CHAPTER 1
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Surgical Technology, 1E Delmar CHAPTER 1 ORIENTATION TO SURGICAL TECHNOLOGY HISTORY OF SURGERY SURGERY TODAY Surgical Specialties HISTORY OF SURGICAL TECHNOLOGY SURGICAL TECHNOLOGY AND SURGICAL TECHNOLOGISTS Field of Surgical Technology Surgical Technology Education and Certification Surgical Technologist-Role(s) and Competencies Daily Roles in the Operating Room Job Descriptions for the Surgical Technologist HEALTH CARE FACILITIES Hospital Organization Financial Considerations and Reimbursement Organizations Related to Hospitals, Health Care, and Surgical Services Hospital Departments and Interdepartmental Communication PERSONAL AND PROFESSIONAL RELATIONS Surgical Technologist’s Lifestyle Surgical Technologist as a Professional Surgical Technology, 2E Delmar 4 4 4 6 6 6 6 7 7 14 14 15 17 18 18 20 21 21 CHAPTER 2 THE SURGICAL PATIENT CHAPTER 1 ORIENTATION TO SURGICAL TECHNOLOGY HISTORY OF SURGERY SURGERY TODAY Surgical Specialties HISTORY OF SURGICAL TECHNOLOGY FIELD OF SURGICAL TECHNOLOGY 3 4 5 6 8 FIELD OF SURGICAL TECHNOLOGY Surgical Technology Education and Certification Roles and Competencies 8 10 Surgical Team Members Job Descriptions for the Surgical Technologist HEALTH CARE FACILITIES Hospital Organization Financial Considerations and Reimbursement Organizations Related to Hospitals, Health Care, and Surgical Services Hospital Departments and Interdepartmental Communication THE SURGICAL TECHNOLOGIST AS A PROFESSIONAL Surgical Technologist’s Lifestyle Professionalism NEW Working Conditions NEW Personal Characteristics NEW Career Opportunities CHAPTER 3 THE SURGICAL PATIENT CHAPTER 2* STANDARDS OF CONDUCT CHAPTER 4 * SPECIAL POPULATION 8 13 11 14 15 19 20 17 11 12 11 8 8 13 *Chapters 2 & 4 are new. They will be listed with entire contents separately at the end of the grid. THE STSR AND THE SURGICAL PATIENT PHYSICAL, PSYCHOLOGICAL, SOCIAL, AND SPIRITUAL NEEDS OF THE SURGICAL PATIENT Understanding the Surgical Patient Causes of Surgical Intervention The Surgical Patient, a Human Being Prioritizing Needs-Maslow’s Hierarchy Select Basic Concepts in Developmental and Social Psychology Cultural and Religious Influences PATIENT BILL OF RIGHTS: A FORMAL 25 25 26 26 26 27 27 32 41 THE STSR AND THE SURGICAL PATIENT PHYSICAL, PSYCHOLOGICAL, SOCIAL, AND SPIRITUAL NEEDS OF THE SURGICAL PATIENT Understanding the Surgical Patient Causes of Surgical Intervention The Surgical Patient, a Human Being Prioritizing Needs-Maslow’s Hierarchy Life Stage Development: Select Basic Concepts Cultural and Religious Influences AHA Patient’s Bill of Rights (Ch.2) 43 43 44 44 44 45 46 49 31 Surgical Technology, 1E Delmar Surgical Technology, 2E Delmar VIEW OF THE PATIENT AS HUMAN Consent for Surgery: A Basic Right Principles of Documentation LEGAL AND ETHICAL CONSIDERATION 43 45 46 AST Code of Ethics Specific Legal Considerations 48 48 SPECIAL POPULATIONS Pediatric Patients Geriatric Patients Other Special Populations: Trauma, HIV Positive, and Organ Donor/Recipient SURGICAL PATIENT CARE: PUTTING IT ALL TOGETHER Using the CARE Approach CHAPTER 3 PHYSICAL ENVIRONMENT AND SAFETY STANDARDS PHYSICAL DESIGN OF THE SURGERY DEPARTMENT Areas of the OR Physical Components of the Operative Suite Substerile Area Direct Support Services HAZARDS AND REGULATORY AGENCIES SAFETY CONSIDERATIONS Air-Handling System Surgical Lights Noise in the Operating Room Ergonomics and Safety Considerations Fire Hazards and Safety Electrical Hazards Ionizing Radiation BIOLOGICAL HAZARDS AND SAFETY CONSIDERATIONS Universal Precautions Standard Precautions Laser and Electrosurgical Plume Latex Allergy CHEMICAL HAZARDS AND SAFETY CONSIDERATIONS Waste Anesthetic Gases Methyl Methacrylate Formalin Ethylene Oxide Glutaraldehyde CHAPTER 4 ASEPSIS HISTORY OF STERILIZATION BASIC TERMINOLOGY PATHOGENS AND INFECTION 51 51 51 53 Consent for Surgery: A Basic Right (Ch.2) Documentation (Ch.2) ETHICAL AND MORAL ISSUES Elements of Ethical Decision Making (Ch.2) Professional Codes of Conduct (Ch.2) Definitions of General Legal Terms Definitions of Traditional Principles (Ch.2) INTRODUCTION (Ch. 4) Pediatric Patients (Ch. 4) Geriatric Patients (Ch. 4) Acquired Immunodeficiency Syndrome Trauma Patients (Ch. 4) 27 45 30 32 34 23 24 57 57 69 68 71 54 54 58 58 59 64 64 66 67 67 67 67 67 68 69 70 71 71 71 74 74 75 75 75 75 75 76 81 81 82 CHAPTER 5 PHYSICAL ENVIRONMENT AND SAFETY STANDARDS PHYSICAL DESIGN OF THE SURGERY DEPARTMENT Areas of the OR Physical Components of the Operative Suite Substerile Area Direct Support Services HAZARDS AND REGULATORY AGENCIES SAFETY CONSIDERATIONS Air-Handling System Surgical Lights Noise in the Operating Room Ergonomics and Safety Considerations Fire Hazards and Safety Electrical Hazards Ionizing Radiation BIOLOGICAL HAZARDS AND SAFETY CONSIDERATIONS Universal Precautions Standard Precautions Laser and Electrosurgical Plume Latex Allergy CHEMICAL HAZARDS AND SAFETY CONSIDERATIONS Waste Anesthetic Gases Methyl Methacrylate Formalin Ethylene Oxide Glutaraldehyde CHAPTER 7 ASEPSIS AND STERILE TECHNIQUE HISTORY OF STERILIZATION BASIC TERMINOLOGY PATHOGENS AND INFECTION 77 78 79 83 83 85 86 86 86 86 86 87 88 89 90 90 90 93 94 94 94 95 95 95 95 130 131 131 Surgical Technology, 1E Delmar Infection Pathogens Associated with Surgical Site Infection Methods of Transmission PRINCIPLES OF ASEPSIS AND STERILE TECHNIQUES Principle 1: Sterile Field Principle 2: Sterile Team Member Attire Principle 3: Movement in and around Sterile Field SURGICAL CONSCIENCE CLEANING, DISINFECTION, AND STERILIZATION Cleaning and Disinfection Disinfectant and Disinfectant/Sterilant Agents INSTRUMENT PREPARATION AND WRAPPING FOR STERILIZATION Instruments Specific Procedural Trays Instrument Sets PACKAGING FOR STERILIZATION AND STORAGE Performance Standards of Packaging Material Performance Characteristics Types of Packaging Materials General Principles of Packaging Sterilization Requirements and Essential Factors Basic Components of a Steam Sterilizer GAS STERILIZATION Ethylene Oxide Alternative Gas Sterilization Methods LIQUID CHEMICAL STERILIZATION PROCESSES IONIZING RADIATION METHODS OF MONITORING THE STERILIZATION PROCESS Mechanical Methods of Monitoring the Sterilization Process Chemical Methods of Monitoring the Sterilization Process Biological Methods of Monitoring the Sterilization Process Bowie-Dick Test EVENT-RELATED STERILITY Environmental Decontamination Environmental Services Case by Case Daily Surgical Technology, 2E Delmar 83 83 85 88 88 89 90 91 91 92 96 100 100 100 100 101 101 101 102 104 106 107 108 110 111 111 112 112 113 113 113 113 