66E Exam 6

Helpfulness: 0
Set Details Share
created 9 days ago by Nick_Bristow
2 views
updated 9 days ago by Nick_Bristow
show moreless
Page to share:
Embed this setcancel
COPY
code changes based on your size selection
Size:
X
Show:
1

Outer ear (top)

Pinna

2

Ear anatomy:

Tympanic membrane

Bones

Semicircular canals

Cochlea

card image
3

Ear bones:

Hammer

Anvil

Stirrups

Malleus

Incus

Stapes

4

Filled w/fluid that moves d/t vibrations

Nerve ending triggered

CN VIII to brain

Cochlea (snail shape)

5

Connects inner ear to brainstem (balance, coordination)

CN VIII (Acoustic)

6

2 portions of temporal bone r/t hearing

Mastoid

Petrous

7

Hearing loss d/t blockage, swelling, trauma, infection, tympanic perforation

Conductive hearing loss

*Failure to conduct sound from external to middle ear

8

Hearing loss d/t ototoxic meds, loud noise, tumor, presbycusis

Sensorineural

*Failure to conduct sound to inner ear (cochlea or CN VIII)

9

Hearing loss from mixture of conductive & sensorineural causes

Mixed hearing loss

10

Forms inside mastoid bone

Prevents ossicles from moving (less vibration, less sound transference)

Negatively impacts hearing

Cholesteatoma

*Supine, arms tucked, head to side, microscope (magnification)

11

Middle ear skin growth, or

Repeated infection w/excess eardrum skin

Can enlarge over time & destroy delicate middle ear bones

Hearing loss, dizziness, facial muscle paralysis

Cholesteatoma

12

Removal of DZ part of mastoid bone

Ossicles, drum & canal stay

Simple mastoidectomy

13

Remove DZ part of mastoid bone w/some of ossicles & canal

Modified radical mastoidectomy

14

Remove ear canal wall & ossicles, eardrum

*Serious complication: Injury to facial nerve

Radical mastoidectomy

15

Why do we need heating lamps for ear drum Sx?

Heats temporal fascia so it's dry enough for when surgeon is ready to replace eardrum

*Must be specific distance from graft specimen to not be too hot

16

CN VII

Facial nerve

17

CN VIII

Acoustic

18

Middle ear packing materials

Gelatin

MeroGel

19

External ear dressing

Glasscock

20

Reconstruction of middle ear bones

Tympanoplasty

21

Blade # used for postauricular incision

#15

22

What does the drape for a middle ear surgery look like?

Clear plastic 1st w/hole

Next sheet is horseshoe

Last is square over top

23

Incision of TM d/t acute otitis media w/exudate

Pressure equalization tubes (PE tubes)

*PE tube must be documented as IMPLANT!

Myringotomy w/PE tubes

*Suction for exudate, clear tube, PE tubes placed, abx drops & cotton shoved in

24

Hole is made in stapes bone w/piston placement

vs.

Stapes removed & replaced w/prosthesis altogether

Stapedotomy

vs.

Stapedectomy

25

This metallic component, if used as a prosthetic, poses a risk for MRIs

Steel

26

Stapes Sx:

1. If local anesthetic, what does surgeon do to check hearing?

2. If GETA, then what?

1. Whispers in pt's ear

2. Check ossicle movement

27

Tx for Meniere's DZ to fix vertigo from excessive endolymph

Endolymphatic shunt

*Check K+ level

**Less invasive Tx is gentamycin infusion in middle ear

28

Removal of Vestibular Schwannoma

Translabryth approach

Hair clipped to midline on affected side

Acoustic Neuroma

29

Allows bones to conduct sound

Used in people who need more than conventional hearing aid

Bone Anchored Hearing Aid (BAHA)

30

2 devices used to restore hearing in those suffering from neurofibromatosis type 2 (NF2)

Auditory Brainstem Implant (ABI)

Penetrating ABI

31

Monitoring device used during neuro & ENT cases

*One probe is sterile - can touch nerves to check impulses

Nerve Impulse Monitoring (NIMS)

32

When covering pt's eyes during CO2 laser ear surgery, what do you NOT COVER the eyes with?

Lacrilube (petroleum based)

*Fire hazard - also have wet towels, bowl of fluid nearby

33

Precision cautery used for ear cases

Requires foot pedal

Bipolar ESU

34

Four para-nasal sinuses

card image
35

Acute process usually precipitated by URI

Acute Sinusitis

36

Neuro pledgets/patties are soaked in this to help vasoconstrict nasal blood vessels

Afrin

37

Bed positioning for septorhinoplasty

90 degrees (sideways) to increase site visibility for surgeon

38

MIS where sinus air cells & ostia are opened w/endoscopic instruments

Bed 130 deg from anesthesia

Lube eyes, use opsite

Functional Endoscopic Sinus Sx (FESS)

39

Largest nasal gland

Near CN VII (facial nerve) - RISK FOR INJURY!

Parotid gland

40

Taking out uvula, pharynx, widening it

Fix sleep apnea, snoring

UPPP

41

Examination of the upper aerodigestive tract (pharynx, larynx, upper trachea and esophagus). It may also involve the removal or biopsy of any abnormal tissue found

Panendoscopy

42

What back-up plan should be in place for bronchoscopy?

Emergency trach

43

Supplements given post-parathyroidectomy

Vitamin D & Ca++

44

Machine that cuts/coagulates using electrical current

Coblator

45

Head:

Acronym for tissue

SCALP

Skin

Connective

Aponeurosis

L

P

46

4 suture lines of skull

card image
47

Weakest part of skull

Pterion

*Above & behind temporofrontal junction

48

Surgical anatomical landmarks of cerebrum

Sulci

49

Brain:

Outer layer

Inner layer

Gray

White

50

Lobe for thinking, memory, behavior, movement, speech

Frontal

51

Lobe for taste & somatosensory, reading

Parietal

52

Lobe for hearing, learning, feelings, smell

Temporal

53

Lobe for vision

Occipital

54

Responsible for movement, coordination, precision

Cerebellum

55

Connects R & L hemispheres of brain

Corpus Callosum

56

Houses thalamus, hypothalamus

Thermal regulation, hunger

Diencephalon

57

Center of brain, includes brain stem

Midbrain

58

Houses cranial nerve innervations

Hindbrain

59

Primitive brain, regulates HR, RR

Continuous w/spinal cord

Brain stem

60

Mnemonic for 12 cranial nerves

card image