Order Ophthalmology Surgery Discussion

Order Ophthalmology Surgery Discussion
Order 5898374
Order Ophthalmology Surgery Discussion
1. Which of the following features of the infant airway compared with the adult
airway is correct?
A. Infants are obligate mouth breathers through the first several months of life.
B. The infant larynx is more cephalad in the neck than the adult larynx.
C. The infant epiglottis is shorter and broader than the adult epiglottis.
D. The narrowest part of the upper airway in the infant is at the level of the vocal
cords.
E. The larger occiput of the infant requires extra elevation of the head to achieve an
optimal “sniffing” position.
2. Which of the following statements is correct concerning airway innervation?
A. The recurrent laryngeal nerve innervates all the intrinsic muscles of the larynx
save the cricothyroid, which is innervated by the external branch of the superior
laryngeal nerve.
B. To numb sensation to the posterior third of the tongue and oropharynx, local
anesthetic can be infiltrated into the base of the palatoglossal arch to block the
lingual nerve.
C. An inferior laryngeal nerve block is completed by injecting local anesthetic 1 cm
below the greater cornu of the hyoid bone bilaterally.
D. A transtracheal block, achieved by injecting local anesthetic through the cricoid
membrane into the trachea, can serve as the sole anesthetic needed for an awake
fiberoptic intubation.
E. Numbing of the oropharynx through topical approaches is rarely effective, and
direct injection of local anesthetics is usually required to achieve adequate
numbing for an awake fiberoptic intubation.
3. In the postanesthesia care unit (PACU), a patient develops hoarseness
following surgical removal of the left lobe of the thyroid (without violation of
the right neck), and you suspect a unilateral recurrent laryngeal nerve injury.
You consult your ENT colleagues to help evaluate recurrent laryngeal nerve
function. Which of the following appearances of the vocal cords would be
expected from this proposed mechanism of injury?
A. Immobile bilateral vocal cords, with an adequate glottic opening and no change
during vocalization
Order Ophthalmology Surgery Discussion
B. Immobile bilateral vocal cords, with a very small glottic opening
C. Immobile left vocal cord and movement of the right vocal cord across midline
during phonation
D. Immobile right vocal cord and movement of the left vocal cord across midline
during phonation
E. Bilateral flaccid, partially abducted, immobile vocal cords
4. 4. A 26-year-old professional singer is in your operating room (OR) undergoing
suspension microlaryngoscopy for vocal cord polyps. Soon after induction and
just after the surgeon places the patient into suspension, the heart rate drops
from 85 to 30 beats per minute. Which of the following is the best initial course
of action?
A. Increase the depth of anesthetic.
B. Administer an opioid.
C. Administer glycopyrrolate.
D. Continue to monitor the heart rate and cycle the blood pressure cuff with the
knowledge that these parameters should recover, as the patient becomes
accustomed to the positioning.
E. Direct the surgeon to take the patient out of suspension and before proceeding
with additional measures.
5. An ENT surgeon is planning microlaryngoscopy for laser ablation of vocal cord
hemangiomas and asks that low-frequency jet ventilation be used so that “the
smallest tube possible can be used.” Which of the following is NOT an
important consideration when using jet ventilation?
A. Care must be taken to allow passive exhalation and avoid breath stacking to limit
the possibility of barotrauma.
B. Reliable pulse oximetry is essential because jet ventilation relies on the venture
effect and entrainment of room air, making the exact FiO2 challenging to measure.
C. Total intravenous anesthesia is required.
D. Pressure monitoring at the distal tip of the jet ventilation catheter is essential.
E. The trigger pressure must be preset at a level to allow adequate synchronization
between the jet ventilator and the patient’s spontaneous breaths
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