114 114 115 115 115 115 Infection Pathogens Associated with Surgical Site Infection Methods of Transmission PRINCIPLES OF ASEPSIS 131 132 Principle 1: Sterile Field Principle 2: Sterile Team Member Attire Principle 3: Movement in and around Sterile Field SURGICAL CONSCIENCE CLEANING, DISINFECTION, AND STERILIZATION Cleaning and Disinfection Disinfectant and Disinfectant/Sterilant Agents INSTRUMENT PREPARATION AND WRAPPING FOR STERILIZATION Instruments Specific Procedural Trays Instrument Sets PACKAGING FOR STERILIZATION AND STORAGE Performance Standards of Packaging Material Performance Characteristics Types of Packaging Materials General Principles of Packaging Sterilization Requirements and Essential FactorS Basic Components of a Steam Sterilizer GAS STERILIZATION Ethylene Oxide Alternative Gas Sterilization Methods LIQUID CHEMICAL STERILIZATION PROCESSES IONIZING RADIATION METHODS OF MONITORING THE STERILIZATION PROCESS Mechanical Methods of Monitoring the Sterilization Process Chemical Methods of Monitoring the Sterilization Process Biological Methods of Monitoring the Sterilization Process Bowie-Dick Test EVENT-RELATED STERILITY Environmental Decontamination Environmental Services Case by Case Daily 138 139 140 135 138 140 141 142 147 151 151 151 151 152 152 152 153 155 158 159 160 163 163 164 165 165 165 165 166 166 167 167 168 168 168 168 Surgical Technology, 1E Delmar Surgical Technology, 2E Delmar CHAPTER 5 GENERAL PATIENT CARE AND SAFETY PREOPERATIVE PATIENT ROUTINES Surgical Consent Preoperative Education Patient Possessions Evening/Morning before Surgery Diet Makeup and Dress Call to Operating Room Family Visit Patient Identification Transportation TRANSFER AND POSITIONING BASIC POSITIONING FOR SURGERY Supine Position Trendelenburg Position Reverse Trendelenburg Position Fowler’s Position and Sitting Position Lithotomy Position Prone Position Kraske (Jackknife Position) Lateral Position Lateral Kidney Position 119 119 120 120 121 122 122 122 122 123 123 123 124 125 125 125 125 125 125 127 127 128 THERMOREGULATORY DEVICES VITAL SIGNS Temperature Pulse Respiration Blood Pressure URINARY CATHETERIZATION Indications Procedure 128 129 129 130 131 131 133 133 133 SKIN PREPARATION Clean Areas and Contaminated Areas Skin Preparation Setup Perineal and Vaginal Preparations Skin Marking HEMOSTASIS AND BLOOD REPLACEMENT Factors Affecting Hemostasis Control of Bleeding during Surgery Mechanical Methods THERMAL HEMOSTASIS PHARMACOLOGICAL AGENTS Blood Loss Blood Replacement CARDIOPULMONARY RESUSCITATION Cardiac Arrest in the Surgical Setting MALIGNANT HYPERTHERMIA 134 136 136 138 138 139 139 139 140 141 142 142 143 144 144 145 CHAPTER 8 GENERAL PATIENT CARE AND SAFETY PREOPERATIVE PATIENT ROUTINES Surgical Consent Preoperative Education Patient Possessions Evening/Morning before Surgery Diet Makeup and Dress Call to Operating Room Family Visit Patient Identification Transportation TRANSFER AND POSITIONING BASIC POSITIONING FOR SURGERY Supine Position Trendelenburg Position Reverse Trendelenburg Position Fowler’s Position and Sitting Position Lithotomy Position Prone Position Kraske (Jackknife Position) Lateral Position Kidney Position NEW Sim’s Position THERMOREGULATORY DEVICES VITAL SIGNS Temperature Pulse Respiration Blood Pressure URINARY CATHETERIZATION Indications Procedure NEW Considerations SKIN PREPARATION SKIN PREPARATION Skin Preparation Setup Perineal and Vaginal Preparations Skin Marking HEMOSTASIS AND BLOOD REPLACEMENT Factors Affecting Hemostasis Control of Bleeding during Surgery Mechanical Methods THERMAL HEMOSTASIS PHARMACOLOGICAL AGENTS Blood Loss Blood Replacement CARDIOPULMONARY RESUSCITATION Cardiac Arrest in the Surgical Setting MALIGNANT HYPERTHERMIA 172 173 175 175 176 177 177 177 177 177 178 179 180 181 183 184 184 185 186 188 189 190 191 191 192 192 193 194 196 199 200 200 200 202 202 203 206 206 206 207 207 207 209 209 210 210 211 212 213 Surgical Technology, 1E Delmar Prevention Treatment EMERGENCY MEDICAL SERVICES INDICATIONS OF EMERGENCY SITUATIONS OBJECTIVES AND PRIORITIES IN ERMERGENCY SITUATIONS Syncope Convulsions/Seizures Management of Seizure Anaphylactic Reactions Clinical Manifestations of Impending Cardiac Arrest Hemolytic Transfusion Reactions CHAPTER 6 SURGICAL PHARMACOLOGY AND ANESTHESIA PHARMACOLOGY Drug Sources Drug Forms Drug Nomenclature Route of Administration Drug Classifications Pharmacokinetics Pharmacodynamics DRUG-HANDLING TECHNIQUES Medication Identification Supplies for Medication Handling Transfer of a Medication to the Sterile Field Medications Commonly Used in the Operating Room HISTORY OF MODERN ANESTHESIA METHODS AND TECHNIQUES OF ANESTHETIC ADMINISTRATION GENERAL ANESTHESIA Depth of General Anesthesia Phases of General Anesthesia Advantages of General Anesthesia Risks and Complications Associated with General Anesthesia Anesthetic Agents Adjuncts to General Anesthesia Anesthesia Equipment NERVE CONDUCTION BLOCKADE Nerve Conduction Blocking Agents Topical Anesthesia Local Anesthesia Regional Anesthesia Epidural Anesthesia NONTRADITIONAL ANESTHESIA OPTIONS TEAM MEMBER ROLES DURING ANESTHESIA ADMINISTRATION Preoperative Visits Surgical Technology, 2E Delmar 145 145 146 146 146 147 147 147 147 148 148 151 151 151 152 152 152 153 154 154 155 156 156 157 160 161 162 162 162 163 163 165 170 171 174 174 175 176 176 178 179 179 180 Prevention Treatment EMERGENCY MEDICAL SERVICES INDICATIONS OF EMERGENCY SITUATIONS OBJECTIVES AND PRIORITIES IN ERMERGENCY SITUATIONS Syncope Convulsions/Seizures Management of Seizure Anaphylactic Reactions Clinical Manifestations of Impending Cardiac Arrest Hemolytic Transfusion Reactions CHAPTER 9 SURGICAL PHARMACOLOGY AND ANESTHESIA PHARMACOLOGY Drug Sources Drug Forms Drug Nomenclature Route of Administration Drug Classifications Pharmacokinetics Pharmacodynamics DRUG-HANDLING TECHNIQUES Medication Identification Supplies for Medication Handling Transfer of a Medication to the Sterile Field Medications Commonly Used in the Operating Room HISTORY OF MODERN ANESTHESIA METHODS AND TECHNIQUES OF ANESTHETIC ADMINISTRATION GENERAL ANESTHESIA Depth of General Anesthesia Phases of General Anesthesia Advantages of General Anesthesia Risks and Complications Associated with General Anesthesia Anesthetic Agents Adjuncts to General Anesthesia Anesthesia Equipment NERVE CONDUCTION BLOCKADE Nerve Conduction Blocking Agents Topical Anesthesia Local Anesthesia Regional Anesthesia Epidural Anesthesia NONTRADITIONAL ANESTHESIA OPTIONS TEAM MEMBER ROLES DURING ANESTHESIA ADMINISTRATION Preoperative Visits 213 213 213 214 214 214 215 215 215 216 211 219 219 220 220 221 221 