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ENT Surgery
Surg Tech ENT
| Question | Answer |
|---|---|
| The ________-style head drape is commonly used for ENT procedures to secure the hair followed by a U and _______ drape | turban, bar |
| The most commonly used autograph for a tympanoplasty is the ________ fascia | temporalis |
| Chronic _________ is the most common reason for a myringotomy | otitis media |
| Cortisporin is a(n) ________ and ________ solution used for ear surgery postop | antibiotic, anti-inflammatory |
| A tympanomastoidectomy will require a(n) _________ incision and a(n) ________ drill with Gelfoam packing at the end | retroauricular, ototome |
| Diagnostic method that assesses the amount of damage to the sound conduction system and determines course of treatment | audiography |
| Diagnostic method that uses cool and warm water introduced into the ear canal to assess balance function | electronystagmography |
| The anatomic structure that connects the middle ear to the nasopharynx | eustachian tube |
| The membranous opening in the wall of the cochlea that receives vibrations from the stapes in the middle ear | oval window |
| The process of cutting up tissue into small pieces to extract it through a small opening | morcellatioin |
| Congenital defect that results in a bony or membranous occlusion of the passageway between the nose and the pharynx | choanal atresia |
| A device attached to suction that uses gravity to capture specimens such as washings for laboratory analysis | Lukens tube |
| Condition of being enlarged due to chronic inflammation; may cause obstruction | hypertrophy |
| Position achieved by placement of a scapular roll to provide enhanced visualization of the oropharyngeal area | hyperextension |
| 2 pronged metal device that emits a clear tone of a fixed pitch when tapped | tuning fork |
| Handheld, lightened instrument used to view external auditory canal | otoscope |
| Measures the vibrations of the eardrum by placing a probe against the tympanic membrane | tympanogram |
| Nerve stimulator should be available for identification of which nerves | facial (VII) and vestibulocochlear (VIII) |
| Why is the OR table reversed for ear procedures? | space under foot board can accommodate for seated team members legs' and for equipment placement |
| Position for most ear procedures | supine with a headrest with operative ear turned upward with arms tucked at pt's side (also remember to pad ulnar nerve and pillow under knees to ease stress on back) |
| What anesthesia is restricted in ear procedures and why? | Nitrous oxide; causes expansion of middle ear and can cause dislocation of a tympanic membrane graft |
| Separation between middle and outer ear | tympanic membrane |
| 3 layers of tympanic membrane | outer epithelial, middle fibrous connective, mucosal membrane inner |
| Fibrous ring surrounding tympanic membrane | annulus |
| What is inserted during a myringotomy to allow for additional drainage and maintain equal pressure? | pressure equalizing tubes (PE tubes) |
| What instrument is used to remove any visible wax in ears prior to a procedure? | curette |
| 3 auditory aussicles | malleus (hammer), incus (anvil), and stapes, (stirrups) |
| Incision for tympanoplasty | transuaral |
| Incision for tympanoplasty with mastoidectomy | retroauricular (postauricular) |
| Which laser is used for middle ear surgeries (stapedectomy/otomy)? | argon |
| 2 types of burrs for ototome | diamond (polishing) or cutting |
| Projection from the mastoid portion of temporal bone | mastoid process |
| Complication of acute otitis media | mastoiditis |
| major s/s of mastoiditis | purulent discharge from external auditory canal, fever, inflammation of mastoid process |
| Cholesteatoma | benign cyst or tumor that fills the mastoid cavity and erodes mastoid air cells; can also cause damage to ossicles |
| What causes cholesteatoma? | epithelial cells that would normally be shed through eustachian tube are unable to migrate out of middle ear due to a blockage of auditory tube |
| Most common s/s of cholesteatoma | discharge from ear, hearing loss, dizziness, weakness of facial muscles (damage to facial (VII) nerve) |
| ____ occurs when there is a body overgrowth of the stapes | otosclerosis |
| 2 main sections of inner ear | bony labyrinth and membranous labyrinth |
| A coiled portion of bony labyrinth that consists of a series of hair cells that directly contact the fibers of the cochlear nerve (branch of vestibulocochlear) | organs of Corti |
| Which objective-power lens is most frequently used for microlaryngoscopy? | 400 mm |
