Tonsillectomy Preoperative Evaluation Elements

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What is the controversial association with upper respiratory tract infections (URI) in pediatric patients undergoing tonsillectomy?

Decreased risk of postoperative bleeding

Increased incidence of perioperative bronchospasm or laryngospasm (correct)

Increased risk of cardiovascular complications

Reduced postoperative pain

What assessment should be performed in adult patients with tonsillar enlargement to determine the presence and severity of obstructive sleep apnea (OSA)?

Blood glucose level measurement

STOP-Bang questionnaire (correct)

Visual acuity test

Pulmonary function test

What further diagnostic studies are warranted for adult patients with severe obstructive sleep apnea (OSA) and tonsillar enlargement?

Thyroid function tests

Echocardiogram and chest radiograph (correct)

Bone density scan

CT scan of the abdomen

What oral examination finding may potentially cause difficulty with mask ventilation or direct laryngoscopy during tonsillectomy?

Tonsils encroaching on airway structures Signup and view all the answers

What is the purpose of evaluating a complete blood count, prothrombin time, or activated partial thromboplastin time?

To diagnose coagulopathy Signup and view all the answers

Which medical conditions are of concern due to the increased risk of airway obstruction and coexisting disease states?

Down syndrome and Treacher Collins syndrome Signup and view all the answers

From which artery does the blood flow to the palatine tonsils primarily arise?

Facial artery Signup and view all the answers

What is the primary sensory innervation to the palatine tonsils?

Glossopharyngeal nerve Signup and view all the answers

What medication may be administered 30 minutes before tonsillectomy to alleviate anxiety and provide sedation?

Midazolam Signup and view all the answers

For which patient should premedication be administered sparingly or not at all before tonsillectomy?

Patients with facial anomalies Signup and view all the answers

What can be initiated pre-operatively to assist with drying of secretions in the pharynx during a tonsillectomy?

Antisialagogue Signup and view all the answers

Which artery supplies blood to the palatine tonsils in addition to the facial artery?

External carotid artery Signup and view all the answers

What is the primary purpose of premedication for a child undergoing tonsillectomy?

To provide relaxation and analgesia Signup and view all the answers

Which nerve supplies sensory innervation to the palatine tonsils in addition to the glossopharyngeal nerve?

Lesser or posterior palatine nerve Signup and view all the answers

What is the most optimal technique for anesthesia and airway management during a tonsillectomy?

Endotracheal tube with general anesthesia Signup and view all the answers

What is the potential consequence of overextending the neck during positioning for a tonsillectomy?

Potential displacement of the C1-C2 vertebrae Signup and view all the answers

What is the purpose of inserting a mouth gag during a tonsillectomy?

To allow suspension of the mouth for visualization Signup and view all the answers

What are the potential complications associated with improper attention to airway management during tonsillectomy?

Inadvertent extubation Signup and view all the answers

What is the recommended position for patients undergoing tonsillectomy?

Supine with shoulders elevated and head extended Signup and view all the answers

What is the most frequently recommended orientation of the operating table regarding the anesthetist during tonsillectomy?

90 degrees toward the anesthetist Signup and view all the answers

What is the primary purpose of administering inhalation agents during tonsillectomy surgery?

To prevent airway obstruction Signup and view all the answers

What is the recommended action if the anesthesia machine alarms 'low tidal volume' during surgical manipulation of the mouth gag?

Confirm or exclude potential causes through diagnosis Signup and view all the answers

What is the consequence of relaxation of the pharyngeal muscles and tissues upon induction of anesthesia during tonsillectomy?

Airway obstruction in some patients Signup and view all the answers

Why is a deeper plane of anesthesia required during a tonsillectomy?

To blunt sympathetic reflexes and physiologic stimulation Signup and view all the answers

What should the anesthetist do if inadvertent extubation is determined during tonsillectomy surgery?

Ensure mask ventilation with 100% oxygen and prepare for reintubation Signup and view all the answers

How can the anesthesia team prevent patient movement during tonsillectomy surgery?

Administering intravenous propofol Signup and view all the answers

Why is a high degree of physiologic stimulation encountered during a tonsillectomy?