221 222 223 223 225 225 226 229 231 231 231 232 232 232 235 240 241 244 244 246 246 246 249 249 249 250 Surgical Technology, 1E Delmar Surgical Technology, 2E Delmar Preoperative Routine-All Types of Anesthesia Postanesthesia Care CHAPTER 7 INSTRUMENTATION, EQUIPMENT, AND SUPPLIES INSTRUMENTATION Classifications Care and Handling Types of Instrument Sets SPECIALTY EQUIPMENT Endoscopes Power Tools Lasers Microscopes Video Monitors, Recorders, and Cameras Fiber-optic Headlights and Light Sources Irrigation/Aspiration (IA) Units Cryotherapy Units Insufflators Nerve Stimulators ACCESSORY EQUIPMENT Suction Systems Electrosurgical Unit Lights Pneumatic Tourniquets 180 SUPPLIES Drapes Sterile Packs Sponges and Dressings Catheters, Tubes, and Drains Nonsuture Needles Irrigators and Syringes CHAPTER 8 WOUND HEALING, SUTURES, NEEDLES, AND STAPLING DEVICES INTRODUCTION TYPES OF WOUNDS Surgical Wound Traumatic Wound Chronic Wound INFLAMMATORY PROCESS TYPES OF WOUND HEALING First Intention (Primary Union) Phases of Wound Healing by First Intention Second Intention (Granulation) Third Intention (Delayed Primary Closure) FACTORS INFLUENCING WOUND HEALING COMPLICATIONS OF THE HEALING WOUND Intraoperative Wound Care Postoperative Wound Care 206 206 207 207 209 211 212 184 188 188 193 193 196 196 197 197 200 200 201 201 201 201 201 202 202 202 204 205 215 215 215 215 216 216 216 216 216 217 217 218 218 219 220 Preoperative Routine-All Types of Anesthesia Postanesthesia Care CHAPTER 10 INSTRUMENTATION, EQUIPMENT, AND SUPPLIES INSTRUMENTATION Classifications Instrument Care and Handling Types of Instrument Sets SPECIALTY EQUIPMENT Endoscopes Power Tools Lasers Microscopes Video Monitors, Recorders, and Cameras Fiber-optic Headlamps and Light Sources Irrigation/Aspiration Units Cryotherapy Units Insufflators Nerve Stimulators ACCESSORY EQUIPMENT Suction Systems Electrosurgical Unit Lights Pneumatic Tourniquets NEW Sequential Compression Devices SUPPLIES Drapes Sterile Packs Sponges and Dressings Catheters, Tubes, and Drains Nonsuture Needles Irrigators and Syringes CHAPTER 11 WOUND HEALING, SUTURES, NEEDLES, AND STAPLING DEVICES INTRODUCTION TYPES OF WOUNDS Surgical Wound Traumatic Wound Chronic Wound INFLAMMATORY PROCESS TYPES OF WOUND HEALING First Intention (Primary Union) Phases of Wound Healing by First Intention Second Intention (Granulation) Third Intention (Delayed Primary Closure) FACTORS INFLUENCING WOUND HEALING COMPLICATIONS OF THE HEALING WOUND Intraoperative Wound Care Postoperative Wound Care 250 253 259 259 264 265 269 269 270 270 273 273 274 274 274 274 274 275 275 275 278 279 280 280 280 282 282 285 288 289 292 292 292 293 294 294 294 294 295 295 295 295 296 297 298 Surgical Technology, 1E Delmar Surgical Technology, 2E Delmar SUTURE History Types of Suture Material Suture Sizes General Factors Affecting Choice of Suture Characteristics of Common Sutures Packaging of Suture Ligatures Ligating Methods Suture for the Procedure Layer Closure Endoscopic Suture Suturing Techniques Accessory Devices STAPLING DEVICES Types of Staplers Meshes or Fabrics NEEDLES Needle Eye Needle Point Needle Bodies CHAPTER 9 THE SURGICAL TECHNOLOGIS IN THE SCRUB ROLE (CASE MANAGEMENT) OPERATING ROOM ATTIRE Clothing Head Coverings Masks Shoe Covers Gloves 221 221 222 222 222 223 225 226 226 227 228 229 229 231 232 233 234 234 235 235 236 SUTURE History Types of Suture Material Suture Sizes General Factors Affecting Choice of Suture Characteristics of Common Sutures Packaging of Suture Ligatures Ligating Methods Suture for the Procedure Layer Closure Endoscopic Suture Suturing Techniques Accessory Devices STAPLING DEVICES Types of Staplers Meshes or Fabrics NEEDLES Needle Eye Needle Point Needle Bodies CHAPTER 12 SURGICAL CASE MANAGEMENT 298 298 299 300 300 300 303 303 303 304 305 307 307 309 310 312 313 314 314 315 315 239 239 240 240 240 241 Surgical Gown Protective Eyewear Other Protective Attire DAILY ROUTINES Furniture Setup ESTABLISHING THE STERILE FIELD Opening Sterile Supplies The Surgical Scrub Hand Drying and Donning the Surgical Gown Closed Gloving Technique for Gowning and Gloving Open Glove Technique When Not Gowned Gowning and Gloving Another Team Member Turning Gown Gown Removal BACK TABLE SETUP Some Basic Principles of Back Table Setup THE MAYO STAND DRAPING THE SURGICAL PATIENT General Principles of Draping 241 242 242 242 242 243 243 246 248 Attire Scrub Suit Hair Cover Mask Shoe Covers Nonsterile Glove Sterile Gloves Sterile Gown Protective Eyewear Other Protective Attire Preparing the OR OR Setup Creating and Maintaining the Sterile Field Opening Sterile Supplies Scrubbing and Donning Sterile Attire Self-Drying and Gowning 323 323 324 324 325 325 326 326 325 326 327 327 329 330 333 335 251 Closed Gloving 338 251 254 Open Gloving Turning the Gown 340 339 254 255 255 256 258 260 260 Turning the Gown Gown and Glove Removal ORGANIZING THE BACK TABLE ORGANIZING THE BACK TABLE Organizing the Mayo Stand Draping the Surgical Patient Draping the Surgical Patient 339 364 341 341 346 346 346 Surgical Technology, 1E Delmar Surgical Technology, 2E Delmar INTRAOPERATIVE ACTIVITIES OF THE STSR Using the APOS Approach During the Intraoperative Phase Case Management: Principles, Techniques, Considerations Principles of Practice Technique of Practice: Passing Instruments 265 Counts Medications and Solutions in the Sterile Field Dressing Application Communication Postoperative Routines 270 270 CHAPTER 10 DIAGNOSTIC PROCEDURES SOURCES OF PATIENT DATA History and Physical Examination Diagnostic Imaging Laboratory Reports Electrodiagnostic Studies Pulmonary Diagnosis Endoscopy Plethysmography and Phleborheography INDICATIONS FOR SURGERY CHAPTER 11 GENERAL SURGERY ANATOMY Abdominal Cavity: General Dimensions Surface Features Abdominal Musculature Peritoneum Retroperitoneum Alimentary Canal Esophagus Stomach Small Intestine Mesentery Colon Rectum Anus 265 INTRAOPERATIVE CASE MANAGEMENT General Principles 353 INTRODUCTION Passing the Instruments (and Other Supplies) Counting Medication Handling 318 356 Dressing Application Intraoperative Communication POSTOPERATIVE CASE MANAGEMENT NEW Applied Theory NEW Positioning of the Sterile Team Members and the Furniture NEW Progression of the Surgical Procedure NEW Preservation of the Sterile Field NEW Drape Removal NEW Immediate Postoperative Care NEW Patient Transfer and Transportation NEW Breakdown of the Setup NEW The Operating Room Cycle NEW The Instrument Cycle CHAPTER 13 DIAGNOSTIC PROCEDURES SOURCES OF PATIENT DATA History and Physical Examination Diagnostic Imaging Laboratory Reports Electrodiagnostic Studies Pulmonary