

It should be clipped immediately prior to surgery. Signup and view all the answers

Why is it important for the perioperative nurse to apply the patient return electrode pad?

To allow for electrical discharges during surgery Signup and view all the answers

What composition of the trachea is primarily responsible for maintaining its structure?

C-shaped rings of cartilage Signup and view all the answers

Which muscle group is located posteriorly to the trachea?

Sternohyoid muscles, sternothyroid muscle, and thyroid glands Signup and view all the answers

Which factor is NOT routinely assessed in a patient's respiratory status pre-operatively?

Presence of heart murmur Signup and view all the answers

Which anaesthetic approach might be indicated for a patient undergoing a tracheostomy lasting less than two hours?

Local anaesthetic with neurolept Signup and view all the answers

Which symptom might indicate long-term complications following facial or neck surgery?

Facial numbness Signup and view all the answers

What is primarily used to prevent coughing during laryngeal surgery?

Topical lidocaine Signup and view all the answers

What type of solution is used to pack the nasal cavity during rhinologic surgeries?

Vasoconstrictor solution Signup and view all the answers

What technique should be followed if hair removal is required before head and neck surgeries?

Using clippers if hair interferes with the surgical site Signup and view all the answers

What is a common reassurance measure for patients during surgery requiring local anaesthetic?

Maintaining a quiet and calm environment Signup and view all the answers

Which of the following is NOT a potential outcome of surgery on the face or neck?

Improved functional abilities Signup and view all the answers

Study Notes

Cochlear and Vestibular Anatomy

The basilar membrane in the cochlea contains hair cells that transduce mechanical vibrations into electrochemical impulses.
The vestibular labyrinth comprises the utricle, saccule, and three semicircular canals, detecting angular acceleration from head movements.
The semicircular canals rely on the vestibular branch of the acoustic nerve (8th cranial nerve) for triggering impulses.

Nose Anatomy and Function

Prominent facial feature, vulnerable to trauma, supported by cartilage and bone.
External nares are the openings leading to the nasal cavity, which humidifies and filters air before entering the lungs.
Alar cartilages shape the tip and nostrils; columella separates the nares.
The nasal cavity is divided by the nasal septum, composed of nasal cartilage, perpendicular plate of the ethmoid, and vomer bone.
The septum's rich blood supply moistens and warms air, while mucus traps particles.
Nasal sinuses communicate with the nasal cavity via the meatus, including the frontal, ethmoid, sphenoid, and maxillary sinuses.

Throat Anatomy

Comprised of oral cavity, pharynx, larynx, and associated structures.
The oral cavity includes the mouth (formed by cheeks, hard palate, tongue, mandible) and salivary glands (sublingual, submandibular, parotid).
The pharynx acts as a passageway from the nose to the esophagus, connecting multiple cavities.
The larynx, a cartilaginous structure, contains the epiglottis, preventing aspiration, and vocal cords (supraglottis, glottis, subglottis).
The trachea, anterior to the esophagus, consists of C-shaped cartilage rings, branching into right and left bronchi.

Perioperative Nursing Considerations

Pre-operative assessment includes evaluating the respiratory status, breathing quality, smoking history, and nutritional status related to swallowing difficulties.
Facial symmetry, landmarks, color, position, lesions, and nodules should be assessed, along with patient pain levels.
Patients undergoing reconstructive facial or neck surgeries may experience body image issues, long-term hearing loss, and aesthetic changes.
Local anesthesia with neurolept can be used for short procedures, emphasizing patient immobility and comfort during surgery.

Surgical Preparation and Techniques

For rhinologic surgeries, the nasal cavity may be packed with vasoconstrictor-solution-soaked patties.
In laryngeal surgery, lidocaine or topical epinephrine may be applied to control coughing and achieve vasoconstriction.
Surgical prep may require hair removal with clippers near surgery time to avoid contamination.
Povidone-iodine is the preferred prep solution, while chlorhexidine is avoided due to ototoxicity.

Patient Positioning

Supine position with shoulder roll is common for head and neck surgeries.
Collaborate with the surgical team to ensure safe patient positioning and secure electrode pads and safety straps.

Instrumentation for ENT Surgeries

Otorhinolaryngology requires delicate instruments; otologic procedures are often performed through the ear canal or from behind the ear.
Specific instruments include myringotomy knives, aural speculums, sinus scopes, and various forceps for fine handling.

Surgical Equipment

Key OR equipment includes monopolar and bipolar cautery, suction, light sources, and surgical microscopes for enhanced visualization.
Precautions are necessary with power drills for safety, and forced-air warming blankets are used to maintain normothermia.

Otologic and Rhinologic Procedures

Closed reduction of nasal fractures can use local infiltration and requires nasal packing.
Nasoseptoplasty aims to correct septum deviations to improve breathing, often requiring local infiltration for hemostasis.
Laryngoscopy allows visualization of vocal cords using a lighted laryngoscope, potentially requiring tissue biopsy with caution to manage bleeding.
Tonsillectomy involves the excision of tonsils and may be done alongside adenoidectomy.

Additional Surgeries

Thyroidectomy refers to the removal of the thyroid gland, often performed in cases of malignancy or hyperthyroidism.

Studying That Suits You

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Description

This quiz tests your understanding of the anatomy and physiology of the ear and vestibular system. Focus on the structures of the cochlea and the functions of the vestibular labyrinth. Challenge yourself to identify the key components involved in hearing and balance.