Otorhinolaryngology Surgery Module 20
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Questions and Answers

What is a potential risk associated with total thyroidectomy?

  • Injury to the facial nerve
  • Injury to the recurrent laryngeal nerves (correct)
  • Hematoma formation in the thigh
  • Airway obstruction due to goiter

    • When dealing with a large goiter that invades the chest, what surgical approach may be necessary?

  • Radical neck dissection
  • Sternotomy (correct)
  • Modified neck dissection
  • Bilateral subtotal thyroidectomy

    • Which statement is true regarding radical neck dissection?

  • Only cervical nodes are removed.
  • The sternocleidomastoid muscle is always preserved.
  • It always requires a tracheostomy.
  • Reconstructive surgery may be needed after the procedure. (correct)

    • What should be closely monitored during the emergence from anesthesia?

    <p>Coughing leading to hematoma</p> Signup and view all the answers

    What is involved in the modified neck dissection?

    <p>Preservation of the sternocleidomastoid muscle</p> Signup and view all the answers

    What is the primary purpose of the c-shaped rings of cartilage in the airway structure?

    <p>To support the trachea and maintain its shape</p> Signup and view all the answers

    Which symptoms may indicate a patient is experiencing long-term effects after facial or neck surgery?

    <p>Facial numbness and difficulty swallowing</p> Signup and view all the answers

    When is local anaesthetic combined with neurolept recommended in surgical procedures?

    <p>For procedures lasting less than two hours</p> Signup and view all the answers

    What is the role of epinephrine in nasal surgeries?

    <p>To induce vasoconstriction and reduce bleeding</p> Signup and view all the answers

    What is a crucial consideration regarding hair removal in head and neck surgeries?

    <p>Hair should be removed only if it obstructs the surgical site</p> Signup and view all the answers

    Why must patients remain immobile during local anaesthetic procedures?

    <p>To ensure accurate surgical exposure and safety</p> Signup and view all the answers

    Which assessment is NOT typically included in pre-operative respiratory evaluations?

    <p>Patient's exposure to pets</p> Signup and view all the answers

    What might be a concern with patients undergoing reconstructive surgery of the face or neck?

    <p>Changes in body image and possible long-term effects</p> Signup and view all the answers

    What is an important pre-operative nursing assessment related to swallowing?

    <p>Identifying weight loss from difficulty swallowing or chewing</p> Signup and view all the answers

    What type of anaesthesia may be used for patients based on their health conditions?

    <p>General anaesthetic if indicated by health condition</p> Signup and view all the answers

    Which part of the ear is primarily responsible for maintaining equilibrium?

    <p>Inner ear</p> Signup and view all the answers

    What is the function of cerumen in the external auditory canal?

    <p>Trapping foreign materials and reducing bacteria</p> Signup and view all the answers

    How do the ossicles in the middle ear contribute to hearing?

    <p>They amplify and transmit sound from air to the inner ear fluid.</p> Signup and view all the answers

    Which structure communicates the middle ear with the pharynx?

    <p>Eustachian tube</p> Signup and view all the answers

    What anatomical structure is responsible for hearing in the inner ear?

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

    What type of infection can spread from the pharynx to the middle ear?

    <p>Otitis media</p> Signup and view all the answers

    Which part of the ear is primarily involved with conducting sound to the inner ear?

    <p>Middle ear</p> Signup and view all the answers

    Which bony structure within the inner ear resembles a snail shell?

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

    What is the primary purpose of myringotomy?

    <p>To create an incision in the tympanic membrane for tube insertion</p> Signup and view all the answers

    Which type of mastoidectomy involves the complete removal of mastoid air cells?

    <p>Radical mastoidectomy</p> Signup and view all the answers

    What is a common postoperative care for tympanoplasty?

    <p>Packing the external auditory canal with antibiotic ointment</p> Signup and view all the answers

    What is essential to monitor during a mastoidectomy to prevent complications?

    <p>Facial nerve function</p> Signup and view all the answers

    Which surgical approach can be utilized for mastoidectomy?

    <p>Endaural approach</p> Signup and view all the answers

    What postoperative instruction is crucial after Functional Endoscopic Sinus Surgery (FESS)?

    <p>Breathe through the mouth</p> Signup and view all the answers

    What is a key component of cochlear implantation surgery?

    <p>Attachment of an external sound processor</p> Signup and view all the answers

    Which of the following is a commonly used agent for visualization during FESS?

    <p>Topical lidocaine with epinephrine</p> Signup and view all the answers

    What can be a source of grafting material in tympanoplasty?

    <p>Ear lobe, back of the ear, or tragus</p> Signup and view all the answers

    What major type of hearing loss is addressed by cochlear implantation?