Diagnosis Endoscopy Plethysmography and Phleborheography INDICATIONS FOR SURGERY CHAPTER 14 GENERAL SURGERY ANATOMY Abdominal Cavity: General Dimensions Surface Features Abdominal Musculature Peritoneum Retroperitoneum Alimentary Canal Esophagus Stomach Small Intestine Mesentery Colon Rectum Anus 361 355 363 353 267 267 268 271 271 272 278 278 278 285 288 289 289 289 289 292 292 293 293 293 293 293 293 294 295 296 297 299 299 359 360 319 353 361 363 363 364 364 365 365 366 371 371 371 378 381 382 383 383 383 386 386 386 387 387 388 388 388 389 390 391 391 393 393 Surgical Technology, 1E Delmar Surgical Technology, 2E Delmar Omenta Pancreas Spleen Liver Biliary Tract GENERAL SURGERY INSTRUMENTATION General Surgery: Minor Set Local Excision Instruments Biliary Instruments Intestinal Instruments Other General Instruments ROOM SETUP POSITIONING DRAPING INCISIONS SURGERY OF THE ABDOMINAL WALL 299 299 300 301 301 303 Specific Anatomic Features of the Groin Area Hernias Hernia Repair SURGERY OF THE ALIMENTARY CANAL Surgery of the Esophagus Gastric Surgery Pathological Conditions of the Stomach Procedures Related to Gastric Secretion, Ulcers, and Neoplasm Procedures for Morbid Obesity Surgery of the Small Bowel Appendectomy Colon Surgery STOMAS Anorectal Surgery Hemorrhoid Ligation and Excision Surgery of the Liver and Biliary Tract Common Bile Duct Exploration SURGERY OF THE PANCREAS AND SPLEEN Select Pathology of the Pancreas Draining Pancreatic Cysts Pancreatic Resection Whipple Pancreaticoduodenectomy Surgery of the Spleen VASCULAR AND OTHER PROCEDURES Treating Varicose Veins Vascular Access Procedures Muscle and Nerve Biopsies Incision and Drainage Excision of Lesion Endoscopy BREAST SURGERY 310 303 303 303 303 303 307 307 307 307 310 310 312 313 313 318 318 320 321 321 325 326 330 330 333 333 342 349 349 349 350 350 353 356 356 356 357 357 358 358 358 Omenta Pancreas Spleen Liver Biliary Tract GENERAL SURGERY INSTRUMENTATION General Surgery: Minor Set Local Excision Instruments Biliary Instruments Intestinal Instruments Other General Instruments ROOM SETUP POSITIONING DRAPING INCISIONS SURGERY OF THE ABDOMINAL WALL: HERNIAS Specific Anatomic Features of the Groin Area Hernias Hernia Repair SURGERY OF THE ALIMENTARY CANAL Surgery of the Esophagus Gastric Surgery Pathological Conditions of the Stomach Procedures Related to Gastric Secretion, Ulcers, and Neoplasm Procedures for Morbid Obesity Surgery of the Small Bowel Appendectomy Colon Surgery STOMAS Anorectal Surgery Hemorrhoid Ligation and Excision Surgery of the Liver and Biliary Tract Common Bile Duct Exploration SURGERY OF THE PANCREAS AND SPLEEN Select Pathology of the Pancreas Draining Pancreatic Cysts Pancreatic Resection Whipple Pancreaticoduodenectomy Surgery of the Spleen VASCULAR AND OTHER PROCEDURES Treating Varicose Veins Vascular Access Procedures Muscle and Nerve Biopsies Incision and Drainage Excision of Lesion Endoscopy BREAST SURGERY 394 394 395 395 396 397 397 399 399 400 400 400 400 400 402 404 404 405 405 407 408 408 408 416 416 416 420 425 427 427 430 430 439 447 447 448 448 448 452 454 454 455 456 456 456 457 457 Surgical Technology, 1E Delmar Surgical Technology, 2E Delmar Breast Anatomy Breast and Axilla: Pathology and Diagnosis Breast Surgery (Noncosmetic) SURGERY OF THE THYROID AND PARATHYROID Anatomy of the Thyroid and Parathyroid Pathological Conditions of the Thyroid and Parathyroid Glands Thyroidectomy TRACHEOTOMY Indications for a Tracheotomy Illustrative Procedure: Tracheotomy CHAPTER 12 OBSTETRIC AND GYNOCOLOGICAL SURGERY INTRODUCTION TO OBSTETRIC AND GYNOCOLOGICAL SURGERY ANATOMY The Pelvis External Genitalia Vagina Uterus Fallopian Tubes Ovaries PREGNANCY-A SPECIAL CONDITION Select Key Terms in Labor and Delivery Labor SPECIAL INSTRUMENTATION, SUPPLIES, DRUGS, AND EQUIPMENT IN OBSTETRIC AND GYNOCOLOGICAL SURGERY Instrumentation Equipment Supplies 358 358 359 361 ROOM SETUP AND BASIC PATIENT POSITIONING AND DRAPING SURGICAL PROCEDURES: OBSTETRICS AND FERTILITY RELATED Pathology and Surgical Conditions: Obstetrics and Fertility Related Vaginal Delivery Cesarean Section Sterilization Procedures Tuboplasty Laproscopic Resection of Unruptured Tubal Pregnancy SURGICAL PROCEDURES: GYNECOLOGICAL PROCEDURES Gynecological Pathology SURGICAL INTERVENTION OVERVIEW Abdominal Incisions for Gynecological 390 362 363 363 363 366 367 376 376 376 377 377 379 380 380 381 381 381 383 383 384 390 391 391 392 394 399 400 403 406 406 406 406 Breast Anatomy Breast and Axilla: Pathology and Diagnosis Breast Surgery (Noncosmetic) SURGERY OF THE THYROID AND PARATHYROID Anatomy of the Thyroid and Parathyroid Pathological Conditions of the Thyroid and Parathyroid Glands Thyroidectomy TRACHEOTOMY Indications for a Tracheotomy Illustrative Procedure: Tracheotomy CHAPTER 15 OBSTETRIC AND GYNOCOLOGICAL SURGERY INTRODUCTION TO OBSTETRIC AND GYNOCOLOGICAL SURGERY ANATOMY The Pelvis External Genitalia Vagina Uterus Fallopian Tubes Ovaries PREGNANCY-A SPECIAL CONDITION Select Key Terms in Labor and Delivery Labor SPECIAL INSTRUMENTATION, DRUGS, EQUIPMENT, AND SUPPLIES IN OBSTETRIC AND GYNOCOLOGICAL SURGERY Instrumentation Equipment Supplies NEW Drugs OR SETUP AND BASIC PATIENT POSITIONING AND DRAPING SURGICAL PROCEDURES: OBSTETRICS AND FERTILITY RELATED Pathology and Surgical Conditions: Obstetrics and Fertility Related Vaginal Delivery Cesarean Section Tubal Occlusion (Sterilization) Procedures Tuboplasty Laproscopic Resection of Unruptured Tubal Pregnancy SURGICAL PROCEDURES: GYNECOLOGICAL PROCEDURES Gynecological Pathology SURGICAL INTERVENTION OVERVIEW Abdominal Incisions for Gynecological 457 457 457 461 461 461 461 461 461 467 478 478 478 481 481 482 483 483 485 486 486 487 487 494 494 487 494 494 494 495 497 503 504 507 510 510 510 510 Surgical Technology, 1E Delmar Surgery Surgical Intervention: Laparoscopy Basic Colposcopy Hysteroscopy Marsupialization of Bartholin’s Gland Cyst Simple Vulvectomy Anterior and Posterior Repair (Colporrhaphy) Cervical Biopsy, Cryotherapy, Laser Treatment, LEEP, and Conization Dilation and Curettage Myomectomy Total Abdominal Hysterectomy and Bilateral Salpingo-oophorectomy Surgical Technology, 2E Delmar 411 414 416 417 419 423 429 431 434 436 Vaginal and Laparoscopically Assisted Vaginal Hysterectomy (LAVH) Radical Cancer Surgery: Total Pelvic Exenteration CHAPTER 13 OPHTHALMIC SURGERY ANATOMY OF THE EYE Orbit Extrinsic Muscles Lacrimal System Globe 441 OPHTHALMIC SURGICAL PATHOLOGY Cataract Small Retinal Detachment Large Retinal Detachment Vitreous Hemorrhage Proliferative Vitreoretinopathy (PVR) Traction Retinal Detachment Epiretinal Membarane