Anesthesia for Lap & ENT Sx

Question 1

What physiologic changes would suggest subcutaneous emphysema?

Answer 1

Crepitus, hypercarbia, elevated ETCO2, decreased lung compliance, cardiac arrhythmias, & HTN

Question 2

Insufflation of the peritoneum displaces the diaphragm in a _____ direction, ______ FRC, ______ Vital capacity, & induces collapse of the _______ regions of the lungs

Answer 2

cephalad; decreases; decreases; dependent

Question 3

The da Vinci system consists of what 3 components?

Answer 3

the vision system
the surgeon console
the patient-side cart

Question 4

______ is a rare but devastating complication following robotic surgery

Answer 4

postoperative visual loss

Question 5

Benefits of TIPS

Answer 5

reduction in bleeding from varices & control of refractory cirrhotic ascites

Question 6

Paired cartilages:

Answer 6

Arytenoid, Corniculate, Cuneiform

Question 7

Unpaired cartilages:

Answer 7

Thyroid, cricoid, epiglottic

Question 8

Innervates laryngeal mucosa below vocal cords

Answer 8

Recurrent laryngeal

Question 9

Innervates laryngeal mucosa above vocal cords (inferior epiglottis)

Answer 9

superior laryngeal (internal branch (vagus))

Question 10

Innervates superior aspect of epiglottis and base of tongue

Answer 10

Glossopharyngeal

Question 11

Innervates all intrinsic muscles except cricothyroid (motor)

Answer 11

Recurrent laryngeal

Question 12

Innervates cricothyroid muscles (motor)

Answer 12

Superior laryngeal (external branch)

Question 13

Tension & elongates vocal cords

Answer 13

cricothyroid (SLN)

Question 14

Relaxes vocal cords

Answer 14

Thyroarytenoid (RLN)

Question 15

Abducts vocal cords

Answer 15

Posterior cricoarytenoid (RLN)

Question 16

Adducts vocal cords

Answer 16

Lateral cricoarytenoid (RLN)

Question 17

Bc SNS hyperactivity is a/w increased amounts of _______, it is essential that all pts having elective thyroidectomy be rendered ______ prior to surgery

Answer 17

thyroid hormone; euthyroid

Question 18

A thyroidectomy is performed as definitive treatment for ____ or ____

Answer 18

Thyrotoxicosis; malignancy

Question 19

The red wire pair of the NIM tube should contact the anterior & posterior of the _____, and the blue wire pair should contact the anterior and posterior portion of the ______

Answer 19

right true vocal cord; left true vocal cord

Question 20

What are the most common complications from thyroid surgery?

Answer 20

hypocalcemia, RLN damage, & hematoma at surgical site

Question 21

Unlike unilateral nerve injury, bilateral nerve injury necessitates immediate intervention requiring what?

Answer 21

emergent reintubation or tracheostomy

Question 22

What increases IOP?

Answer 22

asphyxia, administration of carbon dioxide, & hypoventilation

Question 23

What decreases IOP?

Answer 23

inhalation anesthetics
hyperventilation
hypothermia
hypertonic solutions (dextran, urea, mannitol, & sorbitol) elevate plasma osmotic pressure –> decrease IOP

Question 24

Acetazolamide is contraindicated in which pts?

Answer 24

marked hepatic or renal dysfunction, or those w/ low sodium levels or abnormal K values