    <p>Sensory hearing loss</p> Signup and view all the answers

    Which instrument is specifically designed to grasp tonsils during head and neck surgeries?

    <p>Tonsil forceps</p> Signup and view all the answers

    What type of microscope is used to provide illumination and magnification during complex ENT procedures?

    <p>Surgical microscope</p> Signup and view all the answers

    Which power tool is utilized in otologic surgeries for working with bones?

    <p>Power drills</p> Signup and view all the answers

    What is the primary purpose of forced-air warming blankets in surgery?

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

    Which of the following items requires a specific drape to prevent contamination during surgery?

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

    What role does a sterile nerve stimulator play during a surgical procedure?

    <p>To protect the recurrent laryngeal nerves</p> Signup and view all the answers

    During surgical procedures, which item is used for the vaporization of scar tissue without damaging surrounding tissue?

    <p>Laser (CO2, KTP, Er:YAG, and Nd:YAG)</p> Signup and view all the answers

    What procedural count is required for most head and neck surgeries?

    <p>Initial, closing, and final count</p> Signup and view all the answers

    Which instrument is specifically designed for functionality in both minor and major surgeries in the head and neck area?

    <p>Debakey or Cooley forceps</p> Signup and view all the answers

    Which item should be placed in the safe mode during its exchange between the surgeon and scrub nurse?

    <p>Power drills</p> Signup and view all the answers

    Study Notes

    Anatomy of the Ear, Nose, and Throat

    • Otorhinolaryngology encompasses the study of the ear (oto), nose (rhino), and throat (laryngo).
    • The ear consists of three parts: external, middle, and inner ear, critical for hearing and balance.
    • The external ear includes the auricle and external auditory canal, filtering sound waves with cerumen (earwax).
    • The middle ear houses three ossicles (malleus, incus, stapes) that amplify sound; its infection risk is heightened due to connection with the pharynx through the Eustachian tube.
    • The inner ear contains hair cell receptors for hearing and balance, structured as a bony labyrinth with the cochlea and vestibular labyrinth.

    Perioperative Nursing Considerations

    • Pre-operative assessment includes evaluating respiratory status, nutritional status, and facial symmetry.
    • Patients may face long-term issues such as hearing loss, facial numbness, and changes in body image.
    • Local anaesthesia is used in short procedures; general anaesthesia may be necessary based on health or surgery type.
    • For nasal surgeries, the nasal cavity is packed with vasoconstrictor solution and anaesthetics; coughing during laryngeal surgery may be managed with topical lidocaine.

    Surgical Preparation

    • Hair removal is performed only if necessary for access to the surgical field, using clippers for safety.
    • Essential instruments include various forceps, retractors, and hemostats; the surgical team must ensure a minor count before and after procedures.
    • The OR requires equipment like bipolar and monopolar cautery, suction, microscopes for detailed procedures, and forced-air warming blankets to avoid hypothermia.

    Otologic Surgeries

    • Myringotomy involves making an incision in the tympanic membrane; tubes are placed temporarily to allow drainage.
    • Mastoidectomy removes mastoid air cells to treat cholesteatoma, requiring careful monitoring of facial nerves.
    • Tympanoplasty repairs the tympanic membrane and ossicles, using grafts from the patient's ear.
    • Cochlear implantation places a device directly in the cochlea for patients with severe hearing loss, necessitating post-operative auditory training.

    Rhinologic Surgeries

    • Functional Endoscopic Sinus Surgery (FESS) utilizes endoscopy for treating sinus issues, focusing on drainage and tissue resection.
    • Post-operative care includes nasal packing and instruction to breathe through the mouth.
    • Thyroidectomies, potentially extensive depending on the severity of conditions like goiters, may necessitate major counts and vigilance against nerve injury.
    • Parotidectomy involves the removal of parotid glands, with risks similar to those in neck dissections.

    Neck Surgeries

    • Radical neck dissection entails removing malignant tissues and potentially necessitating reconstructive surgery.
    • Different dissection types preserve critical anatomical structures, affecting surgical strategy and complications.
    • Tracheostomy is performed for airway access in emergencies or as part of planned surgeries.

    General Surgical Interventions

    • Continuous monitoring of patient status, especially during anaesthesia emergence, is vital to prevent complications such as hematomas.
    • Surgical interventions can lead to significant quality-of-life changes due to potential postoperative impairments.

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    Related Documents

    MODULE 20 Otorhinolaryngology Surgery RPN2023 PDF

    Description

    This quiz covers key concepts from Module 20 on otorhinolaryngology surgery. It focuses on the anatomy of the ears, nose, and throat, and is based on essential readings from Alexander’s Care of the Patient in Surgery and other relevant texts. Test your understanding of surgical instrumentation and standards in this field.

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