Corneal Pathology Chalazion Dacryocystitis Strabismus 451 SPECIAL CONSIDERATIONS IN OPHTHALMIC SURGERY Special Equipment Instruments SURGICAL INTERVENTION Strabismus Correction: Recession/Resection Adjustable Suture Surgery Scleral Buckle Enucleation and Evisceration of the Eye (Traditional Approach) Keratoplasty (Corneal Transplant) 453 442 448 448 448 449 449 451 451 452 452 452 452 452 452 452 452 452 453 453 454 454 457 458 462 464 Surgery Surgical Intervention: Laparoscopy Basic Colposcopy Hysteroscopy Marsupialization of Bartholin’s Gland Cyst Simple Vulvectomy Anterior and Posterior Repair (Colporrhaphy) Cervical Biopsy, Cryotherapy, Laser Treatment, LEEP, and Conization Dilation and Curettage Myomectomy Total Abdominal Hysterectomy and Bilateral Salpingo-oophorectomy (TAHBSO) Vaginal and Laparoscopically Assisted Vaginal Hysterectomy (LAVH) Radical Cancer Surgery: Total Pelvic Exenteration CHAPTER 16 OPHTHALMIC SURGERY ANATOMY OF THE EYE Orbit Extrinsic Muscles Lacrimal System Globe Cavities and Chambers of the Eye OPHTHALMIC SURGICAL PATHOLOGY Cataract Small Retinal Detachment Large Retinal Detachment Vitreous Hemorrhage Proliferative Vitreoretinopathy (PVR) Traction Retinal Detachment Epiretinal Membarane Corneal Pathology Chalazion Dacryocystitis Strabismus NEW Glaucoma NEW Pterygium SPECIAL CONSIDERATIONS IN OPHTHALMIC SURGERY Special Equipment Instruments SURGICAL INTERVENTION Strabismus Correction: Recession/Resection Adjustable Suture Surgery Scleral Buckle Enucleation and Evisceration of the Eye (Traditional Approach) Keratoplasty (Corneal Transplant) 515 518 518 521 521 524 533 535 538 542 546 547 554 554 555 555 556 558 558 558 558 558 558 559 559 559 559 559 559 559 558 559 560 560 561 562 563 566 567 571 573 Surgical Technology, 1E Delmar Cataract Extraction Phacoemulsification Vitrectomy CHAPTER 14 OTORHINOLARYNGOLOGIC SURGERY ANATOMY OF THE EAR Outer Ear Middle Ear Inner Ear PATHOLOGY OF THE EAR Pathology Affecting the Outer Ear Pathology Affecting the Middle Ear Pathology Affecting the Inner Ear Diagnostic Procedures/Tests for the Ear SPECIAL PREOPERATIVE CONSIDERATIONS SPECIAL INSTRUMENTS, SUPPLIES, DRUGS INTRAOPERATIVE PREPARATION EAR PROCEDURES Myringotomy Myringoplasty/Tympanoplasty Mastoidectomy Stapedectomy Stapedotomy Cochlear Implants ANATOMY OF THE NOSE AND SINUSES External Nose Internal Nose Paranasal Sinuses Blood Supply to the Nose Olfaction PATHOLOGY OF THE NOSE AND PARANASAL SINUSES Rhinitis/Sinusitis Nasal Polyps Hypertrophied Turbinates Deviated Nasal Septum Septal Perforation Epistaxis DIAGNOSTIC PROCEDURES Direct Vision Mirror Examination Radiography SPECIAL PREOPERATIVE CONSIDERATIONS SPECIAL INSTRUMENTS, SUPPLIES, AND DRUGS Surgical Technology, 2E Delmar 468 470 470 476 476 476 476 477 477 478 478 479 479 480 480 480 480 484 487 487 488 488 488 488 488 489 490 490 490 490 491 491 491 492 492 492 492 492 492 493 Cataract Extraction Phacoemulsification Vitrectomy Surgical repair of Ptosis Iridectomy Trabeculoplasty NEW OPTHALMIC MEDICATIONS CHAPTER 17 OTORHINOLARYNGOLOGIC SURGERY ANATOMY OF THE EAR Outer Ear Middle Ear Inner Ear PATHOLOGY OF THE EAR Pathology Affecting the Outer Ear Pathology Affecting the Middle Ear Pathology Affecting the Inner Ear Diagnostic Procedures/Tests for the Ear PREOPERATIVE CONSIDERATIONS 577 580 580 562 563 563 560 SPECIAL INSTRUMENTS, SUPPLIES, DRUGS 592 EAR PROCEDURES Myringotomy Myringoplasty/Tympanoplasty Mastoidectomy Stapedectomy Stapedotomy Cochlear Implants ANATOMY OF THE NOSE AND SINUSES External Nose Internal Nose Paranasal Sinuses Blood Supply to the Nose Olfaction PATHOLOGY OF THE NOSE AND PARANASAL SINUSES Rhinitis/Sinusitis Nasal Polyps Hypertrophied Turbinates Deviated Nasal Septum Septal Perforation Epistaxis DIAGNOSTIC PROCEDURES Direct Vision Mirror Examination Radiography PREOPERATIVE CONSIDERATIONS 592 592 596 600 600 600 601 601 SPECIAL INSTRUMENTS, SUPPLIES, AND DRUGS 606 587 587 588 588 589 589 589 590 590 591 601 601 602 602 603 603 603 604 604 604 604 604 605 605 605 605 605 Surgical Technology, 1E Delmar INTRAOPERATIVE PREPARATION NASAL PROCEDURES Submucous Resection (SMR) Polypectomy Intranasal Antrostomy Removal of Foreign Body Internal Maxillary Artery Ligation Sinus Procedures Caldwell-Luc Ethmoidectomy Sphenoidectomy Drainage of the Frontal Sinus Sinus Endoscopy ANATOMY OF THE UPPER AERODIGESTIVE TRACT Pharynx Larynx Trachea Bronchi and Lungs Esophagus PATHOLOGY AFFECTING THE UPPER AERODIGESTIVE TRACT Pharyngitis Epiglottis Tonsillitis Sleep Apnea Laryngitis Polypoid Corditis or Vocal Cord Polyps Vocal Cord Nodules Vocal Cord Granulomas Laryngeal Neoplasms Tracheitis and Bronchitis Laryngotracheobronchitis (Croup) Foreign Bodies PATHOLOGY AFFECTING THE ESOPHAGUS Esophagitis Ulceration of the Esophagus Neoplasms Affecting the Esophagus Foreign Bodies Zenker’s Diverticulum DIAGNOSTIC PROCEDURES/TESTS Direct Visualization Indirect Visualization Laboratory Tests Radiological Examinations Videostroboscopy Polysomnography Multiple Sleep Latency Test (MSLT) SPECIAL PREOPERATIVE CONSIDERATIONS SPECIAL INSTRUMENTS, SUPPLIES, DRUGS INTRAOPERATIVE PREPARATION Surgical Technology, 2E Delmar 496 496 496 499 499 499 500 500 500 502 502 503 503 505 505 506 507 507 507 508 508 508 508 509 509 510 510 510 510 510 510 511 511 511 511 511 511 511 511 511 512 512 512 512 512 512 512 513 514 NASAL PROCEDURES Submucous Resection (SMR) Polypectomy Intranasal Antrostomy Removal of Foreign Body Internal Maxillary Artery Ligation Sinus Procedures Caldwell-Luc Ethmoidectomy Sphenoidectomy Drainage of the Frontal Sinus Sinus Endoscopy ANATOMY OF THE UPPER AERODIGESTIVE TRACT Pharynx Larynx Trachea Bronchi and Lungs Esophagus PATHOLOGY AFFECTING THE UPPER AERODIGESTIVE TRACT Pharyngitis Epiglottis Tonsillitis Sleep Apnea Laryngitis Polypoid Corditis or Vocal Cord Polyps Vocal Cord Nodules Vocal Cord Granulomas Laryngeal Neoplasms Tracheitis and Bronchitis Laryngotracheobronchitis (Croup) Foreign Bodies PATHOLOGY AFFECTING THE ESOPHAGUS Esophagitis Ulceration of the Esophagus Neoplasms Affecting the Esophagus Foreign Bodies Zenker’s Diverticulum DIAGNOSTIC PROCEDURES/TESTS Direct Visualization Indirect Visualization Laboratory Tests Radiological Examinations Videostroboscopy Polysomnography Multiple Sleep Latency Test (MSLT) PREOPERATIVE CONSIDERATIONS 609 609 612 612 612 613 613 613 615 616 616 616 618 SPECIAL INSTRUMENTS, SUPPLIES, DRUGS 626 618 620 621 621 621 621 621 622 622 623 623 623 623 623 624 624 624 624 624 624 624 624 625 625 625 625 625 625 625 626 626 626 626 Surgical Technology, 1E Delmar AERODIGESTIVE TRACT PROCEDURES Adenoidectomy Tonsillectomy