| 3 types of tonsils | pharyngeal (adenoids), palatine (tonsils), and lingual |
| What is the most commonly used autograft in otologic procedures? | temporalis fascia |
| Where are palatine (tonsils) located? | oropharynx |
| Where are pharyngeal tonsils (adenoids) located? | nasopharynx |
| What condition is a stapedectomy performed for? | otosclerosis |
| Otosclerosis | progressive, hereditary disease where there is a bony overgrowth of stapes |
| During a septoplasty, what is the separate mayo stand used for? | for supplies necessary to administer local and/or topical anesthesia such as cottonoids |
| Each nasal cavity has ___ turbinates (conchae) | 4 |
| Inferior Turbinectomy | affected turbinate is incised |
| Microdebrider Turbinectomy | imaging system (endoscope) is used to view surgical site then a microdebrider is used to remove turbinate without damaging surrounding tissue |
| Laser Turbinectomy | laser is used to vaporize tissue along anterior inferior aspect of turbinate to approximately 1/2 of its length |
| Choanal atresia | congenital defect caused by the failure of the nasopharyngeal septum to rupture during embryonic development |
| What kind of endoscope is used in a choanal atresia repair? | 4-mm 30 degree angled |
| 4 pairs of paranasal sinuses | sphenoid, maxillary, ethmoid, frontal (SMEF) |
| Location of frontal sinuses | within frontal bone behind eyebrows - may be one cavity or divided |
| Location of ethmoid sinuses | between eyes and have a honeycomb apperance |
| Location of sphenoid sinuses | directly behind nose at center of skill - may be one cavity or divided |
| Location of maxillary sinuses | below eyes and lateral to nasal cavity |
| Why is a FESS performed? | dx procedure or treat a variety of sinus disorders, anatomical defects, and inflammatory conditions (ex: chronic sinusitis) |
| Purpose of Caldwell-Luc procedure | remove diseased portions of antral wall, evacuate sinus contents, and establish drainage through nose |
| When is a Caldwell-Luc procedure contraindicated? | in peds pts prior to descent of permanent teeth |
| Name of incision in Caldwell-Luc procedure | gingivobuccal |
| Most efficient method of examining pharynx | direct visualization |
| Polysomnography | exam used to dx sleep apnea and determine its severity |
| Most common used laser for procedures involving larynx and oropharynx | CO2 |
| Pharynx | tubular structure that serves the respiratory tract by receiving air from nose and mouth and digestive system as a passageway for foods and liquids |
| Location of pharynx | begins at internal nares and terminates posterior to larynx at level of esophagus |
| 3 regions of pharynx | nasopharynx, oropharynx, and laryngopharynx |
| What organism most commonly causes tonsillitis? | streptococcal |
| Recurrent adenoiditis can lead to... | hypertrophy |
| 3 pairs of salivary glands | parotid, submandibular, sublingual |
| Parotid glands | largest of the 3 glands located on lateral sides of face anterior to external ear |
| Common disorder for Parotidectomy | formation of stones that block Steno's duct |
| Excretory salivary duct | Stensen's duct |
| Location of Stensen's duct orifice | inner surface of cheek opposite second molar tooth of upper jaw |
| Major concern when performing Parotidectomy | care for facial nerve (VII) - it travels through parotid gland, dividing the superficial portion from deeper portion |
| UPPP | uvulopalatopharyngoplasty - tx for sleep apnea |
| Dx test for UPPP | polysomnography |
| How many laryngeal cartilages form the larynx? | 9 |
| Largest and most superior of laryngeal cartilages? | thyroid cartilage |
| thyroid cartilage is aka | Adam's apple |
| FESS | functional endoscopic sinus surgery - diseased tissue, bone, or cartilage is excised |
| sternocleidomastoid muscle | turns head left and right |
| What bone is used to replace mandible during a mandibulectomy? | fibula |
| First step of a TMJ arthroscopy | irrigation solution is injected into joint space to distend capsule |
| Tracheostomy | creation of a tracheal stoma, usually permanent - mucous membrane of trachea is sutured to skin |
| Tracheotomy | creation of an opening in trachea, usually temporary, for placement of a tracheotomy tube |
| Tracheotomy tools in order: | 1. tracheal hook 2. scalpel with #15 blade 3. tracheal spreader 4. trach tube with obturator in place |
| Biggest procedural consideration during tracheotomy | test balloon prior to placing tube and have syringe attached for anesthesia |
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