Due to manipulation of the airway and removal of the tonsils Signup and view all the answers

What is the appropriate response if the anesthesia machine indicates 'no compliance present, large air leak present with bag ventilation'?

'No compliance' indicates inadequate bag ventilation; adjust bag ventilation technique Signup and view all the answers

What should be done if there are no breath sounds present during assessment after the anesthesia machine alarms 'low tidal volume'?

Conduct a thorough diagnosis to identify potential causes Signup and view all the answers

Why is it essential to maintain a mask seal while preparing for reintubation after inadvertent extubation?

To maintain sufficient oxygenation during the reintubation procedure Signup and view all the answers

What is the primary sensory innervation below the vocal cords?

Recurrent laryngeal nerve Signup and view all the answers

Which nerve provides sensation to the larynx above the vocal cord level?

Superior laryngeal nerve Signup and view all the answers

Which artery supplies arterial blood to the larynx?

Superior laryngeal artery Signup and view all the answers

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

Cricothyroid muscle Signup and view all the answers

Which nerve provides motor innervation to the larynx, except for the cricothyroid muscle?

Recurrent laryngeal nerve Signup and view all the answers

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

Recurrent laryngeal nerve Signup and view all the answers

Tonsillectomy Preoperative Evaluation Elements

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Questions and Answers

What is the controversial association with upper respiratory tract infections (URI) in pediatric patients undergoing tonsillectomy?

What assessment should be performed in adult patients with tonsillar enlargement to determine the presence and severity of obstructive sleep apnea (OSA)?

What further diagnostic studies are warranted for adult patients with severe obstructive sleep apnea (OSA) and tonsillar enlargement?

What oral examination finding may potentially cause difficulty with mask ventilation or direct laryngoscopy during tonsillectomy?

What is the purpose of evaluating a complete blood count, prothrombin time, or activated partial thromboplastin time?

Which medical conditions are of concern due to the increased risk of airway obstruction and coexisting disease states?

From which artery does the blood flow to the palatine tonsils primarily arise?

What is the primary sensory innervation to the palatine tonsils?

What medication may be administered 30 minutes before tonsillectomy to alleviate anxiety and provide sedation?

For which patient should premedication be administered sparingly or not at all before tonsillectomy?

What can be initiated pre-operatively to assist with drying of secretions in the pharynx during a tonsillectomy?

Which artery supplies blood to the palatine tonsils in addition to the facial artery?

What is the primary purpose of premedication for a child undergoing tonsillectomy?

Which nerve supplies sensory innervation to the palatine tonsils in addition to the glossopharyngeal nerve?

What is the most optimal technique for anesthesia and airway management during a tonsillectomy?

What is the potential consequence of overextending the neck during positioning for a tonsillectomy?

What is the purpose of inserting a mouth gag during a tonsillectomy?

What are the potential complications associated with improper attention to airway management during tonsillectomy?

What is the recommended position for patients undergoing tonsillectomy?

What is the most frequently recommended orientation of the operating table regarding the anesthetist during tonsillectomy?

What is the primary purpose of administering inhalation agents during tonsillectomy surgery?

What is the recommended action if the anesthesia machine alarms 'low tidal volume' during surgical manipulation of the mouth gag?

What is the consequence of relaxation of the pharyngeal muscles and tissues upon induction of anesthesia during tonsillectomy?

Why is a deeper plane of anesthesia required during a tonsillectomy?

What should the anesthetist do if inadvertent extubation is determined during tonsillectomy surgery?

How can the anesthesia team prevent patient movement during tonsillectomy surgery?

Why is a high degree of physiologic stimulation encountered during a tonsillectomy?

What is the appropriate response if the anesthesia machine indicates 'no compliance present, large air leak present with bag ventilation'?

What should be done if there are no breath sounds present during assessment after the anesthesia machine alarms 'low tidal volume'?

Why is it essential to maintain a mask seal while preparing for reintubation after inadvertent extubation?

What is the primary sensory innervation below the vocal cords?

Which nerve provides sensation to the larynx above the vocal cord level?

Which artery supplies arterial blood to the larynx?

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

Which nerve provides motor innervation to the larynx, except for the cricothyroid muscle?

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

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