Incision and Drainage of a Peritonsellar Abscess Uvulopalatopharyngoplasty Laryngoscopy Bronchoscopy Esophagoscopy Panendoscopy Radical Neck Dissection with Mandibulectomy CHAPTER 15 ORAL AND MAXILLOFACIAL SURGERY ANATOMY OF THE ORAL CAVITY Lips Teeth Palate Cheeks Tongue ANATOMY OF THE FACE AND CRANIUM Orbit Facial Muscles and Innervation EMBRYOLOGICAL EVELOPMENT OF THE FACE PATHOLOGY OF THE ORAL CAVITY Mouth Jaw Bones Mandibular Fractures Frontal Fractures Orbital Fractures Zygomatic Fractures Midfacial Fractures Craniofacial Deformities DIAGNOSTIC TESTS ORAL PROCEDURES: GENERAL CONSIDERATIONS Tooth Extraction Tooth Restoration Implantation MAXILLOFACIAL PROCEDURES: GENERAL CONSIDERATIONS Graft Materials Repair of Mandibular/Maxillary Fractures Application of Arch Bars Wire Fixation Plate and Screw Fixation of Mandibular Fracture Frontal Fracture Repair Orbital Floor Fracture Repair Reduction of Zygomatic Fractures Surgical Technology, 2E Delmar 514 514 514 517 517 519 521 522 522 522 530 530 530 530 530 530 531 532 532 533 533 533 534 534 535 535 535 536 536 536 537 538 541 541 541 542 543 543 546 546 549 550 553 AERODIGESTIVE TRACT PROCEDURES Adenoidectomy Tonsillectomy Incision and Drainage of a Peritonsellar Abscess Uvulopalatopharyngoplasty Laryngoscopy Bronchoscopy Esophagoscopy Panendoscopy Radical Neck Dissection with Mandibulectomy CHAPTER 18 ORAL AND MAXILLOFACIAL SURGERY ANATOMY OF THE ORAL CAVITY Lips Teeth Palate Cheeks Tongue ANATOMY OF THE FACE AND CRANIUM Orbit Facial Muscles and Innervation EMBRYOLOGICAL EVELOPMENT OF THE FACE PATHOLOGY OF THE ORAL CAVITY Mouth Jaw Bones Mandibular Fractures Frontal Fractures Orbital Fractures Zygomatic Fractures Midfacial Fractures Craniofacial Deformities DIAGNOSTIC TESTS ORAL PROCEDURES: GENERAL CONSIDERATIONS Tooth Extraction/Odontectomy Tooth Restoration Implantation MAXILLOFACIAL PROCEDURES: GENERAL CONSIDERATIONS Graft Materials Repair of Mandibular/Maxillary Fractures Application of Arch Bars Wire Fixation Plate and Screw Fixation of Mandibular Fracture Frontal Fracture Repair Orbital Floor Fracture Repair Reduction of Zygomatic Fractures 628 628 628 631 631 633 636 636 636 636 645 645 645 646 646 646 646 647 647 648 649 649 649 649 650 650 650 651 651 651 652 653 657 657 658 658 659 659 662 663 666 667 670 Surgical Technology, 1E Delmar Surgical Technology, 2E Delmar Le Fort I Fracture Repair Le Fort II and III Fracture Repair Craniofacial Reconstruction Correction of Retrognathism or Prognathism 554 557 557 560 Temporomandibular Joint Procedures CHAPTER 16 PLASTIC AND RECONSTRUCTIVE SURGERY ANATOMY Skin and Underlying Structures Palate Nose Hand Breast SURGICAL PATHOLOGY Pathology Affecting the Skin Cleft Lip and Palate Pathology Affecting the Hand Pathology Affecting the Breast DIAGNOSTIC PROCEDURES AND TESTS SPECIAL INSTRUMENTATION, SUPPLIES, DRUGS, AND EQUIPMENT Nasal Set Dermatome Mesh Graft Device SURGICAL INTERVENTION Rhytidectomy Blepharoplasy Suction Lipectomy Abdominoplasy Skin Grafts Cheiloplasty and Palatoplasy Rhinoplasty Hand Surgery Mammoplasty 561 CHAPTER 17 GENITOURNARY SURGERY ANATOMY Suprarenal (Adrenal) Glands Kidneys Ureters Urinary Bladder Male Reproductive System PATHOLOGY AFFECTING THE ADRENAL GLANDS Cushing’s Syndrome Adrenal Insufficiency (Addison’s Disease) Pheochromocytoma PATHOLOGY AFFECTING THE URINARY SYSTEM 567 567 568 570 570 575 575 575 577 578 581 582 582 582 583 584 584 586 587 588 589 592 593 595 602 611 611 611 614 615 615 617 617 617 618 618 Le Fort I Fracture Repair Le Fort II and III Fracture Repair Craniofacial Reconstruction Correction of Retrognathism or Prognathism Temporomandibular Joint Procedures CHAPTER 19 PLASTIC AND RECONSTRUCTIVE SURGERY ANATOMY Skin and Underlying Structures Palate Nose Hand Breast SURGICAL PATHOLOGY Pathology Affecting the Skin Cleft Lip and Palate Pathology Affecting the Hand Pathology Affecting the Breast DIAGNOSTIC PROCEDURES AND TESTS SPECIAL INSTRUMENTATION, SUPPLIES, DRUGS, AND EQUIPMENT Nasal Set Dermatome Mesh Graft Device SURGICAL INTERVENTION Rhytidectomy Blepharoplasy Suction Lipectomy Abdominoplasy Skin Grafts Cheiloplasty and Palatoplasy Rhinoplasty Hand Surgery Mammoplasty NEW Dermabrasion NEW Scar Revision CHAPTER 20 GENITOURNARY SURGERY ANATOMY Suprarenal Glands Kidneys Ureters Urinary Bladder Male Reproductive System PATHOLOGY AFFECTING THE ADRENAL GLANDS Cushing’s Syndrome Adrenal Insufficiency (Addison’s Disease) Pheochromocytoma PATHOLOGY AFFECTING THE URINARY SYSTEM 671 675 675 679 682 685 685 687 687 687 694 694 694 696 697 701 701 701 701 702 704 704 704 706 707 708 709 713 714 716 723 713 713 732 732 732 735 736 737 739 739 739 739 739 Surgical Technology, 1E Delmar Bladder Tumors Urinary Calculi Kidney Disorders PATHOLOGY AFFECTING THE MALE REPRODUCTIVE SYSTEM Phimosis Hypospadias/Epispadias Benign Prostatic Hyperplasia Cancer of the Prostate Cryptorchidism Testicular Torsion Testicular Cancer Trauma to the Genitourinary System DIAGNOSTIC PROCEDURES/TESTS History and Physical Laboratory Findings Radiological Findings Biopsy Endoscopy SPECIAL EQUIPMENT, INSTRUMENTS, SUPPLIES, DRUGS PREOPERATIVE AND INTRAOPERATIVE PREPARATION Incisional Options SURGICAL PROCEDURES Adrenalectomy Nephrectomy Renal Transplant Stone Removal Cystostomy Cystectomy/Ileal Conduit Procedures for Stress Incontinence Affecting Women Transurethral Endoscopy of the Genitourinary Tract Circumcision Orchiectomy Orchiopexy Vasectomy Vasovasostomy Prostatectomy CHAPTER 18 ORTHOPEDIC SURGERY BONE AND BONE TISSUE Bone Tissue Types of Bones Types of Joints Bone Growth and Bone Cells Intramembranous Bones Surgical Technology, 2E Delmar 618 618 619 621 621 621 622 622 622 622 622 623 623 623 623 629 630 630 631 632 633 635 636 637 641 642 643 645 650 653 655 657 657 660 660 660 669 670 671 672 673 674 Bladder Tumors Urinary Calculi Kidney Disorders PATHOLOGY AFFECTING THE MALE REPRODUCTIVE SYSTEM Phimosis Hypospadias/Epispadias Benign Prostatic Hypertrophy Cancer of the Prostate Cryptorchidism Testicular Torsion Testicular Cancer Trauma to the Genitourinary System DIAGNOSTIC PROCEDURES/TESTS History and Physical Laboratory Findings Radiological Findings Biopsy Endoscopy SPECIAL EQUIPMENT, INSTRUMENTS, SUPPLIES, DRUGS PREOPERATIVE AND INTRAOPERATIVE PREPARATION Incisional Options SURGICAL PROCEDURES Adrenalectomy Nephrectomy Renal Transplant Stone Removal Cystostomy Cystectomy/Ileal Conduit Procedures for Stress Incontinence Affecting Women Transurethral Endoscopy of the Genitourinary Tract Circumcision Orchiectomy Orchiopexy Vasectomy Vasovasostomy Prostatectomy NEW Hydrocelectomy NEW Varicocelectomy NEW Hypospadias Repair