Exam 18: Otorhinolaryngologic Surgery

Excision of the submandibular gland is performed to remove mixed tumors and calculi associated with extensive chronic inflammation.The submandibular gland lies in close proximity to several important nerves and vessels.What perioperative nursing consideration is significant relative to submandibular surgery?

What mouth structure is considered the boundary between the buccal cavity and the lingual cavity?

The palatine and lingual tonsils are situated in the oropharynx,while the adenoids are located in the nasopharynx.Both adenoids and tonsils consist of:

Sally Anders,a perioperative nurse,is orienting a new perioperative nurse to otolaryngologic surgery.She and the new nurse are the scrub persons and are preparing the sterile back table with instruments,accessory devices,and the medications used for the local anesthetics.They also set up a prep table with the initial local anesthetics to be given before the start of the procedure.Sally is determined to impart the critical nature of patient safety and prevention of medication errors during these procedures.Her back table contains multiple medications that will be used for local anesthesia,vasoconstriction,and hemostasis.As a perioperative registered nurse scrub person,it is necessary that she and her orientee:

Which of the diagnostic modalities listed below does not employ the use of ionizing radiation?

Audible facial nerve monitors (nerve integrity monitor systems)are used intraoperatively during procedures in which the facial nerve is at risk for injury.The purpose of this monitoring technique is to assist in the early identification of the nerve,to increase the possibility of its preservation by minimizing trauma,and to assess its integrity after dissection.Communication with the anesthesia provider is essential because:

The external ear canal lining is protected and lubricated with cerumen (earwax),which traps foreign material and:

Myringotomy is often accompanied by the aspiration of fluid under pressure in the tympanum,and the subsequent placement of small,hollow,pressure equalization tubes.It is indicated for acute otitis media (AOM)in the presence of an exudate that has not responded to antibiotic therapy.If left untreated,what is the main concern for a child with chronic otitis media?

During endoscopic sinus surgery,patient eye protection includes:

Of the three salivary glands,which one is the largest?

The nasal septum is lined with blood vessels and mucus-secreting cells.The proper name of this lining is the:

The nasal cavity is associated with the ear by way of the ,and communicates with the conjunctiva through the __.Select the options that are appropriate to complete the sentence.

Tympanoplasty is the surgical repair of the tympanic membrane and the tympanum and the reconstruction of the ossicular chain.Conductive hearing loss is caused by an obstruction in the external canal or middle ear,which impedes the passage of sound waves to the inner ear.A common cause of conductive hearing loss would be:

Select the structure of the trachea that is a landmark during bronchoscopy.

Microlaryngoscopy facilitates improved diagnosis and allows the laryngologist to view,with relative ease,areas that previously were inaccessible or difficult to visualize.What are the two most common indications for microlaryngoscopy?

A stapedotomy is removal of the stapes superstructure and creation of a fenestra (opening)in the fixed stapes footplate for treatment of abnormal bone growth around the footplate that results in its immobility.A prosthesis is placed to restore ossicular continuity and alleviate conductive hearing loss.The patient scheduled for a stapedotomy will probably have a surgical diagnosis of:

Laryngoscopy is direct visual examination of the interior of the larynx by means of a rigid,lighted speculum known as a laryngoscope to obtain a specimen of tissue or secretions for pathologic examination.What risk reduction strategy should the perioperative nurse employ in preparing for the conclusion of the procedure?

During a stapedotomy or stapedectomy procedure,the perioperative nurse manages and controls the environment of care by maintaining a quiet,warm,and comfortable OR.Energy modality devices and monitor alarms are turned down to the lowest audible setting for the team to hear without startling the patient.The English-speaking,nonanxious patient sedated using local or MAC anesthetics is well prepared by the perioperative nurse for sensory and procedural expectations.What event occurs near the conclusion of the procedure that predicts patient outcome?

Partial laryngectomy is removal of a portion of the larynx.It is done to remove superficial neoplasms that are confined to one vocal cord or to remove a tumor extending into the ventricle or the anterior commissure or a short distance below the cord.The patient should be prepared for an altered voice quality postoperatively as well as for the possibility of total laryngectomy if the tumor proves too extensive for partial resection.The perioperative nurse,in preparing the patient for surgery and post procedure expectations,can describe the postoperative voice as:

Acoustic neuromas arise from the Schwann cells of the vestibular portion of the eighth cranial nerve and are benign tumors.What is the postauricular incisional approach that offers the best chance of saving the integrity of the facial nerve?