NEW Insertion of Inflatable Penile Prosthesis CHAPTER 21 ORTHOPEDIC SURGERY BONE AND BONE TISSUE Bone Tissue Types of Bones Types of Joints Bone Growth and Bone Cells Intramembranous Bones 739 740 740 743 743 743 743 744 744 744 744 745 745 745 745 751 751 751 751 752 754 757 757 757 762 763 764 766 771 774 776 778 778 783 784 784 781 781 782 782 792 792 794 794 797 798 Surgical Technology, 1E Delmar Endochondral Bone Mineral Storage Factors That Affect Bone Growth Clinical and Bone Landmark Terms PATHOLOGY Types of Fractures Normal Bone Healing Pathological Bone Healing Diagnostic Terms and Procedures THE SKELETON The Skull Vertebral Column Bones of the Thoracic Region Clavicles Scapula Pectoral Girdle Humerus Radius and Ulna Hand and Wrist Pelvis Hip and Femur Tibia and Fibula Ankle and Foot EQUIPMENT Positioning Devices Pneumatic Tourniquets Traction Lasers Radiography Air Flow Continuous Passive Range-of-Motion Machines (CPM) Transcutaneous Electrical Nerve Stimulation (TENS) Electrical Stimulation of Bone Saws, Drills, and Reamers Arthroscopic Equipment SUPPLIES Implants Suture Polymethyl Methacrylate (PMMA) Pharmacology PROCEDURES Bone Grafting Knee Arthroscopy Arthroscopic Repair of Meniscal Tear Endoscopic Carpal Tunnel Release Colle’s Fracture Open Reduction-Internal Fixation (ORIF) of the Humerus Repair of the Rotator Cuff Total Hip Arthroplasty Surgical Technology, 2E Delmar 674 674 675 675 676 676 676 682 684 685 685 688 689 689 689 689 690 690 690 691 692 692 694 695 695 696 696 696 696 696 696 696 697 697 697 697 697 698 698 698 699 699 700 703 706 709 713 716 720 Endochondral Bone Mineral Storage Factors That Affect Bone Growth Clinical and Bone Landmark Terms PATHOLOGY Types of Fractures Normal Bone Healing Pathological Bone Healing Diagnostic Terms and Procedures THE SKELETON The Skull Vertebral Column Bones of the Thoracic Region Clavicles Scapula Pectoral Girdle Humerus Radius and Ulna Hand and Wrist Pelvis Hip and Femur Tibia and Fibula Ankle and Foot EQUIPMENT Positioning Devices Pneumatic Tourniquets Traction Lasers Radiography Air Flow Continuous Passive Range-of-Motion Machines Transcutaneous Electrical Nerve Stimulation Electrical Stimulation of Bone Saws, Drills, and Reamers Arthroscopic Equipment SUPPLIES Implants Suture Methyl Methacrylate Pharmacology PROCEDURES Bone Grafting Knee Arthroscopy Arthroscopic Repair of Meniscal Tear Endoscopic Carpal Tunnel Release Colle’s Fracture Open Reduction-Internal Fixation (ORIF) of the Humerus Repair of the Rotator Cuff Total Hip Arthroplasty NEW Arthroscopic Anterior Cruciate Ligament Repair 798 798 798 798 798 805 805 806 808 808 808 811 812 812 812 812 812 813 814 814 814 814 816 818 818 819 819 819 819 820 820 820 820 820 820 821 821 821 821 821 822 822 824 827 832 835 842 846 852 830 Surgical Technology, 1E Delmar CHAPTER 19 CARDIOTHORACIC SURGERY ANATOMY OF THE CHEST The Thorax The Trachea The Bronchial Tree The Lungs ANATOMY AND PHYSIOLOGY OF THE HEART Location of the Heart Coverings of the Heart The Heart Wall The Heart Chambers The Heart Valves Blood Flow Through the Heart Blood Supply for the Heart The Cardiac Cycle Cardiac Output Cardiac Conduction Anatomical Development of the Heart OPERATIVE PATHOLOGY The Chest Wall The Mediastinum The Lungs Thoracic Trauma Thoracic Outlet Syndrome Thoracic Aortic Aneurysm Coronary Artery Disease Valvular Disease Cardiomyopathy Cardiac Dysrythmias Congenital Heart Defects DIAGNOSTIC PROCEDURES: THORAX Bronchoscopy Mediastinoscopy Thoracoscopy Thoracentesis DIAGNOSTIC PROCEDURES: CARDIAC Radiological Studies SURGICAL INTERVENTION: THORACIC Surgical Technology, 2E Delmar 729 729 730 730 731 732 733 733 733 733 733 735 735 735 736 736 736 738 738 739 739 739 741 741 742 745 746 746 748 750 750 751 751 751 751 753 753 NEW Above-the-Knee Amputation NEW Metacarpal Phalangeal Joint Arthroplasty NEW Triple Arthrodesis NEW Achilles Tendon Repair NEW Bunionectomy NEW Shoulder Joint Arthroscopy NEW Acromioplasty NEW Internal Fixation of Femoral Shaft Fracture NEW Total Hip Arthroplasty NEW Total Knee Arthroplasty CHAPTER 22 CARDIOTHORACIC SURGERY ANATOMY OF THE CHEST The Thorax The Trachea The Bronchial Tree The Lungs ANATOMY AND PHYSIOLOGY OF THE HEART Location of the Heart Coverings of the Heart The Heart Wall The Heart Chambers The Heart Valves Blood Flow Through the Heart Blood Supply for the Heart The Cardiac Cycle Cardiac Output Cardiac Conduction Anatomical Development of the Heart OPERATIVE PATHOLOGY The Chest Wall The Mediastinum The Lungs Thoracic Trauma Thoracic Outlet Syndrome Thoracic Aortic Aneurysm Coronary Artery Disease Valvular Disease Cardiomyopathy Cardiac Dysrythmias Congenital Heart Defects DIAGNOSTIC PROCEDURES: THORAX Bronchoscopy Mediastinoscopy Thoracoscopy Thoracentesis DIAGNOSTIC PROCEDURES: CARDIAC Radiological Studies SURGICAL INTERVENTION: THORACIC 832 840 840 841 842 845 846 851 853 859 864 864 866 866 867 868 868 869 869 869 869 870 871 871 872 872 872 873 873 873 874 875 877 877 879 881 882 882 884 887 887 887 887 889 889 889 889 Surgical Technology, 1E Delmar Special Preoperative Considerations Special Instrumentation, Supplies, Drugs, and Equipment Patient Preparation Thoracoscopy Scalene/Supraclavicular Node Biopsy Thoracotomy for Upper Lobectomy Thoracotomy for Right Pneuonectomy Thoracotomy for Wedge Resection or Segmentectomy Decortication of Lung SURGICAL INTERVENTION: CARDIAC (ADULT) Preoperative Considerations Patient Preparation Techniques of Cardiopulmonary Bypass (CPB) Mechanical Circulatory Assistance Coronary Artery Bypass Grafting (CABG) Aortic Valve Replacement Mitral Valve Replacement Thoracic Aortic Aneurysmectomy (TAA) Pericardictomy/Pericardial Window Heart Transplantation Permanent Pacemaker Insertion Percutaneous Transluminal Coronary Angioplasty (PTCA) SURGICAL INTERVENTION: CARDIAC (PEDIATRIC) Special Preoperative Preparation Atrial Septal Defect Ventricular Septal Defect Patent Ductus Arteriosus Correction of Aortic Coarctation Procedure for Correction of Tetralogy of Fallot Procedure for Correction of Transposition of the Great Arteries CHAPTER 20 PERIPHERAL VASCULAR SURGERY PERIPHERAL VASCULAR SURGERY SURGICAL ANATOMY Blood Vessels Blood Pressure The Arterial System The Venous System OPERATIVE PATHOLOGY AND DIAGNOSIS Arterial Embolism Arteriosclerosis Obliterans Aneurysms of the Abdominal Aorta SURGICAL INTERVENTIONS Peripheral Vessel Angioplasty Bypass Grafting and Endarterectomy Surgical Technology, 2E Delmar 753 753 754 755 758 758 762 762 762 763 763 764 765 767 769 774 778 779 781 781 782 783 784 784 784 785 785 785 787 787 790 790 790 791 793 795 796 796 797 797 799 799 800 Special Preoperative Considerations Special Instrumentation, Supplies, Drugs, and Equipment Patient Preparation Thoracoscopy Scalene/Supraclavicular Node Biopsy Thoracotomy for Upper Lobectomy Thoracotomy for Right Pneuonectomy Thoracotomy for Wedge Resection or Segmentectomy Decortication of Lung SURGICAL INTERVENTION: CARDIAC (ADULT) Preoperative Considerations Patient Preparation Techniques of Cardiopulmonary Bypass 889 889 Mechanical Circulatory Assistance Coronary Artery Bypass Grafting Aortic Valve Replacement Mitral Valve Replacement Thoracic Aortic Aneurysmectomy Pericardictomy/Pericardial Window Heart Transplantation Permanent Pacemaker Insertion Percutaneous Transluminal Coronary Angioplasty SURGICAL INTERVENTION: CARDIAC (PEDIATRIC) Special Preoperative Preparation Atrial Septal Defect Ventricular Septal Defect Patent Ductus Arteriosus Correction of Aortic Coarctation Procedure for Correction of Tetralogy of Fallot Procedure for Correction of Transposition of the Great Arteries CHAPTER 23 PERIPHERAL VASCULAR SURGERY PERIPHERAL VASCULAR SURGERY SURGICAL ANATOMY Blood Vessels Blood Pressure The Arterial System The Venous System OPERATIVE PATHOLOGY AND DIAGNOSIS Arterial Embolism Arteriosclerosis Obliterans Aneurysms of the Abdominal Aorta SURGICAL INTERVENTIONS Peripheral Vessel Angioplasty Bypass Grafting and Endarterectomy 904 905 911 916 917 918 919 920 921 890 892 895 895 899 899 899 900 900 901 901 921 922 922 922 923 924 924 925 928 928 928 930 931 933 934 935 935 936 937 937 939 Surgical Technology, 1E Delmar Surgical Technology, 2E Delmar Features of Peripheral Vascular Procedure Aortofemoral Bypass Abdominal Aortic Aneurysmectomy Femoropopliteal Bypass Femorofemoral Bypass Axillofemoral Bypass Carotid Endarterectomy CHAPTER 21 NEUROSURGERY SURGICAL ANATOMY Divisions of the Nervous System Cranium Vertebral Column Blood Supply Cranial Nerves Spinal Nerves NEUROSURGICAL PATHOLOGY Cervical Spine Thoracic Spine Lumbar Spine Neoplasms Head Injury Spinal Cord Injury Cerebrovascular Disease Congenital Abnormalities INFECTION Abscess Spinal Tumors Peripheral Nerve Disorders NEUROSURGICAL PROCEDURES Special Instrumentation, Supplies, Drugs, and Equipment Patient Preparation Craniotomy Craniectomy Ventriculoperitoneal and Ventriculoatrial Shunt Transphenoidal Hypophysectomy Stereotactic Procedure Cranioplasty Spinal Procedures Peripheral Nerve Procedure 802 803 806 810 813 815 818 APPENDIX A: COMMON PREFIXES 881 825 825 825 831 833 833 833 834 835 836 836 837 838 840 840 841 842 842 843 843 844 844 848 849 858 862 865 868 869 869 876 Features of Peripheral Vascular Procedure Aortofemoral Bypass Abdominal Aortic Aneurysmectomy Femoropopliteal Bypass Femorofemoral Bypass Axillofemoral Bypass Carotid Endarterectomy CHAPTER 24 NEUROSURGERY SURGICAL ANATOMY Divisions of the Nervous System Cranium Vertebral Column Blood Supply Cranial Nerves Spinal Nerves NEUROSURGICAL PATHOLOGY Cervical Spine Thoracic Spine Lumbar Spine Neoplasms Head Injury Spinal Cord Injury Cerebrovascular Disease Congenital Abnormalities INFECTION Abscess Spinal Tumors Peripheral Nerve Disorders NEUROSURGICAL PROCEDURES Special Instrumentation, Supplies, Drugs, and Equipment Patient Preparation Craniotomy Craniectomy Ventriculoperitoneal and Ventriculoatrial Shunt Transphenoidal Hypophysectomy Stereotactic Procedure Cranioplasty Spinal Procedures Peripheral Nerve Procedure NEW ADVANCES IN NEUROSURGERY NEW Intraoperative MRI NEW Three-Dimensional Reconstruction NEW Radiosurgery NEW Minimall Invasive Techniques NEW Stereotaxis NEW Intraoperative Ultrasound NEW Brain Mapping NEW Endoscopic Neurosrgery NEW Deep Brain Stimulation 940 943 947 950 954 956 959 APPENDIX B: COMMON PREFIXES 1036 966 966 966 973 974 974 974 976 976 977 978 979 980 982 982 983 984 984 985 985 986 986 990 991 1001 1005 1008 1011 1012 1012 1020 1022 1022 1022 1022 1022 1022 1023 1023 1023 1023 Surgical Technology, 1E Delmar AND SUFFIXES APPENDIX B: MEASUREMENTS INDEX Surgical Technology, 2E Delmar 884 886 AND SUFFIXES APPENDIX C: MEASUREMENTS Not Ready NEW APPENDIX A: ANATOMY PLATES NEW CHAPTERS CHAPTER 2 STANDARDS OF CONDUCT LEGAL ISSUES Definitions of General Legal Terms Definitions of Traditional Principles Torts Consent for Surgery: A Basic Right Documentation Event/Incident Reports Advance Directives ETHICAL AND MORAL ISSUES Moral Principles Bioethics AHA Patient’s Bill of Rights Elements of Ethical Decision Making Professional Codes of Conduct Surgical Conscience SCOPE OF PRACTICE Job Descriptions and Competencies Credentialing Accreditation Core Curricula for Surgical Technology and Surgical Assisting Career Development Clinical Ladder Program RISK MANAGEMENT AND LIABILITY Medical Errors Safe Medical Device Act Malpractice Insurance CHAPTER 4 SPECIAL POPULATIONS INTRODUCTION PEDIATRIC PATIENTS Monitoring the Pediatric Patient Shock Fluids and Electrolytes Infection Metabolic and Nutritional Responses Trauma PATIENTS WITH OBESITY Review of Surgical Considerations Specific Considerations of Bariatric Surgery PATIENTS WITH DIABETES Complications Associated with Diabetes Care of the Patient with Diabetes in Surgery PREGNANT PATIENTS Considerations when Caring for Pregnant 1039 1025 23 23 24 25 27 29 30 30 30 31 31 31 32 34 34 34 35 36 36 36 36 37 38 38 39 39 57 57 59 60 60 61 61 61 62 64 64 64 65 66 66 67 Surgical Technology, 1E Delmar Surgical Technology, 2E Delmar Patients Anesthesia Intraoperative Considerations for the Surgical Technologist IMMUNOCOMPROMISED PATIENTS Acquired Immunodeficiency Syndrome Considerations for the Surgical Team Members PATIENTS WITH DISABILITIES GERIATRIC PATIENTS TRAUMA PATIENTS THE “GOLDEN HOUR” AND TRAUMA PATIENTS KINEMATICS Blunt Trauma Penetrating Trauma TRAUMA SCORING CONSIDERATIONS FOR THE SURGICAL TECHNOLOGIST Preservation of Evidence Hypothermia Infection PREPARATION OF THE CASE CHAPTER 6 BIOMEDICAL SCIENCE INTRODUCTION COMPUTERS Surgical Applications Hardware Software Word Processing Graphics Internet Basics ELECTRICITY Surgical Applications Basic Principles of Electricity PHYSICS Medical and Surgical Applications Mechanics Nuclear Physics Gravity SURGICAL ROBOTS Terminology Design Remote Manipulation Geometry Hearing and Vision Decontamination and Sterilization of Robotic Components Clinical Applications THE OR OF THE FUTURE Surgical Planning and Rehearsal Surface-Based Registration ROLE OF THE SURGICAL 67 67 68 68 68 69 69 71 71 71 71 72 72 72 72 73 73 73 99 99 99 100 103 104 105 106 107 107 108 112 112 113 122 122 122 123 123 124 124 125 125 125 125 125 126 126 Surgical Technology, 1E Delmar Surgical Technology, 2E Delmar TECHNOLOGIST
